3- Clinical Psychology

Question 1

You are seeing a family consisting of a mother, a father, and a daughter in therapy. Every time the mother says something, the father and the daughter argue with whatever she says. The behavior of the father and the daughter can be best described by the term
Select one:
A. triangulation.
B. fusion.
C. coalition.
D. joining.

Answer 1

Correct Answer is: C
All of these choices sound good, so to answer the question, you have to understand what each of these terms mean in the language of family therapy, and also not miss the fact that the question is asking about the behavior of the father and the daughter (as opposed to the behavior of the father and the mother). In family therapy, the term coalition refers to an alliance of two family members against a third. According to Minuchin, dysfunctional families are sometimes characterized by stable coalitions of a parent and a child against the other parent.
The other terms in the question don’t apply to the behavior of the father and the daughter. Triangulation refers to a situation in which another family member is brought into a conflict that actually exists only between two members, such as when two parents constantly try to get their child to take their side in a conflict the parents are having with each other. Fusion, a term used by Bowen, refers to an inability to separate intellectual from emotional functioning, or an inability to separate one’s own thoughts and feelings from those of other family members. And joining is a technique described by Minuchin that involves adopting the family’s affective style in order to help establish a working relationship, gain greater understanding of the family structure, and gain more leverage in bringing about family change.
Additional Information: Theoretical Constructs: Structural Family Therapy

Question 2

All of the following statements are consistent with Minuchin’s concept of enmeshed or disengaged families, except:
Select one:
A. in an enmeshed family, parents may devote an excessive amount of attention to one symptomatic family member who serves as the “symptom bearer” for the entire family.
B. enmeshed parents tend to be loving and considerate and do a lot for their children.
C. in a disengaged family, excessive conflict prevents effective communication.
D. in a disengaged family, parents may not notice when their children need support or guidance.

Answer 2

Correct Answer is: C
According to Minuchin, boundaries in a family system can be described as enmeshed or disengaged; the two terms represent opposite ends of a continuum. Enmeshed boundaries are overly diffuse; the result is a family in which members are overly close and dependent. Disengagement describes boundaries that are overly rigid; members of a disengaged family tend to be isolated from each other.
in a disengaged family, excessive conflict prevents effective communication.

Contrary to this choice, members of disengaged families tend to avoid conflict. The other choices are true of enmeshed or disengaged families.

Additional Information: Theoretical Constructs: Structural Family Therapy

Question 3

The techniques of "externalizing" a problem, relative influence questioning, and bringing an "outside witness" into the therapy session are most associated with
Select one:
A. Structural Therapy
B. Systemic Therapy
C. Dialectical Behavioral Therapy
D. Narrative Therapy

Answer 3

Correct Answer is: D
Narrative Therapy is premised on the notion that our identities are based on the stories we tell ourselves about our lives, or our narratives. Narrative therapists work to help people (they reject the term “client’) fully describe these stories, and restructure and reframe their stories and thereby their identities. The therapist adopts a co-operative and egalitarian stance, and works to help the person discover his own narrative rather than imposing one. Some techniques associated with Narrative Therapy include 1) naming the problem, which encourages focus, precision, and control; 2) externalizing the problem, which involves framing the problem as having an effect on, rather than being within, the person (e.g., “depression invaded your life”), the goal being to separate the problem from the person’s identity; 3) relative influence questioning, which involves contrasting the effect the problem has had on the person’s life with the effect that the person’s life has had on the problem (i.e., the control over the problem the person has had); 4) deconstructing unique outcomes, whereby the therapist encourages the person to focus and expand on experiences that are not consistent with a problem-saturated narrative; and 5) outsider witness, in which a third party is brought into the therapy session and the person tells this witness his revised or developing life narrative. Therapy ends when the person’s story is revised to the point that it is rich enough to sustain a healthy future.
Additional Information: Narrative Therapy

Question 4

What type of therapy is being practiced if a psychotherapist uses a method called WDEP to teach a patient new ways of coping?
Select one:
A. Cognitive therapy
B. Family systems therapy
C. Rational emotive behavioral therapy
D. Reality therapy

Answer 4

Correct Answer is: D
The WDEP system is a feature of Reality Therapy, developed by Glasser and based on Choice theory. In Reality Therapy, the emphasis is on personal responsibility and balance of five basic needs: survival (i.e., breathing, digesting, and sweating); to love and belong (i.e., need for friends and family); power (i.e., self-esteem, recognition, and competition); freedom (i.e., make choices); and fun (i.e, play, laughter, learning, recreation). Reality therapy uses questioning techniques and the WDEP system provides a questioning framework with each letter representing an identifying idea: W - exploring the client’s wants and perceptions, D - direction or what client is doing (acting, thinking, feeling, physiology) to get what they want, E - evaluate whether client’s behavior is getting him/her closer or further from goal, and P- planning or creating and implementing a workable plan to make positive changes. Other techniques used in this therapy include role playing, the use of humor, confronting the client, and helping the client formulate plans.

Question 5

A prominent politician who has advanced his career by strongly denouncing homosexuality and rights for gay people is caught engaging in a homosexual act in a public bathroom. From the perspective of psychoanalytic theory, the politician's fierce condemnation of homosexuality would have been a sign of
Select one:
A. repression.
B. denial.
C. reaction formation.
D. sublimation.

Answer 5

Correct Answer is: C
In psychoanalytic theory, defense mechanisms function outside of conscious awareness to reduce anxiety caused by unconscious conflicts or external threats to the ego. Both healthy and neurotic people employ defense mechanisms; they only become a problem if the ego relies on them excessively or inflexibly. Anna Freud described and classified different types of defense mechanisms. In reaction formation, one perceives an anxiety-provoking impulse or feeling as its opposite, such as by turning love into aggression, aggression into love, or a wish into a fear. A psychoanalyst might say that the politician is using reaction formation to transform unacceptable homosexual impulses into the opposite feeling of fierce opposition to it. Regarding the other choices, repression, the most basic defense mechanism, involves excluding an unacceptable impulse from consciousness. In denial, the person rejects a threatening fact that is true, even in the face of overwhelming evidence to support it. It is common in addiction, in which the people commonly deny the seriousness of the problem. And in sublimation, the person rechannels socially unacceptable impulses into socially useful activity, such as art or work; this is considered the healthiest and most successful defense mechanism.
Additional Information: Defense Mechanisms

Question 6

Which of the following statements is true regarding electromyograph (EMG) biofeedback?
Select one:
A. It is more effective in treating tension headaches than migraine headaches.
B. It is more effective in treating migraine headaches than tension headaches.
C. It is equally effective in treating tension headaches and migraine headaches.
D. It is ineffective in treating tension and migraine headaches.

Answer 6

Correct Answer is: A
Overall, biofeedback works equally well for tension and migraine headaches. However, a different modality of biofeedback is used for each of these conditions. EMG biofeedback, in which the person is trained to decrease muscle tension of the facial and/or neck muscles, is the most commonly used modality for biofeedback treatment of tension headaches; this is why “more effective in treating tension headaches than migraine headaches” is the best answer. For migraine headaches, thermal hand warming biofeedback, whereby the person is trained to warm his or her hands, is the most commonly used modality.
Additional Information: Headaches

Question 7

Ethnic minority clients with a strong affiliation with their own culture tend to
Select one:
A. not benefit from therapy.
B. drop out of therapy prematurely.
C. prefer ethnically similar therapists and counselors.
D. respond to therapy in the same way as non-minority clients, regardless of the therapist.

Answer 7

Correct Answer is: C
Research supports the notion that ethnic minority clients with a strong affiliation with their own culture tend to prefer ethnically similar counselors, and some research show that outcome for such clients is better when the counselor is ethnically similar.
Additional Information: Therapist-Client Similarity

Question 8

The concept "collaborative empiricism" is affiliated with which of the following theorists?
Select one:
A. Perls
B. Freud
C. Ellis
D. Beck

Answer 8

Correct Answer is: D
Collaborative empiricism is a central technique of Beck’s cognitive-behavioral therapy and refers to the therapist and client working together to gather evidence and test the logic, or hypotheses, of the client’s thoughts and beliefs.
Additional Information: Introduction (Beck’s Cognitive Therapy)

Question 9

When working with ethnically, linguistically, and racially diverse populations, a therapist should emphasize:
Select one:
A. acculturation
B. client’s individual goals
C. the political, social, and economic affects on mental health
D. which stage of identity development the client is in

Answer 9

Correct Answer is: B
Although all of the choices offered are important to consider when working with diverse populations, a therapist should not “emphasize” any of the choices other than the client’s individual goals.
Additional Information: Multiculturalism

Question 10

Which of the following is not a characteristic of Western culture-bound values?
Select one:
A. cause-effect approach
B. openness and intimacy
C. clear distinction between mental and physical well-being
D. strict adherence to a schedule

Answer 10

Correct Answer is: D
Sue and Sue (1999) described three premises from the Western perspectives of counseling, based on the assumption of individualism, that can have an effect on the therapeutic relationship. They are identified as class-bound values, culture-bound values and language variables. Class-bound values include valuing of time boundaries or a strict adherence to time schedules, an ambiguous and unstructured approach to problem solving, and the emphasis on long- range goals and solutions. Culture-bound values focus on individualism versus collectivism, cause and effect relationships for client problems, emphasis on emotional/verbal expressiveness, active participation and openness to discussing intimate aspects of the client’s life, and the separation of physical and mental well-being* (which makes these options incorrect). Language variables are those in which standard English and verbal communication are stressed.

Question 11

Which of the following would most likely be the focus of an object-relations therapist?
Select one:
A. communication skills training and facilitating catharsis
B. paradoxical interventions and circular questioning
C. helping the client identify introjects and providing support
D. exploring intergenerational transmission processes and cognitive restructuring

Answer 11

Correct Answer is: C
There are a variety of object-relations theories and therapies based on them. However, most focus on how introjects, or internalized images of significant others from the past, affect our current relationships and functioning. In addition to helping clients identify introjects, an objects-relations therapist would be likely to provide support and “re-parenting,” in order to help the client develop new, healthier introjects.
Additional Information: Object-Relations Theory

Question 12

In group therapy, which of the following situations is most likely to increase a given member’s self-disclosure?
Select one:
A. the group leader has made it clear that self-disclosure is expected
B. a temporary and uncomfortable silence has pervaded the group
C. other members of the group have freely self-disclosed
D. the group consists solely of verbal and intelligent individuals

Answer 12

Correct Answer is: C
This question is actually about social psychology as much as it is about group therapy. Research in social psychology has illustrated that we are more likely to talk openly about ourselves after someone else opens up about him or herself. This phenomenon has been termed “self-disclosure reciprocity.”
Additional Information: Reciprocity

Question 13

Relying on the work of Heinz Kohut, a therapist would stress the use of which of the following when working with a narcissistic client?
Select one:
A. coaching
B. empathy
C. congruence
D. interpretation of drives

Answer 13

Correct Answer is: B
According to Kohut, a consistent lack of parental empathy is what leads to narcissism in a child in the first place. Therefore, to help the narcissistic client develop a more healthy, cohesive sense of self, the therapist must provide empathy.
Additional Information: Heinz Kohut

Question 14

A minority group member who is a client of yours expresses very strong negative feelings towards her own culture in a therapy session. This client is most likely in which stage of the Minority Identity Development model developed by Atkinson, Morten, and Sue?
Select one:
A. resistance
B. dissonance
C. conformity
D. denial

Answer 14

Correct Answer is: C
The authors mentioned in the question have developed a model of cultural identity development in minority group members, called the Minority Identity Development (MID) model. The model’s five stages are conformity, dissonance, resistance and immersion, introspection, and synergetic articulation and awareness. Individuals in the conformity stage prefer the dominant culture’s values to those of their own culture. They are likely to have feelings of racial self-hatred, negative beliefs about their own culture, and positive feelings toward the dominant culture.
Additional Information: Minority Identity Development Model

Question 15

Troiden’s (1989) model of homosexual identity development indicates:
Select one:
A. females typically realize that they are homosexual at a younger age than males.
B. females and males typically realize they are homosexual at about the same age.
C. males typically begin to “come out” as homosexual at a younger age than females.
D. males and females typically begin to “come out” as homosexual at about the same age.

Answer 15

Correct Answer is: C
Troiden’s model distinguishes between four age-related stages: sensitization, identity confusion (self-recognition), identity assumption, and identity commitment. Sensitization begins before puberty and consists of homosexual feelings or experiences without an understanding of them in terms of self-identity. Identity confusion, sometimes referred to as self-recognition, is when an individual realizes that he or she may be homosexual. This usually develops in adolescent males around 17 years and in females around 18 years of age. During identity assumption, the individual comes out as a homosexual - typically from 19-21 years for males and 21-23 for females. Identity commitment is characterized by the individual adopting a homosexual lifestyle - which usually occurs from 21-24 years for males and 22-23 for females.
Additional Information: Troiden’s Model of Homosexual Identity Development

Question 16

According to recent outcome studies, which of Yalom's therapeutic factors is the most direct indicator of group outcome success as well as growth within the individual group members?
Select one:
A. catharsis
B. collusion
C. cohesion
D. universality

Answer 16

Correct Answer is: C
Recent studies indicate cohesiveness in a group, characterized by warmth and acceptance, self-disclosure and risk-taking behavior, freedom to express feelings openly (both positive and negative) is most associated with group member improvement and outcome success. As Yalom described, the therapeutic factors do not occur in isolation - they are interdependent and group cohesion serves as a necessary precondition for the other factors. Early confrontation, later positive alliance, later affective confrontation and fewer leader interventions in later sessions are also associated with successful group outcomes. (See: Burlingame, G.M., MacKenzie K.R., Strauss B. (2004). Small group treatment: evidence for effectiveness and mechanisms of change. In: Lambert, M., editor. Bergin and Garfield’s handbook of psychotherapy and behavior change. 5th ed. New York: John Wiley and Sons Inc, 647-96.)
Additional Information: Benefits of Group Therapy

Question 17

Which of the following statements is most consistent with Troiden’s (1989) model of gay and lesbian identity development?
Select one:
A. Identity confusion and identity assumption begin somewhat earlier for females than males, but identity commitment begins earlier for males than females.
B. Identity confusion, identity assumption, and identity commitment begin somewhat earlier for males than females.
C. Identity confusion, identity assumption, and identity commitment begin somewhat earlier for females than males.
D. There are no gender differences in the age of onset for homosexual identity development.

Answer 17

Correct Answer is: B
Troiden’s (1989) model of homosexual identity development describes four stages: Sensitization, identity confusion, identity assumption, and identity commitment. Sensitization begins before puberty and consists of homosexual feelings or experiences without an understanding of them in terms of self-identity. Identity confusion, which usually develops in adolescent males around 17 years and in females around 18 when they realize that they may be homosexual. During identity assumption, the individual comes out as a homosexual - typically from 19-21 years for males and 21-23 for females. Identity commitment is characterized by the individual adopting a homosexual lifestyle - which usually occurs from 21-24 years for males and 22-23 for females [The formation of homosexual identities, Journal of Homosexuality, 17(1/2), 43-73].
Additional Information: Troiden’s Model of Homosexual Identity Development

Question 18

When a psychologist takes a phenomenological approach, this means that she focuses on
Select one:
A. unconscious determinants of behavior.
B. subjective experience.
C. behavioral antecedents of behavior.
D. self-actualization.

Answer 18

Correct Answer is: B
The term phenomenology refers to subjective experience. Phenomenology formed the basis of person-centered psychotherapy, the school of psychotherapy founded by Carl Rogers. He was influenced by the work of Combs and Snygg, who defined the “phenomenal field” as “the entire universe, including himself, as it is experienced by the individual at the instant of action…it is the universe…in which each individual lives, the everyday situation of self and surrounding which each person takes to be reality.” Rogers believed that the therapist’s goal was to get closer to this phenomenal field; his method included listening to the person’s report of recent subjective experiences, and paraphrasing or rephrasing these reports. Rogers also believed that self-actualization was a goal of therapy, but the term phenomenology refers to subjective experience, not self-actualization.
Additional Information: Client-Centered Therapy

Question 19

Irvin Yalom concludes that, unless careful selection criteria are used, the majority of group therapy patients may drop out of therapy discouraged and without benefit. He also proposes that the most important criterion for deciding who to include in group therapy is:
Select one:
A. willingness to learn from others.
B. previous group experience.
C. motivation.
D. psychological mindedness.

Answer 19

Feedback
Correct Answer is: C
Yalom argues (and the research backs him up) that group therapy patients must be highly motivated not only for therapy in general but also for group therapy in particular.
Additional Information: Composition of Groups

Question 20

Eysenck’s 1952 study on psychotherapy outcome:
Select one:
A. concluded that individuals who receive psychotherapy are better off than 80% of controls
B. concluded that psychologists and psychiatrists are more effective than master’s level clinicians
C. challenged the effectiveness of most psychotherapy treatments
D. led to many other outcome studies, most of which have supported his findings

Answer 20

Correct Answer is: C
Eysenck, in his 1952 study, found that 64% of patients in eclectic therapy and 44% of psychoanalytic patients improved versus a 72% improvement rate for untreated patients. His methodology and findings have been criticized for decades following his report and most studies since then have found psychotherapy to be superior to no treatment.
concluded that individuals who receive psychotherapy are better off than 80% of controls

This choice is one of the conclusions of Smith and Glass’ (1978) meta-analysis.

concluded that psychologists and psychiatrists are more effective than master’s level clinicians

This was not one of Eysenck’s conclusions, and it is also contrary to a finding of Consumer Report’s 1995 study which failed to find a relationship between therapist level of training and outcome.

led to many other outcome studies, most of which have supported his findings

This is partly correct, in that many other outcome studies did follow Eysenck’s study; however, most of these have contradicted his findings. Indeed, even Eysenck modified his conclusion in 1985 by indicating that at least one therapy, behavior therapy, is superior to placebo or no treatment.

Additional Information: Eysenck

Question 21

Traditional psychoanalytic psychotherapy and brief therapies derived from it share several characteristics but also differ in a number of ways. Which of the following is not true about brief forms of psychodynamic psychotherapy?
Select one:
A. In brief psychotherapy, past experiences are important to the degree that they contribute to the client’s current conflicts.
B. Brief therapy targets specific therapeutic goals, which are identified during the first few sessions.
C. In order to solve a client’s problems rapidly, brief therapy makes use of the “transference cure” rather than fostering the client’s insight into his or her problems.
D. Brief therapy can be described as a problem-solving process in which the therapist helps the client use his or her own resources to resolve current difficulties.

Answer 21

Correct Answer is: C
This is the opposite of what is true. In brief forms of psychodynamic psychotherapy, client insight is desirable, although it is limited to those areas that are identified as the targets of therapy.

Question 22

Brief dynamic therapy is least likely to involve
Select one:
A. a focus on specific problems.
B. an emphasis on restoring the person to a previous level of normal functioning.
C. an attempt to engender insight into the unconscious.
D. the use of techniques such as free association and dream interpretation.

Answer 22

Correct Answer is: B
An emphasis on restoring the person to a previous level of normal functioning sounds more like the goal of crisis intervention than that of brief psychotherapy. Brief dynamic therapy is focused on specific symptoms; whereas, the goal of long-term psychodynamic therapy is usually global personality change. These symptoms are usually viewed as pathological; in other words, the emphasis is on altering the normal level of functioning rather than returning the person to it. Two of the responses (“an attempt to engender insight into the unconscious” and “the use of techniques such as free association and dream interpretation”) describe possible aspects of brief dynamic therapy. Techniques of long-term dynamic therapy, such as free association and dream interpretation, may be used. In addition, there may be an attempt to engender insight into the unconscious, but (unlike as in long-term therapy) the patient is left to assimilate this insight on his or her own.
Additional Information: Brief Psychotherapy

Question 23

The clinical scales of the MMPI-2 were developed using empirical criterion keying. This means that
Select one:
A. items which distinguish between specific subgroups of people are retained for the final version of the test.
B. items that have high correlations with the previous version of the test are retained for the final version of the test.
C. items that have high correlations with other tests designed to measure similar constructs are retained for the final version of the test.
D. items which appear to measure what they are designed to measure are retained for the final version of the test.

Answer 23

Correct Answer is: A
In empirical criterion keying, items are assessed to determine how well they distinguish between prespecified criterion groups (e.g., between depressed and non-depressed individuals). The items that best distinguish between the groups are maintained for the final version of the scale or the test.
Additional Information: Introduction (MMPI-2)

Question 24

Someone advocating an emic rather than an etic approach to cross-cultural psychology would argue that the study of a culture
Select one:
A. should be undertaken from a detached and objective position.
B. should be undertaken from within the culture itself.
C. should involve a comparison across different cultures.
D. should use the history of the culture being studied as a reference point.

Answer 24

Feedback
Correct Answer is: B
The emic/etic distinction was first made by an anthropologist named Pike in 1954 and has since been applied to cross-cultural psychology. The etic approach to the study of a culture involves studying it from the outside, using universally accepted means of investigation. The emic approach, by contrast, involves studying the culture from the inside and trying see it as its own members do.
Additional Information: Emic-Etic Distinction

Question 25

``` An effective behavioral treatment to reduce the symptoms of depression is Structured Learning Therapy (SLT). SLT contains all of the following except: Select one: A. social skills training B. overcorrection C. modeling D. role-playing ```

Answer 25

Correct Answer is: B Structured Learning Therapy incorporates "social skills training," an early approach to the treatment of depression, along with "modeling," "role-playing," skill instruction, and performance appraisal (which make these the incorrect options). (See: A. P. Goldstein, Psychological Skills Training: The Structured Learning Technique, New York, Pergamon Press, 1980.)

Question 26

Irving Yalom (1985) felt the most important therapeutic factors in groups were: Select one: A. Altruism, universality, installation of hope B. Instillation of hope, catharsis, existential factors, C. Cohesiveness, altruism, universality D. Interpersonal learning, catharsis and cohesiveness .

Answer 26

Correct Answer is: D Yalom felt the most important factors in group process were interpersonal learning, which gave members an opportunity to learn valuable interpersonal skills, catharsis, where group members are able to openly express their feelings in front of other members, and group cohesiveness where group members feel a sense of cohesiveness and friendliness with other group members. However the importance of these factors is relative. Higher functioning group participants rate interpersonal learning and universality as more important. In lower functioning clients the instillation of hope is deemed most important. Additional Information: Therapeutic Factors of Group Therapy

Question 27

The final stage in Atkinson, Morten, and Sue's Minority Identity Development Model is characterized by: Select one: A. identification with the majority group and dis-identification with the minority group B. identification with the minority group and dis-identification with the majority group C. disillusionment with both the minority group and the majority group D. biculturalism or multiculturalism

Answer 27

Correct Answer is: D In the final stage of the Minority Identity Development Model (which was later renamed the Racial/Cultural Identity Development Model) "the person becomes bicultural or multicultural without a sense of having sold out his/her integrity" [D. W. Sue and D. Sue, Counseling the culturally different: Theory and practice, 3rd edition,1999, New York, John Wiley, p. 136]. Additional Information: Minority Identity Development Model

Question 28

The most correct statement that can be made about biofeedback as a therapeutic treatment for pain reduction is that Select one: A. the significant effects found can be accounted for by the type of instrumentation employed. B. it is effective for certain types of patients only. C. its effectiveness has diminished over the years. D. it is probably no different from relaxation training in its effectiveness.

Answer 28

Correct Answer is: D Research on the efficacy of biofeedback for pain reduction indicates that it is as effective as treatments such as relaxation training. This is true for the treatment of most disorders or conditions, however in cases such as the treatment of Raynaud's Disease or migraine headaches, some studies suggest that biofeedback is the treatment of choice. Additional Information: Biofeedback

Question 29

The Treatment of Depression Collaborative Research Program (TDCRP), conducted by the National Institute of Mental Health, compared Cognitive Therapy, antidepressant medication, pill placebo, and interpersonal psychotherapy treatments in depressed outpatients. The results of this study found: Select one: A. cognitive therapy is more effective than the other treatments for mild to moderate depression B. cognitive therapy is more effective than the other treatments for moderate to severe depression C. no difference in observed outcome between cognitive therapy and antidepressant medications (ADMs) for mild to moderate depression. D. no difference in observed outcome between cognitive therapy and antidepressant medications (ADMs) for moderate to severe depression.

Answer 29

Correct Answer is: C Findings of the NIMH's TDCRP research project indicate no differences in outcome were observed between CT and ADM among all patients. In other words, overall, cognitive therapy (CT) and antidepressant medication are about equally effective in the treatment of depression. In a secondary analysis of more severely depressed patients, however, ADM outcomes were superior to both cognitive therapy and placebo. Antidepressant medications (ADMs) are the most widely used treatment for major depressive disorder (MDD) in the United States and evidence supports the efficacy of ADMs, particularly among more severely depressed patients, as first-line therapy for patients with moderate to severe MDD. (See: DeRubeis, R.J., Hollon, S.D., Amsterdam, J.D., Shelton, R.C., Young, P.R., Salomon, R.M., O'Reardon, J.P., Lovett, M.L., Gladis, M.M., Brown, L.L., & Gallop,R. (2005) Cognitive Therapy vs Medications in the Treatment of Moderate to Severe Depression. Archives of General Psychiatry.62(4):409-416.)

Question 30

Self-in-Relation theory suggests that: Select one: A. the self progresses from infantile dependence to mature independence B. one's self depends on how one connects to others C. people prefer to be right rather than happy D. the relationships between siblings is the most important influence in the development of the self

Answer 30

Correct Answer is: B Self-in-Relation theory is a feminist theory which emphasizes the importance of one's connections with others, particularly a daughter's relationship with her mother. The development of the self is viewed as progressing from infantile dependence towards a mature state of interdependence. the self progresses from infantile dependence to mature independence This is in contrast to the traditional Western view of human development -- a progression from infantile dependence towards a state of greater and greater separation, individuation, and independence. people prefer to be right rather than happy This refers to Self Verification theory which proposes that people need and seek confirmation of their self-concept, regardless of whether their self-concept is positive or negative. Additional Information: Self-in-Relation Theory

Question 31

An African-American client refuses to work with a non African-American therapist under any circumstances. From the perspective of Atkinson, Morten, and Sue's Minority Identity Development Model, Select one: A. the client's reaction is typical and expected due to lifelong experiences of racism. B. the client's reaction reflects a failure of racial identity development. C. the client may be in the dissonance stage of identity development. D. the client may be in the resistance and immersion phase of identity development.

Answer 31

Correct Answer is: D Atkinson, Morten, and Sue's Minority Identity Development Model is based on the notion that the phases of development are rooted in the struggle to form a strong sense of self- and group identity in the face of oppressive conditions. They identified five phases of cultural identity development that blend into each other, without clear boundaries: 1) conformity, in which individuals reject the values of their own racial group and strive to assimilate into the dominant culture; 2) dissonance, a transition phase where positive attitudes towards the dominant culture and negative attitudes toward one's own group are examined and questioned; 3) resistance and immersion, which involves unconditional acceptance of one's own racial group and complete rejection of the dominant culture; 4) introspection, where the person questions the monolithic viewpoints of the previous stage, is able to see positive as well as negative aspects of the dominant culture, and focuses more on individual identity issues; and 5) synergistic articulation and awareness, which is characterized by a secure balance between personal and racial identity, the desire to eliminate all forms of oppression as opposed to just oppression aimed at one's own group, and appreciation of positive aspects of the dominant culture. From the perspective of this theory, the resistance and immersion phase of development would most likely include rejecting any possibility of working with a therapist of a different racial group. It is true that such a refusal could be due to lifelong experiences of racism, as stated by the choice "the client's reaction is typical and expected due to lifelong experiences of racism." However, because you are asked to answer from the perspective of the Minority Identity Development Model, the correct answer is a better option. Additional Information: Minority Identity Development Model

Question 32

The use of the technique known as self-instruction with hyperactive children involves Select one: A. programmed learning. B. having the children write down their daily goals in advance. C. having the children make self-statements. D. having the children do the their schoolwork by themselves.

Answer 32

Correct Answer is: C Donald Meichenbaum developed the technique of self-instruction as a means of helping impulsive and hyperactive children to perform tasks more successfully. The technique involves teaching the subject to make appropriate self-statements while performing a desired task. Additional Information: Self-Instructional Training

Question 33

According to the theory of psychopathology on which Beck's model of cognitive therapy is based, which of the following is true regarding the role of schema? Select one: A. Dysfunctional schemas always cause problems, even if they are not associated with symptomatic behavior. B. Certain types of schema, known as "core schema" are not accessible to the conscious mind. C. Schemas govern cognition but not other psychological phenomena such as memory, affect, or motivation. D. Dysfunctional schema develop over the course of life experience beginning in childhood.

Answer 33

Correct Answer is: D According to Beck, schemas are relatively stable cognitive patterns on which attention to and interpretations of external events are based. In a depressed individual, the person's interpretation of external events is distorted to fit the schema. For example, a person who views him- or herself as worthless and deserving rejection will tend to interpret the statements and behaviors of others as rejection. Beck believed that life experiences, beginning in childhood, provide the basis for forming schemas. As an example, the belief that all losses are irreversible is a core schema that may have been formed due in large part to the death of a parent in childhood. Let's briefly go through the other choices. Dysfunctional schemas always cause problems, even if they are not associated with symptomatic behavior. This choice is incorrect because not all schemas -- even dysfunctional schemas -- cause problems. This is because, according to Beck, some schemas are inactive and remain so unless they are activated by external events. Certain types of schema, known as "core schema" are not accessible to the conscious mind. This is wrong because Beck believed that schemas -- including core schemas, or basic assumptions about oneself and the world -- are readily available to the patient's conscious mind; this is one way that he distinguishes the cognitive therapy approach from psychoanalysis. Schemas govern cognition but not other psychological phenomena such as memory, affect, or motivation. This is wrong because Beck believed that schemas are involved in memory, affect, and motivation, as well as all other functions related to perception and information processing. Additional Information: Schemas (Beck)

Question 34

``` Of the following ethnic groups which group is not considered a race? Select one: A. Hispanic B. Native American C. African-American D. Asian-American ```

Answer 34

Correct Answer is: A Hispanics are an ethnic group like African-Americans, Asian-Americans, and Native Americans. Unlike these groups, Hispanics are not a specific race. According to the 1998 Census Bureau, the total Hispanic population of the US accounts for 11% of the total population. Sixty-three percent are of Mexican origin, 14.4% are of Central and South American origin, 10.6% of mainland Puerto Rican origin, 4.2% of Cuban origin, and 7.4% other (Alfredo Ardilis, Testing Hispanic Populations, Texas Psychologist, Winter 2000). Additional Information: Counseling Hispanic Clients

Question 35

``` A person's negative attitudes toward an individual because of his or her sexual orientation is referred to by Gregory Herek (2000) as: Select one: A. sexual prejudice B. homophobia C. homosexism D. gay inequality ```

Answer 35

Correct Answer is: A Gregory Herek, an authority on prejudice against lesbians and gay men, suggests the use of the term "sexual prejudice" to refer to all negative attitudes based on sexual orientation, whether the target is homosexual, bisexual, or heterosexual. Herek suggests that "sexual prejudice" is a more appropriate term than "homophobia" - which refers to heterosexuals' dread of being in close quarters with homosexuals and homosexuals' self-loathing. Additional Information: Sexual Prejudice

Question 36

Jungian theory differs from Freudian theory in that Select one: A. Jung had a more optimistic outlook on the ability of psychoanalysis to effect a cure. B. Jung endorsed the notion of psychic determinism. C. Jung focused on the "here-and-now"; Freud focused on the past. D. Jung had a different theory about the role of the unconscious than Freud.

Answer 36

Correct Answer is: D Among other things, Jung and Freud disagreed about the nature of the unconscious. For Freud, the unconscious is primarily the product of the individual's personal history -- it contains innate drives as well as material (e.g., fantasies, memories, affects) accumulated over the life span. For Jung, the unconscious consists of both a personal and collective component. The collective unconscious contains latent memories of our cultural past, archetypes (innate ideas that ready us for human experience), and even prehuman memories. Additional Information: Carl Jung's Analytical Psychology

Question 37

A young child starts to act out while waiting for the food to be served at a restaurant. According to systems theory, in order to the restore the family to its previous state of equilibrium, the parent will: Select one: A. use negative feedback to restore homeostasis B. use negative feedback to unbalance the system further and bring the child back into line C. use positive feedback to restore homeostasis D. use positive feedback to correct the child's behavior

Answer 37

Correct Answer is: A In systems theory, feedback refers to information from within the system which results in changes in either the existing homeostasis or the maintenance or restoration of homeostasis. Positive feedback alters the system to accommodate novel input or a new state of equilibrium and negative feedback maintains or restores the status quo of the system. If a child misbehaves while the family is at a restaurant, negative feedback occurs when the parent corrects the misbehaving and restores homeostasis.

Question 38

A client presents as cool, calm, and collected, but has an underlying rage and by the end of the session, the therapist feels angry. This is an example of: ``` Select one: A. parallel process. B. projective identification. C. introjection. D. diagnostic overshadowing. ```

Answer 38

Correct Answer is: B Projective identification is a defense mechanism in which one or more parts of the self are falsely attributed to another, which are then unconsciously accepted by the recipient, and the projector then identifies with the projected part in the other. Recreating the supervisee-client relationship in the supervisee-supervisor relationship through a combination of transference, countertransference, and projection is referred to as parallel process*. Introjection* involves absorbing the values or behaviors of others, including the larger society, without really understanding or assimilating those values or behaviors. Introjection represents a disturbance in the boundary between self and others - the person does or believes things that are not reflective of a self that is clearly distinct from others in the environment. Diagnostic overshadowing* refers to the tendency to attribute all of a client's emotional, behavioral, and social problems to one salient characteristic instead of considering other, alternative explanations (* incorrect choices).

Question 39

Lazarus cognitive appraisal theory suggests the emotional reaction to a situation follows a cognitive assessment of the situation and identifies three types of appraisal: Select one: A. central appraisal, peripheral appraisal and re-appraisal. B. conscious, unconscious and semiconscious appraisal. C. phonemic, structural and semantic appraisal. D. primary appraisal, secondary appraisal and re-appraisal.

Answer 39

Correct Answer is: D Lazarus cognitive appraisal theory suggests the emotional reaction to a situation follows a cognitive assessment of the situation. His theory differentiates between three types of appraisal: primary, which refers to one's perception of the situation (i.e., positive, negative, or irrelevant); Secondary, which refers the assessment of resources available to deal with the situation; and re-appraisal, referring to watching the situation and changing the other types of appraisals as necessary. Structural, phonemic, and semantic are from the levels of processing theory of memory.

Question 40

An individual's symptoms of tension headaches, nausea, hyperventilation and heart palpitations would be most likely to be interpreted by a client-centered therapist as relating to: Select one: A. overwhelming environmental stress B. being unable to fulfill one's own needs C. unresolved intrapsychic conflicts D. denied threats to the self-concept

Answer 40

Correct Answer is: D According to client-centered therapy, when an individual's natural tendency toward growth and actualization is disrupted by incongruence between the self and experience (e.g., others' evaluations differing from one's self-concept), personality and behavioral problems arise. Denying or distorting the experience is one way of dealing with the incongruence. According to Rogers, denial and distortion leads to anxiety which may result in visceral symptoms such as those listed in the question. Additional Information: Theory of Personality and Pathology and Goals of Therapy (Client-Centered Therapy)

Question 41

A genogram would be used by a Bowenian therapist to: Select one: A. identify genetic (biological) contributions to maladaptive behavior. B. examine family relationships over several generations. C. evaluate the progress and outcome of therapy. D. examine interactions between a family and its environment.

Answer 41

Correct Answer is: B A genogram, as Bowen described, is a schematic diagram of the family's relationships used to identify behavior patterns that recur in the family and usually includes at least three generations. The term ecomap ("examine interactions between a family and its environment") is sometimes used interchangeably with genogram; however the question notes the use of a genogram by a Bowenian therapist, so "examine family relationships over several generations" is the best answer. Additional Information: Goals and Techniques of Therapy (Extended Family Systems Therapy)

Question 42

``` Asian-American students often outperform their non-Asian peers on various measures of academic achievement. Research suggests that the best predictor of higher achievement in Asian-Americans is: Select one: A. estimate of ability. B. fear of academic failure. C. self-efficacy beliefs. D. effort beliefs. ```

Answer 42

Correct Answer is: B Asian-American and non-Asian students not only differ in terms of achievement but also in their attributions for academic success. Asian-Americans are more likely to cite fear of failure as the main contributor to academic success, while non-Asians are more likely to attribute successful performance to effort. Additional Information: Counseling Asian-American Clients

Question 43

``` An African-American client who is referred to an African-American therapist states that he has been cheated because he is getting sub-standard care. According to the minority identity development model, this person is in which stage of development? Select one: A. conformity B. dissonance C. resistance D. introspection ```

Answer 43

Correct Answer is: A The Minority Identity Development (MID) model defines five stages of identity development in African-Americans and other minority groups who share an experience of oppression. The stages are Conformity, Dissonance, Resistance and Immersion, Introspection, and Synergistic Articulation and Awareness. In the first stage, Conformity, the person is likely to have strong negative feelings toward one's own culture and strong positive feelings toward the dominant culture. Thus, an African-American who feels cheated by having to see an African-American therapist would likely be in the Conformity stage of development. Additional Information: Minority Identity Development Model

Question 44

``` A therapist typically conceptualizes cases from a psychodynamic theoretical framework and uses related techniques however, she uses an empty chair technique in a therapy session. The therapist's use of this technique is consistent with: Select one: A. theoretical integration. B. assimilative integration. C. technical eclecticism. D. common factors. ```

Answer 44

Correct Answer is: B An openness to various ways of integrating diverse theories and techniques characterizes psychotherapy integration. What differentiates psychotherapy integration from an eclectic approach is that in an eclectic approach, a therapist chooses interventions based on what works without considering a theoretical basis for using the technique, while psychotherapy integration attends to the relationship between technique and theory. Assimilative Integration is an approach to psychotherapy integration in which the therapist has a commitment to one theoretical approach but also is willing to use techniques from other therapeutic approaches. Additional Information: Psychotherapy Integration

Question 45

A primary tenet of rational-emotive therapy is that: Select one: A. a belief determines behavior. B. self-attributions determine behavior. C. conditioning determines behavior. D. internalized role constructs determine behavior.

Answer 45

Correct Answer is: A RET is basically a cognitively-based theory even though in practice therapists use many modalities. The idea is that beliefs -- irrational beliefs -- determine our maladaptive behaviors. The belief that you mustn't make anyone mad at you is an example. Additional Information: Rational Emotive Behavior Therapy (REBT)

Question 46

``` A student seeks counseling at the university counseling center due to feelings of failure as a student. When asked about his grades, he states that his grade point average is 3.9 but thinks that he should be doing better. He is most likely using which of the following cognitive distortions? Select one: A. arbitrary inference B. overgeneralization C. personalization D. dichotomous thinking ```

Answer 46

Correct Answer is: A Arbitrary inference occurs when one draws a specific conclusion without supporting evidence, or even in the face of contradictory evidence. This best applies to the student in this question. Despite having a nearly perfect GPA, the student believes he's a failure and should be doing better. Overgeneralization is the application of a general rule based on a few isolated incidents. Personalization is attributing external events to oneself without evidence of a causal connection. And dichotomous thinking is categorizing experiences into one of two extremes. Additional Information: Cognitive Distortions (Beck)

Question 47

According to Marlatt and Gordon, which of the following most increases the chance of relapse in a substance abuser? Select one: A. life changes B. negative affects C. physiological cravings D. decreased treatment durations due to the limits set by managed care companies

Answer 47

Correct Answer is: B Marlatt and Gordon are best known for their Relapse Prevention Therapy which views substance dependence as a collection of maladaptive over-learned habits. According to their research, nearly 75% of all relapses are due to negative affects, interpersonal conflict, and social pressure. Additional Information: Relapse Prevention Therapy (Marlatt & Gordon)

Question 48

``` According to Prochaska and DiClemente's Stages of Change Model, which stage best applies to a man who is aware of his drinking problem, recognizes the benefits of getting sober, and plans to quit drinking on his birthday in three months? Select one: A. Minimization B. Precontemplation C. Contemplation D. Preparation ```

Answer 48

Correct Answer is: C Prochaska and DiClemente described five Stages of Change in their model - which applies to many types of behaviors - not just substance abuse. The first stage is "Precontemplation," characterized by denial, resistance, and no plans to change. In the second stage, "Contemplation," a person begins to recognize the benefits of change and, although somewhat ambivalent, plans to change within the next 6 months. This best describes the person in this question. In the third stage, "Preparation," a person has decided to take action within the next 30 days and may have already begun to take small steps towards change. In the next stage, "Action," the person is actively engaged in making changes or acquiring new behaviors. The final stage is the "Maintenance" stage, in which the person has maintained action for at least 6 months and is actively working to prevent a relapse. Additional Information: Transtheoretical Model of Change

Question 49

``` Depressogenic schemata such as arbitrary inference and selective abstraction are associated with: Select one: A. Lewinsohn B. Beck C. Seligman D. Ellis ```

Answer 49

Correct Answer is: B Depressogenic schemata, or cognitive distortions, such as overgeneralization, personalization, magnification, arbitrary inference, and selective abstraction are reflected statements in Beck's "depressive cognitive triad." "Lewinsohn" is associated with the findings that depressed individuals' self-evaluations reflect an unbiased perception of reality and more accurately correspond with observer evaluations, "Seligman" is associated with the theory of learned helplessness, and "Ellis" with Reactive Emotive Therapy (RET). Additional Information: Cognitive Distortions (Beck)

Question 50

A business executive parent and artistic adolescent child come to a solution-focused family therapist for help dealing with conflicts in their relationship. Which of the following techniques are most likely to be used? Select one: A. Miracle and scaling questions B. Joining and restructuring C. Non-directive listening and interpretation D. Paradoxical directives and reframing

Answer 50

Correct Answer is: A Solution-focused therapists use a variety of techniques designed to identify solutions to client's problems. Two such techniques are the miracle and scaling questions. The miracle question invites the client to imagine what it would be like if his/her problem was suddenly gone. The scaling question invites each family member to rate a situation to see how the problem is perceived by others. Joining and restructuring Joining and restructuring are used by structural family therapists. Non-directive listening and interpretation Non-directive listening and interpretation are used by object relations family therapists. Paradoxical directives and reframing Paradoxical directives and reframing are used by strategic family therapists.

Question 51

In terms of worldview, Sue and Sue (1990) propose that minority groups are increasingly more likely to exhibit an Select one: A. external locus of control and responsibility. B. internal locus of control and responsibility. C. external locus of control, internal locus of responsibility. D. internal locus of control, external locus of responsibility.

Answer 51

Correct Answer is: D Sue and Sue (Counseling the Culturally Different, New York, John Wiley, 1990) indicate that minority group members are becoming increasingly aware of their own ethnic identity and adopting a worldview that reflects an internal locus of control and an external locus of responsibility. external locus of control and responsibility. An external locus of control and responsibility is more characteristic of a "placater" who adopts a passive role. internal locus of control and responsibility. Internal locus of control and responsibility is characteristic of the Westernized approach to counseling and white middle-class clients. external locus of control, internal locus of responsibility. An external locus of control and internal locus of responsibility is more characteristic of "marginalized" individuals who have been oppressed by the dominant group. Additional Information: Worldview

Question 52

``` According to Beck, depression is caused by Select one: A. biochemical factors. B. early parental rejection. C. dysfunctional automatic thoughts. D. dysfunctional irrational thoughts. ```

Answer 52

Feedback Correct Answer is: C The purpose of Beck's cognitive therapy is to modify dysfunctional automatic thoughts that are seen as the cause of maladaptive emotional responding (e.g., depression and anxiety). Unlike Ellis, who identifies irrational thoughts as the cause of clients' problems, Beck believes that these thoughts may or may not be irrational. Additional Information: Depression (Beck)

Question 53

``` The term "collaborative empiricism" is associated with: Select one: A. Aaron Beck B. Albert Ellis C. Fritz Perls D. Donald Meichenbaum ```

Answer 53

Correct Answer is: A In Beck's cognitive-behavioral therapy "collaborative empiricism" refers to the collaborative relationship between client and therapist using a rational, logical approach to examine the client's thoughts and assumptions - which are treated as hypotheses to be tested. Additional Information: Introduction (Beck's Cognitive Therapy)

Question 54

Which of the following is not an advantage of the use of co-therapists in group therapy, according to Yalom? Select one: A. The observational range of co-therapists is greater than that of a single group leader. B. Co-therapists broaden the range of possible transferential reactions, making the nature of the client's transferential distortions more evident. C. A co-therapist can provide a beginning group therapist with needed objectivity and expertise. D. When co-therapists pursue their own separate agendas in therapy, clients have the opportunity to intervene and learn conflict management skills.

Answer 54

Correct Answer is: D According to Yalom, a potential disadvantage of the co-therapy format is that co-therapists may be overly competitive and pursue their own interpretations rather than supporting inquiries begun by the group. If this occurs, the group will be distracted and unsettled. The other choices describe potential advantages of the use of co-therapists. Additional Information: Co-Therapists (Group Therapy)

Question 55

``` Johnny, age 10, teaches his brother Justin, age 5, how to ride a skateboard. This interaction can best be described as: Select one: A. Parallel process B. Complementary communication C. Elaborative rehearsal D. Symmetrical communication ```

Answer 55

Correct Answer is: B Communication patterns can be characterized as either symmetrical or complementary. In symmetrical communication there is equality between the partners. In complementary communication there is inequality, with one member taking a dominant role and the other a subordinate role. In this example, Johnny, the older brother, took on the dominant teacher role and his younger brother was in the subordinate role of student. Although completely unrelated to this model, you should also be familiar with the other two terms -- parallel process and elaborative rehearsal. Parallel process is a phenomenon in clinical supervision where the therapist in training behaves toward the supervising therapist in ways that mirror how the client is behaving toward the therapist in training. Elaborative rehearsal involves thinking about how new information relates to existing memory. Additional Information: Complementary Communications

Question 56

The effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) in the treatment of Posttraumatic Stress Disorder is due to: Select one: A. exposure to anxiety-provoking stimuli B. changes in the functioning of the brain due to lateral eye movement stimulation C. unconditional positive regard D. placebo effect

Answer 56

Correct Answer is: A Eye Movement Desensitization and Reprocessing (EMDR) is a controversial therapeutic technique which combines techniques from cognitive-behavioral and other treatment approaches with lateral eye movements. Clients receiving EMDR are asked to recall anxiety-provoking memories and are then instructed to track the therapists fingers which are moved from side to side. This process is repeated until the clients anxiety is extinguished. Although Francine Shapiro, the developer of the technique, originally proposed that the bilateral eye movements accelerate the reprocessing of traumatic memories, a meta-analysis of 34 studies indicated that the eye movement component did not contribute to the effectiveness of EMDR. Rather, it appears that the element of exposure is responsible for its effects. The meta-analysis did find EMDR to be more effective than no-treatment or non-exposure treatments; however, it was no more effective than other exposure techniques. (P. R. Davidson, & K. C. Parker, Eye movement desensitization and reprocessing (EMDR): A meta-analysis. Journal of Consulting and Psychology-Clinical Psychology, 2001, 69(2), 305-316). Additional Information: Eye Movement Desensitization and Reprocessing (EMDR)

Question 57

Which of the following is likely to be most effective for alleviating chronic pain? Select one: A. biofeedback B. hypnotherapy C. relaxation and coping skills training D. autogenic training and contingency management

Answer 57

Correct Answer is: C Most experts advocate a comprehensive treatment approach for chronic pain. Their recommended treatments involve teaching the patient a number of coping skills designed to alleviate pain and improve the patient's feelings of control. See, for example, H. Philips, The effects of behavioral treatment on chronic pain, Behaviour Research and Therapy, 1987, 25, 365-377.

Question 58

``` When working with African-American families, Nancy Boyd-Franklin recommends: Select one: A. An ecostructural approach B. A multisystems approach C. A matrilineal approach D. Both a and b ```

Answer 58

Correct Answer is: D Boyd-Franklin (1989) recommends the use of a multisystems (ecostructural) approach when working with African-American families. During both the assessment and treatment processes this approach targets the individual, the immediate and extended family, nonblood relations and friends, church and other community services. Additional Information: Counseling African-American Clients

Question 59

In writing about the relationship between therapist/client ethnic match and therapy outcome, Stanley Sue has noted that "ethnicity of therapist or client and ethnic match are distal variables." By distal variable, he means one which Select one: A. may contribute to but does not directly impact therapy outcome. B. is one of many variables that directly impact therapy outcome. C. is the major factor in influencing therapy outcome. D. is completely unrelated to therapy outcome.

Answer 59

Correct Answer is: A The dictionary definition of distal is the more distant of two things. In research and theory, a distal variable is an indirect factor that is less temporally close to other variables and indirectly contributes to but does not directly impact outcome. Distal variables are often global, stable, and trait-like factors, such as demographic variables, family characteristics, and personality traits. For example, Sue wrote that "Ethnicity of therapist or client and ethnic match are distal variables...Ethnicity per se tells us very little about the...behavior of individuals, therapists or clients, who interact in a therapy session". Distal variables are usually contrasted with proximal variables. Proximal means nearest, and a proximal variable is a process or detail aspect of the environment that directly impacts and occurs relatively shortly before outcome. Proximal variables can usually be manipulated or changed. In reference to the quote in the question, the behaviors of therapists and clients would most likely exemplify proximal variables. Additional Information: Therapist-Client Similarity

Question 60

``` Traditional Western approaches to individual psychotherapy can best be described as: Select one: A. linear and reductionist B. non-linear and holistic C. relativistic and abstract D. elitist and futile ```

Answer 60

Correct Answer is: A Traditional Western approaches to individual psychotherapy emphasize linear causal relationships and are reductionistic, that is, they tend to explain complex phenomena in terms of relatively simple principles. Non-linear, holistic, and relativistic are terms used to describe non-western and systems approaches. Additional Information: Cultural Encapsulation

Question 61

``` Howard et al.'s (1993) phase model of psychotherapy change does NOT include: Select one: A. remoralization B. reexamination C. remediation D. rehabilition ```

Answer 61

Correct Answer is: B The phase model of psychotherapy, an extension of the dose-response model of treatment response, was first proposed by Howard et al. in 1993 and is a client stage model that outlines a progressive, 3-stage sequence of change. The first phase, remoralization, focuses on the client's subjective well-being and occurs during the first few sessions. The second phase, remediation, focuses on symptom reduction and generally occurs between the 5th and 15th sessions. The third and final phase is rehabilitation which focuses on life functioning gains and emerges more gradually. According to this model, effective courses of treatment are initially characterized by a restored subjective sense of well-being then, as a function of this improvement, the client may benefit from interventions to provide symptom reduction or relief (e.g., decrease difficulty concentrating or sleep disruption) and finally, is able to either resume their former level of role functioning (e.g., doing well at work) or initiate new roles (e.g., obtaining a new job). (See: Howard, K. I., Lueger, R. J., Maling, M. S., & Martinovich, Z. (1993). A phase model of psychotherapy outcome: Causal mediation of change. Journal of Consulting and Psychology-Clinical Psychology, 61, 678-685. and K. Howard et al., Evaluation of psychotherapy: Efficacy, effectiveness, and patient progress, American Psychologist, 51, 1059-1064, 1996.)

Question 62

BASIC ID is utilized by which of the following to assess what interventions will work for a particular client? Select one: A. Rational emotive therapy B. Multimodal therapy C. Eye movement desensitization and reprocessing D. Cognitive behavioral modification

Answer 62

Correct Answer is: B BASIC ID is an acronym that represents the seven areas of the client's life that are examined in Lazarus's multimodal therapy: behavior, affective responses, sensations, images, cognitions, interpersonal relationships, drugs, biological functions, nutrition and exercise. Rational emotive therapy (RET) is a form of cognitive-behavioral therapy (CBT) in which the primary focus proposes changes in thinking will lead to changes in behavior, thereby alleviating or improving symptoms. The emphasis is on changing irrational thinking patterns that cause emotional distress into thoughts that are more reasonable and rational. Eye movement desensitization and reprocessing (EMDR) is therapeutic technique which combines techniques from cognitive-behavioral and other treatment approaches with lateral eye movements. Clients receiving EMDR are asked to recall anxiety-provoking memories and are then instructed to track the therapists' fingers which are moved from side to side. This process is repeated until the clients' anxiety is extinguished.

Question 63

``` A therapist seeing a family consisting of a couple and their son asks the father to describe the relationship between the mother and her son. The therapist is using which of the following techniques? Select one: A. circular questioning B. embedded suggestion C. joining the family D. process interruption ```

Answer 63

Correct Answer is: A Circular questioning involves asking questions that highlight differences among family members or define relationships between them. Usually, it will involve asking a family member about the perceptions of the relationship between other family members, as in this question. The technique is designed to provide information about family processes to the therapist and other family members, to get family members to see problems from different perspectives, to lead to further exploration, and to form the basis for further circular questioning. It is particularly associated with the Milan Systemic School of family therapy. Additional Information: Goals and Techniques of Therapy (Strategic Family Therapy)

Question 64

Cognitive behavior therapy, compared to operant behavior treatments, has been found to be: Select one: A. less effective across most diagnostic categories. B. superior with more intelligent clients. C. approximately equally effective with all types of disorders. D. more effective with addictive disorders.

Answer 64

Correct Answer is: C The question is about the research showing that all types of treatments are about equal with all types of disorders. Outside of Agoraphobia, Specific Phobias (including school phobia), and sometimes some physiological problems, such as enuresis, psychological treatments tend to be about equal in their efficacy. Additional Information: Evaluation of Cognitive Therapy

Question 65

``` In Gestalt therapy, introjection, projection, deflection, confluence and retroflection are examples of: Select one: A. layers of neurosis B. resistances to contact C. natural anxiety D. neurotic anxiety ```

Answer 65

Correct Answer is: B Gestalt therapy focuses on the "here and now" which encourages clients to gain awareness and full experiencing in the present. The term contact refers to interacting with nature and others without losing one's individuality. Resistances to contact are the defenses that one develops as a self-protective attempt to avoid the anxiety necessitated by change and prevents full experiencing in the present. The question lists the five defenses or types of resistance to contact. The five layers of neurosis, proposed by Perls (1969) to describe the process of working through neurosis are: phony, phobic, impasse, implosive, and explosive. Neurotic anxiety is the result of not facing normal anxiety. Additional Information: Theory of Personality (Gestalt Therapy)

Question 66

Wolfgang Kohler, a founder of the gestalt school of learning and thought, is known for applying gestalt learning principles to the development of Select one: A. unfinished business. B. insight. C. integration of all parts of the psyche. D. awareness of psychological boundaries.

Answer 66

Correct Answer is: B Kohler, a founder of the gestalt school of psychology, studied insight learning. In one of his experiments, a chimpanzee had to get some food placed outside his cage. He had two sticks but they were too short to reach the food. As he was sitting with the two sticks in his hand, the chimp had what Kohler called an "a-ha experience": He quickly fit the sticks together and was able to get the food. This a-ha experience -- a sudden, novel solution to the problem -- is the basis of insight learning. According to Kohler, insight learning cannot be explained by traditional behavioral theories of learning, which are based on reinforcement and associations between stimuli. Additional Information: Gestalt Learning Theory

Question 67

``` Research by Sue and his colleagues (1991) suggests that which of the following clients is most likely to return for a second session of psychotherapy? Select one: A. an African-American client B. a Latino-American client C. an Anglo-American client D. an Asian-American client ```

Answer 67

Correct Answer is: D Studies on therapy dropout rates have produced inconsistent results. This question is asking about a particular study, however (Sue et al., 1991), which found that African-Americans have the highest dropout rates, while Asian-Americans have the lowest dropout rates. Additional Information: Utilization of Mental Health Services by Minority Group Members

Question 68

Which of the following is not an aspect of crisis theory? Select one: A. overwhelming emotions are the prime motivators for change B. crisis theory emphasizes the cognitive and behavioral elements of a crisis C. people in crisis tend to follow a predictable sequence of responses D. crisis intervention will be more successful when a client is able to understand how his or her behavior is related to the crisis

Answer 68

Correct Answer is: A According to crisis theory, people in crisis tend to follow a predictable sequence of responses* and a key goal of crisis intervention is to help individuals in crisis learn more effective coping so that they can respond more adaptively when having similar experiences in the future. Crisis management strategies often include grief work; active listening; encouraging the open expression of feelings; increasing understanding of the crisis; promoting greater acceptance of reality; exploring constructive ways of coping; linkage to a social network; decision counseling; and reinforcement of newly learned coping behaviors. While addressing a client's emotions, including overwhelming ones, is a part of crisis intervention, crisis theory and crisis intervention also emphasize the cognitive and behavioral elements of a crisis*. Although crisis theorists do predict that crisis intervention will be more successful when a client is able to understand the crisis situation (e.g., how his or her behavior is related to the crisis)*, neither insight nor the resolution of internal conflicts is considered a prerequisite for change or problem-solving during crisis intervention (* These are correct statements which makes them incorrect options). Additional Information: Goals and Characteristics of Crisis Intervention

Question 69

IPT believes that depression is primarily caused by: Select one: A. Disturbances in early life especially related to attachment B. Biochemical factors C. Disturbances in cognitive functioning D. Faulty cognitions

Answer 69

Correct Answer is: A Interpersonal therapy, described by Klerman and Weisman (Klerman G..L., Rounsanville B.. Chevron E., and Weissman M., 1984 Interpersonal Psychotherapy of Depression. New York: Basic Books) relates depression to difficulties with social roles and interpersonal relationships. These are traceable to a lack of strong attachments early in life. The primary goals of IPT are symptom reduction and improved interpersonal functioning. Additional Information: Interpersonal Psychotherapy

Question 70

In working with a triangulated family, a structural family therapist would Select one: A. work with the most differentiated family members in order to reduce their emotional reactivity. B. use a paradoxical intervention by taking steps to increase the family's initial level of triangulation. C. train the family in communication skills and techniques. D. upset the family's balance by blocking the family from its normal interactional pattern.

Answer 70

Correct Answer is: D Minuchin, the founder of structural family therapy, defines triangulation as a family boundary problem in which each parent demands that the child side with him or her against the other parent. According to Minuchin, the therapist's goal in this and other situations in which parents attempt to deflect conflict onto children is to restructure the parent-child and spousal subsystems so they function correctly. This involves introducing some stress into the family system to upset the family's balance and block the family from its normal way of interacting. For example, Minuchin describes strategies such as prohibiting children from talking about symptomatic behavior with their parents, rewarding parents for their capacity to nurture and support each other, and restructuring the parents in a coalition against their child. Additional Information: Goals and Techniques of Therapy (Structural Family Therapy)

Question 71

A therapist working from the perspective of Beck's cognitive therapy would approach the treatment of Panic Disorder by Select one: A. having the client identify maladaptive thoughts that precede panic attacks and then restructuring those thoughts. B. connecting the panic attacks to the client's overall attributional styles. C. teaching the client methods of self-reinforcement to use when he or she is not having a panic attack and methods of self-punishment to use when he or she is having one. D. identifying and modifying the client's interpretation of panic attacks and their associated physical symptoms.

Answer 71

Correct Answer is: D Cognitive therapists believe that Panic Disorder is connected to "catastrophic misinterpretations" of bodily sensations, symptoms, and mentation. The client's "overcastrophization" of early signs of the attack such as hyperventilation results in a full-blown attack. Thus, at least initially, therapy focuses on identifying and modifying the client's misinterpretations of symptoms and thoughts immediately before and during the attack.

Question 72

``` Which of the following types of therapists would be most interested in interpreting the defenses against anxiety that underlie a individual's current maladaptive behavior patterns? Select one: A. reality therapy B. solution-focused therapy C. personal construct therapy D. object relations therapy ```

Answer 72

Correct Answer is: D Object relations therapy, a psychodynamic therapy, centers on how unconscious processes impact present relationships by identifying and interpreting defenses and transferences. reality therapy Glasser's reality therapy focuses on current issues and current problems. solution-focused therapy Solution focused adopts a here-and-now orientation and focuses on identifying solutions to problems. personal construct therapy Kelly's personal construct therapy combines cognitive, behavioral, and humanistic concepts and focuses on the impact of the individual's perspective on his/her experience of the world.

Question 73

``` According to Janet Helms' (1995) White Racial Identity Development Model, the final stage of racial identity development is: Select one: A. autonomy B. disintegration C. reintegration D. immersion-emersion ```

Answer 73

Correct Answer is: A According to Helms, autonomy is the final stage of racial identity development. Autonomy is characterized by a nonracist White identity based on a realistic understanding of the strengths and weaknesses of White culture. At this stage, Whites value and seek out cross-racial interactions. Additional Information: Helms' Racial Identity Models

Question 74

"According to current research, the Rorschach has very low validity." This statement is Select one: A. true. B. true, except for children between ages 5-10. C. true, except for its use with a nonverbal population. D. false.

Answer 74

Correct Answer is: D The Rorschach, while having a reputation for low validity due to its clinical origins, has increased in validity since the development of John Exner's scoring system. Hiller, Bornstein, Rosenthal, Berry and Brunell-Neuleib report in Psychological Assessment (September, 1999) that since earlier critiques, two recent developments have given the Rorschach a more favorable outlook. First is the development of Exner's Comprehensive System for the Rorschach (Exner, 1974; 1978) which systematized scoring procedures for the Rorschach, and reported findings from a large archive of Rorschach protocols of normal adults, as well as from various psychiatric groups. Second, two meta-analyses were published, both comparing criterion-related validity evidence for the Rorschach to that of its chief rival, the MMPI (Atkinson, 1986; Parker, Hanson, and Hemsley, 1989). These studies conclude that validity is roughly equivalent for both instruments. Moreover, in Hiller et al.'s (1999) article, "A Comparative Meta-Analysis of Rorschach and MMPI Validity," their findings indicate that the MMPI had larger validity coefficients than the Rorschach for studies using psychiatric diagnoses and self-report measures as criterion variables, whereas the Rorschach had larger validity coefficients than the MMPI for studies using objective criterion variables. Additional Information: The Rorschach Inkblot Test

Question 75

``` Which of the following therapeutic approaches refers to changing or adapting to the environment by altering one's own behaviors or responses? Select one: A. emic B. etic C. alloplastic D. autoplastic ```

Answer 75

Correct Answer is: D Autoplastic ("self-change" ) refers to changing or adapting to the environment by altering one's own behaviors or responses. An emic perspective involves focusing on the intrinsic distinctions that are meaningful to members of a particular culture or society. An etic perspective involves focusing on extrinsic distinctions that have meaning for the observer of the culture or society. Alloplastic refers to changing or adapting to the environment by effecting changes in the environment.

Question 76

In the transtheoretical model, "zero temptation and 100% self-efficacy" is: Select one: A. an unrealistic expectation of behavioral change. B. the definition of successful behavioral change. C. the result of complete behavioral change in the termination stage. D. the result of 'decisional balance' in the maintenance stage.

Answer 76

Correct Answer is: C Prochaska and DiClemente's transtheoretical or stages of change model distinguishes between six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. Many descriptions of the model only include the first five stages because the termination stage of "zero temptation and 100% self-efficacy" is not necessary for success and rare for most behaviors. Maintenance is when a person has maintained action, consolidates the change and is actively working to prevent a relapse. For many, the maintenance stage lasts forever and the model accepts temptation or the potential for relapse, such as an occasional craving for a cigarette or a drink, as normal and an opportunity to learn. At each stage, an individual weighs the pros and cons of adopting a new behavior, Prochaska and DiClemente called this weighing "decisional balance."

Question 77

The term "incongruence" as defined by Carl Rogers refers to a chasm between Select one: A. the real self and the ideal self. B. self-as-object and self-as-process. C. the perceived self-concept and the real self. D. the person's current maturity level and the person's potential.

Answer 77

Correct Answer is: A According to Carl Rogers' theory, which underlies his person-centered approach to psychotherapy, the healthy person is one striving toward self-actualization, which means that he is open to experience, creative, trusting of his feelings, flexible in his self-concept, and striving to meet his full potential as a human being. He contrasted the self-actualizing tendency with incongruence, which refers to a conflict between the real (or perceived) self and the ideal self. Incongruence results from conditions of worth being placed on the person, by oneself and/or others, which means that the person is only positively regarded under certain conditions. By contrast, unconditional positive regard fosters the self-actualizing tendency, and Rogers identified unconditional positive regard--along with genuineness and empathy--as one of three therapist attitudes crucial to the success of person-centered therapy. Additional Information: Theory of Personality and Pathology and Goals of Therapy (Client-Centered Therapy)

Question 78

``` The tendency to attribute all behavioral, social and emotional problems to a diagnosis or psychopathology while alternative explanations and comorbid diagnoses are often not considered is referred to as: Select one: A. diagnostic overshadowing B. psychosocial masking C. intellectual distortion D. baseline exaggeration ```

Answer 78

Feedback Correct Answer is: A Research by Reiss et al. (1982) found mental disorders in individuals with mental retardation are often unrecognized, undiagnosed, and untreated. The underestimation was proposed to be the result of a phenomenon called "diagnostic overshadowing," where the presence of mental retardation decreases the diagnostic significance of an accompanying mental health disorder. Or as an example with slow learners there may be the reverse case of diagnostic overshadowing. That is, professionals ignore the real world influences of low intelligence such as poor coping skills, poor social skills, repeated failure experiences and the risk factors associated with poverty and attribute all behavioral, social and emotional problems to psychopathology. The other response choices are three of four non-specific factors associated with mental retardation that influence the diagnostic process: intellectual distortion, emotional symptoms are difficult to elicit because of deficits in abstract thinking and in receptive and expressive language skills; psychosocial masking, the effect of disabilities or limited social experiences on the content of psychiatric symptoms; cognitive disintegration, the tendency to become disorganized under emotional stress or a decreased ability to tolerate stress leading to anxiety-induced decompensation; and baseline exaggeration, the fact that chronic maladaptive behaviors may significantly increase in severity or frequency during a period of emotional stress or after the onset of psychiatric illness. (See: Reiss, S., Levitan, G.W., Szyszko, J. (1982). Emotional Disturbance and Mental Retardation: Diagnostic Overshadowing. American Journal of Mental Deficiency, 86(6), 567-74.)

Question 79

``` In the MMPI-2, which of the following could be considered a suppressor variable? Select one: A. D B. F C. K D. L ```

Answer 79

Correct Answer is: C Although correlated with other scores in a test, a suppressor variable is irrelevant to what is being measured by the test. Therefore, it can be used as a correction factor to partial out the effects of the irrelevant variable. In the case of the MMPI-2, the K scale serves as a measure of clinical defensiveness and can be used as a correction factor for several of the clinical scales. Additional Information: K or "Correction" Scale (MMPI-2)

Question 80

According to recent research studies, which of the following statements is most true regarding therapy with African-American clients conducted by Caucasian therapists? Select one: A. It is likely to be less effective as compared to therapy conducted by an African-American therapist. B. The effectiveness of therapy is related to a number of client and therapist variables, such as the client's suspiciousness of Caucasians in general and the therapist's own racial identity development. C. The effectiveness of therapy is likely to be enhanced if the therapist ignores racial issues in the early stages of therapy, but brings them up in the later stages of therapy after an alliance has been established. D. Race is not likely to be an important issue in therapy with African-American clients.

Answer 80

Correct Answer is: B Most research (especially recent research) suggests that client-therapist racial or ethnic similarity per se does not have a significant impact on therapy outcome. However, ethnic or racial matching does interact with a number of other variables in affecting outcome. For instance, recent research with African-American clients shows that cultural mistrust, or suspiciousness of Caucasians due to the historical animosity between the two racial groups, is negatively correlated with therapy effectiveness. Other research has suggested that Caucasian therapists' own racial identity development is moderately correlated with their multicultural counseling skills. The effectiveness of therapy is likely to be enhanced if the therapist ignores racial issues in the early stages of therapy, but brings them up in the later stages of therapy after an alliance has been established. By the way, the opposite of this choice is true: The research suggests that the impact of cultural differences can be lessened if the therapist attends to and raises racial issues during the early stages of therapy. Additional Information: Counseling African-American Clients

Question 81

According to Derald Wing Sue's locus of control and locus of responsibility theory, a person who gives up on getting a desirable job because he believes it is impossible to do so due to outside forces such as discrimination likely has a worldview of Select one: A. external locus of control, internal locus of responsibility. B. external locus of control, external locus of responsibility. C. internal locus of control, external locus of responsibility. D. internal locus of control, internal locus of responsibility.

Answer 81

Correct Answer is: B J.B. Rotter identified internal-external locus of control as a personality trait related to attributional tendency. People with an internal locus of control tend to view positive and negative outcomes as the result of their own actions; i.e., they believe they have control over their own fate. Those with an external locus of control view outside forces, such as luck or powerful external entities, as in control over what happens to them. Derald Wing Sue identified locus of responsibility as an additional attributional tendency. People with an internal locus of responsibility credit or blame themselves for what happens to them; those with an external locus of responsibility place credit or blame with others. According to Sue, one's worldview can fall into one of four quadrants, based on their locus of control and locus of responsibility. For example, people with an internal locus of control and external locus of responsibility (IC-ER) might blame society for their problems, but believe that they have the ability to overcome these problems; this is the typical worldview of an activist or militant. Sue noted that IC-IR is the quadrant considered normal and healthy in the dominant culture, but that this is not necessarily the case in minority cultures. In this question, the person believes he has no control over his ability to get a job and blames the problem on discrimination. Therefore, he has an external locus of control and external locus of responsibility. Additional Information: Worldview

Question 82

``` An adolescent's behavior is motivated primarily by her needs for power and attention. Her problems would probably be best addressed by a therapist adopting the approach of: Select one: A. Adler. B. Ellis. C. Perls. D. Freud. ```

Answer 82

Correct Answer is: A Probably the best way to approach this question is to see if the notions of power and attention are linked to any of the people listed in the responses. For Adlerians, a desire to belong is a primary motivator of behavior, but this desire may be channeled into the mistaken goals of power, attention, inadequacy, or revenge. Additional Information: Alfred Adler's Individual Psychology

Question 83

``` Primary strategies or skills associated with _________________ include open-ended questions, affirmations, reflective listening, and summary statements. Select one: A. interpersonal therapy B. motivational interviewing C. solution-focused therapy D. reality therapy ```

Answer 83

Correct Answer is: B While the listed strategies are useful for most therapies, they are the stated primary strategies of motivational interviewing as they are considered helpful for increasing client motivation. There are five specific methods useful throughout the process of motivational interviewing. The first four are represented by the acronym OARS: open-ended questions, affirmations, reflective listening, and summarizing. These methods are largely derived from a client-centered approach and are utilized to explore client ambivalence and clarify reasons for change. The fifth method, "eliciting change talk" , is specific to motivational interviewing and describes its directive nature. This strategy integrates and guides the use of the other four. (Note it is also appropriate sometimes to ask closed-ended questions, change the focus, provide information, state an opinion, give advice when requested, etc. in addition to these foundational skills to enhance client motivation.) Additional Information: Motivational Interviewing

Question 84

``` A self-report inventory that assesses general psychiatric symptoms on a Likert-type scale is the: Select one: A. MCMI-III B. Rorschach C. MMPI-II D. SCL-90 ```

Answer 84

Correct Answer is: D The Symptom Checklist 90 (SCL-90) is a self-report inventory assessing general psychiatric symptoms of anxiety, depression, somatization, obsessive-compulsiveness, and hostility. Clients respond to the stimulus term, such as "feel nervous inside" on a 5-point Likert type scale from "not at all" which gives a score of 0, to "extremely" which gives a score of 4. Additional Information: Symptom Checklist 90 (SCL-90)

Question 85

In contrast to feminist therapists, non-sexist therapists: Select one: A. emphasize the importance of therapist self-disclosure B. focus more on individual change than social change C. de-emphasize the effects of gender on personality development D. stress the egalitarian nature of the therapist-client relationship

Answer 85

Correct Answer is: B Note that this question is asking how non-sexist therapy differs from feminist therapy. A key distinction is that non-sexist therapy is more concerned with personal responsibility and personal change, while feminist therapy places equal or greater emphasis on the sociopolitical contributions to pathology and the need for social change. Additional Information: Non-Sexist Therapy

Question 86

A father and his 19-year-old son present for therapy due a variety of conflicts in their relationship. The father is a businessman and the son is an artist. What techniques would a solution-focused family therapist use? Select one: A. Joining and restructuring. B. Paradoxical directives and reframing C. Miracle and scaling questions D. Non-directive listening and interpretation

Answer 86

Correct Answer is: C Solution-focused therapists use a variety of techniques designed to identify solutions to client's problems. The miracle and scaling questions are two such techniques used by solution-focused therapists. The miracle question invites the client to imagine what it would be like if his/her problem was suddenly gone. The scaling question invites each family member to rate a situation to see how the problem is perceived by others. Joining and restructuring Joining and restructuring is used by structural family therapists. Paradoxical directives and reframing Paradoxical directives and reframing is used by strategic family therapists. Non-directive listening and interpretation Non-directive listening and interpretation is used by object relations family therapists.

Question 87

In gestalt therapy, transference would most likely be Select one: A. viewed as a distortion that interferes with here-and-now awareness. B. viewed as a good way to learn about a client's past relationships. C. seen a sign that the client is not a good candidate for psychotherapy. D. ignored.

Answer 87

Correct Answer is: A Gestalt therapy is an experiential mode of psychotherapy that emphasizes personal responsibility and focuses on the person's experience and awareness in the present moment (i.e., the here and now), as well as the environmental and social contexts in which experiences take place. In Gestalt therapy, an open, authentic patient-therapist relationship, in which the patient is expected to take responsibility for his or her own progress, is an important part of the process. In this relationship, Gestalt therapists focus on strengthening the contact boundary, or the degree to which the therapist and the client can engage in authentic dialog and contact while still maintaining the distinction between self and other. Transferences are seen as distortions in this boundary and in the awareness of what is actually occurring in the therapy situation. Transferences are not ignored in Gestalt therapy--they are explored and worked through as they arise, but unlike as in psychoanalysis, they are not encouraged. Additional Information: Goals and Techniques of Gestalt Therapy

Question 88

``` Which of the following variables is most strongly related to a preference for therapists of the same racial group in African-American psychotherapy clients? Select one: A. education B. IQ score C. racial/cultural identification D. presenting issue ```

Answer 88

Correct Answer is: C Research shows that the stronger a client's identification is with his or her racial or cultural background, the more likely he or she is to prefer a therapist from a similar background. Additional Information: Therapist-Client Similarity (Other Variables)

Question 89

``` Increased awareness is the primary goal of which of the following types of therapy? Select one: A. Self Psychology B. Reality Therapy C. Gestalt Therapy D. Existential Therapy ```

Answer 89

Correct Answer is: C Although increased awareness can be considered an important goal of many types of therapy, it is perhaps most central to Gestalt Therapy. Gestalt therapy strives to increase an individual's awareness of the self, the environment, and the nature of the self-environment boundary. Additional Information: Goals and Techniques of Gestalt Therapy

Question 90

Cross's (1991) Black Racial (Nigresence) Identity Development Model includes the stage called Pre-Encounter. At this stage an African-American prefers a therapist Select one: A. of their own race. B. of the Caucasian race. C. of a minority group; but not African-American. D. that is African, but not American.

Answer 90

Correct Answer is: B Cross's Identity Development Model includes four stages. The first stage is Pre-encounter in which whites are seen as the ideal, while African Americans are denigrated. The second stage or Encounter stage leads to an interest in developing an African-American identity and a preference for a therapist of one's own race. The third stage (Immersion/Emersion) involves a struggle between old and emerging ideas about race. There is an initial idealization of African-Americans and a denigrating of whites. Toward the end of this stage the person becomes less emotionally immersed and moves toward internalization of a new identity. In the fourth and final stage (Internalization/Commitment), the individual adopts an African-American world view. Additional Information: Black Racial Identity Development Model (Cross)

Question 91

Therapist self-disclosure in feminist therapy: Select one: A. encourages participation by the client in the early stages of therapy. B. promotes client passivity in the therapeutic relationship. C. contributes to an egalitarian relationship between the client and therapist. D. facilitates a special bonding between the therapist and the client.

Answer 91

Correct Answer is: C One of the main characteristics of feminist therapy is its emphasis on an egalitarian relationship between the client and therapist. Feminist therapists consider self-disclosure with clients as a way of supporting an egalitarian relationship. Therapist self-disclosure may be used to encourage client participation, but this response isn't as good as the correct option in describing the role of self-disclosure in feminist therapy. Feminist therapy discourages client passivity and feminist therapists typically discourage special bonding as it may encourage client dependence on the therapist.

Question 92

An individual who is in the contemplation stage of change is: Select one: A. unaware of a problem. B. aware of a problem, thinking of change. C. intending to change. D. working on modifying their behavior.

Answer 92

Correct Answer is: B Prochaska and DiClemente's transtheoretical, or stages of change, model is an eclectic model that integrates interventions from various theories of psychotherapy and distinguishes between six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. Many descriptions of the model only include the first five stages because the termination stage of "zero temptation and 100% self-efficacy" is not necessary for success and rare for most behaviors. At each stage, an individual weighs the pros and cons of adopting a new behavior, which Prochaska and DiClemente called "decisional balance." The first stage is "Precontemplation," characterized by denial, resistance, and no plans to change. In the second stage, "Contemplation," a person begins to recognize the benefits of change and, although somewhat ambivalent, plans to change within the next 6 months. This best describes the person in this question. In the third stage, "Preparation," a person has decided to take action within the next 30 days and may have already begun to take small steps towards change. In the next stage, "Action," the person is actively engaged in making changes or acquiring new behaviors. The final stage is the "Maintenance" stage, in which the person has maintained action for at least 6 months and is actively working to prevent a relapse. Additional Information: Transtheoretical Model of Change

Question 93

According to meta-analytic studies of psychotherapy, Select one: A. so few well-controlled studies have been done that no conclusions can be made concerning treatment outcome. B. behavior therapy is better than psychoanalysis. C. behavior therapy is the treatment of choice for phobias. D. a person participating in therapy would have just as much chance of improving as a control subject.

Answer 93

Correct Answer is: C The research on psychotherapy outcome is pretty consistent in its conclusions. Common findings include that therapy is generally effective for children and adults of all backgrounds and that, with the exception of certain specific problem areas, all therapies are about equal. This question is about one of those exceptions. According to outcome research, phobias respond best to behavioral techniques such as exposure treatments. Additional Information: Other Issues in Therapy Outcome Research

Question 94

From the perspective of psychoanalytic theory, mania represents: Select one: A. a biological illness that psychoanalysis can do nothing about. B. acting-out of libidinous impulses. C. a regression to an infantile state. D. a defense against depression.

Answer 94

Correct Answer is: D According to classical psychoanalytic theory, mania occurs as a defense against depression, due to an inability of the person to tolerate or admit to being depressed. Additional Information: Defense Mechanisms

Question 95

A feminist therapist would likely consider which intervention most essential? Select one: A. a lifestyle analysis B. a functional assessment of a specific problem area. C. social action D. maintaining an anonymous role as a therapist

Answer 95

Correct Answer is: C Whereas non-sexist therapy is more concerned with personal responsibility and personal change, feminist therapy places equal or greater emphasis on the sociopolitical contributions to pathology and the need for social change. The feminist approach to psychotherapy rests on the assumption that social roles and socialization are important determinants of behavior and that psychological conflicts are alternative roles and options. A primary goal of feminist therapy is empowerment or helping women become more self-defining and self-determining. One of the main characteristics of feminist therapy is its emphasis on an egalitarian relationship between the client and therapist. Feminist therapists consider self-disclosure with clients as a way of supporting an egalitarian relationship. Therapist self-disclosure may be used to encourage client participation. Feminist therapy discourages client passivity and feminist therapists typically discourage special bonding as it may encourage client dependence on the therapist. Additional Information: Feminist Therapy

Question 96

``` Schema therapy was developed to treat the chronic characterological aspects of disorders. A key aspect of this approach is the use of a technique referred to as: Select one: A. treatment failure reassessment B. early maladaptive schema C. limited reparenting D. emotive therapy ```

Answer 96

Correct Answer is: C Schema therapy integrates elements of cognitive-behavioral, attachment, Gestalt, object relations, constructivist, and psychoanalytic therapy to treat chronic characterological aspects of disorders (versus acute psychiatric symptoms) by addressing the core psychological themes typical of individuals with characterological disorders. These core themes are referred to as "early maladaptive schemas" . Early maladaptive schemas are self-defeating emotional and cognitive patterns that begin early in development and repeat throughout life. Note, according to this theory maladaptive behaviors develop as response to schemas and are driven by schemas but are not part of schemas. The therapist works with clients in addressing their schemas utilizing cognitive, affective, behavioral, and interpersonal strategies including: exploring the therapist-client relationship, maladaptive coping styles and using emotive techniques. When clients repeat dysfunctional schema-based patterns, the therapist confronts them empathically with reasons for change and supplies a partial antidote to needs that were not adequately met in childhood. Through this "limited reparenting," clients gain the ability to view their characterological problems as ego-dystonic and become more empowered to give them up. More recently schema therapy has also been blended with mindfulness meditation to add a spiritual dimension. Schema therapy has been found to be useful in treating chronic depression, anxiety, eating disorders, long-standing difficulties in maintaining intimate relationships and substance abuse relapse. (See: Young, J.E. (1990, 1999). Cognitive therapy for personality disorders: A schema-focused approach (revised edition). Professional Resource Press, Sarasota, Florida. And: Young, J.E., Klosko, J.S., & Weishaar, M. (2003). Schema Therapy: A Practitioner's Guide. Guilford Publications: New York.) Additional Information: Schema therapy

Question 97

You are seeing a client who exhibits all the major symptoms of a Major Depressive episode. You should Select one: A. invite his wife in to aid in completing a more comprehensive family history. B. assess for early child abuse. C. refer him to a psychiatrist for a medical evaluation. D. assess for recent deaths in his family.

Answer 97

Correct Answer is: C While the other choices could be options, "all the major symptoms" should tip you off to your client's level of distress. Standard 1.20 (Consultations and Referrals) states, "Psychologists arrange for appropriate consultations and referrals based principally on the best interests of their patients." Additional Information: Boundaries of Competence

Question 98

Research on the use of mental health services by members of minority groups indicates that: Select one: A. utilization rates are lower for members of all minority groups than for whites. B. utilization rates are higher for members of all minority groups than for whites. C. utilization rates are higher for members of some minority groups and lower for members of other minority groups than for whites. D. utilization rates for members of minority groups are about the same as the rates for whites.

Answer 98

Correct Answer is: C It's difficult to draw any general conclusions about utilization rates because the research findings are inconsistent. However, a 1991 study by Sue et al. (which is frequently cited in the literature) reports underutilization by Asian-and Latino-Americans and overutilization by African-Americans. The results of other studies also suggest that there are group differences in utilization rates, so this response ("utilization rates are higher for members of some minority groups and lower for members of other minority groups than for whites") is the best. Additional Information: Utilization of Mental Health Services by Minority Group Members

Question 99

Classical psychoanalytic theory and the object-relations theories both emphasize Select one: A. the interaction between the id, the ego, and the superego. B. the importance of separation and individuation in childhood. C. the need for a therapist to "re-parent" the patient. D. the role of early childhood experiences in personality development.

Answer 99

Correct Answer is: D Both Freudian theory and object-relations theory stress the role of early childhood experience in personality development. Freud believed that adult personality hinges to a large extent on how conflicts (e.g., the oedipal conflict) are resolved in childhood, while the object-relations theorists posit that a child's early experiences determine the development of his or her introjects (mental representations of self and others), which determine personality functioning as an adult. the interaction between the id, the ego, and the superego. This choice applies to Freudian theory. the importance of separation and individuation in childhood. This applies to object-relations theory. the need for a therapist to "re-parent" the patient. This applies to object-relations theory. Additional Information: Object-Relations Theory

Question 100

``` From the perspective of Beck's cognitive therapy, suicidal individuals are characterized by a high degree of hopelessness coupled with: Select one: A. maladaptive interpretations. B. poor problem-solving skills. C. the "cognitive triad." D. impulsivity. ```

Answer 100

Correct Answer is: B This is a difficult question if you are not familiar with Beck's work on suicide. Maladaptive interpretations and beliefs are, of course, an important focus in cognitive therapy regardless of the client's problem. However, since this question is asking specifically about suicide, you'd want to choose the response that fits that problem. According to Beck, suicide risk is heightened by a combination of hopelessness and poor problem-solving skills.

Question 101

Hand washing frequency by health care workers is low despite the importance of compliance for reducing rates of hospital-acquired infection. Research indicates the most effective interventions for increasing hand washing include: Select one: A. continued performance feedback and written materials B. education, continued performance feedback and reminders C. automated sinks, education and availability of moisturizing soap D. automated sinks, written materials and reminders

Answer 101

Correct Answer is: B Studies on interventions to increase compliance with hand hygiene practices have found that no single intervention has consistently improved handwashing frequency in healthcare workers. Individual intervention findings indicate: one-time educational interventions and performance feedback on compliance rates are associated with a short-term influence; distribution of written materials and strategically placed reminders had a modest but more sustained effect; automated sinks increased the quality of handwashing however decreased the frequency; and the availability of moisturizing soaps had little or no effect on frequency. Research suggests the most effective approach is a multifaceted one that includes education in combination with written material, reminders and continued feedback of performance. The availability of an alcohol-based hand gel, when added to the multifaceted approach also appears to result in a modest improvement in compliance. (See: Naikoba, S. & Hayward, A. (2001). The effectiveness of interventions aimed at increasing handwashing in healthcare workers - a systematic review. Journal of Hospital Infection. 47, 173-180.)

Question 102

``` A Latina is most likely to experience her symptoms of depression as a Select one: A. spiritual or physical problem. B. family problem. C. woman's problem. D. mental or emotional problem. ```

Answer 102

Correct Answer is: A While psychological problems are often experienced as "emotional" by Anglos, members of a number of minority groups (including Latinos) often experience them as physical or spiritual in origin. Additional Information: Counseling Hispanic Clients

Question 103

``` A therapist is working with a newly arrived refugee client about her difficulties in acculturation. The therapist does not have firsthand experience as a refugee or immigrant, but knows what it is like to move from one city to another, transfer employment, lose work, and experience the loss of family or friends. That the therapist is able to understand, accept, and feel the client's situation, while simultaneously maintaining a separate sense of cultural self is an example of: Select one: A. cultural encapsulation B. cultural universality C. active empathy D. cultural empathy ```

Answer 103

Correct Answer is: D Cultural empathy means a therapist understands and appreciates cultural differences in a way that extends the boundaries of traditional empathy, retaining his or her separate cultural identity while simultaneously aware of and accepting the cultural values and beliefs of the client. It is a way of relating interpersonally with the ability to accurately understand the experience of culturally diverse clients and the ability to communicate this understanding effectively with an attitude of concern across cultures. Cultural encapsulation*, according to Gilbert Wrenn (1962), refers to when a therapist defines reality according to one set of cultural assumptions, becomes insensitive to cultural variations, disregards evidence disproving their assumptions, depends on technique-oriented or quick-fix solutions to problems and judges others from their own self-reference criteria. Cultural universality* refers to the assumption that Western concepts of normality and abnormality can be considered universal and equally applicable across all cultures. Active empathy* refers to when therapists actively communicate appreciation about all aspects of clients' lives (* incorrect options). Additional Information: Cultural Empathy

Question 104

Minuchin, the founder of structural family therapy, defines "triangulation" as occurring when Select one: A. the child and one parent "gang up" on the other parent. B. the parents either consistently attack or protect the child. C. each parent demands that the child side with him/her. D. two members of the family consistently challenge the therapist's authority.

Answer 104

Correct Answer is: C Minuchin defines three types of "rigid triangles" that involve chronic boundary disturbances - triangulation ("each parent demands that the child side with him/her"); detouring ("the parents either consistently attack or protect the child"); and a stable coalition ("the child and one parent 'gang up' on the other parent"). Additional Information: Theoretical Constructs: Structural Family Therapy

Question 105

When patients bring medical information they have accessed on the Internet to a doctor's visit, the doctor-patient relationship is most likely to suffer if Select one: A. the physician feels that the patient is challenging the authority of the physician. B. the patient brings inaccurate information. C. the patient makes a clinically inappropriate request for medication based on the information. D. the physician is not very "tech-savvy."

Answer 105

Correct Answer is: A According to a survey of physicians in the United States, a large percentage of patients bring medical information they have accessed on the Internet to doctor's visits. The survey found that the doctor-patient relationship could be harmed if this information is inaccurate, or if the physician feels his or her authority is being challenged. However, the latter factor, physicians' perceptions of a challenge to their authority, was a stronger predictor of harm to the relationship than any other factor. This factor was also the strongest predictor of deterioration in health outcomes and the quality of care received.

Question 106

All of the following are true regarding Feminist Object Relations Theory except: Select one: A. it emphasizes the importance of the maternal relationship with the child. B. it proposes that gender differences are the result of girls being taught to remain attached to their mothers while boys are taught to separate from their mothers. C. it proposes that girls develop a healthier self-object when raised primarily by their father due to earlier separation from their mother. D. it proposes that mothering "reproduces itself" since mothers perpetuate the oppressiveness of the division of labor.

Answer 106

Correct Answer is: C Nancy Chodorow was one of the first to apply a feminist perspective to an Object Relations model. In The Reproduction of Mothering (Berkeley, University of California Press, 1978) she focused on the relationship between mother and child and how gender differences result from the mother being the primary caretaker. The division of labor which occurs in families (although less so in recent years), is characterized by women being more involved in affective, interpersonal relationships than men. This is inevitably passed on to both boys and girls who 'reproduce' this sexual and familial division of labor. Additional Information: Feminist Object-Relations Theory

Question 107

``` Cultural differences and factors have an influence on the manifestation of client symptoms. If a psychologist assumes an Asian client's somatic complaints are really reflective of a mental disorder it is an example of: Select one: A. demand characteristics B. diagnostic overshadowing C. the fundamental attribution bias D. self-perception bias ```

Answer 107

Correct Answer is: B Diagnostic overshadowing is a term to describe when a therapist's ability to recognize or consider other symptoms or conditions is "overshadowed" by one aspect of a client's symptoms or condition. Demand characteristics* are unintentional cues in the experimental environment or manipulation that allow participants to guess the hypothesis and, as a result, participants may behave differently than they would under normal conditions. The fundamental attribution bias* refers to the tendency to overestimate dispositional (personality) factors and underestimate situational factors in explaining the behavior of others. Self-perception bias* refers to an individual inferring what their internal state is by perceiving how they are acting in a given situation (* incorrect options). Additional Information: Diagnostic overshadowing

Question 108

According to Sue and Sue's Racial/Cultural Identity Development Model, a person in the dissonance stage would experience: Select one: A. appreciation of the self and depreciation of the dominant group B. depreciation of the self and appreciation of the dominant group C. appreciation of the self and the dominant group D. conflict between appreciation and depreciation of the self and the dominant group

Answer 108

Correct Answer is: D Even if you were unfamiliar with Sue and Sue's Racial/Cultural Identity Development Model, you may have been able to guess correctly if you realized that the term "dissonance" refers to conflict. Sue and Sue's (1990) Racial/Cultural Identity Development Model (R/CID) is an elaboration of the Minority Identity Development model (MID) proposed by Atkinson, Morton, and Sue (1989). Both models describe the same stages (conformity, dissonance, resistance and immersion, introspection, and integrative awareness) but the R/CID model elaborates on individuals' attitudes toward self and others. During the Conformity stage, a person depreciates the self (and others of the minority group) but appreciates the dominant majority group. During the Dissonance stage, minority individuals experience conflict between appreciation and depreciation of the self and the majority group. In the Resistance and Immersion stage, the individual appreciates the self and depreciates the majority group. In the Introspection stage, the person again experiences conflict and questions the basis of his or her appreciation and depreciation of self and others. And, finally, in the Integrative Awareness stage, the person experiences self-appreciation and selective appreciation of the majority group [D. W. Sue and D. Sue, Counseling the culturally different: Theory and practice, 3rd edition, 1999, New York, John Wiley]. Additional Information: Minority Identity Development Model

Question 109

``` According to Janet Helms' (1995) White Racial Identity Development Model, the fourth status of racial identity development is: Select one: A. immersion-emersion B. disintegration C. reintegration D. pseudo-independence ```

Answer 109

Correct Answer is: D Helms' White Racial Identity Model (1984, 1995) consists of two Phases (Abandonment of Racism and Defining Non-racist White Identity) with six specific racial identity statuses equally distributed between the two phases: 1) Contact Status, 2) Disintegration Status, 3) Reintegration Status, 4) Pseudo-independence Status, 5) Immersion/Emersion Status, and 6) Autonomy Status. The first status, "contact" , is characterized by ignorance and disregard of any racial differences. The next stage, "disintegration" *, involves awareness of racial inequalities which results in moral confusion and conflict. The third status, "reintegration" *, involves Whites being viewed as superior to minorities. Next is "Pseudo-Independence" , which is marked by dissatisfaction with reintegration. Then is "Immersion-Emersion" *, during which people embrace their whiteness without rejecting minorities (* incorrect options). The last status, "Autonomy" , is reached when a person internalizes a nonracist White identity, whereby similarities and differences are acknowledged but are not perceived as threatening. Additional Information: Helms' Racial Identity Models

Question 110

One of the most consistent findings of the research on client factors in the therapy process is that Select one: A. more seriously disturbed clients have better outcomes in therapy. B. higher levels of intelligence predict better therapy outcomes. C. age is significantly related to therapy outcome. D. men are more likely to seek therapy.

Answer 110

Correct Answer is: B One of the most consistent findings of the research on client factors is that higher levels of intelligence predict better therapy outcome (Luborsky, 1989). more seriously disturbed clients have better outcomes in therapy. This answer is incorrect because seriously disturbed individuals actually have poorer outcomes (Garfield, 1994). age is significantly related to therapy outcome. Age appears to be unrelated to therapy outcome. men are more likely to seek therapy. This would have to state that women are more likely to seek therapy to be correct (Luborsky et al., 1989). Additional Information: Client Variables

Question 111

``` Despite his many accomplishments and positive feedback from his supervisor, a client believes his work performance is below average because he feels like a failure. This is an example of: Select one: A. minimization B. selective abstraction C. emotional reasoning D. personalization ```

Answer 111

Correct Answer is: C Emotional reasoning is one of several cognitive distortions described by Beck. It refers to a person believing that because he or she feels a negative emotion, there must be a corresponding negative external situation. minimization Minimization is seeing something as less significant than it really is. selective abstraction Selective abstraction occurs when one focuses on a detail, taken out of context, at the expense of other information. personalization Personalization is the attribution of external events to oneself without evidence of a causal connection. Additional Information: Cognitive Distortions

Question 112

Which of the following is NOT true regarding the Halstead-Reitan Neuropsychological Test Battery? Select one: A. It provides information on a range of cognitive strengths and weaknesses. B. It can usually be completed within 45 to 60 minutes. C. It must be administered by a highly trained examiner. D. The results are reflected in a combined score known as the Impairment Index.

Answer 112

Feedback Correct Answer is: B The Halstead-Reitan Neuropsychological Test Battery is a set of tests designed to assess attention, language, memory, abstract thinking, motor speed, and spatial reasoning ("range of cognitive strengths and weaknesses"). The purpose of the test is to provide an overall assessment of brain function. The battery must be administered by a highly trained examiner. The results of each subtest are combined into an Impairment Index. However, contrary to the correct choice (which is an incorrect statement), the battery usually requires 4 to 5 hours to administer. Additional Information: Halstead-Reitan (H-R)

Question 113

``` Hypnosis would least likely be used in the treatment of: Select one: A. Substance Abuse. B. Obsessive-Compulsive Disorder. C. Specific Phobia. D. chronic pain. ```

Answer 113

Correct Answer is: B Hypnosis is contraindicated in individuals who have difficulty giving up control, such as obsessive-compulsive patients, or those who have difficulty with basic trust, such as paranoid patients. By contrast, hypnosis is often employed in the treatment of the other disorders. In the treatment of Substance Abuse, varying degrees of success have been reported; however, it continues to be used. It is also commonly used to help induce relaxation and/or gain access to painful memories in treating individuals with Anxiety Disorders; moreover, according to some, it is particularly effective in treating individuals with Specific Phobia because they are highly hypnotizable. Finally, hypnosis is also commonly used in the treatment of medical conditions that have a psychological component such as asthma, chronic pain, obesity, etc.

Question 114

In their often-cited research study, Sue and his colleagues (1991) found that ethnic matching of therapist and client: Select one: A. improves therapy outcome and reduces premature termination for African-American clients but not for Asian-American or Mexican-American clients. B. improves therapy outcome and reduces premature termination for Asian-American and Mexican-American clients but has less of an effect on these variables for African-American clients. C. substantially improves therapy outcome and reduces premature termination for Asian-Americans, Mexican-Americans, and African-Americans. D. is related to premature termination for African-Americans and Whites but has little or no impact on other measures of treatment outcome.

Answer 114

Correct Answer is: B This is a difficult question because the research is so inconsistent on this issue. However, this question is referring to a specific study, which makes it easier as long as you're familiar with that study's results. One of the things that Sue and his colleagues learned was that the effects of ethnic matching differ for different minority groups. Specifically, ethnic matching seems most beneficial for Asian- and Hispanic-Americans, so this response best summarizes their findings. Additional Information: Therapist-Client Similarity

Question 115

From the perspective of humanistic schools of psychology, psychopathology would be seen as being due to: Select one: A. man's irrational nature, which interferes with a disciplined course of behaviors to enhance personal growth. B. defenses that interfere with one's own natural tendency toward personal growth. C. biological factors that inhibit personal growth. D. a lack of insight into one's past, which interferes with the tendency toward personal growth in the present.

Answer 115

Correct Answer is: B The humanistic school of psychotherapy, which is exemplified by approaches to therapy such as person-centered therapy, Gestalt therapy, and transactional analysis, emphasizes human capacities and potentialities rather than deficiencies. From the humanistic perspective, we have a natural tendency toward self-actualization or personal growth. Neurosis or pathology occurs due to defensive distortions (e.g., blocks to awareness in Gestalt therapy, or conditions of worth in person-centered therapy) that prevent this natural tendency from operating. Additional Information: Theory of Personality and Pathology and Goals of Therapy (Client-Centered Therapy)

Question 116

``` The term "success identity" is associated with: Select one: A. Eric Berne B. William Glasser C. Fritz Perls D. Carl Rogers ```

Answer 116

Correct Answer is: B According to Glasser's Reality Therapy, when an individual is capable of fulfilling his or her own needs for survival, power, belonging, freedom and fun, without harming self or infringing on the rights of others, then he or she has developed a "success identity." When the needs are met irresponsibly then the individual has developed a "failure identity." Bern is associated with transactional analysis (TA); Perls is associated with gestalt therapy; and Rogers is associated with client-centered therapy.

Question 117

From a family systems perspective, all of the following statements are true, except Select one: A. change in any one part of the family is associated with change in all other parts. B. the system is composed of interrelated parts. C. there is a constant dynamic toward chaos which is checked through family rituals and beliefs. D. the system maintains a balance of periods of change and periods of stability.

Answer 117

Correct Answer is: C A basic tenet of systems theory is that a system seeks homeostasis, or balance and stability. Consequently, the alternative description of a system as always tending toward chaos is actually opposite to what is the case. All the other alternatives are more or less true of the systems approach. Additional Information: Properties of a Family System

Question 118

``` According to Sue and Sue (2003), what represents an "invisible veil" which operates outside the level of conscious awareness? Select one: A. class-bound values B. worldviews C. cultural-bound values D. cultural-universality ```

Answer 118

``` Correct Answer is: B Sue and Sue state that individuals are products of cultural conditioning with their "worldviews," or values and beliefs, representing an invisible veil which operates outside the level of conscious awareness. The resulting assumption is that everyone shares the same reality and truth regardless of race, culture, ethnicity, or gender. This assumption of universality is erroneous yet seldom questioned due to being firmly ingrained in one's worldview, and often results in people operating on misinformation. "Cultural universality" refers to the assumption that Western concepts of normality and abnormality can be considered universal and equally applicable across all cultures. Cultural relativism, including lifestyles, "class values," "cultural values" and worldviews, affect the expression and determination of deviant behavior. (Sue, D.W., & Sue, D. (2003). Counseling the culturally diverse: Theory and practice (4th ad.). New York: John Wiley.) ```

Question 119

``` The form of therapy most associated with techniques such as scaling, exception talk, and the "Miracle Question" is Select one: A. brief psychodynamic therapy. B. solution-focused therapy. C. hypnotherapy. D. strategic family therapy. ```

Answer 119

Correct Answer is: B Solution-focused therapy is a form of brief therapy that views problems as maintained by the constructs through which they are viewed, including the language used to describe them and the repetitive behavioral sequences surrounding them. It attempts to activate the client's own strengths and intervene only to the degree necessary, seeking to minimize assumptions and speculations about the problem, and to avoid fostering a dependence on the therapist. The focus is typically on generating specific solutions to single problem. Solution-focused therapy is associated with a number of specific interventions, which have been characterized as methods of change discourse, solution discourse, and strategy discourse. Change discourse emphasizes the client's ability to change in order to address the problem; solution discourse refers to more directive therapist interventions; and strategy discourse represents cooperation between the client and therapist in solving the problem. Examples of change discourse include exception talk, in which the therapist seeks to highlight exceptions to the problem, and deconstructing the problem, whereby the problem is translated from abstract terms such as "depression" into concrete, observable client behavior. Examples of solution discourse include the "Miracle Question", whereby the client is asked to envision specifically what his life would be like if the problem were solved or managed; and scaling, which involves setting priorities and evaluating progress. And strategy discourse involves interventions such as therapist reinforcement of the client's resources as a way of activating them, as well as cooperative development of specific solutions to the client's problems. Additional Information: Solution-Focused Therapy

Question 120

J. Berry, who views acculturation as a multidimensional construct, would describe an integrated client as one who: Select one: A. Has a low retention of the minority culture B. Has high maintenance of the mainstream culture C. Rejects the mainstream culture but has a high retention of the minority culture D. Gets along with others in the workplace

Answer 120

Correct Answer is: B J. Barry conceptualizes acculturation as many models existing on a continuum, with the minority culture and the majority or mainstream culture at opposite poles. Integration would be displayed by an individual who has high retention of the minority culture and high maintenance of the mainstream culture. Additional Information: Berry's Acculturation Model

Question 121

Which of the following best describes the underlying assumptions of the use of cognitive-behavioral techniques for pain management? Select one: A. Since pain, to a large extent, is due to tension, it is important to incorporate relaxation techniques into treatment. B. Chronic pain is connected to early childhood experiences, such as modeling of the sick role by parents. C. The environmental contingencies associated with the display of symptoms and the person's perception of control over symptoms must be attended to. D. Chronic pain has a variety of social, cultural, and economic causes.

Answer 121

Correct Answer is: C You probably could have answered this question just by using what you know about cognitive therapy and behavioral therapy -- you did not really need to know much about pain management. Behavioral treatments for managing pain tend to emphasize the importance of environmental contingencies (e.g., avoidance of work, sympathy) in maintaining pain, while cognitive techniques focus on the patient's beliefs -- particularly beliefs about control over his or her own life and therefore over his or her pain. Of course, this is consistent with the principles of cognitive-behavioral treatments in general. Additional Information: Introduction (Cognitive-Behavioral Therapies)

Question 122

A new group being led by Dr. Domato includes members from a variety of cultural backgrounds. Dr. Domato should: Select one: A. treat group members as individuals and not assume that culture is relevant to their problems. B. focus on the sociocultural factors that underlie each group member's problems. C. help each member determine whether or not cultural biases and racism are contributing to their problems. D. allow members to decide when it is the right time to discuss cultural issues.

Answer 122

Correct Answer is: C APA's Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations applies to this situation. It specifically states that when working with members of ethnic/cultural minorities, psychologists "seek to help a client determine whether a 'problem' stems from racism or bias in others so that the client does not inappropriately personalize problems." The Guidelines do not advocate adopting a "colorblind" perspective or, at the other extreme, assuming that a client's problems are always related to cultural issues. Additional Information: Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations

Question 123

In more severe cases of depression, Beck's cognitive therapy initially focuses on: Select one: A. the individual's cognitive distortions. B. appropriate behavioral tasks. C. using free associations to identify automatic thoughts. D. Socratic questioning.

Answer 123

Correct Answer is: B All of the techniques listed (except free association) are characteristic of Beck's cognitive therapy. However, when a client has severe depression, the first goal in therapy is to increase his or her activity level. This is accomplished through the use of behavioral tasks. Once the client is active, cognitive procedures are used to identify and modify cognitive distortions. Additional Information: Beck's Cognitive Therapy

Question 124

Differences in communication style can act as a barrier in cross-cultural counseling. For example, some cultures have a high-context style, while others are more low-context. Which of the following is true about high-context communication and culture? Select one: A. The communication found in high-context cultures reflects an emphasis on rules of law and procedures. B. People belonging to high-context cultures rely heavily on nonverbal cues when communicating with others. C. People in high-context cultures make extensive use of elaborative codes in their speech. D. High-context communication changes rapidly and easily.

Answer 124

Correct Answer is: B The notions of high- and low-context communication were introduced by Edward T. Hall, the author of The Silent Language (1959) and The Hidden Dimension (1969). In the United States, the communication style of the Anglo majority is low-context, but many racial/ethnic minorities (e.g., Latino, Asian, African-American) make use of a high-context style. High-context communication is based on nonverbal language. Low-context communication on the other hand is based upon the verbal part of messages. Additional Information: Communication Styles

Question 125

``` Cognex and Aricept are used in the treatment of Alzheimer's Dementia and are believed to Select one: A. increase serotonin levels. B. increase ACh levels. C. decrease glutamate levels. D. decrease serotonin levels. ```

Answer 125

Correct Answer is: B Don't expect to get this right the first time. What is important is that you now know that tacrine hydrochloride (Cognex) and donepezil hydrochloride (Aricept) have beneficial effects on memory and reasoning for some patients with mild to moderate Alzheimer's Dementia. It is hypothesized that these drugs prevent the breakdown of ACh and thus increase the availability in the brain. While these drugs seem to help temporarily, they are not considered a cure. Serotonin has not been shown to be involved in Alzheimer's. While glutamate may be involved, the drugs mentioned do not target this neurotransmitter.

Question 126

``` A therapist using Beck's cognitive approach to therapy would rely primarily on which of the following to induce desirable changes in a depressed client? Select one: A. Socratic questioning B. interpretation C. reflecting D. clarification and explanation ```

Answer 126

Correct Answer is: A Questioning is a very important strategy in Beck's cognitive therapy and, in fact, the majority of communications by the therapist take the form of questions designed to help the client consider particular issues, options, and so on. Additional Information: Questioning

Question 127

On the Halstead-Reitan, the Impairment Index is used as a measure of brain damage and Select one: A. represents the examinee's mean score on the relevant subtests. B. is derived from the number of subtests on which the examinee scored below the criterion score. C. is a profile that makes it possible to compare the examinee's score pattern to those of people with and without brain damage. D. is calculated by totaling the examinee's scores on the individual subtests.

Answer 127

Correct Answer is: B The Impairment Index is calculated by adding the number of subtests on which the examinee scored below the cutoff and dividing the sum by the total number of subtests. (Originally, ten subtests were used; some experts now recommend including only seven.) The higher the Impairment Index, the greater the likelihood of brain damage. Additional Information: Halstead-Reitan (H-R)

Question 128

``` When scores on the MMPI scales 1 and 3 are higher than on scale 2, this pattern is referred to as a: Select one: A. defensive profile B. passive-aggressive V C. conversion V D. psychotic V ```

Answer 128

Correct Answer is: C A conversion V pattern on the MMPI-2 occurs when the scale 2 (depression) score is significantly lower than scores on scales 1 (hypochondriasis) and 3 (hysteria). This pattern is characteristic of individuals with a tendency to somaticize psychological problems, have chronic pain with an organic etiology, have conversion disorder or other somatoform disorder. In the defensive profile pattern, the F scale score is significantly lower than scores on the L and K scales and indicates an attempt to present in a favorable light. In the psychotic V, or paranoid valley, pattern, the scale 7 score is significantly lower than scores on scales 6 and 8. In the passive-aggressive V pattern, the scale 5 score is significantly lower than scores on scales 4 and 6.

Question 129

Rationalist, cognitive therapy is most likely to involve Select one: A. relaxation training, systematic desensitization, and guided imagery. B. cognitive restructuring, reducing automatic thoughts, and thought stopping. C. a focus on unconscious and developmental processes. D. stress inoculation training, self-instruction, and stimulus control.

Answer 129

Correct Answer is: B In the literature, a distinction has been made between rationalist and constructivist cognitive therapies. Rationalist therapies are based on the assumptions that irrationality is the primary source of neurotic pathology, that explicit beliefs and logical reasoning can serve as a guide to emotion and behavior, and that the core process in effective therapy is the substitution of rational for irrational thought. The techniques described in the correct choice ("cognitive restructuring, reducing automatic thoughts, and thought stopping") are all designed to increase rational thought processes and/or decrease irrational thinking; thus, they are most in line with the assumptions of rationalist cognitive therapy. As compared to rationalist therapy, constructivist cognitive therapy is based on more complex and abstract assumptions, in which unconscious, developmental, and interactional processes are emphasized. You might have been thrown off by the word "rationalist" in the question. If so, it would have been best to answer the question as if it were about cognitive therapy in general. The best answer would still be "cognitive restructuring, reducing automatic thoughts, and thought stopping". Additional Information: Beck's Cognitive Therapy

Question 130

``` When applied to teaching children, gestalt psychology would emphasize: Select one: A. repetition. B. rote learning. C. reinforcement. D. learning patterns. ```

Answer 130

Correct Answer is: D Gestalt psychology is based on the patterns we perceive. The idea is that the brain completes figures even if the actual retinal image isn't complete or perfect. We tend to fill in blanks ourselves. So, as applied to children and learning, "learning patterns" is the best answer. Additional Information: Gestalt Learning Theory

Question 131

In the early stages of group therapy, two participants dominate the discussion, giving the other members little opportunity to speak. Other group members are expressing anger towards those two members as well as the therapist. According to Irwin Yalom, the therapist would be best advised to Select one: A. interpret this situation as a stage in the group's developmental level B. explore the processes influencing this dynamic with the group. C. exert more power by explicitly instructing the two dominating members to yield some of their time. D. remain silent for one or two more sessions to let the situation play out.

Answer 131

Correct Answer is: B According to Irwin Yalom, author of the book "The Theory and Practice of Group Psychotherapy," two major roles of a group therapist are to help keep the group focused on the here-and-now, and help illuminate process. By illuminating process, the therapist must encourage the group to examine, understand, and learn from its own transactions and interactions. Illumination of process requires that the group to perform what he calls a "self-reflective loop", which means it stays focused on the here-and-now but also pauses to examine here-and-now events that just occurred. Therefore, Yalom would handle the situation described in this question by having the group examine what just happened as well as the interpersonal processes that could explain what happened. The correct answer best expresses this. interpret this situation as a stage in the group's developmental level Though Yalom does note that hostilities and resistances are common in the early stages of group therapy, he would not likely try to explain this concept in the form of an interpretation based on a theory of group development, as suggested by this choice, because that could take the focus off of the here-and-now. exert more power by explicitly instructing the two dominating members to yield some of their time. This choice is not a great answer, because even though Yalom would not rule out using an explicit instruction to group members if necessary, his focus would not be on "exerting power." remain silent for one or two more sessions to let the situation play out. This choice is not correct because Yalom believes that a group therapist should actively steer groups back towards here-and-now experiences and the self-reflective loop when the group moves away from these focuses. Additional Information: Role of The Group Leader

Question 132

A Jungian archetype is: Select one: A. a role people play in relationships B. a structural component of the collective unconscious C. an unconscious perspective of the world gained through personal experience D. based on a striving for superiority

Answer 132

Correct Answer is: B An archetype is a structural component of the collective unconscious. It is inherited from the life experiences of all of the human race and affects one's perceptions of the world. an unconscious perspective of the world gained through personal experience This is more descriptive of the "personal unconscious" which is based on an individual's own experiences. Additional Information: Carl Jung's Analytical Psychology

Question 133

Classical Adlerian psychotherapy: Select one: A. provides six stages as a systematic procedure B. provides twelve phases as a teaching guideline C. is a progression through twelve stages D. is a creatively practiced art without stages

Answer 133

Correct Answer is: C Classical Alderian psychotherapy is characterized as a diplomatic, warm, empathetic, and Socratic style of treatment. For teaching purposes, Adlerian psychotherapy can be divided into twelve stages, and within each stage, cognitive, affective, and behavioral changes are gradually advanced. The stages reflect progressive strategies for awakening a client's underdeveloped feeling of community. There are six different phases in this psychotherapy and within these phases there can be up to three stages. These are not rigid, systematized steps as therapy is considered a creative practice and unique for the individual. (See: Stein, H. (1988). Twelve Stages of Creative Adlerian Psychotherapy. Individual Psychology, 44, 138-143.) Additional Information: Alfred Adler's Individual Psychology

Question 134

All of the following statements about Beck's cognitive theory of the origin and maintenance of depression are true, except Select one: A. experiences in early childhood play a role in the development of depression in adulthood. B. depressed individuals are suffering from personality pathology due to relatively stable and omnipresent dysfunctional models of the world. C. the cognitive triad of depressive cognitions is negative beliefs about the self, future, and the world. D. automatic depressive thoughts are the result of logical errors that occur when the individual tries to interpret a situation in terms of a dysfunctional schema.

Answer 134

Correct Answer is: B This choice is not true of Beck's theory: "depressed individuals are suffering from personality pathology due to relatively stable and omnipresent dysfunctional models of the world". According to Beck, dysfunctional schemas (i.e., models of the world) are not always present. Rather, they are activated by particular environmental events -- often, events that bear some resemblance to events earlier in life that caused the schema to develop. For instance, a business failure could activate the schema "no matter what I try, I'll fail because I'm inadequate" that might have been formed due to experiences in childhood. Unless activated by such events, schema lie dormant and don't affect functioning. You might have thought that this choice ("experiences in early childhood play a role in the development of depression in adulthood") sounded more like the psychoanalytic than the cognitive viewpoint. However, as should be clear from this explanation, Beck also believes that past experiences play a role in the development of mental illness. Additional Information: Depression (Beck)

Question 135

``` ______________ is the form of therapy that helps the client find meaning in life. Select one: A. Gestalt therapy B. Somatic therapy C. Logotherapy D. Narrative therapy ```

Answer 135

Correct Answer is: C Logotherapy is a form of existential therapy developed by Victor Frankl that postulates a will to meaning. Frankl's basic beliefs regarding the philosophy of Logotherapy include the following tenets: Life has meaning under all circumstances, even the most miserable ones; Our main motivation for living is our will to find meaning in life; And we have freedom to find meaning in what we do, and what we experience, or a least in the stand we take when faced with a situation of unchangeable suffering. (See: Frankl, V. Man's Search for Meaning, 1984). "Gestalt therapy" is a type of humanistic therapy, developed by Fritz Perls, that encourages clients to become aware of their true feelings and to take responsibility for their own actions. "Somatic therapy" describes forms of treatment involving manipulations of the body and is associated with the bio-medical model. The three main types of somatic therapy are: drug therapy, ECT and psychosurgery (i.e., lobotomy and leucotomy). "Narrative Therapy" is a form of Postmodern therapy that emphasizes the importance of the stories of people's lives and the differences that can be made through specific telling and retelling of these stories.

Question 136

Doug comes to see you because he is having problems with his supervisors at work, feeling undervalued and finding it difficult to maintain the new friendships he has made since moving to the area a year ago. You decide a "client-centered" approach with Doug would be most effective. The primary goal of such therapy is: Select one: A. development of "awareness" B. congruence between self and experience C. giving up irrational beliefs and ideas D. understanding of underlying intrapsychic conflicts

Answer 136

Correct Answer is: B A primary goal of the client-centered approach to therapy is achieving congruence between self and experience. Eliminating incongruence allows clients to reclaim their "self-actualizing" urges, or tendency to act, develop, and experience life in a manner that is consistent with their self-concept. Key to Rogers's theory is his concept of self, which includes the individual's perceptions of who he or she is, can do, etc. and of his or her relationships with other people, things, and so forth. Individuals are also thought to possess an image of the ideal self, or of the person they want to be. development of "awareness" This choice is associated with Gestalt therapy. giving up irrational beliefs and ideas This is associated with Rational Emotive therapy. understanding of underlying intrapsychic conflicts This is associated with psychoanalysis.

Question 137

``` Which of the following variables is most strongly related to positive outcome after exposure to a highly stressful situation? Select one: A. perceived social support B. actual social support C. accessible social support D. quality of social support ```

Answer 137

Correct Answer is: A Many studies have confirmed the predictions of the buffering hypothesis, which states that perceived social support provides a buffer that reduces the adverse effects of stressful situations. Additional Information: Stress-Buffering Hypothesis

Question 138

According to Jung, the term individuation refers to: Select one: A. differentiating between self and object. B. integrating aspects of the self to form a unique identity. C. the capacity to separate one's emotional and intellectual functioning. D. experiencing a state of anonymity.

Answer 138

Correct Answer is: B Individuation, as defined by Jung, involves integrating the conscious and the unconscious elements of the psyche and is the goal of psychological development. differentiating between self and object. This choice describes Mahler's separation-individuation phase of early development. the capacity to separate one's emotional and intellectual functioning. This refers to Bowen's concept of differentiation, which states the greater an individual's differentiation, the better he/she is able to resist emotionally fusing with other family members. experiencing a state of anonymity. Deindividuation, which occurs under conditions of anonymity, refers to the loss of a person's identity and a loosening of normal restraints against deviant behavior. It is used to explain why someone may be more willing to behave in uncharacteristic ways when acting as a member of a group than when acting alone.

Question 139

A psychoanalytic therapist would attribute an anxiety disorder to: Select one: A. denial of negative impulses B. primitive fantasies of aggression C. failure of the defensive function of the ego D. a narcissistic injury in early life

Answer 139

Correct Answer is: C If you considered the purpose of the defense mechanisms (to reduce anxiety), this question was pretty easy. A psychoanalytic therapist would associate response ("denial of negative impulses") with a passive-aggressive character; ("primitive fantasies of aggression ") with psychosis and ("a narcissistic injury in early life") with a depressive character.

Question 140

A person who takes the MMPI-2 obtains a score of 62 on the depression scale. This means that Select one: A. the person is probably clinically depressed. B. the test results are not valid. C. the person's score is 1.2 standard deviation units above the mean. D. the person's score is 12 raw score points above the mean

Answer 140

Correct Answer is: C A T-score is a standardized score, which means that it indicates how many standard deviation units a given raw score is above or below the mean. The T-score distribution has a mean of 50 and a standard deviation of 10. This means that a score of 62 -- 12 T-score points above the mean -- is 1.2 standard deviations above the mean, since 10 X 1.2 is 12. Additional Information: Pattern Analysis (MMPI-2)

Question 141

In treating a patient with Dissociative Identity Disorder, the first thing a cognitive therapist would do is: Select one: A. set treatment goals. B. label the maladaptive beliefs that cause or contribute to the patient's problems maintaining a coherent sense of identity. C. be supportive and try to establish a therapeutic alliance. D. attempt to establish inter-personality communication.

Answer 141

Correct Answer is: C The literature on both cognitive therapy and the treatment of multiple personality (Dissociative Identity Disorder) strongly emphasizes the need to develop a strong therapeutic alliance in the initial stages of therapy.

Question 142

``` A couple avoids any marital conflict by focusing their attention on their child's problems. According to Minuchin's Structural Theory, this is an example of: Select one: A. triangulation B. enmeshment C. joining D. detouring ```

Answer 142

Correct Answer is: D Detouring is a type of boundary problem in which the spouses avoid tensions between themselves by blaming or overprotecting their child. triangulation Triangulation occurs when each parent attempts to get the child to side with him or her against the other. enmeshment Enmeshment results from very unclear boundaries that promote dependence. joining Joining is a therapeutic technique used to blend into the family system. Additional Information: Theoretical Constructs: Structural Family Therapy

Question 143

According to the APA's Guidelines for Psychological Practice with Older Adults, which of the following statements regarding psychotherapy effectiveness is most accurate? Select one: A. older adults do not respond as well as younger adults B. older adults respond better than younger adults C. older adults respond similarly to younger adults, although older adults tend to respond quicker D. older adults respond similarly to younger adults, although older adults tend to respond slower

Answer 143

Correct Answer is: D The American Psychological Association, in its Guidelines for Psychological Practice with Older Adults [American Psychologist, 2004, 59(4), 236-260] concluded that older adults may respond more slowly to various forms of psychotherapy but there are few significant differences in effectiveness relative to younger adults. Additionally, tailoring an intervention to the specific needs of an older client may increase its effectiveness. (See: M. Gatz, et al., Empirically validated psychological treatments for older adults, Journal of Mental Health and Aging, 1999, 4(1), 9-46.) Additional Information: Counseling Elderly Clients

Question 144

According to Irwin Yalom, a potential complication of concurrent individual and group therapy is that Select one: A. patients may wait until the individual therapy session to react to what occurs in the group therapy setting. B. feedback from the group therapy sessions may contradict feedback from individual therapy, thereby confusing the client. C. the client may drop out of individual therapy due to a feeling that he is getting all the support he needs from the group. D. individual and group therapy may be overly redundant if they are conducted by two therapists who are very similar in their approaches to therapy.

Answer 144

Correct Answer is: A Irwin Yalom is the author of the book "The Theory and Practice of Group Psychotherapy" and is considered to be one of the foremost experts in the field. In his book, he identifies a number of potential advantages and complications of concurrent individual and group psychotherapy. One potential complication is that clients may hold off on responding to what occurs in group therapy because they prefer to wait for the relative safety of individual sessions. In his words, "the client may interact like a sponge in the group, taking in feedback and carrying it away to gnaw on like a bone in the safe respite of the individual therapy hour." (p. 432). individual and group therapy may be overly redundant if they are conducted by two therapists who are very similar in their approaches to therapy. Contrary to this option, Yalom states that concurrent individual and group therapy, if conducted by different therapists, is more likely to succeed when the two therapists share the same theoretical approach to treatment. Additional Information: Concurrent Participation in Individual Therapy and Group Therapy

Question 145

``` Biofeedback is often part of treatments aimed at lowering tension and arousal and increasing relaxation. For this purpose, biofeedback is being used to control the: Select one: A. sympathetic nervous system. B. parasympathetic nervous system. C. somatic nervous system. D. endocrine system. ```

Answer 145

Feedback Correct Answer is: B Biofeedback and other stress/anxiety reducing techniques are designed to induce a positive parasympathetic state since it is the parasympathetic nervous system that is responsible for rest, relaxation, and recuperation. On the other hand, if you wanted to increase blood flow to change body temperature, biofeedback would affect the sympathetic nervous system. Additional Information: Biofeedback

Question 146

According to some experts, one potential drawback of concurrent participation in group and individual therapy is that Select one: A. group therapy may increase resistance to individual therapy. B. the patient may bring group therapy issues into individual therapy. C. the patient may use group therapy rather than individual therapy as a support system. D. the patient may save his or her disclosures for individual therapy, leaving nothing for the group.

Answer 146

Correct Answer is: D Although there are a number of advantages to the combined use of group and individual therapy, there are also some potential drawbacks, including that there may be a draining off of clinical material from the therapy group by the individual sessions. Other potential problems include that the concurrent approach may interfere with the full development of the transference in individual therapy, and that the addition of group therapy may increase the anxiety levels of certain patients. If you didn't know this, you may have been able to use the process of elimination and common sense to choose the best answer. For instance, there is no reason to assume that group therapy would increase resistance to individual therapy; in fact, experts have noted that it can reduce such resistance. Moreover, the patient bringing up group issues in individual therapy does not seem to be a problem; indeed, experts have pointed out that an advantage of the concurrent approach is that group-induced frustrations can be worked through in individual therapy. Finally, relying on group therapy more than individual therapy for support does not seem to be a problem either, since one of the major purposes of group therapy is to provide additional support. Additional Information: Concurrent Participation in Individual Therapy and Group Therapy

Question 147

From the perspective of Beck's cognitive-behavioral model, automatic thoughts are Select one: A. basic irrational beliefs that underlie depression and other maladaptive behaviors. B. interpretations of a situation that determine one's behavioral and emotional responses. C. central, firmly-held beliefs about the self. D. misinterpretations of situations that reflect some type of cognitive distortion.

Answer 147

Correct Answer is: B According to Beck, everyone has automatic thoughts - they're not necessarily associated with cognitive distortions or psychological distress. However, when automatic thoughts provide an unrealistic interpretation of the situation ("This is awful!"), they may lead to maladaptive behavioral or emotional responses. Additional Information: Automatic Thoughts

Question 148

A collateral form of family organization is one in which Select one: A. the nuclear family takes precedence. B. extended family members rely on each other for support. C. the relationship between spouses is emphasized above other family relationships. D. family members are disengaged from each other

Answer 148

Correct Answer is: B A collateral family system or organization is one in which the extended family (e.g., cousins, aunts, uncles, adult siblings) is emphasized and where extended family members rely on each other for support. In Western society, a collateral family organization is more common in non-dominant subcultures, such as African-American, American Indian, and Asian-American, than it is in the dominant culture. Additional Information: Extended Family Systems Therapy

Question 149

``` According to many experts in cross-cultural psychology and counseling, Western assumptions about psychology, as compared to non-Western assumptions, are characterized by all of the following except Select one: A. an emphasis on context. B. an emphasis on linearity. C. abstraction. D. an emphasis on individualism. ```

Answer 149

Correct Answer is: A The study of psychology and the practice of psychotherapy require the application of certain assumptions about human beings in general and what constitutes healthy behavior. Many such assumptions are culturally driven and Western assumptions may not always apply across cultures. For instance, one author makes a distinction between high-context and low-context cultures. The distinction refers to a culture's tendency to cater towards in-groups. In high context cultures, which cater towards in-groups, people expect meanings to be embedded in the context of situations, because they expect others around them to have similar experiences and expectations; thus, much more is left unsaid. By contrast, in low-context cultures, where there is a less of an expectation of similar experiences, people search for meaning in words, phrases, and abstract concepts. From the perspective of this framework, Western cultures, contrary to the first choice, are low in context. The other choices describe characteristics of Western culture that may influence counseling and psychology. Linear thinking, or the notion that each cause has an effect and each effect has a cause, is an underlying assumption that may cause difficulty in communicating with clients from cultures where events may be viewed as causally unconnected. Abstraction is also more characteristic of Western culture, as noted in the discussion above about context. And many Western psychological theories emphasize the importance of individual happiness and control of one's destiny, whereas in other cultures, functioning as part of the family or community without thinking oneself may be more highly valued. Additional Information: Worldview

Question 150

``` An 18-year-old high school student is referred to you for personality assessment due to behavioral problems. Which of the following assessment instruments would be most appropriate to use? Select one: A. MMPI-A B. MMPI-2 C. WAIS-III D. Halstead-Reitan ```

Answer 150

Correct Answer is: A Knowing that the MMPI-A is recommended for use with ages 14 to 18, while the MMPI-2 is recommended for individuals 18 years and older, may have left you a bit stumped about which to use for an 18-year-old. The MMPI-A manual acknowledges this period of overlap and recommends choosing the instrument on a "case by case basis," but it also suggests using the MMPI-A for high school students. Furthermore, in a recent study comparing the MMPI-A and MMPI-2 administered to 18-year-olds, the researchers concluded that the MMPI-2 tended to overpathologize and the MMPI-A tended to underpathologize. Due, in part, to the concern with overpathologizing individuals, the researchers recommended using the MMPI-A with 18-year-olds. But to optimally gain sensitivity to psychopathology, they also recommended using T-score cutoffs of 60 instead of 65 on the MMPI-A [T. M. Osberg and D. L. Poland, Comparative accuracy of the MMPI-2 and the MMPI-A in the diagnosis of psychopathology in 18-year-olds, Psychological Assessment, 2002, 14(2), 164-169]. Additional Information: Introduction (MMPI-2)

Question 151

A new client comes to a session and is very quiet. He is slumped in his chair and holding his arms close to his body. According to neurolinguistic programming (NLP), what should a therapist do in order to build trust with this client? Select one: A. use "feeling" words B. use "thinking" words C. make eye contact D. adjust his posture to match the client's

Answer 151

Correct Answer is: D Adjust his posture to match the client's is the best choice, because it involves reflecting the kinesthetic presentation of the client, which is emphasized in this question. Neurolinguistic programming (NLP) suggests that a therapist's ability to communicate effectively with a client will be influenced by his or her ability to identify and then work with the client's preferred sensory mode; for example, if a client prefers a visual mode, the therapist should use terms such as "I see," if a client prefers an auditory mode, the therapist should use expressions such as "I hear you."

Question 152

Which of the following would most likely be utilized by a therapist whose work is based on Minuchin's structural family therapy? Select one: A. giving homework, enactment, making a family map B. taking a family history, issuing paradoxical directives, tracking C. taking a family history, joining the family, making a genogram D. reframing, issuing paradoxical directives, exploring multigenerational transmission processes

Answer 152

Correct Answer is: A Minuchin's structural family therapy focuses on modifying aspects of the family structure (e.g., rules, boundaries, coalitions) that underlie family dysfunction. Homework is commonly assigned as a way of bringing about concrete change in the family's behavior; enactments are role-plays that Minuchin often used to evaluate and modify the family structure; and family maps, or diagrams of the family's boundaries, are constructed to help families and the therapist understand the family structure. The other options can be eliminated because they include an intervention that focuses on the family's past whereas structural family therapy tends to focus on a family's present functioning.

Question 153

Which of the following practices is not a behavioral technique? Select one: A. A client practices drink refusal skills with her therapist. B. A client visualizes herself as a successful, non-drinking person. C. A client drives home a different way to avoid the places she used to drink. D. A client writes down what, how much, and with whom she drinks.

Answer 153

Correct Answer is: B Visualizing oneself as a non-drinking person is useful, but it is not, technically, a behavioral technique. Behavioral techniques are directly observable.

Question 154

``` An African-American adult repeatedly expresses his superiority as an African-American and expresses contempt for all Caucasians. According to Cross' Nigrescence Theory, this person is most likely in which stage of development? Select one: A. Pre-encounter B. Encounter C. Immersion-Emersion D. Internalization-Commitment ```

Answer 154

Correct Answer is: C According to the Nigrescence model, during the Immersion-Emersion stage of identity development there is a tendency for African-Americans to idealize other African-Americans and the culture and denigrate Caucasian individuals and culture. Additional Information: Black Racial Identity Development Model (Cross)

Question 155

Researchers in the area of cognitive therapy have conducted studies regarding the predominant types and styles of cognition in different mental disorders. These studies have found all of the following to be distinguishing features of cognitions in depression and anxiety, except Select one: A. in depression, cognitions about hopelessness and failure are more common than in anxiety. B. depressed people are more likely to have absolute thoughts about negative themes; anxious people are more likely to have questioning thoughts about the future of events. C. anxious people tend to be self-absorbed; depressed people tend to be more absorbed with others. D. depressed people have enhanced recall of negative feedback; anxious people have enhanced recall of threatening situations.

Answer 155

Correct Answer is: C Self-absorption is characteristic of the cognitive and information processing style of both depressed and anxious individuals. The other choices about the differences between depressed and anxious individuals are true. Additional Information: Depression and Anxiety (Beck)

Question 156

When comparing feminist therapy to a more psychodynamic approach, feminist theory Select one: A. Disallows the mother's role B. Takes factors other than a woman's view of herself into consideration C. Relies much more on the emphasis of the biological mother D. Encourages women to call men to task for the oppression of women

Answer 156

Correct Answer is: B The feminist approach to psychotherapy rests on the assumption that social roles and socialization are important determinants of behavior. Psychological conflicts are then alternative roles and options. A primary goal is empowerment or helping women become more self-defining and self-determining. Additional Information: Feminist Therapy

Question 157

A family seeks therapy due to on-going conflicts between the parents and their 16-year-old daughter. A solution-focused therapist would LEAST likely: Select one: A. use direct and indirect compliments B. tell them to solve the conflict by themselves C. work with the family to generate solutions to the conflict D. ask future-oriented questions

Answer 157

Correct Answer is: B Solution-focused therapy is a form of brief therapy that focuses on solutions rather than problems or their causes. Underlying this approach is the assumption that clients possess the resources needed to achieve their goals. use direct and indirect compliments Solution-focused therapists use direct and indirect compliments. tell them to solve the conflict by themselves Contrary to this choice, a solution-focused therapist would not likely tell clients to solve the conflict by themselves. work with the family to generate solutions to the conflict The therapist would work with them to generate solutions to their problem. ask future-oriented questions Solution-focused therapists use future-oriented questions -- such as the miracle question. Additional Information: Solution-Focused Therapy

Question 158

``` During a family therapy session, the mother and adolescent daughter constantly disagree with and criticize everything the father says. From the perspective of structural family therapy, this is an example of: Select one: A. detouring. B. a coalition. C. a triangle. D. pseudohostility. ```

Answer 158

Correct Answer is: B For structural family therapists, a coalition occurs when there is an alliance (usually covert) between two family members against a third member. The term triangle could also apply to this situation because it has several definitions in the family therapy literature. Coalition is a better answer, though, because it specifically refers to the situation described in the question. Additional Information: Theoretical Constructs: Structural Family Therapy

Question 159

All of the following statements are true of the technique of stress inoculation training, except: Select one: A. its mechanism of action is analogous to that of medical inoculation. B. it consists of three distinct phases. C. it is based on the notion that immediate imaginal exposure to a fearful stimulus at its maximal intensity results in rapid extinction of the fear. D. it relies heavily on the technique of self-instruction.

Answer 159

Correct Answer is: C Meichenbaum's stress inoculation training is based on the medical inoculation model: the idea is to give the person the opportunity to deal with a low "dose" of anxiety-provoking stimuli, in order to help the person build coping skills (which are analogous to immunity). Contrary to the correct choice (which is an incorrect statement), the technique consists of three steps (education, rehearsal, and real-life application) in which the person's exposure to stressful stimuli proceeds from least-anxiety to most anxiety-provoking. As part of the training, clients are taught to use appropriate self-statements (i.e., self-instruction) to guide them through the coping process. Additional Information: Stress Inoculation Training

Question 160

Studies evaluating the effectiveness of differing types of psychotherapy for older adults indicate: Select one: A. although older adults may respond more slowly, older and younger adults respond comparably to most forms of therapy. B. although younger adults may respond more slowly, older and younger adults respond comparably to most forms of therapy. C. younger adults respond much better older adults to most forms of psychotherapy D. older adults respond much better than younger adults to most forms of psychotherapy

Answer 160

Correct Answer is: A The American Psychological Association in its Guidelines for Psychological Practice with Older Adults [2004] concluded there are few significant differences in the effectiveness of various psychotherapeutic techniques for older and younger adults. It also notes that effectiveness may be increased by tailoring an intervention to the specific needs of an older individual.

Question 161

``` Somatic therapy may include all of the following except: Select one: A. psychosurgery B. transtheoretical therapy C. psychopharmacological therapy D. electroconvulsive shock therapy ```

Answer 161

Correct Answer is: B Associated with the bio-medical model, somatic therapy refers to types of treatment involving manipulations of the body. Three main types of somatic therapy are: psychopharmacological or drug therapy*, which is the most common; electroconvulsive shock therapy (ECT)*, which involves administering a muscle relaxant and anaesthetizing a patient before passing an electric current through the non-dominant brain hemisphere; and psychosurgery*, which is the most extreme form of somatic therapy (* incorrect options). Psychosurgery is rarely used and reserved only for acute conditions such as severe depression, chronic anxiety, and severe obsessional disorders for which all other treatments have been unsuccessful. Psychosurgery involves either lobotomy (removal of brain tissue) or leucotomy (cutting the connections to a particular part of the brain). Prochaska and DiClemente's transtheoretical or Stages of Change theory is an eclectic model that integrates interventions from various theories of psychotherapy. Transtheoretical therapy incorporates the identified stages of change: precontemplation, contemplation, preparation, action, and maintenance in selecting and utilizing therapeutic interventions. For example, people are most likely to respond to feedback and education in the contemplation stage and social reinforcers in the maintenance stage. Additional Information: Somatic Therapies

Question 162

When scoring the Rorschach, "form quality" is a measure of the degree to which: Select one: A. determinants are fully integrated B. a response meaningfully integrates two or more adjacent detail areas C. the examinee's response corresponds to the actual structure of the inkblot D. the examinee's response makes use of the entire inkblot

Answer 162

Correct Answer is: C Form quality refers to the degree to which an examinee's response is consistent with the form (shape) of the inkblot. Additional Information: The Rorschach Inkblot Test

Question 163

``` A therapist who assigns a couple the task of looking for things in their relationship that they would like to continue is most likely using which of the following therapeutic approaches? Select one: A. behavioral B. solution-focused C. structural D. strategic ```

Answer 163

Correct Answer is: B Solution-focused therapy uses a variety of techniques including formula tasks that help clients become aware of solutions they already have in place. For example, using the formula first session task the therapist asks the clients to observe, and describe in the next session, what happens in their lives that they would like to continue to have happen. Additional Information: Solution-Focused Therapy

Question 164

``` The Vineland Adaptive Behavior Scales (Vineland-II) is most likely to be used to facilitate the diagnosis of which of the following? Select one: A. learning disabilities B. conduct disorders C. autism spectrum disorders D. adjustment disorder ```

Answer 164

Correct Answer is: C Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) is used to evaluate personal and social skills of people from birth to age 90 and is organized around four behavior domains: communication, daily living skills, socialization, and motor skills. VABS is one of the most frequently used measures of adaptive functioning and is the leading instrument for supporting the diagnosis of intellectual and developmental disabilities. It is also used to identify individuals who have developmental delays, mental retardation, autism spectrum disorders, ADHD, brain injury, or dementia and for assisting in the development of educational and treatment plans. Although cognitive IQ tends to remain stable, problems in adaptation can improve with remedial training.

Question 165

``` It is estimated that 60 percent of children with Tourette's syndrome also have AD/HD. In treating Tourette's and other Tic Disorders, which of the following medications requires the greatest caution when used for treatment? Select one: A. pimozide B. fluoxetine C. clonidine D. methylphenidate ```

Answer 165

Correct Answer is: D Tourette's syndrome is a chronic tic disorder that involves vocal and motor tics. Recent estimates indicate 60 percent of children with Tourette's have AD/HD, and approximately 7 percent of children with AD/HD have tics or Tourette's syndrome. The symptoms are often mild, and a significant social impact only occurs in rare severe cases. According to recent research, psychostimulant medication is not related to the development of Tourette's syndrome in children with AD/HD. However, when there is a family history of tics or Tourette's syndrome, a cautious treatment approach is recommended as some individuals will experience worsening of their tics with stimulant treatment.

Question 166

According to psychoanalytic theory, defense mechanisms are derived: Select one: A. by the unconscious part of the ego transforming the warded-off impulse into a symptom which allows for both gratification of the wish and adherence to the prohibition against its expression. B. to satisfy the id's wish for unbridled gratification without threatening the needs of the ego or the superego. C. as a means of keeping unconscious libidinal or aggressive impulses from reaching consciousness. D. as a result of conflict between the ego's attempt to follow reality and the superego's demands for adherence to social norms.

Answer 166

Correct Answer is: C According to psychoanalytic theory, the function of defense mechanisms is to keep warded off impulses or wishes from reaching consciousness. Anxiety results when defense mechanisms break down and an impulse or wish can no longer be contained in the unconscious. Additional Information: Defense Mechanisms

Question 167

``` Which of the following is not one of the dimensions in Hofstede's theory of culture? Select one: A. power distance B. uncertainty avoidance C. conscientiousness D. masculinity/femininity ```

Answer 167

Correct Answer is: C Hofstede's five cultural dimensions are power distance*, uncertainty avoidance*, individualism, masculinity*, and long-term orientation (* incorrect options). Research findings indicate the United States scores high on individualism, low on power distance, moderate to high on masculinity and moderate scores on uncertainty avoidance.

Question 168

``` _________________ is a present-oriented, structured and time-limited treatment that integrates biological and psychosocial approaches. Select one: A. Motivational interviewing B. Solution-focused therapy C. Interpersonal psychotherapy D. Reality therapy ```

Answer 168

``` Correct Answer is: C Interpersonal psychotherapy (IPT) is a manualized psychotherapy first designed for the treatment of nonbipolar, nonpsychotic major depression with the focus on the problems of depression and interpersonal distress. IPT focuses on interpersonal aspects of depression and uses the biopsychosocial model which frames depression as a medical illness occurring in a social context The goal of IPT is to alleviate symptoms with interpersonal relationships as a point of intervention. IPT has been found to be effective for the treatment of depression patients from adolescence to late life, for women with postpartum depression and for patients with medical comorbidity (See: Weissman, M.M., Markowitz, J.W., Klerman, G.L. (2000). Comprehensive guide to interpersonal psychotherapy. New York, Basic Books.) ```

Question 169

``` A Caucasian comes to a stage where he does not want to have racist views. According to Helms, which stage of identity development is this person in? Select one: A. Reintegration B. Pseudo-independence C. Immersion-Emersion D. Autonomy ```

Answer 169

``` Correct Answer is: C Janet Helms (1984) originally developed her White and People of Color Racial Identity Model to try and help resolve interracial tension in cross cultural psychotherapy. She developed a white racial identity model that reflects abandonment of racism and the development of a nonracist white identity. At the Immersion-Emersion level of identity development, people embrace their whiteness without rejecting members of minority groups and attempt to determine how they can feel proud of their own race without being racist. In Reintegration, people resolve their conflicts by adopting the position that whites are superior. In Pseudo-Independence, people become dissatisfied with reintegration and re-examine their beliefs about racial inequalities. In Autonomy, Whites internalize a nonracist white identity and seek out cross-racial interactions. ``` Additional Information: Helms' Racial Identity Models

Question 170

Asian-American clients are LEAST likely to: Select one: A. prefer a direct-structured approach to therapy B. be inhibited and reserved in therapy C. smile to express disapproval D. use silence as a way of communicating respect

Answer 170

Correct Answer is: C Although Asian-Americans are a diverse group, certain generalizations have been found. Asian-Americans tend to prefer a "direct-structured approach to therapy", are "inhibited and reserved in therapy", and use "silence as a way of communicating respect" (the other three options). When Asian-Americans smile and laugh it may convey meanings other than happiness, in particular, embarrassment, discomfort, or shyness; however, smiling is less likely to be used to express disapproval. Sue and Sue (1999) have noted that this cultural difference may have contributed to conflicts in Los Angeles following the Rodney King verdict, when African-Americans misinterpreted Korean store owners' smiling as arrogance and a lack of compassion, when they were actually expressing embarrassment and apprehension [Counseling the Culturally Different: Theory and Practice, 3rd Ed., New York: John Wiley]. Additional Information: Counseling Asian-American Clients

Question 171

``` Gregory Herek (1992) ascribes violence against gays and lesbians to: Select one: A. stigmatization. B. bigotry. C. homophobia. D. heterosexism. ```

Answer 171

Correct Answer is: D According to Gregory Herek, violence against gays and lesbians is attributable to a combination of psychological (individual) and cultural heterosexism. Heterosexism is defined as an "ideological system that denies, denigrates, and stigmatizes among nonheterosexual forms of behavior, identity, relationships, or community" (p. 150). [Psychological heterosexism and anti-gay violence: The social psychology of bigotry. In G. M. Herek & K. T. Berrill, Hate crimes: Confronting violence against lesbians and gay men (pp. 149-169), Newbury Park, Sage, 1992].

Question 172

Recent research on psychotherapy outcome indicates: Select one: A. 28% of therapy clients show marked improvement in symptoms after the 8th session B. 72% of therapy clients show marked improvement in symptoms after the 8th session C. 53% of therapy clients show marked improvement in symptoms after the 26th session D. 75% of therapy clients show marked improvement in symptoms after the 26th session

Answer 172

Correct Answer is: D Howard et al. (1986) reviewed the benefits that clients experienced due to attending therapy sessions as a function of the dosage of therapy sessions. Performing a meta-analysis of 15 previous outcome studies, their results verified that the longer patients remain in therapy, the greater their gains. They found that 15% of patients improve between intake and the first session (presumably due to spontaneous remission and the ameliorative effects of having sought treatment), 50% improve after eight sessions, and 75% improve after 26 sessions. Consistent with these findings, research by Kafta et al. (1994) found approximately 75% of the psychotherapy clients showed an alleviation of acute symptoms after the 28th session. (See: Howard, K. I., Kopta, S. M., Krause, M. S., and Orlinsky, D. E. (1986). The dose-effect relationship in psychotherapy. American Psychologist, 41, 159-164; Kopta, S. M., Howard, K. I., Lowry, J. L., and Beutler, L. E. (1994). Patterns of symptomatic recovery in psychotherapy. Journal of Consulting and Psychology-Clinical Psychology, 62, 1009-1016.) Additional Information: Other Issues in Therapy Outcome Research

Question 173

Which of the following statements is a major assumption of crisis theory? Select one: A. insight must precede change B. overwhelming emotions are the prime motivators for change C. internal conflicts preclude problem solving D. people can learn to cope with stress

Answer 173

Correct Answer is: D According to crisis theory, people in crisis tend to follow a predictable sequence of response and a key goal of crisis intervention is to help individuals in crisis learn more effective coping so that they can respond more adaptively when having similar experiences in the future. Crisis management strategies often include grief work; active listening; encouraging the open expression of feelings; increasing understanding of the crisis; promoting greater acceptance of reality; exploring constructive ways of coping; linkage to a social network; decision counseling; and reinforcement of newly learned coping behaviors. While addressing a client's emotions, including the overwhelming ones*, is a part of crisis intervention, crisis theory and crisis intervention also emphasize the cognitive and behavioral elements of a crisis. Although crisis theorists do predict that crisis intervention will be more successful when a client is able to understand the crisis situation (e.g., how his or her behavior is related to the crisis), neither insight* nor the resolution of internal conflicts* is considered a prerequisite for change or problem-solving during crisis intervention (* incorrect options).

Question 174

According to recent meta-analyses of child psychotherapy outcome studies, which of the following statements is most true? Select one: A. There are no differences between the effectiveness of behavioral and non-behavioral interventions in the treatment of children. B. Girls respond better to psychotherapy than boys, with adolescent girls responding best. C. Girls respond better to psychotherapy than boys, with younger girls responding best. D. At all age levels, boys respond better to psychotherapy than girls.

Answer 174

Correct Answer is: B This is one of the many areas where the results of research are contradictory and somewhat controversial. However, the most recent meta-analyses of research in this area have found that across treatment approaches, girls respond better than boys, with adolescent girls responding best of all. This is somewhat contradictory to earlier research, which found that younger children respond better than older children. Because the findings of research sometimes contradict each other, it can be frustrating to decide which is the best answer to questions such as these. Of course, you'd want to find an answer that is consistent (or not inconsistent, at least) with the results of all the research. However, if such a response is not available, you should go with the results of more recent research. Additional Information: Therapy Outcome with Children and Adolescents

Question 175

Albert Ellis' Rational Emotive Behavior Therapy focuses on Select one: A. uncovering childhood causes of current dysfunction. B. present problems and practical ways to solve them. C. reward and punishment for appropriate and inappropriate affective responses. D. self-monitoring and thought stopping.

Answer 175

Correct Answer is: B Albert Ellis' Rational Emotive Behavior Therapy (REBT, sometimes referred to as Rational Emotive Therapy, or RET) is based on the notion that irrational thinking, feeling, and behavior is behind most problems encountered in therapy. It relies on Ellis' A-B-C model of disturbance: An activating event (A) triggers irrational beliefs about that event (B), and those beliefs have consequences (C) such as negative emotions and self-defeating behavior. REBT adds D and E to this chain of events: The therapist disputes (D) the irrational beliefs, leading to their replacement with rational beliefs and an effective outlook (E). REBT focuses mostly on the present--currently-held maladaptive attitudes, emotions and behaviors. It does recognize that events in early life may play a role in people's problems, but it views the past as affecting people by contributing to beliefs that we hold in the present. Additional Information: Rational Emotive Behavior Therapy (REBT)

Question 176

``` An external locus of control and internal locus of responsibility are characteristic of: Select one: A. a self-confident person B. a hostile person C. a depressed person D. most minorities ```

Answer 176

Correct Answer is: C The locus of control/locus of responsibility model adds another element to the learned helplessness model in regards to depression. As you know, the learned helplessness model views depressed people as making internal, stable, and global attributions to negative events. However, the "internal" factor in the helplessness model refers only to locus of responsibility. As seen in the cognitive distortion called "personalization," a depressed person uses an internal locus of responsibility to blame him or herself for negative events. Paradoxically, depressed people also feel a lack of control over events, that is, they have an external locus of control - seeing external factors such as fate, luck, or other people as the cause of what happens to them. A "self-confident person" is most likely to have an internal locus of control and responsibility. A "hostile person" is more likely to blame others, that is, would have an external locus of responsibility. And, contrary to this option ("most minorities"), only marginalized minorities are likely to have an external locus of control and an internal locus of responsibility. Additional Information: Reformulated Learned Helplessness Model

Question 177

``` Although a therapy group started out with spontaneous, frequent interactions between group members, it has taken on a restrictive interaction pattern in which members speak in rotation so that only two or three members get to talk during each session. This is an example of: Select one: A. procedural norms. B. power maintenance. C. task orientation. D. family re-enactment. ```

Answer 177

Correct Answer is: A This situation is discussed by Yalom in his book titled The Theory and Practice of Group Psychotherapy. The question describes the procedure the group follows, and it apparently reflects a change in group norms. Therefore, the situation is an example of procedural norms. Additional Information: Group Therapy

Question 178

In their discussion of mental health services for Latino clients, Rogler et al. (1987) describe three ways to increase the cultural sensitivity of therapy for members of this group. These methods include all of the following except: Select one: A. incorporating elements of Latino culture into therapy. B. increasing the accessibility of mental health services for Latino clients. C. selecting standard treatments that best fit Latino culture. D. obtaining cultural sensitivity training.

Answer 178

Correct Answer is: D Although all of the actions described in the responses could be called culturally sensitive, only the first three were described by Rogler and his colleagues, which makes "obtaining cultural sensitivity training" the correct response. [L. H. Rogler et al., What do culturally sensitive mental health services mean? The case of Hispanics. American Psychologist, 1987, 42(6), 656-570.] Additional Information: Counseling Hispanic Clients

Question 179

``` In psychodynamic theory, the concept of secondary gain is most similar to the social learning theory concept of: Select one: A. discrimination learning B. reinforcement C. punishment D. extinction ```

Answer 179

Correct Answer is: B The concept of secondary gain from the psychodynamic approach refers to the benefit a person obtains from an experience in connection with a mental health or physical problem (i.e., concern from family and friends) that reinforces the problem. In social learning theory, the concept of reinforcement is congruent with secondary gain because that concept is also concerned with actions that support continuing a specific behavior. The social learning concepts of discrimination learning, punishment, and extinction are not congruent with secondary gain.

Question 180

``` The acronym BASIC I.D is associated with: Select one: A. Frankl B. Lazarus C. Prochaska and DiClemente D. Beutler ```

Answer 180

Correct Answer is: B Lazarus' MultiModal Therapy (MMT), Beutler's eclectic psychotherapy and Prochaska and DiClemente's transtheoretical or Stages of Change theory are eclectic models that integrate interventions from various theories of psychotherapy. According to Lazarus' MMT, the acronym BASIC ID represents the categories of interrelated aspects of personality which need to be addressed for effective treatment: behavior, affect, sensation, imagery, cognition, interpersonal relationships, and the need for drugs or other biological functioning. Technically eclectic and theoretically drawing mainly from a broad-based social and cognitive learning theory, multimodal therapy is essentially psychoeducational, contends that many problems arise from misinformation and missing information and focuses on results or outcomes. In addition to use of a range of techniques, multimodal clinicians tailor treatment to meet the individual client's needs (i.e., different relationship styles, individual, couples or group therapy) holding that "the correct method delivered within and geared to the context of the client's interpersonal expectancies, will augment treatment adherence and enhance therapeutic outcomes." (See: Lazarus, A. A. (2006). Multimodal therapy: A seven-point integration. In G. Stricker & J. Gold (Eds.). A casebook of psychotherapy integration. Washington, DC: APA Books.) Beutler's eclectic psychotherapy is based on the paradigm of specific treatments for specific conditions and that the therapist, therapist-client relationship and interactions variables are more important than specific techniques. Frankl's Logotherapy, is a distinct branch of humanistic/existential psychotherapy and consists of three cornerstones: freedom of will, will to meaning and the meaning of life (Frankl 1967, 1986). These are also the cornerstones of existential analysis which refers to the analytical therapeutic process involved in addressing an individual's spiritual and existential needs. Logotherapy states the primary motivational force in human beings is the search for a meaning in life. (See: Frankl, V. E. (1986). The doctor and the soul: From psychotherapy to logotherapy (Revised and expanded). New York: Vintage Books.)

Question 181

``` A family therapist who uses anecdotes from her own family to emphasize similarities with the client family is doing which of the following? Select one: A. reframing B. triangulating C. diffusing boundaries D. joining ```

Answer 181

Correct Answer is: D Joining, a technique used by structural family therapists, involves taking steps to become a family insider by, among other things, assuming the same type of communication style, sharing personal stories, etc.

Question 182

``` The development of depressive symptomology according to Beck's cognitive theory, a diathesis-stress model, proposes _____________ serves as the vulnerability. Select one: A. a genetic predisposition B. depressogenic schema C. exposure to a negative event D. a negative attributional style ```

Answer 182

Correct Answer is: B Diathesis-stress models state that illness is the result of diathesis (vulnerability) combined with stress, with the nature of the vulnerability depending on the type of theory. Beck's theory of depression identifies the source of vulnerability as cognitive factors. His cognitive diathesis-stress model of depression suggests some people, when exposed to a negative life event (stress), are vulnerable to experiencing depression as they have depressogenic schemata (dysfunctional attitudes). A negative attributional style or types of attributions such as internal, stable, and global attributions are recognized as the diathesis in Abramson, Metalsky, and Alloy's (1989) hopelessness model of depression.

Question 183

``` Murray Bowen's approach to family therapy was strongly influenced by: Select one: A. gestalt therapy B. psychodynamic theory C. existentialism D. communications theory ```

Answer 183

Correct Answer is: B Murray Bowen was psychoanalytically trained and his extended family systems therapy was strongly influenced by his analytic training. For example, his transgenerational approach focuses on addressing relationship issues in one's family of origin and developing insight in order to resolve current problems. Additional Information: Theoretical Constructs (Extended Family Systems Therapy)

Question 184

Solution-focused brief therapists in group work: Select one: A. utilize questioning B. focus on identifying an individual's problem C. use a directive, expert stance. D. emphasize insight as the main mechanism of change.

Answer 184

Correct Answer is: A Solution-focused brief therapy, also referred to as solution focused or brief therapy, is a form of psychotherapy based on social constructionist philosophy that focuses on solutions rather than problems or their causes. Underlying this approach is the assumption that clients possess the resources needed to achieve their goals. The solution-focused therapist works with people to generate solutions to their problem using direct and indirect compliments and future-oriented questions such as the miracle question. Additional Information: Solution-Focused Therapy

Question 185

``` A couple comes to therapy complaining that all their conversations end in arguments. This is characteristic of which pattern of communication? Select one: A. symmetrical B. complimentary C. pseudohostility D. mystification ```

Answer 185

Correct Answer is: A Communication patterns can be characterized as either symmetrical or complimentary. In symmetrical communication there is equality between the partners, however, this can result in competition and conflict. complimentary In the complimentary communication pattern there is inequality, with one partner taking a dominant role and the other a subordinate role. pseudohostility Pseudohostility presents as superficial bickering in order to avoid real conflicts. mystification In mystification, the person uses denial to mask what is really going on. Additional Information: Symmetrical Communications

Question 186

Stuart's operant interpersonal therapy: Select one: A. is based on object relations theory B. encourages couples to focus on positive aspects of one's partner C. discourages the use of a "quid pro quo" approach among couples D. maintains that successful marriages are based on contingent punishments

Answer 186

Correct Answer is: B Richard Stuart applied operant conditioning and social exchange theory in the context of marital therapy. He encourages couples to focus on positive aspects of each other and to use reciprocal reinforcement or "quid pro quo." He maintained that in successful marriages rewards exceed costs and are built on positive reinforcement, rather than negative reinforcement, punishment, or coercion. Additional Information: Operant Interpersonal Therapy

Question 187

Research on the impact of therapist experience on therapy outcome suggests that Select one: A. there is a strong positive relationship between experience and outcome. B. there is a moderate relationship between experience and outcome, with the relationship being strongest when the client's symptoms are mild to moderate. C. there is a moderate relationship between experience and outcome, with the relationship being strongest when the client's symptoms are severe. D. there is, contrary to what might be expected, no predictable relationship between experience and outcome.

Answer 187

Correct Answer is: C Most research studies report a moderate relationship between a therapist's experience and the outcomes of therapy for the client overall, but a somewhat stronger relationship when the client's symptoms are severe. This makes sense: Experience would seem to be more important for very troubled clients. See A. Roth and P. Fanagy, What Works for Whom? A Critical Review of the Psychotherapy Research, New York, Guilford Press, 1996. Note that in the Clinical Psychology section, we report that there is little relationship between therapist experience and outcome. This finding is based on older research, and you should use the newer information included in this explanation. Additional Information: Therapist Variables

Question 188

``` The conviction that love, friendship and occupation are the three major life tasks is most similar to the theory and beliefs of: Select one: A. Maslow. B. Adler. C. Rogers. D. Berne. ```

Answer 188

Correct Answer is: B The three tasks (friendship, occupation, and love) all involve social interactions which is most consistent with Adler's emphasis on social factors and need to belong (i.e., social interest). Adler held people are primarily motivated by an innate social interest and that the goal in life is to act in ways that fulfill social responsibilities. Additional Information: Alfred Adler's Individual Psychology

Question 189

``` A client expresses anger at his therapist for being unsupportive rather than acknowledge feelings of hostility toward an unsupportive spouse. This is an example of the defense mechanism called: Select one: A. sublimation B. projection C. undoing D. displacement ```

Answer 189

Correct Answer is: D Displacement is a defense mechanism in which an uncomfortable impulse is expressed toward a safe target, rather than the true target, of the impulse. "Sublimation" is the transformation of unwanted impulses away from destructive acts into something that is socially acceptable and/or creatively effective. "Projection" is a defense mechanism in which one attributes to others one's own unacceptable or unwanted thoughts or/and emotions. "Undoing" is an ego defense mechanism in which a person relieves anxiety over a behavior by attempting to make up for it in other areas.

Question 190

An elevated F score on the MMPI-2 (i.e., the F is greater than 70 and the K is very low) indicates that the: Select one: A. person is answering in a socially desirable manner. B. score should be considered in relation to the total profile. C. person is likely being careless or deliberately malingering. D. total profile can be considered valid.

Answer 190

Correct Answer is: C The validity scales on the MMPI-2, of which the F is one, are checks on response styles. Specifically, the F scale indicates if the person is answering in a deviant way, or is perhaps actually deviant. The higher the F, the more the answers suggest that the person is attempting to appear odd, disturbed, etc. Additional Information: F or "Infrequency" Scale (MMPI-2)

Question 191

``` Psychoanalytic theory and ethology both emphasize Select one: A. critical periods. B. psychic determinism. C. the oedipal complex. D. imprinting. ```

Answer 191

Correct Answer is: A A critical period is a discrete time period during which an organism is particularly sensitive to environmental events that could influence its development one way or the other. Both ethology (the study of animals in their natural habitat) and psychoanalytic developmental theory emphasize critical periods. For example, Lorenz's research found that the critical period for imprinting in geese is 2-3 days after they are born. And in Freud's theory of development, the different stages (e.g., oral, anal) represent critical periods for successful or unsuccessful resolution of specific psychosexual conflicts. Additional Information: Critical versus Sensitive Periods

Question 192

``` Based on the psychotherapy outcome research, your best estimate of the percentage of therapy clients showing measurable improvement at the end of therapy is: Select one: A. 25%. B. 45%. C. 60%. D. 75%. ```

Answer 192

Correct Answer is: D The right answer to this question really depends on which research study is being asked about since the reported rates of improvement vary from study to study. However, 75% is the number referred to most often in the literature and is the best answer to this question. Additional Information: Beck's Cognitive Therapy

Question 193

``` Freud's latency stage corresponds most to which of the following stages in Erikson's theory of psychosocial development. Select one: A. autonomy vs. shame B. identity vs. role confusion C. initiative vs. guilt D. industry vs. inferiority ```

Answer 193

Correct Answer is: D Both Freud and Erik Erikson proposed a stage theory of development. The stages in Freud's psychosexual theory are based on the focus of libidinal energy at a given age range. The five stages are oral, anal, phallic, latency, and genital. The latency stage occurs after the Oedipus conflict has been resolved and libidinal energy is temporarily latent. It lasts from about the ages of 7 through 11. Both Freud and Erikson's theories hold that failure to resolve conflicts at a particular stage could lead to fixation at (Freud's term) or a developmental regression to (Erikson's term) that stage later on. They differ in that 1) Erikson's theory posits stage development throughout the life span, whereas Freud's stages end at the age of 12; and 2) Erikson focuses on psychosocial development, not psychosexual development. Erikson's eight stages, each reflecting a psychosocial conflict that takes precedence at that stage, in order are trust vs. mistrust, autonomy vs. shame, initiative vs. guilt, industry vs. inferiority, ego identity vs. role confusion, intimacy vs. isolation, generativity vs. stagnation, and integrity vs. despair. The industry vs. inferiority stage occurs approximately between the ages of 6-12, and the focus is on learning new skills and knowledge and developing a sense of industry; failure to resolve the conflict could result in feelings of inadequacy and low self-esteem later in life. Because it spans the same age range as Freud's latency stage, it is the best answer to this question. Additional Information: Erikson's Theory of Psychosocial Development

Question 194

``` According to Thomas and Cross's Model of Psychological Nigrescence, which of the following stages represents the final stage of racial identity development for African-Americans? Select one: A. pre-encounter B. immersion-emersion C. encounter D. internalization-commitment ```

Answer 194

Correct Answer is: D Thomas and Cross's Model of Psychological Nigrescence focuses on the development of African-Americans toward racial identity. The first stage is characterized by an Euro-American perspective, whereas the final stage (internalization-commitment) is characterized by a desire to improve the condition of African-Americans. Additional Information: Black Racial Identity Development Model (Cross)

Question 195

A mother, father, and teenage son come to see you for family therapy. The family emigrated to the United States from a Latin American country five years ago. The son is not getting along with his parents and disobeys them constantly. Which of the following is a likely explanation for their problem? Select one: A. different levels of acculturation within the family B. the son has Conduct Disorder C. this is a common style of interaction in Latino families D. the son is frustrated because he is having trouble with the English language

Answer 195

Correct Answer is: A In immigrant families, a possible cause of conflict is differential levels of acculturation within the family -- that is, some members of the family may adopt the values and behavioral patterns of the new culture faster than others. This is especially true when one of the family members is an adolescent, who will likely have both greater contact with and a stronger desire to be accepted by peers in the new culture. Additional Information: Acculturation

Question 196

Whether sex therapy results in sustained change over time appears to vary depending on the presenting problem. According to outcome research on sex therapy, which of the following is not true? Select one: A. Sex therapy for vaginismus is highly effective in the short and long-term. B. Sex therapy for erectile dysfunction is highly effective in the short and long-term. C. Low sexual desire in men shows a relatively poor treatment response in the short and long-term. D. Low sexual desire in women shows a relatively poor treatment response in the short-term but is highly effective in the long-term.

Answer 196

Correct Answer is: D Although research on the results of sex therapy is limited, findings indicate that sex therapy for vaginismus* and erectile dysfunction* is highly effective in the short- and long-term (one to six years). Results for premature ejaculation however suggest short-term success but less permanent results. Low sexual desire in men shows a relatively poor treatment response* in the short- and long-term and the long-term results of treatment for low sexual desire in women is also relatively poor (* incorrect options). Some studies suggest clients that receive an occasional "booster" session, post-treatment may maintain better improvement through preventive measures and even though some individuals had returned to pretreatment dysfunctions in sexual behavior, sex therapy yielded an improvement in the way a many felt about their sexuality. (See: Hawton, K. (1992). "Sex Therapy Research: Has it Withered on the Vine?" Annual Review of Sex Research 3:49-72.; Heiman, J.R. (2002). Sexual dysfunction: overview of prevalence, etiological factors, and treatments. Journal of Sex Research, 39(1): 73-79.)

Question 197

Individuals who recall memories under hypnosis, compared to non-hypnotized individuals, Select one: A. have more confidence in their memories and are more likely to recall events accurately. B. have more confidence in their memories but are less likely to recall events accurately. C. have less confidence in their memories and are less likely to recall events accurately. D. have less confidence in their memories but are more likely to recall events accurately.

Answer 197

Correct Answer is: B Research shows that memories retrieved under hypnosis tend to be less accurate than other memories. Nonetheless, individuals who recall information while under hypnosis have greater confidence in their memories as compared to controls. In some research studies, hypnotized subjects were reluctant to admit that their memories were inaccurate even when confronted with clear evidence demonstrating this to be the case. Additional Information: Hypnotherapy

Question 198

``` The strongest bond among Hispanic-American families is typically between: Select one: A. parent and child B. husband and wife C. siblings D. godparent and godchild ```

Answer 198

Correct Answer is: A The strongest bond in Hispanic-American families is most often found between parent and child, and especially the mother-son and father-son relationships [See C. Falicov, Latino families in therapy, New York: Guilford, 1998]. Additional Information: Counseling Hispanic Clients

Question 199

According to research on mothers who exhibit parental alienation syndrome and are going through a custody evaluation, the pattern of scores on the MMPI-2 would most likely be: Select one: A. low F scale score and elevated L and K scale scores B. low K and F scale scores and elevated L scale score C. low L and F scale scores and elevated K scale score D. low L and K scale scores and elevated F scale score

Answer 199

Correct Answer is: A Research indicates many parents undergoing a custody evaluation produce defensive MMPI-2 score patterns. Siegel and Langford (1998) expanded on these findings by examining the MMPI-2 profiles of mothers with parental alienation syndrome and those without, who were going through a custody evaluation. Results showed mothers with parental alienation syndrome had a lower F scale score and higher L and K scale scores than mothers without parental alienation syndrome (See: Siegel, J.C. and Langford, J.S. (1998). MMPI-2 validity scales and suspected parental alienation syndrome, American Journal of Forensic Psychology, 16(4), 5-14.) Additional Information: Validity Scales

Question 200

``` When a therapist shifts the perspective of looking at an individual's behavior from an intrapersonal to an interpersonal definition of the individual's problem, the therapist is: Select one: A. relabeling. B. reframing. C. schema restructuring. D. cognitive restructuring. ```

Answer 200

Correct Answer is: B Reframing is a technique of family therapy, especially structural and strategic, that involves redefining a problem behavior in order to get the family to see it in a new light with the purpose being to increase the family's compliance with treatment. For example, a therapist may tell parents that their child who often "talks back" is expressing a need for love and insecurity rather than anger and disrespect. Reframing the situation may then increase the parents' willingness to change their own behavior, rather than focusing only on the child, or identified patient. Relabeling*, involves substituting a benign label for a pathological label a family attaches to a problem in order to change the meaning. Schema restructuring* is the kind of learning that involves fundamental changes in the nature of the schema itself. Cognitive restructuring*, involves replacing maladaptive thought patterns with constructive and adaptive thoughts and beliefs (* incorrect options).

Question 201

An example of a paradoxical directive would be: Select one: A. Telling an argumentative couple they must take turns telling the other what they appreciated about each other B. Telling an argumentative couple that they must argue four hours a day C. Arranging flowers in a vase D. Recommending to an arguing couple that they take a second honeymoon

Answer 201

Correct Answer is: B A paradoxical directive is an instruction to engage in the symptomatic behavior. The idea is to utilize the energy of resistance and use to help the couple make changes in their communication patterns. Additional Information: Goals and Techniques of Therapy (Strategic Family Therapy)

Question 202

Research indicates lesbians' disclosure of sexual orientation is associated with: Select one: A. increased isolation from family members. B. increased self-esteem. C. increased anxiety. D. increased anonymous socializing.

Answer 202

Correct Answer is: B Research by Jordan and Deluty (1998) indicates sexual orientation disclosure, or "coming out" , by lesbians is associated with positive outcomes such as a lower level of anxiety, a lower likelihood of engaging in anonymous socializing (i.e., going to bars) and greater family support following disclosure to family members. The study also revealed higher self-esteem and greater positive affectivity the more widely lesbian women disclosed their sexual orientation. (See: Jordan, K. M. and Deluty, R.H. (1998). Coming out for lesbian women: Its relation to anxiety, positive affectivity, self-esteem, and social support, Journal of Homosexuality, 35(2), 41-63.)

Question 203

The prevalence of mental disorders in people over 65 is: Select one: A. higher than any other age group B. lower than any other age group C. higher, and includes cognitive impairment D. The same as the under 65 population

Answer 203

Correct Answer is: B Contrary to what may be expected, the prevalence of mental disorders in people 65 and older is lower than any other age group; only cognitive impairment shows a definite age-associated increase in incidence. (Dorothy M. Tucker, Ph.D, "Treating Our Elders: Exploring the Relationship Between Psychology and Medicine" California Psychologist, March 2000, pg. 4 Volume XXXIII Number Three.)

Question 204

George Kelly emphasized that: Select one: A. people view the world through cognitive schemas B. individuals progress from infantile dependency to mature interdependency C. psychopathology is caused by past traumatic events D. psychopathology is caused by a maladaptive "style of life"

Answer 204

Correct Answer is: A George Kelly was perhaps the first cognitive theorist and introduced his "psychology of personal constructs" in 1955. A construct, which is synonymous with a schema, is a cognitive template through which the world is interpreted. individuals progress from infantile dependency to mature interdependency This choice represents a major tenet of Self-in-Relation Theory. psychopathology is caused by past traumatic events This is contrary to what Kelly believed. He believed that individuals' interpretations of events are more important than the events themselves. psychopathology is caused by a maladaptive "style of life" This uses the language of Adler. Additional Information: Personal Construct Therapy

Question 205

Psychologists working with clients who identify with a traditional Asian culture should be aware of all of the following cultural tendencies that may influence the therapeutic process except Select one: A. a preference to defer to the opinion of elders. B. a tendency to stand very close to others. C. the possibility that psychological symptoms may be somaticized. D. the possibility that trying to work with the client as a "partner" may engender a lack of confidence in the process.

Answer 205

Correct Answer is: B Even though therapists should respond to clients as individuals and not stereotype people, they must also consider social and cultural factors in assessing individuals, interpreting their responses, and devising treatment plans -- especially when a client strongly identifies with a culture that differs from the dominant one. For instance, as stated by the first choice, Asian culture is characterized by strong deference to elders, which sometimes leads to reluctance to discuss background family issues in therapy. Clients with a traditional Asian background also may report physical problems when experiencing psychological discomfort (i.e., somaticize); this tendency may be due to Asian medicine's belief in a close relationship between mind and body. And, when seeking mental health services, these clients may expect that the therapist will serve as an expert who provides directive advice and quick relief for the presenting problem. Thus, as stated by this choice ("the possibility that trying to work with the client as a 'partner' may engender a lack of confidence in the process"), trying to establish an egalitarian relationship may engender a lack of confidence in the clinician. The correct choice ("a tendency to stand very close to others"), however, describes a tendency that opposes traditional Asian cultural preferences. Clients from this background often believe that touching strangers is inappropriate and prefer more distance between themselves and others than what is typical in Western culture -- which itself is characterized by a greater need for personal space than many other cultures. Additional Information: Counseling Asian-American Clients

Question 206

The Racial Identity Attitude Scale, developed by Helms and Parham (1996), is used to assess the stages of African-American racial identity development which are: Select one: A. conformity, dissonance, resistance and immersion, introspection, and articulation and awareness B. separation, marginalization, assimilation, and integration C. pre-encounter, encounter, immersion-emersion, and internalization D. encounter, resistance, integration, and awareness

Answer 206

Correct Answer is: C The Racial Identity Attitude Scale, developed by Helms and Parham (1996), is based on Cross' (1971, 1978) stages of African-American identity development. The stages are pre-encounter, encounter, immersion-emersion, and internalization. conformity, dissonance, resistance and immersion, introspection, and articulation and awareness This choice includes the stages of Atkinson, Morten, and Sue's Minority Identity Development Model. separation, marginalization, assimilation, and integration This refers to Berry's Acculturation model, which consists of independent dimensions, rather than stages. encounter, resistance, integration, and awareness This choice contains terms from each of the other models. Additional Information: Helms' Racial Identity Models

Question 207

``` A therapist interested in evaluating the defenses that impact an individual's current maladaptive behavior patterns would be a practitioner of: Select one: A. personal construct therapy B. reality therapy C. object relations therapy D. solution-focused therapy ```

Answer 207

Correct Answer is: C Object relations therapy, as a psychodynamic therapy, involves an interest in defenses and transferences. Associated with Melanie Klein amongst others, object relations therapy incorporates traditional psychodynamic strategies such as the influence of unconscious processes underlying an individual's relationships, and identifying and interpreting defenses against anxiety and transferences. George Kelly's "personal construct therapy" combines cognitive, behavioral, and humanistic concepts. It emphasizes the effect of the individual's perspective on his/her experience of the world. Developed by William Glasser, "reality therapy" focuses on an individual's present issues and problems. Steve de Shazer and other strategic family therapists developed "solution-focused therapy" which focuses on the here-and-now and identifying solutions to problems. Additional Information: Object-Relations Theory

Question 208

Therapists working with elderly patients should be aware that Select one: A. elderly patients have very poor memory. B. elderly patients cannot benefit much from psychotherapy. C. individual differences among elderly patients are greater than individual differences among younger patients. D. elderly people tend to drop out of therapy prematurely.

Answer 208

Correct Answer is: C A number of authors have noted that elderly individuals tend to vary greatly -- even more so than younger people -- in terms of physical abilities, intellectual abilities, interests, and personality characteristics. The other choices represent myths or stereotypes about the elderly that should be avoided. Additional Information: Counseling Elderly Clients

Question 209

Hypnosis involves three factors Select one: A. Absorption, regression, dissociation B. Dissociation, absorption, suggestibility C. Suggestibility, dissociation, regression D. Regression, distortion, suggestibility

Answer 209

Correct Answer is: B According to Hales, Yudofsky and Talbott, (1944), hypnosis involves three factors, 1) absorption, whereby the individual is completely engrossed in a central experience, 2) dissociation, whereby the ordinary functioning of consciousness and memory are altered in some way and 3) suggestibility, whereby individuals have a tendency to be less inhibited and restricted while in the trance-like state. Additional Information: Hypnosis

Question 210

``` Psychodrama seeks to examine and resolve difficult situations through guided dramatization and the release of creative forces inherent in the individual. The issue or problem to be explored in the psychodrama is chosen by the: Select one: A. protagonist B. antagonist C. director D. audience ```

Answer 210

Correct Answer is: A Most associated with Jacob L. Moreno, psychodrama employs experiential methods, role theory, sociometry and group dynamics to facilitate insight, personal growth, and integration on cognitive, behavioral and affective levels. Psychodrama provides participants a safe, supportive environment in which to practice new and more effective roles and behaviors. There are three distinct components of group interaction in a classically structured psychodrama session: the warm-up, the action and the sharing phases. In the warm-up phase, the group theme is identified and a protagonist (which is the the correct option), individual(s) who represents the theme in the drama, is selected. In the action phase the problem is dramatized and the protagonist explores new methods of resolving it. Then in the sharing phase, group members or the audience* may express or share their associations, experience or connection with the protagonist's work. The other components of psychodrama include: auxiliary egos*, or group members who assume the roles of significant others in the drama; the director*, a trained psychodramatist who guides participants through each phase of the session; and the stage, the physical space in which the drama is conducted (* incorrect options). Additional Information: Psychodrama

Question 211

A therapist working from the perspective of Minuchin's school of thought would examine a family system in terms of Select one: A. multigenerational transmission processes. B. subsystems and boundaries. C. fusion and differentiation. D. communication style.

Answer 211

Correct Answer is: B Salvador Minuchin's Structural Family Therapy is based on and extends general family systems theory. The goal is to restructure maladaptive family structures, including family subsystems and boundaries. Additional Information: Theoretical Constructs: Structural Family Therapy

Question 212

``` A therapist assisting a family in bringing the unconscious issues within the family to a conscious level would most likely be utilizing: Select one: A. object relations family therapy B. existential family therapy C. systemic family therapy D. structural family therapy ```

Answer 212

Correct Answer is: A Only object relations family therapy is a psychodynamic therapy, which is interested in the impact of unconscious issues or intrapsychic phenomena on current family relationships or behavior.

Question 213

A social-role theorist might contend that minority clients drop out of treatment more readily when matched with a white therapist, because: Select one: A. the therapist indicates discomfort B. higher power or status groups are more adept at reading or perceiving members of lower status groups than those from lower status groups reading people from higher status groups. C. lower power or status groups are more adept at reading or perceiving members of higher status groups than those from higher status groups reading people from lower status groups. D. the client lacks awareness of the differences in power and status.

Answer 213

Correct Answer is: C Social-Role theorists assert that individuals in positions of lower power and status are better at reading/perceiving members of higher status groups than are those from higher status groups at reading people from lower status groups. Thus, for example, women may be more adept at attending to men, than men are at attending to the feelings and experiences of women. Similarly white therapists may be less familiar with the culture and life experience of minority clients than are minority therapists with white clients (See: Sue, S. & Zane, N. (1987). The role of culture and cultural techniques in psychotherapy: A critique and reformulation. American Psychologist, 42, 37-45.)

Question 214

``` The stages of the Minority Identity Development (MID) model developed by Atkinson, Morten, and Sue (1994) reflect changes in which of the following? Select one: A. acculturation B. ego development C. locus of control D. self-awareness ```

Answer 214

Correct Answer is: A You may have had trouble with this one, but if you're familiar with the MID model and the characteristics of its stages (conformity, dissonance, resistance and immersion, introspection, synergetic articulation), you may have recognized that each stage involves a different combination of attitudes toward one's own culture and the majority culture and, therefore, reflects different levels of acculturation. Additional Information: Minority Identity Development Model

Question 215

``` According to Bowen, to reduce tension between them, family members often resort to: Select one: A. scapegoating. B. retribalization. C. triangulation. D. emotional divorce. ```

Answer 215

Correct Answer is: C Of the terms listed in the responses, only two are associated with Bowen (triangulation and emotional divorce). Bowen described triangles as a means of reducing tension and conflict between two family members who refocus their attention on the triangulated member. Additional Information: Theoretical Constructs (Extended Family Systems Therapy)

Question 216

``` After doing poorly on a geometry test, a student concludes that he is stupid, despite the fact that he usually receives A's and B's in all of his other classes. According to Beck, this would be an example of: Select one: A. Personalization B. Dichotomous thinking C. Selective abstraction D. Learned helplessness ```

Answer 216

Correct Answer is: C Selective abstraction occurs when one focuses on a detail that is taken out of context, at the expense of other information. Personalization Personalization is when external events are incorrectly attributed to oneself. Dichotomous thinking Dichotomous or polarized thinking is categorizing experiences into one of two extremes, i.e., either/or thinking. Additional Information: Cognitive Distortions (Beck)

Question 217

``` African-American families use an authority structure that can be best characterized as: Select one: A. matriarchal B. patriarchal C. egalitarian D. too diverse to generalize ```

Answer 217

Correct Answer is: C Although African-American families were previously believed to most often have a matriarchal authority structure, more recent authors have concluded that they are typically egalitarian. That is, the husband and wife equally share authority in the family. Additional Information: Counseling African-American Clients

Question 218

``` There is a clear value to the role of theory in psychotherapy integration in three of the four following approaches. Which is not concerned with theory? Select one: A. Assimilative Integration B. Theoretical Integration C. Technical Eclecticism D. Common Factors ```

Answer 218

Correct Answer is: C Psychotherapy integration is a term that has been applied to: the organizing principle for understanding the Common Factors present in all psychotherapy; Assimilative Integration; Technical Integration; and Theoretical Integration. Common Factors refers to aspects present in most, if not all, approaches to therapy across all theoretical lines and in all psychotherapeutic activities (i.e., therapeutic alliance; expectation that positive change will result from treatment; therapist qualities such as attention, empathy, and positive regard). Assimilative Integration is an approach in which the therapist has a commitment to one theoretical approach but also is willing to use techniques from other therapeutic approaches. Theoretical Integration is the most difficult level to achieve integration as it requires integrating concepts from different theoretical approaches (e.g. behavioral and psychoanalytic) wherein the basic philosophy in each theory may differ. Unlike Assimilative Integration, which starts with a single theory and brings together techniques from different approaches, Theoretical Integration attempts to bring together differing theories and develop a "Grand Unified Theory." Technical Eclecticism (which is the correct option), is a variation of Assimilative Integration as there is also a variety of techniques, but there is no unifying theoretical understanding that underlies the approach. It is not concerned with theory, instead the therapist relies on experience and knowledge to choose interventions most appropriate for an individual with the benefit to the individual being of more significant than adhering to any one theory. (See: Stricker, G., and J. Gold. (Eds.) Comprehensive handbook of psychotherapy integration.New York: Plenum, 1993.) Additional Information: Psychotherapy Integration

Question 219

``` According to this type of psychotherapy, feelings are acknowledged and accepted as uncontrollable and the focus is on taking constructive action, not the alleviation of discomfort or the attainment of some ideal feeling state. Select one: A. Naikan therapy B. Network therapy C. Morita therapy D. Rational-emotive therapy (RET) ```

Answer 219

Correct Answer is: C Morita Therapy, sometimes referred to as the psychology of action, is a Japanese therapeutic intervention developed by Japanese psychologist Shoma Morita in the early part of the twentieth century originally to treat anxiety and neurosis. Morita therapy doesn't deal with the past, inner dynamics, or with emotions directly as a prerequisite to change. Emphasis is on learning to accept the internal fluctuations of thoughts and feelings and ground behavior in reality and the purpose of the moment. The focus is on the external environment, behavior, and distinguishing what is and is not controllable. All emotions are accepted as valid, pain is inevitable and there is no attempt to control or govern feelings. Concrete effort to take action, with or without success and despite the accompanying emotions, is encouraged. Progress is measured by degree of responsiveness to behavioral demands and in the effort for self improvement. Like cognitive behavioral therapy, Morita therapy deals with changing behaviors and dysfunctional cognitive processes through reframing the meaning of anxiety, focusing on attitudinal blocks to behavior and taking personal responsibility for behavior. Another Japanese approach, Naikan Therapy*, or the psychology of reflection, is based on clients asking themselves three questions: what have I received from? What have I given to? What troubles or difficulties have I caused to? Through such self-reflection, a client's awareness of the role they play in the relationship or situation, the amount of support they've received, and an appreciation for others is said to be increased. It is often combined with use of Morita Therapy. In Network Therapy*, the client's family, friends, and relatives (i.e. the client's network) are brought together, through the therapist's initiative, to implement the therapeutic process. Rational-emotive therapy*, views irrational thoughts as the cause of clients? problems and that the maintenance of problems is due primarily to self-indoctrination (* incorrect options). (See: Ishiyama, F. I. (1990). A Japanese perspective on client inaction: Removing attitudinal blocks through Morita therapy. Journal of Counseling and Development, 68, 566-570. and Goddard, K. (1991) Morita therapy: A literature review. Transcultural Psychiatric Research Review. 28(2); 93-115.)

Question 220

According to the theory underlying Gestalt therapy, introjection involves: Select one: A. viewing other people's emotions as one's own B. failing to develop a healthy "social interest" C. blaming oneself for the problems of others D. interpreting the values of the larger society as one's own

Answer 220

Correct Answer is: D Introjection involves absorbing the values or behaviors of others, including the larger society, without really understanding or assimilating those values or behaviors. Introjection represents a disturbance in the boundary between self and others -- the person does or believes things that are not reflective of a self that is clearly distinct from others in the environment. This choice ("viewing other people's emotions as one's own") is incorrect because it is primarily values, not emotions, that are absorbed from the environment in Gestalt therapy's view of introjection. Additional Information: Theory of Personality (Gestalt Therapy)

Question 221

According to Sue and Sue (2003), culture influences certain aspects of communication and potentially impacts interactions between individuals from diverse cultural backgrounds. One of these culturally influenced characteristics of communication is paralanguage, which refers to: Select one: A. rate of speech, pauses, loudness of voice, and other vocal cues B. culturally shared meanings for words or phrases C. facial expressions, posture, gestures, eye contact and other bodily movements D. personal and interpersonal use of space

Answer 221

Correct Answer is: A The term paralanguage is used to refer to vocal cues, other than words or language, individuals use to communicate meaning. The term kinesics is used to refer to bodily movements such as facial expressions, posture, gestures, eye contact and the term proxemics refers to the perception and use of personal and interpersonal space (which are incorrect options).

Question 222

A difference between the brief dynamic therapies and crisis intervention is: Select one: A. brief dynamic therapies focuses on specific symptoms B. crisis intervention focuses on specific symptoms C. crisis intervention views the patient's symptoms as pathological D. brief dynamic therapies views the patient's symptoms as pathological

Answer 222

Correct Answer is: D Brief dynamic therapies emphasize specific symptoms, viewed as pathological, and addresses underlying personality issues with emphasis on altering the normal level of functioning. Crisis intervention also focuses on specific symptoms; however, crisis intervention views symptoms as expected responses to acute trauma and seeks to return the person to the pre-trauma level of functioning. Additional Information: Brief Psychotherapy

Question 223

According to Beck, a depressed man is most likely to believe that: Select one: A. the world is unfair, his future is hopeless, but he is a good person B. he is worthless, his future is hopeless, but the world is just C. he is worthless, his future is hopeless, and the world is unfair D. he is worthless, the world is unfair, but his future is hopeful

Answer 223

Correct Answer is: C Depressed people tend to distort their perceptions and interpret events from a negative perspective. Beck referred to the "cognitive triad" which consists of negative thoughts about the self, future, and the world. This choice best represents the cognitive triad: he is worthless, his future is hopeless, and the world is unfair. Additional Information: Depression (Beck)

Question 224

``` During the first of structural family therapy's three steps, which of the following techniques is most useful? Select one: A. constructing a family map B. relabeling and reframing C. enactment D. tracking and mimesis ```

Answer 224

Correct Answer is: D Structural family therapy entails three overlapping steps: joining, evaluating/diagnosing, and restructuring. Joining is the initial step in structural family therapy. Tracking (identifying and using the family's values, life themes, etc.) and mimesis (adopting the family's behavioral and affective style) are methods used to join the family system. Constructing a family map* is a technique used for the structural diagnosis of the family. Relabeling and reframing* are restructuring techniques. Enactment* is used to facilitate diagnosis and restructuring of the family (* incorrect options). Additional Information: Goals and Techniques of Therapy (Structural Family Therapy)

Question 225

``` Research on psychotherapy outcomes suggest that, overall, culturally diverse groups do about as well as Anglo clients. However, as a specific group, less favorable outcomes are shown by Select one: A. African-Americans. B. Asian-Americans. C. Hispanics. D. Anglo-Americans. ```

Answer 225

Correct Answer is: A Using a Global Assessment Scale, Sue (1991) found that patients from all groups show improvement in scores following therapy, but as a group, African-Americans have less favorable outcomes than Asian, Hispanic, or Anglo Americans. Additional Information: Therapist-Client Similarity

Question 226

``` After being chewed out at work by his boss, a man comes home and yells at his family. According to psychoanalytic theory, the man is displaying which of the following defense mechanisms? Select one: A. projection B. displacement C. reaction formation D. sublimation ```

Answer 226

Correct Answer is: B In psychoanalytic theory, defense mechanisms function outside of conscious awareness to reduce anxiety caused by unconscious conflicts or external threats to the ego. Anna Freud described and classified different types of defense mechanisms. In displacement, the person redirects sexual or aggressive impulses away from a dangerous or threatening target to a safer target or outlet. In this question, the man's boss is the true target of his anger, but he redirects his anger towards his family. Regarding the other choices, projection involves attributing one's own unacceptable impulses or emotion to someone else. In reaction formation, the person converts an unacceptable wish or impulse to its opposite; the classic case would be a clergyman preaching rabidly against sexual immorality while strongly desiring or engaging in the very behavior he criticizes. And in sublimation, the person rechannels socially unacceptable impulses into socially useful activity, such as art or work; this is considered the healthiest and most successful defense mechanism. Additional Information: Defense Mechanisms

Question 227

``` Studies have been conducted to determine the relationship between number of therapy sessions and outcomes. Some of these studies demonstrate that, after only a few sessions, clients are most likely to show improvement in terms of which of the following? Select one: A. insight B. interpersonal skills C. sense of hopelessness D. stress ```

Answer 227

Correct Answer is: C The primary benefit of a few sessions of therapy is its impact on feelings of despair and hopelessness, which many new therapy clients feel. Apparently, the reduced sense of hopelessness is due to the fact that the client begins to feel that therapy may actually be of some help. Additional Information: Phase Model of Psychotherapy Effectiveness

Question 228

A meta-analysis differs from a literature review in that Select one: A. a meta-analysis involves a review of research in a more broadly defined area than a literature review. B. a literature review involves a review of research in which no statistical hypothesis tests were used. C. a meta-analysis, but not a literature review, involves calculation of an effect size. D. a literature review, but not a meta-analysis, involves calculation of an effect size

Answer 228

Correct Answer is: C Both meta-analyses and literature reviews involve a summation of research studies related to a particular topic or hypothesis. However, unlike a literature review, a meta-analysis involves calculation of an "effect size," or a statistic that indicates the average effect of a particular treatment across the studies reviewed. This involves converting data from many different studies into a common metric so that their results can be combined and compared. A literature review, by contrast, provides descriptive information only. Additional Information: Meta-Analysis

Question 229

Using a psychoanalytic approach, the sequence of interventions would be: Select one: A. confrontation, clarification, interpretation, working through B. clarification, confrontation, interpretation, working through C. confrontation, interpretation, clarification, working through D. free association, catharsis, interpretation, working through

Answer 229

Correct Answer is: A The first stage of psychoanalytic interventions is confrontation, in which the analyst points out that the client's behavior is connected to an unconscious conflict or motivation. The second stage is clarification, in which there is an exploration to better understand the client's unconscious motives. Interpretation is the third stage and includes a hypothesis about the source and meaning of a thought or behavior and is intended to illicit greater insight and understanding. Regardless of how correct or well-timed an interpretation may be, there must be a final stage of working through, during which the client gradually assimilates the insights into his or her personality. Additional Information: Steps in Psychoanalysis

Question 230

In psychoanalytic practice, transference is: Select one: A. counteracted through direct interpretation of its use as a resistance. B. discouraged as an interference with the treatment process. C. a sign that treatment is having an effect and discussed as the patient is made conscious of it. D. actively encouraged through direct confrontations regarding the patient's thoughts and feelings toward the therapist.

Answer 230

Correct Answer is: C Psychoanalysis as a treatment rests on the work of interpreting transference and resistance. The goal is to replace the acting-out neurosis with the transference neurosis, so that the patient can be made to see his or her conflicts as they are exemplified by his or her reactions in the analytic situation. In fact, the transference neurosis is something the therapist attempts to engender by remaining neutral and letting the patient project his or her feelings toward past significant others onto the therapist. Thus, it is a sign that the analysis is having an effect. If the patient cannot develop a true transference neurosis, as is true of many severely disturbed individuals, psychoanalytic success will be limited. Additional Information: Psychoanalytic Therapy: Techniques and Goals

Question 231

A common error made in working with mentally retarded individuals in therapeutic or educational settings is Select one: A. underestimating the patient's abilities. B. consulting family members. C. asking the individual to assess his or her own capabilities. D. having the patient participate in setting therapeutic goals.

Answer 231

Correct Answer is: A This is the type of question you should approach using common sense and the process of elimination. It is never a mistake to have students or therapy clients participate in assessment and goal setting to the degree that they are able. Also, you'd want to consult family members to assess current functioning in the home setting. So this leaves the first choice as the only reasonable option, and in fact, many authors have noted that therapists and teachers sometimes tend to underestimate the ability of mentally retarded clients and students.

Question 232

``` One commonality between Skinner and Freud is a(n) _______ view of behavior. Select one: A. deterministic B. holistic C. phenomenological D. adaptive ```

Answer 232

Correct Answer is: A Freud and Skinner differ on almost every dimension, with their main difference involving the origin of causation however they have a commonality in their reliance on determinism. Skinner maintained that all behavior is environmentally controlled through reinforcement contingencies, whereas Freud contended the primary cause of behavior is internal, unconscious mental mechanisms or psychic determinism.

Question 233

An African-American family presents for family therapy. From a systems perspective, it would be most advisable to: Select one: A. focus on multi-generational issues. B. see each family member individually. C. use behavioral techniques. D. educate family members about community resources.

Answer 233

Correct Answer is: A You probably could answer this one correctly by focusing on the word "systems" since, of the choices, focusing on more than one generation most implies that you would be looking at the entire family system. In addition, African-American culture, as compared to Anglo culture, tends to be characterized by a greater emphasis placed on relationships with extended family members. Additional Information: Counseling African-American Clients

Question 234

When applied to work with a client from an ethnic minority population, the term "healthy paranoia" refers to Select one: A. a lack of awareness on the part of the therapist of the client's cultural norms. B. a client's problems reflecting to some degree a rational response to discrimination. C. a client with a family history of paranoia who displays only minimal signs of paranoia. D. a client who refuses to work with a therapist who is not from the same background.

Answer 234

Correct Answer is: B Healthy paranoia refers to the phenomenon whereby clients from ethnic minority populations present as generally suspicious, but their behavior has more to do with a reaction to discrimination and racism than a personal problem. Often, this issue can interfere with the therapist-client relationship and needs to be addressed directly. Therapists also must keep this possibility in mind before assigning a diagnosis of psychopathology to such clients. Additional Information: Healthy Cultural Paranoia

Question 235

High levels of stress are associated with: Select one: A. tension headaches, but not migraine headaches. B. migraine headaches, but not tension headaches. C. both tension headaches and migraine headaches. D. neither tension headaches nor migraine headaches.

Answer 235

Correct Answer is: C As their name suggests, tension headaches are associated with stress. The psychological correlates of migraine headaches are less clear, and more than one theory has been proposed regarding this issue; however, clinical observation has suggested that stress often plays a role in their onset. Additional Information: Headaches

Question 236

``` The Stroop test demonstrates loss of response inhibition following: Select one: A. temporal lobe damage. B. parietal lobe damage. C. frontal lobe damage. D. severation of the corpus callosum. ```

Answer 236

Correct Answer is: C Performance deficits on the Stroop test demonstrate a loss of response inhibition following frontal lobe damage. Subjects are presented with a list of color words (blue, green, red, and so forth) with each word printed in colored ink, but not in the color denoted by the word (for example, the word "yellow" is printed in blue, green or red ink). The subject's task is to name the ink color in which each word is printed as quickly as possible. A correct response requires the inhibition of reading the color name. Patients with left frontal lesions are often unable to inhibit reading the words and thus were impaired at this task. Additional Information: The Stroop Color-Word Test

Question 237

``` Which of the following concepts is not a feature of Transactional Analysis (TA)? Select one: A. parent, adult, child ego states B. life positions C. psychosocial stages D. egograms ```

Answer 237

Correct Answer is: C The psychosocial stages of development are associated with Erik Erikson's theory. Transactional Analysis (TA) is a model of people and relationships that is based on two notions: first, that we have functional 'ego-states' to our personality; and second, that these parts converse with one another in 'transactions.' Berne's theory proposes we each have internal models or ego states of parents [i.e., Critical Parent (CP), Nurturing Parent (NP)], children [i.e., Free Child (FC), Adapted Child (AC)] and adults*, and that we play these roles with one another in our relationships as well as with ourselves internally. The ego states, which are expressed relative to one another, can be mapped using an egogram*. Life positions* in TA refer to the view we have of ourselves in relation to other people around us such as "I'm okay, You're okay" and its variations. (* These are correct statements which make them incorrect options.)

Question 238

Reduced incidence of substance abuse among Native American adolescents would most likely result from: Select one: A. normalizing substance use within tribal communities B. increasing the legal consequences of substance use C. aversive conditioning D. increasing bicultural competence

Answer 238

Correct Answer is: D Interventions designed to increase "bicultural competence" have been found effective in preventing substance abuse among Native American adolescents. These interventions help individuals develop coping skills that "blend the adaptive values and roles of both the culture in which they were raised and the culture by which they are surrounded" (LaFromboise, Assertion training with American Indians: Cultural/behavioral issues for trainers. Las Cruces: New Mexico State University, 1982, p. 12). Normalizing substance use would likely increase the incidence of substance abuse and has been regarded as one of the factors that contributes to the high rate of substance abuse among Native Americans. Increasing legal consequences of substance use has not been found to be a very effective deterrent for adolescents presumambly because adolescents do not always make rational decisions based on consideration of the perceived consequences of committing a crime. (D. M. Kahan, Between economics and sociology: The new path of deterrence. Michigan Law Review, 1997, 95, 2477-2497). Finally, aversive conditioning is more likely to be used as a treatment, rather than a method of prevention.

Question 239

``` Narrative therapy is associated with which of the following interventions? Select one: A. the miracle question B. discovering faulty cognitions C. externalizing conversations D. the scaling question ```

Answer 239

Correct Answer is: C Michael White and David Epston's narrative therapy is a postmodern therapeutic approach that explores the importance of the life stories people tell and the differences that can be made through the telling and re-authoring of these stories. A narrative therapist helps clients to deconstruct the meaning of the reality of their lives and relationships, showing the difference between the reality and the internalized stories of self, encouraging them to re-author their lives according to alternative and preferred stories of self-identity and ways of life and think of their lives within the framework of different stories. The re-authored stories externalize a client's condition or problem. "The person is not the problem. The problem is the problem." Some narrative techniques include encouraging patients to write stories, letters, essays or poems and recalling experiences in which a concern was vanquished or they responded to another individual with cathartic satisfaction. (See: White, M. & Epston, D. (1990). Narrative Means to Therapeutic Ends. New York: W. W. Norton.) The miracle and scaling questions are two techniques used by solution-focused therapists. The miracle question invites the client to imagine what it would be like if his/her problem was suddenly gone. The scaling question invites each family member to rate a situation to see how the problem is perceived by others. Additional Information: Narrative Therapy

Question 240

``` Client-therapist matching of ethnicity is a good predictor of Select one: A. treatment length. B. treatment outcome. C. both treatment length and outcome. D. neither treatment length nor outcome. ```

Answer 240

Correct Answer is: A While the findings are not entirely clear, overall there is a greater impact on premature termination rather than outcome, due to ethnic matching. It also seems that some groups are more likely to benefit than others. When there are benefits, they are usually related more to dropout rates than to treatment effectiveness. Additional Information: Therapist-Client Similarity

Question 241

``` A treatment approach that focuses on helping clients resolve their ambivalence about changing their behavioral patterns is: Select one: A. Cognitive-behavioral B. Motivational interviewing C. Conflict-Resolution therapy D. Solution-Oriented Therapy ```

Answer 241

Correct Answer is: B Motivational interviewing was originally developed by William Miller and is based on Prochaska and DiClemente's trans-theoretical model of change which views change as a process that occurs in stages. Motivational Interviewing is a therapeutic approach designed to help clients build commitment, resolve ambivalence, and reach a decision to change. It attempts to match therapeutic interventions with the client's stage of readiness to change. Additional Information: Motivational Interviewing

Question 242

A new professor is teaching her first class on feminist theory. What is she required to do? Select one: A. Present a balanced view of feminist theory vs. other theories B. Concentrate solely on feminist theory; it is a given that there are other views of psychology C. Use it as a forum for presenting her dissertation findings D. Present other theories, but explain why feminist theory is the most appropriate paradigm for women

Answer 242

Correct Answer is: A Present a balanced view of feminist theory vs. other theories is the best choice. This is more in line with Standard 7.03 (b) which deals with objectivity: "When engaged in teaching or training, psychologists present psychological information accurately" than two of the other options: "concentrate solely on feminist theory; it is a given that there are other views of psychology" and "present other theories, but explain why feminist theory is the most appropriate paradigm for women". Additional Information: Accuracy in Teaching

Question 243

Which of the following is the reason why many experts recommend 6 to 8 sessions as the duration of crisis intervention therapy? Select one: A. Six to eight sessions is about how long many crises last. B. Most people who are experiencing a crisis would not be able to endure the anxiety evoked by long-term psychotherapy. C. Most people who are experiencing a crisis cannot afford long-term psychotherapy. D. Individuals in a crisis state are usually so unbalanced that their unconscious mental contents have become conscious; as a result, the assessment and exploration phase of dynamic therapy is not necessary.

Answer 243

Correct Answer is: A A crisis occurs when a person's normal ways of adapting and coping are insufficient to meet the demands of a highly stressful situation. Intervention focuses on resolution of the immediate problem and restoration of the person to a previous level of functioning and coping. The assumption is that the person's problems do not represent a mental illness or any type of pathology; instead, the reaction, though maladaptive and inadequate, is viewed as understandable, under the circumstances. Since global personality change is not a goal, the duration is 6 to 8 sessions, in line with the normal evolution of a crisis. Additional Information: Goals and Characteristics of Crisis Intervention

Question 244

``` The therapist intentionally stays neutral in which therapeutic approach? Select one: A. psychoanalytic B. cognitive C. reality D. client-centered ```

Answer 244

Correct Answer is: A The assumption in "psychoanalytic psychotherapy" is that the therapist's neutrality allows the client to project onto the therapist positive or negative feelings he or she originally had for another significant person in the past. Analysis is the primary technique, and the primary targets of analysis are the client's free associations, resistances, transferences, and dreams. In some forms of "cognitive" therapy, the therapist may be quite confrontive and challenge a client's cognitions and behaviors rather than remaining consistently neutral. "Reality" therapy is also a confrontive form of therapy: It strives to teach clients specific behaviors that will enable them to fulfill their needs and the therapist-client relationship is viewed as a crucial aspect of therapy. Reality therapists also model responsible behaviors for their clients. Finally, "client-centered", or Rogerian, therapy is based on the assumption that if the right environment is provided by the therapist, a client will be able to achieve congruence between self and experience and be carried by his or her own innate tendency toward self-actualization. The "right environment" includes three facilitative conditions: unconditional positive regard, accurate empathic understanding, and genuineness or congruence. Additional Information: Psychoanalytic Therapy: Techniques and Goals

Question 245

According to Atkinson, Sue, and Sue, the ideal outcome of racial/cultural identity development is Select one: A. full acceptance of one's own culture. B. giving individual identity priority over cultural identity. C. recognizing that all cultures have acceptable and unacceptable aspects. D. recognizing the impact of racial/cultural oppression on one's mental health.

Answer 245

Correct Answer is: C The final stage in Atkinson et al.'s racial/cultural identity development model is referred to as the "integrative awareness stage." Individuals in this stage recognize that all cultures have both positive and negative aspects and decide which aspects they want to accept or reject. Additional Information: Minority Identity Development Model

Question 246

``` An anxious client has a churning stomach, which BASIC I.D. area would be primarily addressed by biofeedback? Select one: A. sensation B. affect C. behavior D. imagery ```

Answer 246

Correct Answer is: A According to Lazarus multimodal therapy (MMT), the acronym BASIC ID represents the seven areas of the client's life or categories of interrelated aspects of personality which need to be addressed for effective treatment: behavior, affect or affective response, sensation, imagery, cognition, interpersonal relationships, and the need for drugs or other biological functioning. Multimodal clinicians tailor treatment to meet the individual client's needs (i.e., different relationship styles, individual, couples or group therapy) holding that "the correct method delivered within and geared to the context of the client's interpersonal expectancies, will augment treatment adherence and enhance therapeutic outcomes." In this question, the first-order anxiety response is in the sensory modality (churning stomach), so sensory techniques such as biofeedback or relaxation exercises would be used as initial treatments. Additional Information: MultiModal Therapy (MMT)

Question 247

Beck's cognitive therapy includes all of the following characteristics except: Select one: A. it is referred to as "collaborative empiricism." B. it is structured and goal-oriented. C. relapse prevention is a focus throughout. D. it is based on an elaboration likelihood model.

Answer 247

Correct Answer is: D Beck's model includes all of the characteristics except an elaboration likelihood model, which is a cognitive model of attitude change that predicts that persuasion can occur in one of two ways--through a central and peripheral route (Petty, 1994). Beck's model is referred to as "collaborative empiricism" because it is founded on a collaborative relationship between the therapist and client, and involves gathering evidence and testing hypotheses about the client's beliefs. Additional Information: Beck's Cognitive Therapy

Question 248

Although conclusions will vary across different studies, which of the following statements is most supported by the overall body of research on therapy outcome for African-American and Caucasian patients? Select one: A. There is no significant difference in outcome between African-American and Caucasian patients. B. African-American patients have better outcomes overall than Caucasian patients. C. Caucasian patients have better outcomes overall than African-American patients. D. Treatment outcomes for African-American patients are better but only when the therapist is also African-American.

Answer 248

Correct Answer is: A Questions like these are difficult to answer, because research in this area is contradictory, and the issue is not resolved. Research has clearly identified a number of variables that potentially interact with race in influencing therapy outcome. For instance, African-American patients tend to have poorer outcomes when working with therapists who are insensitive to or unknowledgeable about racial or cultural issues. There are also studies that show that African-Americans are more likely to terminate therapy prematurely than Caucasians, and even a few studies which show they are likely to have poorer outcomes. However, the bulk of the literature and thinking on this issue supports the notion that race, in and of itself, is not a good predictor of therapy outcome. Additional Information: Counseling African-American Clients

Question 249

``` The object relations approach focuses on the role of ________ in personality development and views it as being an innate drive. Select one: A. sexuality B. social interest C. attachment D. identity ```

Answer 249

Correct Answer is: C Object relations theory emphasizes the role of early attachments between the individual and its caregivers on the individual's personality development. It also views attachment as an innate capacity that has survival value. Additional Information: Object-Relations Theory

Question 250

``` A psychologist who drinks five cups of coffee before each therapy session in order to be alert has decided that she will "go cold turkey" at the beginning of the next month. Prochaska and DiClemente (1992) would say that she is in the following stage of change. Select one: A. contemplation B. preparation C. action D. maintenance ```

Answer 250

Correct Answer is: B This is one of those rare theories where the name of the stages actually sounds like what they signify. Prochaska and DiClemente listed five stages in the change process. The first stage is precontemplation when the person has little insight that there is a need for change. The second stage is contemplation; the person is aware of and considering the need for change, but has not committed to it. The third stage is preparation which is an indication of the person's clear intent to take action in the future. Taking that action is the fourth stage. Maintenance is when our psychologist consolidates the change and takes steps to prevent the relapse (Stages of change in the modification of problem behaviors, in M.Hersen et al,. eds. Progress in Behavior Modification, Vol. 28, Sycamore, IL, 1992). Additional Information: Transtheoretical Model of Change

Question 251

``` The "fourth force" in psychology has been identified as: Select one: A. humanistic B. psychodynamic C. multiculturalism D. behavioral ```

Answer 251

Correct Answer is: C Multiculturalism has been defined as the fourth force in psychology, one which complements the behavioral, psychodynamic and humanistic explanations of human behavior. This "fourth force" originated within the civil rights and social movements of the 1960s. Pedersen (1991) defined multiculturalism as "a wide range of multiple groups without grading, comparing, or ranking them as better or worse than one another and without denying the very distinct and complementary or even contradictory perspectives that each group brings with it." Others advocate a narrower definition of multiculturalism, with attention to the racial/ethnic minority groups within a culture. Multicultural counseling often includes issues of race, ethnicity, culture, social class, sexual orientation, gender, physical ability, age, and religious preference. (See: Pedersen, Paul B. (1991). Multiculturalism as a fourth force in counseling. Journal of Counseling and Development, 70, 6-12.)

Question 252

``` Meta-analysis was first used in psychological research by: Select one: A. Binet B. Smith and Glass C. Eysenck D. Horn and Cattell ```

Answer 252

Correct Answer is: B Gene Glass coined the term "meta-analysis" in 1976 and Smith and Glass first used the technique in their psychotherapy outcome studies in 1977. A prior version of the technique was actually developed by Karl Pearson in 1904 (who is better known for his correlation coefficient); however, it was Smith & Glass' classic study which modified and popularized the technique. The benefit of meta-analysis is that it allows researchers to statistically compare the results of several independent studies to yield a single effect size indicating the magnitude of an independent variable's effect. Additional Information: Meta-Analysis

Question 253

According to Margaret Mahler, individuation involves Select one: A. developing relationships with significant others. B. developing an interest in the outside world. C. coming to recognize the existence of self and others. D. coming to recognize that Mother does not cease to exist when she disappears from sight.

Answer 253

Correct Answer is: C According to Mahler, a child must separate and individuate so that he or she can move from being part of a mother-child unit to being a member of a family. Separation occurs when the child disengages and differentiates from the mother, while individuation occurs when the child develops an inner representation of the mother, an ability to test reality, a sense of time, and an awareness of the existence of others as distinct from him or herself. In other words, when the child individuates, he or she moves away from symbiosis with the mother and toward the recognition and experience of his or her individual existence. Additional Information: Object-Relations Theory

Question 254

According to Aaron Beck, when faced with a negative event, a depressed person is most likely to maintain an: Select one: A. internal locus of control and internal locus of responsibility B. internal locus of control and external locus of responsibility C. external locus of control and internal locus of responsibility D. external locus of control and external locus of responsibility

Answer 254

Correct Answer is: C The locus of control/locus of responsibility model adds another element to the learned helplessness model in regards to depression. As you know, the learned helplessness model views depressed people as making internal, stable, and global attributions to negative events. However, the "internal" factor in the helplessness model refers only to locus of responsibility. As seen in the cognitive distortion called "personalization," a depressed person uses an internal locus of responsibility to blame him or herself for negative events. Paradoxically, depressed people also feel a lack of control over events, that is, they have an external locus of control - seeing external factors such as fate, luck, or other people as the cause of what happens to them. Additional Information: Etiology (Major Depressive Disorder)

Question 255

``` From the perspective of rational emotive therapy (RET), emotional disturbances are maintained primarily by Select one: A. self-indoctrination. B. environmental consequences. C. social pressure. D. denial. ```

Answer 255

Correct Answer is: A Ellis, the founder of RET, viewed behavioral disorders as stemming from both biological predisposition and early life experiences but argued that their maintenance was due primarily to self-indoctrination. Specifically, during early childhood, children tend to internalize the critical attitude of their parents and then perpetuate that attitude as they grow older. Additional Information: Rational Emotive Behavior Therapy (REBT)

Question 256

In addition to improved interpersonal relationships, a primary goal of interpersonal therapy (ITP) is: Select one: A. alleviating or reducing symptoms. B. satisfying needs in responsible ways. C. resolving underlying conflicts. D. living in an authentic, meaningful way.

Answer 256

Correct Answer is: A Based on a medical model, interpersonal therapy (ITP) views mental disorders as illnesses and focuses on symptom reduction in addition to improving interpersonal relationships. Additional Information: Interpersonal Therapy (IPT)

Question 257

``` Communication-interaction therapy espouses that communication has both a "report" function and a Select one: A. Principle of equifinality B. Command function C. Circular model of causality D. Paradoxical strategy ```

Answer 257

Correct Answer is: B Family therapists from the Mental Research Institute in Palo Alto such as Gregory Bateson, Virginia Satir, and Jay Haley described communication as having a "report function" that contains the content or informational aspect of the communication, and the "command function", that is often conveyed nonverbally and exemplifies the relationship between the communicators. The other choices are other concepts from the Mental Research Institute. "Principles of equifinality" refers to the idea that no matter where the system change occurs, the end result is the same. "Circular model of causality" is a concept in their approach that describes a symptom as both a cause and an effect of dysfunctional communication patterns. "Paradoxical strategies" include prescribing the symptom and relabeling, or changing the label a family attaches to a problem in order to change the meaning. Additional Information: Communication/Interaction Therapy

Question 258

If you want to keep a borderline patient involved with group therapy, what would be the best technique? Select one: A. You have them consult with a psychiatrist for a medication evaluation. B. You help the patient with the defense mechanism of splitting. C. You invite a client with a histrionic personality disorder to join the group. D. Offer individual therapy in addition to group therapy.

Answer 258

Correct Answer is: D Marsha Linehan (1993) has been achieving success with borderline patients with her use of dialectical behavioral therapy (DBT) which involves a combination of groups skills training and individual outpatient therapy. This combination has been successful at decreasing premature dropout rates in group therapy, as well as reducing suicide attempts and inpatient hospitalization rates. Additional Information: Dialectical Behavioral Therapy (DBT)

Question 259

The Mini Mental Status Exam (MMSE) is especially useful for: Select one: A. assessing reality testing in individuals with a Psychotic Disorder B. assessing level of consciousness in individuals with Delirium C. screening for Mental Retardation in children and adolescents D. screening for Dementia in older adults

Answer 259

Correct Answer is: D The Mini Mental Status Exam (MMSE) is a screening tool for cognitive functioning that assesses five areas of cognitive functioning: orientation, registration, attention and calculation, recall, and language. It is most useful for screening for Dementia in older adults. Additional Information: Mini Mental Status Exam

Question 260

Freud's psychosexual stages of development are based on: Select one: A. various levels of consciousness B. interpersonal conflicts which develop during specific age intervals C. areas of the body that experience sexual excitability in a fixed sequence D. five levels of basic human needs which can be hierarchically ordered

Answer 260

Correct Answer is: C Freud's psychosexual stages are based on the erogenous zones or areas of the body which become particularly sensitive to erotic stimulation during different developmental stages. various levels of consciousness This refers to Freud's structural model of the unconscious, preconscious, and conscious. interpersonal conflicts which develop during specific age intervals This refers to Erickson's theory of personality development. five levels of basic human needs which can be hierarchically ordered This refers to Maslow's theory. Additional Information: Psychosexual Development (Freud)

Question 261

``` Meyer's (2003) minority stress model identifies distal and proximal factors that contribute to mental health outcomes in gay, lesbian, and bisexual populations. A proximal stressor from the model is: Select one: A. homonegativism B. internalized homophobia C. minority group status D. discrimination and violence ```

Answer 261

Correct Answer is: B Meyer's minority stress model distinguishes between distal factors, which are external, objective events and conditions, and proximal factors, which are an individual's perceptions and appraisals of events and conditions. The minority stress model identifies three proximal stressors - expectations of rejection, concealment of sexual orientation, and internalized homophobia (the correct option). Minority group status* and exposure to "prejudice events" such as discrimination and violence* are identified as a distal events or as an "environmental circumstance" in Meyer's model. Prejudice, discrimination and stigma were linked with mental health problems. Homonegativism* refers to the beliefs and values of prejudiced individuals and is not part of the minority stress model (* incorrect options). [Meyer, I.H. (2003) Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence, Psychological Bulletin, 129(5), 674-697.]

Question 262

According to family therapists: Select one: A. when one family member improves, others will improve also. B. no member of a family will improve unless all members improve. C. if the identified patient improves, the family system will improve. D. if the family system changes, the identified patient will improve.

Answer 262

Correct Answer is: D You needed to approach this question from the point of view of a system. A system means that everything functions together. Knowing just that little piece, you probably could have gotten to the correct answer: once the system changes, the individuals will change. The work is at the systems level, not at the individual level. The alternative stating that "no member will improve unless all members improve" comes close to this idea, but it's not exactly the point of system theory. And, besides, you don't have to have all members improving before any one member improves. According to systems theory, individual symptoms can remit, however, without systemic change, other problems (either in that individual or in another family member) will arise. Additional Information: Properties of a Family System

Question 263

According to Nancy Chodorow (1978) roles in society will change only when we have a system of parenting in which men and women are equally responsible for child rearing. Chodorow feels: Select one: A. The present system doesn't reflect the gendered division of labor B. The present system teaches girls to remain attached to their mothers C. The present system teaches boys to remain attached to their mothers D. The present system cannot be explained through object relations theory

Answer 263

Correct Answer is: B Chodorow uses the principles of object relations theory (thus "cannot be explained through object relations theory" is incorrect) to show that girls are taught to stay attached to their same sex mother while boys are taught to differentiate (opposite of "teaches boys to remain attached to their mothers") from their mothers. Chodorow argues that the present system represents a gendered division of labor and that changes in gender relations will only occur when men and women are equally responsible for child rearing. Additional Information: Feminist Object-Relations Theory

Question 264

High-context cultures are characterized by Select one: A. reliance on elaborated (versus restricted) communication codes. B. heavy reliance on nonverbal (versus verbal) messages. C. restraint of feelings. D. emphasis on short-term goals.

Answer 264

Correct Answer is: B The terms "high context" and "low context" have been used to describe cultural differences in communication. A high-context style is characterized by reliance on nonverbal and culturally-shared cues and is characteristic of a number of cultural/racial minority groups including African-, Hispanic-, and Asian-Americans. Additional Information: Communication Styles

Question 265

Research suggests that, generally speaking, individuals who migrate to the United States from another country would be most likely to experience symptoms of psychiatric disorders: Select one: A. immediately before they migrate to the United States. B. immediately after they arrive in the United States. C. about one or two years after they arrive in the United States. D. five years or more after they arrive in the United States.

Answer 265

Correct Answer is: C In general, psychiatric disorders among immigrants and refugees are most frequent somewhere between the end of the first year through the third year after they immigrate to this country. This observation is related to what has been termed the "social displacement syndrome." This is the tendency of immigrants to initially experience elation and optimism, followed by a period of frustration, depression, and confusion as the reality of the adjustments required by their new lives sets in.

Question 266

According to Berry's acculturation model, marginalization is characterized by: Select one: A. low involvement in the mainstream culture. B. low involvement in both the mainstream culture and the minority culture. C. low involvement in the minority culture. D. low involvement in the mainstream culture and high involvement in the minority culture.

Answer 266

Correct Answer is: B Berry's model of acculturation distinguishes between two dimensions -- retention of the minority culture and maintenance of the majority culture. He proposes that these dimensions are independent, which means that a person can be high on one and low on the other; high on both; or low on both. Berry uses the term "marginalization" to describe the situation where a member of a minority group does not identify strongly with either culture.

Question 267

Which of the following factors are considered most important for competent multicultural counseling? Select one: A. commitment, sensitivity, and technique B. sensitivity, instillation of hope, and acceptance C. acceptance, awareness, and flexibility D. awareness, knowledge, and skills

Answer 267

Correct Answer is: D Multicultural competence is most often attributed to one's level of awareness, knowledge, and skills. "Awareness" refers to awareness of one's own beliefs, values, and stereotypes. "Knowledge" refers to knowledge of the worldviews of clients with different cultural backgrounds. And "skills" refers to the skills that are most appropriate for clients with different cultural backgrounds (D. W. Sue, Multidimensional facets of cultural competence. Counseling Psychologist, 2001, 29(6), 790-821). Additional Information: Counseling Ethnic Minorities

Question 268

Which of the following best describes the purpose of reframing in family therapy? Select one: A. It is a paradoxical technique designed to harness the family's resistance in the service of positive behavioral change. B. It is designed to increase the family's compliance with the therapist's directives and the treatment plan in general. C. It is designed to restore the family's homeostasis, or "balance." D. It is designed to increase the family's ability to differentiate intellectual from emotional functioning.

Answer 268

Correct Answer is: B Reframing is a technique of family therapy, especially structural and strategic family therapy. It involves relabeling or redefining a problem behavior in order to get the family to see it in a new light. For example, a therapist might tell a family that a child who frequently "talks back" is expressing insecurity and the need for love, rather than anger and disrespect. The purpose of reframing is usually to increase the family's compliance with treatment. In the example given, reframing might increase the family members' willingness to make changes in their own behavior, rather than focusing only on the identified patient. Additional Information: Reframing (Strategic Family Therapy)

Question 269

The term "best practices" refers to: Select one: A. empirical evidence to support effectiveness of counseling approaches B. counselor characteristics that contribute to increased effectiveness. C. matching certain client problems with specific counseling models D. clinical decision making accountability and concerns for service costs

Answer 269

Correct Answer is: A The term "best practices" is defined as approaches to counseling practice that have empirical evidence to support their effectiveness. It is one way managed care companies and practitioners strive to maintain accountability for costs of services and clinical decision making, as well as ascertain the most effective practices available to individuals. Additional Information: Type of Treatment (Psychotherapy Outcome)

Question 270

Which of the following techniques would be least useful when working cross-culturally with a traditional Japanese family in therapy? Select one: A. when possible, framing a family member's problems in an academic or vocational context to increase comfort with the counseling process B. establishing your credibility by providing information about your education and background in the first session C. providing the family with an immediate benefit in order to prevent premature termination D. fostering empowerment of family members by adopting an egalitarian approach

Answer 270

Correct Answer is: D Japanese (and other Asian) clients vary. However, a common generalization is that they prefer a structured, direct approach; another is that they view the therapist as a knowledgeable expert, so adopting an egalitarian approach would not be desirable. Additional Information: Counseling Asian-American Clients

Question 271

``` Beck identified a number of cognitive distortions including the tendency to focus solely on a detail that is taken out of context. He termed this: Select one: A. Selective abstraction B. Overgeneralization C. Personalization D. Dichotomous thinking ```

Answer 271

Correct Answer is: A Focusing solely on a detail is an example of selective abstraction. Overgeneralization is abstracting a general rule from one or two situations and then broadly applying it to other situations. Personalization is attributing external events to oneself without evidence of a causal correlation. Dichotomous thinking is categorizing experiences in one of two extremes. Additional Information: Cognitive Distortions (Beck)

Question 272

Differing locus of control and locus of responsibility combinations yield the four worldviews described by Sue and Sue (2003). Mainstream American culture would best be characterized by an: Select one: A. internal locus of control and external locus of responsibility B. internal locus of control and internal locus of responsibility C. external locus of control and internal locus of responsibility D. external locus of control and external locus of responsibility

Answer 272

Correct Answer is: B Worldview refers to the manner in which people perceive, evaluate and react to encountered situations. Sue and Sue describe mainstream American culture "as the epitome of the individual-centered approach that emphasizes uniqueness, independence and self-reliance" (p.277). This is characterized by an internal locus of control and locus of responsibility in Sue, D.W. & Sue, D. (2003). Counseling the culturally diverse: Theory and practice. 4th edition. New York: John Wiley.

Question 273

``` According to Piaget, cognitive adaptation to the environment is achieved through: Select one: A. symbolic thought and imitation B. accommodation and assimilation C. conservation and seriation D. reflexes and sensorimotor action ```

Answer 273

Correct Answer is: B For Piaget, cognitive adaptation to the environment is achieved via the dual processes of assimilation and accommodation. Piaget proposed children's cognitive structures and processing strategies direct both what is noticed, selected, or accommodated to, in the environment and how what is accommodated to is assimilated or interpreted.

Question 274

A patient obtains a T-score of 100 on the MMPI-2's F scale. This score indicates that Select one: A. the examinee is trying to fake good. B. the examinee is disoriented and confused. C. the examinee is defensive. D. the entire test should be considered invalid.

Answer 274

Correct Answer is: D The F, or Infrequency, scale is one of the MMPI-2's validity scales. It contains items that are answered in the scored direction very infrequently. Elevated scores on this score (i.e., T scores above 65) can occur for a number of reasons, including "faking bad," confusion and disorientation, and cognitive deficits. Mildly to moderately elevated scores on the validity scales can be interpreted clinically; however, scores of about 90 or greater could indicate random responding and completely invalidate the test. Additional Information: F or "Infrequency" Scale (MMPI-2)

Question 275

``` The first, non-pathologizing model of homosexual identity formation is associated with which of the following individuals? Select one: A. Troiden B. Cass C. Sophie D. Hanley-Hackenbrunch ```

Answer 275

Correct Answer is: B Vivienne Cass proposed individuals go through a six-stage, non-age specific, process of homosexual identity development. The stages are: identity awareness (conscious of being different); identity comparison (believes may be homosexual, acts heterosexual); identity tolerance (realizes is homosexual); identity acceptance (begins to explore gay community); identity pride (becomes active in gay community); and synthesis (fully accepts self and others). Richard Troiden outlined a four-stage age-graded model: sensitization, identity confusion, identity, identity assumption, and commitment. (See: Cass, V. C. (1979). Homosexual identity formation: A theoretical model. Journal of Homosexuality, 4, 219-235).Sophie postulated a four-stage coming out process: first awareness, testing and exploration, identity acceptance, and commitment. Hanley-Hackenbruch developed a three-stage model: prohibition; ambivalence/practicing or compulsion/exploration; and consolidation/integration. Two limitations shared by all four of the models are: the assumption of a stable, core sexual orientation which, at least in the final stages, excludes bisexual or transgender identity development; and the cross-cultural applicability of the developmental models.

Question 276

In brief psychodynamically-oriented therapy: Select one: A. positive transferences are encouraged and are viewed as essential to treatment progress. B. positive and negative transferences are encouraged early in treatment to ensure that a transference neurosis develops. C. positive and negative transferences are both discouraged because of the here-and-now focus of the treatment. D. negative transferences are encouraged because they are more likely than positive transferences to produce useful information for interpretation.

Answer 276

Correct Answer is: A Brief and long-term psychodynamic psychotherapy share a number of characteristics. A primary difference is that, in brief psychotherapy, a full-scale transference neurosis is discouraged. However, positive transference is seen as an important contributor to therapy progress.

Question 277

``` Which of the individuals listed is most associated with an emphasis on social interest? Select one: A. Berne B. Rogers C. Adler D. Perls ```

Answer 277

Correct Answer is: C Adler proposed an innate social interest primarily motivates people and acting in ways that fulfill social responsibilities is the goal of life.

Question 278

``` : Eric Berne feels which of the following reflect a person's characteristic pattern of giving and receiving strokes? Select one: A. Life position B. Transaction C. Script D. Ego state ```

Answer 278

Correct Answer is: C Berne called a person's life plan a script, and espoused that it reflected the person's characteristic pattern of giving and receiving strokes. The "life position" is one of the I'm OK, You're OK Sequence. "Transaction" was the term for communication between ego states and the "ego states" are parent, child, adult. Additional Information: Theory of Personality (Transactional Analysis)

Question 279

``` The initial stage in structural family therapy is to "join" the family system. To do so, which of the following would be most useful? Select one: A. mimesis B. enactment C. positioning D. alignment ```

Answer 279

Correct Answer is: A Mimesis is the term used to describe adopting a family's communication and affective style and is one way of joining the family system. Additional Information: Goals and Techniques of Therapy (Structural Family Therapy)

Question 280

Manual-guided treatment is to used to: Select one: A. reduce "treatment errors" and legal liability of practitioners B. ensure validity of procedures used to evaluate effectiveness of treatment C. improve treatment outcomes for diverse populations and diagnoses D. ascertain treatment effects in research by standardizing treatment delivery

Answer 280

Correct Answer is: D Initially, treatment manuals were developed to standardize treatments so that their effects could be empirically evaluated and provide guidelines for training therapists. Manual-guided treatments detail the theoretical underpinnings of a treatment, the treatment goals, and specific therapeutic strategies and guidelines. Research on manual-guided treatment outcome is inconsistent but has generally not found it to have substantially better outcomes than treatments not guided by the use of a manual, contrary to "improve treatment outcomes for diverse populations and diagnoses". (See: Beutler, L. E., et al. (2000). Therapist variables, in M. Lambert (ed.), Bergin and Garfield's Handbook of Psychotherapy and Behavior Change (pp. 227-306), New York: John Wiley & Sons.)

Question 281

``` A score of 15 on the Beck Depression Inventory-II denotes: Select one: A. severe depression B. moderate depression C. mild depression D. minimal depression ```

Answer 281

Correct Answer is: C The Beck Depression Inventory-II (BDI-II) assesses various aspects of depression through 21 individual items that the taker rates from 0-3 on a severity scale. Scores ranging from 0 to 13 indicate minimal depression. Scores from 14-19 indicate mild depression, 20-28 indicates moderate and 29 or higher reflect severe depression.

Question 282

``` In working with Native American clients, a therapist using Network Therapy would act primarily as a(n): Select one: A. catalyst B. wise parent C. blank screen D. educator ```

Answer 282

Correct Answer is: A Network Therapy has been recommended as an appropriate intervention for Native American clients. The therapist acts primarily as a catalyst who initiates the process and brings the client's family, friends, and relatives (i.e. the client's network) together to implement the therapeutic process. Additional Information: Counseling Native American Clients

Question 283

``` From the Freudian perspective, phobias are a means of reducing anxiety stemming from an unresolved conflict. Freud explained Little Hans's fear of horses, for instance, as due to an unresolved conflict that had its origins in the: Select one: A. genital stage. B. phallic stage. C. anal stage. D. oral stage. ```

Answer 283

Correct Answer is: B Freud described Little Hans's fear of horses as displacement of anxiety stemming from an unresolved Oedipus conflict. Additional Information: Phallic Stage (Freud)

Question 284

On which of the following dimensions does object relations psychotherapy differ most distinctly from traditional psychoanalytic therapy? Select one: A. interpretation of transference and resistance B. focus on maladaptive cognitions C. focus on authenticity of the patient's mode of being-in-the-world D. emotional neutrality or non-neutrality of the therapist

Answer 284

Correct Answer is: D There are different forms of object-relations therapy, but they tend to focus on the patient's modes of relating to others, including issues such as intimacy, control, autonomy and trust. The patient's object relations manifest in his or her interactions with the therapist, and the therapist strives to provide a safe caring environment in which the patient can resolve the pathological qualities of the transference relationship and by extension, other relationships (in some forms of object relations therapy, this is referred to as "re-parenting"). Unlike traditional psychoanalytic therapy, the therapist does not adopt a passive or neutral stance. The answer choice ("interpretation of transference and resistance") might have seemed liked a good answer, because in object relations therapy, interpretations do not play a curative role to the extent they do in traditional psychoanalytic therapy. However, they are a part of the therapeutic process in many forms of object relations therapy and therefore do not distinguish the two forms of therapy as well as emotional stance of the therapist. The other two choices have little to do with either traditional psychoanalytic therapy or objects relations therapy. Additional Information: Object-Relations Theory

Question 285

All of the following are generally considered to be characteristic of brief psychotherapy, except: Select one: A. time limited therapy B. lack of theoretical orientation C. effective for acute symptoms D. encourages the development of a positive transference between the client and the therapist.

Answer 285

Correct Answer is: B There are many different approaches to brief therapy including psychodynamic, cognitive-behavioral, and eclectic to name a few; however, brief therapy is always based on theory. Brief therapy, as its name implies, is time limited and effective for acute symptoms. A positive transference is also generally considered to be essential to the success of brief therapy. Additional Information: Brief Psychotherapy

Question 286

Premature termination would be most likely to occur when Select one: A. an African-American client has a Caucasian therapist. B. an African-American client has an African-American therapist. C. a Caucasian client has an African-American therapist. D. a Caucasian client has a Caucasian therapist.

Answer 286

Correct Answer is: A Research with African-American clients on the relationship between therapist-client racial similarity and therapy effectiveness has yielded contradictory results and suggests that this relationship is mitigated by a variety of factors. A clearer relationship exists between similarity and premature termination, with the probability of premature dropout increasing when an African-American client works with a racially dissimilar therapist. Additional Information: Therapist-Client Similarity

Question 287

``` According to Janet Helms, a White member of a city council meeting, which consists of members from different racial and cultural backgrounds, is most likely to work cooperatively if the member is in which stage of development: Select one: A. contact B. integration C. reintegration D. autonomy ```

Answer 287

Correct Answer is: D Janet Helms developed the White Racial Identity Development Model, which consists of six stages. "Contact", the first stage, is characterized by ignorance and disregard of any racial differences. The next stage is "disintegration" which involves awareness of racial inequalities which results in moral confusion and conflict. This is followed by "reintegration", in which Whites are viewed as superior to minorities. "Pseudo-Independence" is marked by dissatisfaction with reintegration. "Immersion-Emersion" follows, during which, people embrace their whiteness without rejecting minorities. "Autonomy", the last stage, is reached when a person internalizes a nonracist White identity, whereby similarities and differences are acknowledged but are not perceived as threatening. Note that "Integration" is not one of the stages in Helms' model; rather, it refers to Berry's Acculturation Model, in which a minority has a high retention for the minority culture and high maintenance of the mainstream culture. Additional Information: Helms' Racial Identity Models

Question 288

``` A child feels confident in reaching out to others because as a baby they had a secure bond with their mother. This information would be important to a psychologist with the theoretical approach of: Select one: A. cognitive- behavioral B. object-relations C. Family systems D. Psychotherapeutic ```

Answer 288

Correct Answer is: B According to object relations theory, an object introject is the mental representation of a person, either the self or the mother. In a healthy environment the child comes to develop representations of itself based on the early interactions with the mother. When normal and age-appropriate development is delayed or skewed by having a distrubed parent, the person could easily fail to develop object introjects. Additional Information: Object-Relations Theory

Question 289

Which of the following statements best describes the role of countertransference in the process of psychoanalytic therapy, according to current psychoanalytic thought? Select one: A. When present, countertransference is invariably detrimental to the therapy process. B. Countertransference helps the therapist identify his or her own unresolved issues and become a better clinician as a result. C. Countertransference can help the therapist identify subtle aspects of the transference and better understand the patient's experience. D. Countertransference allows the therapist to show the patient that he or she is human after all.

Answer 289

Correct Answer is: C Countertransference refers to the therapist's transference responses to the patient. According to current psychoanalytic thought, a therapist's analysis of his or her own countertransference reactions can help the therapist recognize subtle aspects of the transference relationship and better understand the patient's experience. Additional Information: Psychoanalytic Therapy: Techniques and Goals

Question 290

``` The form of therapy based partially on the work of Harry Stack Sullivan that typically focuses on specific problem areas such as grief, role transitions, and social deficits is Select one: A. narrative therapy. B. interpersonal therapy. C. self-control therapy. D. rational-emotive therapy. ```

Answer 290

Feedback Correct Answer is: B Interpersonal Psychotherapy (IPT) is a short-term approach to the treatment of depression, and specifically for four problem areas it views as common in depressed clients: grief, role disputes, role transitions, and interpersonal deficits. The approach is based in part on the work of Harry Stack Sullivan, who is credited as one of the first pioneers of psychotherapy to focus on intrapersonal as opposed to intrapsychic problems. Treatment, which may consist of 12-20 sessions, is divided into three phases. In the initial phase, the presenting issue is identified and conceptualized as an interpersonal problem. Interventions in the intermediate phase depend on the specific problem area, but they focus directly on the problem area and interpersonal or social issues that contribute to it. Typical interventions include social skills training, role playing, and homework assignments. In the termination phase, the therapist and the client review the latter's progress, acknowledge the new skills acquired, and address feelings of loss that termination may evoke. Although originally developed as an individual therapy for adult depression, IPT has been modified and applied to treating adolescents and couples, and also to the treatment of other disorders seen as connected to interpersonal deficits, such as eating disorders. Additional Information: Interpersonal Psychotherapy

Question 291

``` Which of the following would most indicate malingering (i.e., an attempt to "fake bad") on the MMPI-2? Select one: A. high K score B. high F score C. low F score D. high L score ```

Answer 291

Correct Answer is: B An elevated F score, particularly within the range of 80 to 99 suggests malingering ("faking bad"), exaggeration of difficulties, resistance to testing, or significant psychopathology. All of the other choices, i.e., high K, high L, and low F scores indicate the reverse, that is, an attempt to be viewed in an overly favorable light ("faking good"). (G. Groth-Marnat, Handbook of psychological assessment, 2nd ed. New York, John Wiley, 1990). Additional Information: F or "Infrequency" Scale (MMPI-2)

Question 292

A culturally-encapsulated therapist: Select one: A. exhibits a bias that involves interpreting all of the presenting problems of minority clients as the direct result of cultural factors. B. has had little or no contact with members of minority groups and exhibits a lack of interest in working with these individuals in therapy. C. attempts to overcome his or her cultural biases by adopting a "culture-blind" perspective that may or may not be appropriate. D. tends to accept cultural stereotypes about members of minority groups without question and is unaware of his or her cultural biases.

Answer 292

Feedback Correct Answer is: D The notion of cultural encapsulation was originally described by Wrenn in 1962. A primary characteristic of a culturally-encapsulated counselor is an acceptance (usually unconscious) of traditional cultural stereotypes. Additional Information: Cultural Encapsulation