Counseling Families, Diagnosis, and Advanced Concepts II Flashcards
(156 cards)
1
Q
A married couple brings their two children to counseling for behavioral problems. The 14-year-old daughter stays out late and their 17 year old son is using drugs. According to most marriage and family therapists the identified patient would be
a. the 17-year old son
b. the 14-year-old daughter
c. the family
d. both children
A
c
2
Q
You are seeing a husband and wife for marriage counseling. During one of the sessions you decide to see them separately. The husband tells you he has seen an attorney because he is filing for divorce. He has not told his wife and indicates that he will not do so. You feel the wife has a right to know this because it will help her plan for the future. You should
a. only tell his wife if he gives you permission
b. communicate his intent to his wife since ethics guidelines state you may do so when a member of the couple is contemplating divorce
c. not tell the wife since research indicates that women respond more positively to divorce when they have less time to think about it
d. terminate the husband unless he tells her
A
a.
3
Q
You are supervising a licensing candidate who is primarily interested in marriage and family counseling. You are very attracted to her and have sex with her. According to ethics guidelines
a. this is perfectly ethical, since this is a student and not a client
b. this is unethical
c. this is perfectly ethical, since this is a supervisee and not a client
d. a and c are both correct
A
b.
4
Q
The fastest growing clientele for professional counselors are persons
a. experiencing bipolar disorder
b. experiencing suicidal ideation
c. experiencing marriage and family problems
d. who abuse their children
A
c.
5
Q
Family counselors generally believe in
a. circular/reciprocal causality (e.g., dynamics of family members)
b. linear causality
c. random causality
d. dream analysis
A
a.
6
Q
Cybernetics is a concept used by family therapists. It is usually associated with the work of
a. Freud and Ellis
b. Norbert Wiener
c. Virginia Satir
d. behavioral family therapists and cognitive family therapists
A
b. Wiener - family has feedback loops to self-correct a family system
7
Q
A family that is stable and reaches an equilibrium is in a state of
a. adaptability
b. enmeshment
c. nonsummativity
d. homeostatsis
A
d. homeostatsis - maintaining a balanced state
8
Q
This concept suggests that any system including the family is greater than the sum of its parts (the individuals in it) and therefore it is necessary to examine patterns rather than merely each individual’s behavior.
A
nonsummativity
9
Q
Adaptability is the ability of the family to balance
a. ego strength
b. stability and change
c. morphostasis and morphogenesis
d. b and c
A
d. morphostasis is the ability of the family to balance stability while morphogenesis refers to the family’s ability to change
10
Q
A family wants to see you for counseling; however, they have a very limited income and can’t afford to pay. You therefore agree to see the family for free (i.e., pro bono). The term that best describes your actions would be
a. aspirational ethics
b. mandatory ethics
c. empathy
d. all of the above
A
a. mandatory - rigid and clear cut
aspirational - describe ideal
11
Q
Experiential conjoint family therapy is closely related to the work of
a. Virginia Satir
b. Albert Ellis
c. Jay Haley
d. Salvador Minuchin, the father of structural family therapy
A
a. Satir - family could be healed via love - clashed with Minuchin who advocated scientific interventions
12
Q
Virginia Satir felt that a major goal of therapy was to improve intrafamily communication (i.e., communication between family members). According to Satir, four basic patterns prevented good communication under stress. These defensive postures or stress positions are: placating, blaming, being overly reasonable, and being irrelevant. Placating means
a. you disagree with all the other family members
b. you pick a favorite family member and agree with him or her
c. you ignore the other family members
d. you try to please everybody out of a fear of rejection
A
d. placating style causes the individual to sacrifice his or her own needs as a way of dealing with stress
13
Q
The placater is a people pleaser under stress while the blamer
a. will sacrifice others to feel good about himself
b. will often say, “if it weren’t for you…”
c. will point the finger at others to avoid dealing with his or her own issues
d. all of the above are typical bx of the blamer
A
d.
14
Q
The person who becomes overly reasonable
a. practices excitation
b. cries a lot during therapy session
c. is likely to engage in the defense mechanism of intellectualization
d. has a high degree of emotion
A
c. emotionally detached
15
Q
According to Satir, the individual displaying an irrelevant style
a. will distract the family from the problem via constantly talking about irrelevant topics
b. will become a people pleaser
c. will analyze the situation more than most
d. all of the above
A
a.
16
Q
Virginia Satir is considered a leading figure in experiential family therapy. _________ is sometimes called the dean of experiential family therapy.
a. Ludwig von Bertalanffy
b. Gregory Bateson
c. Carl Whitaker
d. Murray Bowen
A
c. Whitaker - experience, not education, changes families - experiential symbolic family therapy
17
Q
Who developed the systems theory model?
a. Ludwig von Bertalanffy
b. Gregory Bateson
c. Carl Whitaker
d. Murray Bowen
A
a. a biologist
18
Q
Carl Whitaker’s interaction with the family could best be described as
a. quiet and empathic
b. joining the family and experiencing it as if he were a family member
c. a reality therapist
d. a cognitive behavior therapist
A
b.
19
Q
According to Whitaker,
a. a cotherapist is helpful
b. a cotherapist should never be used
c. a cotherapist should be used only with blended families
d. all of the above could be true
A
a. cotherapist could provide meaninful feedback
20
Q
Psychotherapy of the absurd is primarily related to the work of
a. Virginia Satir
b. Carl Whitaker
c. Maxie C. Maultsby, Jr.
d. William Glasser
A
b.
21
Q
Psychiatrist noted for creating rational self-counseling that is similar to Ellis’s REBT is
a. Virginia Satir
b. Carl Whitaker
c. Maxie C. Maultsby, Jr.
d. William Glasser
A
c.
22
Q
A behavioristic marriage and family therapist is counseling the entire family together. She turns to the 18 year old son who is attending community college and says, “You must complete your sociology essay before you can use the family car and go out with your friends.” Which theorist is primarily guiding her intervention strategy?
a. David Premack’s principle or law
b. Ivan Pavlov and John B. Watson
c. B. F Skinner
d. all of the above
A
a. Premack’s work suggests that a family member must complete an unpleasant task (LPB) before he or she would be allowed to engage in a pleasant task (HPB)
23
Q
A behavioristic marriage and family therapist is counseling the entire family together. She turns to the 18 year old son who is attending community college and says, “I know you like to play golf. Therefore, every time you cut the grass your father will take you to play golf. I am going to have you and your dad sign a contract that you agree with this policy.” Which principle is primarily guiding her strategy?
a. negative reinforcement
b. thought stopping
c. shaping with successive approximations
d. quid pro quo
A
d. quid pro quo - latin for “one thing for another”
24
Q
A male is supervising a female counselor for state licensing. He tells her that he will continue to supervise her as long as she has sex with him. This is an example of
a. quid pro quo
b. a legal but not an ethical violation
c. a and b
d. none of the above
A
a.
25
A behavioristic family counselor suggests that the family chart the number of times that 6-year-old Billy says, "no" when he is told to do something. The baseline of the chart would refer to
a. the period when positive reinforcement is being implemented
b. the period when negative reinforcement is being implemented
c. the period when quid pro quo is being implemented
d. the period before the behavior modification begins
d.
26
The family counselor explains to Mrs. Smith that the next time that 9 year old Sally hits her little brother she must sit in the family room by herself. The counselor is using
a. shaping
b. shaping with successive approximations
c. reciprocity
d. time-out, a procedure that most behaviorists feel is a form of extinction
d.
27
Mrs. Chance tells a family therapist that she pays all the bills, does all the cleaning, and brings in 90% of the family's income. Moreover, Mrs Chance is convinced that her husband does not appreciate her or show her affection. According to the behavioristic principle of family therapy known as reciprocity
a. there is a good chance that Mrs Chance will consider leaving the marriage
b. it may seem paradoxical; nevertheless, Mrs Chance will be more committed to making the marriage work
c. it may seem paradoxical; nevertheless, Mr. Chance will consider leaving the marriage
d. this situation will have virtually no impact on this couple's marriage.
a.
28
A couple is having sexual problems that stem from anxiety. A marriage counselor who is a strict behaviorist would most likely
a. dispute the couple's irrational thinking
b. prescribe thought stopping
c. rely on systematic desensitization procedures
d. rely primarily on paraphrasing and reflection
c. Wolpe's systematic desensitization
29
A family counselor notices that the husband in a blended family is having obsessive sexual thoughts about a women living down the street. A strict behaviorist would most likely
a. analyze the man's dreams
b. have him chart the incidence of the bx, but do little else
c. practice thought stopping
d. rely primarily on Joseph Wolpe's systematic desensitization
c.
30
You secure a job as the executive director of a family counseling agency. As you go through your files you discover that five years before you took the job the agency selected 100 families and counseled them using strict behavioristic model. The agency took next group of 100 families and counseled them using Satir's experiential conjoint family therapy model. Each family received 12 sessions of therapy and each family took a before/after assessment that accurately depicted how well the families were functioning. You decide to run a t test to examine whether or not a statistically significant difference is evident between the two approaches. This is
a. an ex post facto correlation study
b. causal-comparative or ex post facto research
c. a true experiment
d. simple survey research
b. occurred in past, researcher did no have control over independent variable, t test eliminates correlation
31
All of the techniques listed below would be used by a behavioristic family therapist except
a. family sculpting
b. a functional analysis of bx followed by operant conditioning
c. modeling
d. chaining and extinction
a. Family sculpting - Satir experiential approach
32
Which statement is true of families?
a. The divorce rate has decreased markedly in the last several years
b. Remarriage today is uncommon
c. Remarriage today is common
d. The divorce rate in the US hovers at about 10%
c. 25% of all marriages are getting remarried, divorce rate is 50%
33
Which statement is true?
a. Single life is short-lived for divorced persons. About 30% of all divorced persons are remarried within 12 months of being divorced.
b. Most persons who are divorced do not remarry
c. Most persons who are divorced wait a minimum of five years to remarry
d. Women remarry quickly, however, men do not.
a.
34
The theory of psychodynamic family counseling is primarily associated with
a. William Glasser
b. Sigmund Freud
c. Virginia Satir and Carl Whitaker
d. Nathan Ackerman
d. Ackerman - analytically trained child psychiatrist, concerned with the internal feelings and thoughts of each individual as well as the dynamics between them
35
In psychoanalytic family therapy the word object means
a. a dream
b. a significant other with whom a child withes to bond
c. transference
d. countertransference
b. individual's attempt to establish a r/s with an object to satisfy needs
36
In psychoanalytic family therapy the term introjects really means that the client
a. internalizes the positive and negative characteristics of the objects within themselves
b. possesses internal verbalizations
c. possesses a finite number of problems solving options
d. possesses the internal motivation to solve his or her own difficulties
a. internalizes (taking in personality attributes of others that become part of your own self-image)
37
Pick the best examples of the psychoanalytic concept of splitting.
a. a client who realistically perceives her therapist as a very empathic person
b. a client who realistically perceives her therapist as only having good qualities
c. a client who sees her therapist as all bad
d. b and c
d.
38
A 72 year old woman you are counseling in a family reminds you of your mother and this is bringing up unresolved childhood issues for you as the counselor. This is an example of
a. positive transference
b. negative transference
c. countertransference
d. ambivalent transference
c. unconscious reaction to the family
39
A family actually changes the structure of their family system. According to Watzlawick, Weakland, and Fisch, the family has achieved
a. second-order change that is more desirable than first-order change
b. first-order change that is more desirable than second-order change
c. mediation
d. a Greek chorus
a. first order change can be defined as changes that are superficial - ameliorates sxs
40
A woman sees her husband as all good sometimes and all bad at others. An analytically trained family therapist who believes in object relations would see this as
a. ambivalent transference
b. splitting
c. dysthymia
d. psychotic behavior
b. splitting
41
Nathan Ackerman is considered a famous psychoanalytic family therapist; So are
a. Carl Rogers and Albert Ellis
b. Arnold Lazarus and Joseph Wolpe
c. William Glasser and Robert Wubbolding
d. James Framo and Robin Skynner
d. Framo - believes that important objects often fuel "love-hate" feelings in kids, Skynner - kids who had poor role models as children possess protective systems
42
```
What model?
Rogers
Ellis
Glasser
Lazarus
Wolpe
```
```
Rogers - person-centered
Ellis - rational emotive behavior therapy
Glasser - reality therapy
Lazarus - BASID ID, multimodal therapy
Wolpe - systematic desensitization
```
43
Cloe Madanes and Jay Haley are associated with the _______ school of family counseling
a. strategic
b. behavioral
c. psychodynamic
d. object relations
a. Haley - strategic therapy, impacted by Milton Erickson
44
When Haley began investigating psychotherapy he
a. was already trained as a Freudian analyst like so many other pioneers in the field
b. was already trained as a behaviorist
c. had studied REBT with Ellis
d. had a degree in the arts and communication rather than the helping professions.
d.
45
Jay Haley believes in giving clients directives. You are counseling a family and during the session the 14 year old daughter exclaims that she is suicidal. The best example of a directive would be
a. You turn to the 14 year old daughter and say, "You seem to be saying that living is too painful."
b. You turn to the 14 year old daughter and say, "Could it be that you want to hurt yourself because your boyfriend no longer wishes to see you?"
c. You turn to the family and say, "If your daughter threatens suicide this week I want the entire family - including your daughter - to stay home and nobody leaves for the day."
d. You turn to the family and say, "Could this be a family problem rather than a difficulty for your daughter?"
c. a directive is when the therapist tells a client or family what to do
46
Which of these responses is the best example of the double-bind concept used in Jay Haley's strategic therapy? You are trying to help a client stop smoking.
a. You hypnotize her and tell her she will never smoke another cigarette again. After you awaken her you admonish her to smoke as many cigarettes as she can for the first three days
b. You recommend that the client chart the number of cigarettes she smokes
c You tell her to mentally visualize herself as a nonsmoker whenever she has the desire to smoke
d. all of the above
a.
47
The directive or prescription given to the smoker in the previous question could best be described as
a. a paradoxical intervention
b. a cognitive intervention
c. an object relations intervention
d. a behavioristic intervention
a.
48
A couple tells a therapist using strategic family therapy that they have a quarrel at least once every evening. The therapist says, "Between now and the next time I see you I want you to have a serious quarrel at least twice every evening." This is an example of
a. relabeling, which is commonly used in this form of therapy
b. reframing, which is commonly used in this form of therapy
c. prescribing the symptom
d. a directive that is not paradoxical or a double bind
c. paradoxical strategy
49
Strategic family counselors often rely on relabeling or reframing. A client says his girl friend yells at him every time he engages in a certain behavior. The best example of reframing or relabeling would be
a. a counselor who remarks, "Research seems to show that when she yells at you it is because she loves you so much. A woman often feels foolish if she hugs or kisses you in a situation like that."
b. a counselor who remarks, "Can you tell me about it in the present moment, as if she is yelling at you this very minute?"
c. a counselor who remarks, "You are upset by her verbal assaults."
d. a counselor who remarks, "Are you really hurt by your girl friend's remark or is it the fact that you are telling yourself how catastrophic it is that she said these things?"
a. redefine a situation in a positive context
50
In strategic family counseling the person with the power in the family
a. has the authority to make rules and enforce them
b. is usually extremely aggressive
c. is usually not willing to follow a family therapist's prescriptions or directives
d. is the one who talks the most
a.
51
Psychoanalytic practitioners do not attack sxs directly. Strategic therapy
a. does not attack the sxs directly either
b. is pragmatic and often focuses on abating sxs
c. does not take a position on whether a counselor should attempt to ameliorate sxs or not
d. takes the position that if you can change each family member's unconscious, then sxs will gradually disappear
b. solution/sxs focused and very action oriented
52
Cloe Madanes insists that sxs serve a function. A child, for example, sees that her mother is depressed. The daughter throws a glass cup tot he floor to break it. This brings her mother out of the depressed state and makes her mother angry and powerful. this is known as
a. symptom substitution
b. the perverse triangle
c. incongruous hierarchy
d. latency
c. Madanes believes to help children find more direct ways to help their parents so that their sxs no longer serve a viable purpose. Incongruent - b/c daughter is in control.
53
Madanes advocates pretend techniques that are somewhat paradoxical. An example might be
a. a child who has panic attacks pretends he has a mental bullhorn in his head and shouts "stop".
b. a child who has panic attacks pretends in his mind that a therapist is counseling him
c. a child who has panic attacks pretends his dad is a therapist during the actual family therapy session
d. a child who has panic attacks pretends to have one during the session and the parents pretend to help him
d.
54
A strategic family therapist says to a family, "I don't know what else you can do to stop the bickering and fighting in your house." This is an example of
a. restraining
b. quid pro quo
c. pretending
d. interpretation
a. restraining - warn family or individual about the negative consequences of change
55
A client remarks that her depression is extremely intense. her strategic counselor remarks, "It is very possible your depression is hopeless. It is possible you will never get over it." Her comment is an example of
a. a blatant ethical violation
b. positioning
c. cohesion
d. behavioral disputation
b. positioning occurs when a helper accepts the client's predicament and then exaggerates the condition
56
Strategic techniques include: (4 paradoxical interventions)
restraining, positioning, prescribing the sxs and relabeling/reframing are all examples of paradoxical interventions since they defy common sense
57
A family counselor treats an Asian-American family exactly like he treats the Hispanic families in his caseload. He also imposes values from his own culture on them. This counselor has been described in the literature as
a. culturally sensitive
b. lacking cultural sensitivity
c. culturally encapsulated, a term suggested by counseling pioneer Gilbert Wrenn
d. b and c
d. cultural encapsulation - results in a counselor imposing goals from his or her own culture on ppl from another culture
58
Which statement is true of African-American families?
a. They are the largest minority in the US
b. Fewer African Americans are getting married than at any time in history and out-of-wedlock births account for two out of three first births to African-American women under the age of 35
c. African Americans are less likely to be concerned about gender roles
d. b and c
d.
59
When working with an African-American family the best approach would probably be
a. Bowen's family therapy; Minuchin's structural family therapy, or Jay Haley's strategic family therapy
b. cognitive family therapy
c. Ackerman's psychoanalytic approach to family therapy
d. a strict reality therapy approach based on the work of psychiatrist William Glasser
a. problem focused, brief, or multigenerational approaches fare best
60
When counseling Asian-American families the best approach would most likely be
a. Nathan Ackerman's psychoanalytic approach
b. behavioral family therapy
c. solution focused/problem focused modalities
d. a, b, and c
c.
61
Which statement is true of Hispanic families?
a. They have a high unemployment rate, often live in poverty and rarely earn high school diplomas or college degrees
b. They have higher than average incomes but usually don't finish high school or college
c. They have college degrees, but still generally live in poverty
d. They prefer long-term tx in therapy
a. less education, high poverty rate - short-term/structural approaches appear to work well
62
A model by Olson, Sprenkle, and Russell suggests that family functioning can be described in two dimensions - cohesion and adaptability. The family therapy term cohesion refers to the level of emotional bonding between family members. Adaptability refers to
a. a family's level of enmeshment or disengagement
b. a family's ability to adapt to the therapist's personality
c. a family's ability to adapt to the theoretical persuasion of the therapist
d. how rigid, structured, flexible or chaotic the family is
d.
63
Which statement is true regarding Native American families?
a. They are a very diverse group as they belong to over 500 state-recognized tribes
b. Extended family and the tribe are very significant
c. A high percentage of children have been placed in foster care homes, residential facilities, or adoption homes that are non-Native American
d. All of the above are true
d.
64
The statement, "Native Americans have a problem with alcoholism and suicide," is
a. false
b. true as far as alcoholism is concerned, however, false where suicide is concerned
c. true
d. true regarding the suicide rate, however, false regarding their use of alcoholic beverages
c.
65
Murray Bowen is known for his work in intergenerational family therapy. When Bowen refers to triangulation he means
a. that most people have three ego states (i.e., the Parent, the Adult, and the Child) in their personality
b. that most ppl have a personality structure composed of the id, the ego, and the superego
c. when a dyad is under stress a third person is recruited to help stabilize the difficulty between the original dyad. This could even be a child placed in the middle of the conflict
d. therapy has three distinct phases
c.
66
One of the primary goals of Bowen's intergenerational family therapy is differentiation. Differentiation is
a. the extent that one can separate one's intellect from one's emotional self
b. the extent that one is different from one's peers
c. the extent that one is different from one's childhood
d. the same as fusion
a.
67
Bowen popularized a three-generational pictorial diagram as a therapy tool. This is known as
a. an histogram
b. a sociogram
c. a genogram
d. family sculpting
c. genogram - should depict three or more generations
68
An intergenerational family therapist says she is concerned with the nuclear family emotional system. She is referring to
a. the fact that although the current family in therapy has an emotional system, this emotional system is influenced by previous generations whether they are alive or dead
b. the fact that a genogram should depict a single generation
c. the fact that emotional discord is a function of the unconscious mind
d. the miracle question
a.
69
Albert Ellis is to REBT as Salvador Minuchin is to
a. the MRI model
b. structural family therapy
c. intergenerational family counseling
d. behavioral family counseling
b.
70
An important technique in structural family therapy is joining. Which statement most accurately depicts this intervention?
a. The therapist meets, greets, and attempts to bond with the family. The therapist will use language similar to that of the family and mimesis which means that he or she will mimic communication patterns
b. the therapist is professional but distant
c. the therapist joins the family and sympathizes with their difficulties
d. Joining is used during the final session of therapy
a.
71
A family is seeing a structural family therapist because there is a huge argument every time the subject of the 16-year-old daughter's boyfriend comes up. The therapist says, "Okay, I want you to play like you are at home and act out precisely what transpires when the subject of your daughter's boyfriend is mentioned." The structural family therapist is using a technique called
a. joining
b. reframing
c. enactment
d. cognitive disputation
c.
72
When a structural therapist uses the term boundaries he or she really means
a. the limits of the human mind
b. the limits of bx in the family
c. the separation of the family members from their family of origin
d. the physical and psychological entities that separate individuals and subsystems from others in the family
d. changing boundaries
73
In Minuchin's structural approach, clear boundaries are
a. pathological
b. rigid
c. also called diffuse boundaries
d. ideal - firm yet flexible
d.
74
A woman is having difficulties at her place of employment. Her husband turns to her in a session and says, "You're on your own, I've got my own problems." A structural family therapist would assert that the boundaries between this couple are
a. rigid
b. clear
c. diffuse
d. a combination of a and c
a. rigid - disengaged
75
A mother insists on accompanying her 20 year old daughter on a date. A structural therapist would assume that
a. the family has clear boundaries
b. the family has rigid boundaries
c. the family has diffuse boundaries
d. the family supports individuation
c.
76
Minuchin would often mimic the family's style. This is known as
a. cognitive disputation
b. the structural map
c. permeable boundaries
d. none of the above
d. mimesis - therapist copies the family's style
77
Ackerman is psychodynamic. Haley is strategic. Minuchin is structural. Bowen is intergenerational. Another well-known intergenerational family therapist would be
a. Alfred Adler
b. the Hungarian analytically trained psychiatrist Boszormenyi-Nagy
c. Andrew Salter
d. Mara Selvini-Palazzoli
b. Boszormenyi-Nagy discusses the importance of give-and-take fairness or relational ethics in the family. Relational ethics - healthy family can negotiate imbalances and preserve a sense of fairness and accountability.
78
Expectations handed down from generation to generation
Family legacy
79
A family member who is emotionally distant is
a. disengaged
b. enmeshed
c. an example of equifinality
d. a placater
a. disengagement
80
During the course of a family session you discover that a man and his 14 year old boy are putting pressure on mom to quit her job. Mom very much likes her work. In Haley's theory this set of dynamics would be called
a. reframing
b. equifinality
c. the perverse triangle
d. paradox
c. perverse triangle - a situation when two members who are at different levels of the family hierarchy team up against another family member. Alliance can be covert or overt, undermines the other parent's authority
81
_______ was a pioneer in the early history of family therapy.
a. Carl Jung
b. David Wechsler
c. Alfred Adler
d. Franz Anton Mesmer
c. Adler
82
Which therapist could best be described as atheoretical?
a. Jay Haley
b. Carl Whitaker
c. Alfred Adler
d. Nathan Ackerman
b. Whitaker asserted that theory is often used as an excuse to keep therapists emotionally distant from the family.
83
Solution-oriented therapy as practiced by William O'Hanlon, Insoo Kim Berg, Steve de Shazer and Michelle Weiner Davis focuses primarily on
a. the past
b. the present
c. the future
d. dream analysis
c. no emphasis on understanding the problem, plan of action for the future
84
Narrative therapy (NT), which highlights stories in counseling, is associated with the work of
a. William O'Hanlon
b. William Glasser
c. Milton H. Erickson
d. Michael White, Cheryl White, David Epston
d. narrative therapy - postmodernism or constructivism - client constructs or invents the way he or she perceives the world: reality is invented or constructed; it is not objective, separate the problem from the person
85
Postmodernist Tom Anderson, a psychiatrist from Norway, became disenchanted with traditional family therapy. He began using a radical approach based primarily on
a. a one-way mirror and a reflecting tx team
b. three therapists
c. the gestalt empty chair technique
d. homework assignments
a. there are no fixed truths in the world, only ppl's individual perceptions of what constitutes reality or the truth. theory is less hierarchical
86
Feminist therapy criticizes traditional therapies
a. because they are androcentric (i.e., they use male views to analyze the personality)
b. because they are gendercentric (i.e., they assume that there are two separate psychological developmental patterns - one for men and one for women)
c. because they emphasize heterosexism and debase same-sex r/s
d. all of the above
d. psychological difficulty can be located in the environment or the political system, rather than in the person
87
The term skeleton keys as used in Steve de Shazer's brief solution-focused therapy (BSFT) indicates
a. a standard or stock intervention that will work for numerous problems
b. a technique where the client goes home to see his or her family of origin
c. a technique that works for one specific problem, but usually will not work with other difficulties
d. a technique that works for one specific problem, but usually will not work with other difficulties
d. a technique in which the therapist hands the client or clients a sheet of paper with a compliment on it
a
88
One criticism of using cognitive behavioral methods like REBT with families or individuals in multicultural counseling would be
a. that the theory is not intended to be used with diverse populations
b. the theory suggests that the therapist must have ethnic or racial ties with the client in order for efficacious treatment to occur
c. that it ignores present moment problems
d. that the cognitive disputation could go against cultural messages
d.
89
Most experts predict that in the 21st century, theories of counseling and psychotherapy will
a. become more integrative since about 30 to 50% of all therapists say they are eclectic
b. become more behavioristic, since this is the approach that uses statistical outcomes
c. become more Rogerian, since the world as a whole is becoming more humanistic
d. not tolerate eclecticism, since it is not scientific
a.
90
Pick the most accurate statement
a. Brief solution-oriented therapy requires the use of a one-way mirror with a tx team behind the mirror
b. Brief solution-oriented therapy does not utilize a tx team behind a one-way mirror
c. Brief solution-oriented therapy sometimes uses a tx team behind a one-way mirror, nevertheless, it is not required
d. Brief solution-oriented therapy does not utilize paradoxical interventions
c.
91
A researcher takes a group of clients and gives them a depression inventory. He then provides each client with two sessions of brief solution-oriented therapy and gives them the same depression inventory. A t test is used to compare the two sets of scores on the same ppl. (i.e., the before and after measures of depression). This would be
a. a between-groups design
b. a correlation coefficient
c. a related measures within subject design
d. survey research
c.
92
A question on the NCE or CPCE regarding a preexperimental design uses the letters XO. The letters stand for
a. X stands for treatment and O stands for observation, measurement, or score
b. X is the means, while O implies that no tx was given
c. X is the median while O stands for other group
d. X stands for tx while O is the number of observations taken
```
a. Experimental designs OXO
O for observation, dependent variable
X for treatment
E for experimental group
C for control group
R for random sampling
NR for no random sampling of groups
```
93
Another type of preexperimental design is the one-group only posttest design. This is best depicted by
a. OXO
b. XO
c. OX
d. XX
b. XO
94
A time series design is a quasi-experimental design
a. that utilizes two randomly chosen groups; a control group and an experimental group
b. that relies on multiple observations of the dependent variable (i.e., the thing you are measuring) before and after the tx occurs
c. a and b
d. is not depicted by any of the answers above
b.
95
The Solomon four-group is considered a true experimental design since each group is chosen via a random sample. when using this design
a. all groups receive a pretest
b. there is no pretest
c. one control group receives a pre-test and one experimental group receives a pretest; the other control group and experimental group do not
d. there is no posttest
c.
96
Which group would most likely avoid eye contact with the counselor and benefit from assertiveness training?
a. African/Black Americans
b. Asian-Americans
c. European Americans
d. All of the above
b.
97
The newest career theory would be
a. constructivist and cognitive approaches
b. the trait-and-factor approach
c. the developmental and psychoanalytic approaches
d. the transactional analysis approach
a.
98
A popular TWA career counseling model by Renee V. Dawis and Lloyd Lofquist uses the abbreviation PEC. This stands for
a. Person Emotion Consequence
b. Person Education Consequence
c. Person Environment Correspondence
d. Person Environment Consequence
c. TWA stands for Theory of Work Adjustment - posits that the person must fit the job, work must meet the needs of the person - r/s works both ways
99
Most experts believe that the number of multigenerational families with a child, a parent, and a grandparent will
a. decrease
b. increase
c. remain static
d. will continue to go up and down on a fairly regular basis
b. increase
100
A researcher wants to prove that structural family therapy is the most effective modality. She conducted a study a year ago using a significance level of .05. Several colleagues felt her significance level needed to come down. She thus ran the same basic experiment again with new ppl using a significance level of .01. Her chances of making a Type I error or so-called alpha error went down. Now assume you compare her new research with her old research. What could you say about the possibility that her results will indicate that structural family therapy was not significantly different when in reality it truly is significant?
a. Statistically, nothing
b. The chance of this occurring will go down when compared to the first experiment
c. The chance of this occurring increases when compared to the first experiment
d. It would totally depend on the sample size
c. Type II error goes up
101
A question on the NCE asks you to compute the coefficient of determination. You are given a correlation coefficient of .70. How would you mathematically accomplish this task?
a. You would subtract .70 from a perfect correlation of 1.00
b. You would multiply the mean of the population by .70
c. You would add .70 to a perfect correlation of 1.00
d. You would square the .70
d. Coefficient of determination is squaring the correlation coefficient, thus in this case the variance would be 49%
102
A correlation coefficient between variables X and Y is .60. If we square this figure we now have the coefficient of determination or true common variance of 36%. What is the coefficient of nondetermination that shows unique rather than common variance?
a. There is no such concept
b. You would subtract 36 from 100
c. It would still be 36%
d. It would be 64%
d.
103
Krumboltz proposes a _________ model of career development
a. social learning
b. trait-and-factor
c. developmental
d. psychoanalytic
a. Krumboltz builds on Albert Bandura's social learning theory, insists that learning not interests guide people into a certain occupation. Theory notes that career decisions are influenced by a. genetic endowment and special abilities, b. environmental conditions and events, c. instrumental learning
104
Krumboltz's social learning theory is sometimes referred to as a cognitive theory because it emphasizes beliefs that clients have about themselves as well as the world of work. When Krumboltz speaks of self-observation generalizations he really means
a. generalizations regarding a given occupation and how successful the client would be in the occupation
b. Pavlov's principle of stimulus generalization
c. Skinner's principle of operant conditioning
d. that in career counseling your primary concern is the manner in which ppl view themselves and their ability to perform in an occupation
d.
105
SCCT stands for
a. social-cognitive career theory
b. social-cognitive family therapy
c. self-control career theory
d. self-contained career therapy
a. SCCT asserts that self-efficacy beliefs can influence one's career decisions - "Can I really do this and what will happen if I try to do this?"
106
Career counselors refer to job shadowing and volunteering as ________ activities, while reading the job hunting book What Color Is Your Parachute? would be ________.
a. noninteractive; interactive
b. interactive/ noninteractive
c. interactive; interactive
d. noninteractive; noninteractive
b.
107
Urie Bronfenbrenner is one of the codevelopers of the National Head Start Program. He proposed a theory of development that is
a. essentially the same as Piaget's constructivism
b. almost identical to Watson's behaviorism
c. an ecological system theory that stresses the microsystem (any immediate or close r/s or organizations the child interacts with); the mesosystem (the way microsystems work together such as family and school); the exosystem (i.e., school, church, neighborhood); and the macrosystem (culture, wars, the fed gov)
d. based on 12 discrete stages
c. Bronfenbrenner's theory is not a stage theory, theory of human ecology
108
Before _________ child psychologists studied the child, sociologists studied the family, anthropologists studied society, economists analyzed the economic framework, and political scientists investigated the political structure.
a. James W. Fowler
b. Daniel Levinson
c. Urie Bronfrenbrenner
d. Nancy Chodorow
c. Bronfrenbrenner
109
The school psychometrician refers Katie to you for individual counseling. She indicates that Katie's IQ is at the 50th percentile. Katie's IQ
a. is in the mentally retarded range
b. cannot be estimated based on this statistic
c. is approximately 100
d. is well above the norm for children her age
c. middle of the normal curve, avg IQ is 100
110
The psychometrician calls you to tell you that she has another student who has an IQ that falls near the 84th percentile. This student's IQ
a. is somewhere in the gifted range, say 140
b. is most likely near 105
c. is approximately 115
d. is between 75 and 80
c. one standard deviation, roughly 15 IQ points
111
An exam has a mean of 50 and a standard deviation of 20. Phil has a score of 90. His score would fall
a. at the 40th percentile
b. at the 5th stanine
c. near the 98th percentile and the 9th stanine
d. in the 6th stanine
c.
112
Mrs. Kim wanted her daughter to attend a private school for gifted children who have very high intelligence. Mrs. Kim's daughter took the Otis Lennon IQ test. Her T score was 80.
Kim's counselor knew that
a. Mrs. Kim would be very upset because her daughter's low score would not allow her to be admitted
b. Mrs. Kim would be elated because her daughter scored exceptionally high and would be admitted
c. she could not give Kim's mother any feedback since a T-score tells you nothing about one's actual IQ score
d. a T-score of 80 is very average
b.
113
The mean score on a new counseling exam is 65. The standard deviation is 15. Tanja scored a 35. This tells us that
a. she had a z score of +1
b. she had a z score of -1
c. she had a t score of 40
d. she had a z score of -2.0
d. z score is same as standard deviation
114
Kia was given a new client with a morbid fear of heights. Her supervisor emphasized that he wanted her to use the most hi-tech form of tx available. Kia should use
a. VRT
b. William Glasser's new reality therapy with choice theory
c. Joseph Wolpe's systematic desensitization (also known as reciprocal inhibition) a form of bx therapy that works well with fears
d. REBT created by Albert Ellis, which was once called RET
a. VRT - Virtual reality therapy created by Dr. Barbara Rothbaum
115
The DSM provides diagnostic criteria for mental retardation. It states that
a. the client must have an IQ score of 70 or below on an individually administered IQ test and the onset of the condition must be prior to age 18
b. the client must have an IQ score on any IQ test below 70.
c. the client must have an IQ score on an individually administered IQ test and the onset of the condition must be prior to age 21
d. the client must have an IQ of 85 or below on an individual or a group IQ test.
a.
116
Measures of central tendency are used to summarize data. A counseling researcher wants to use a measure of central tendency which reacts to every score in the distribution. He will thus
a. use the median, or middle score when the data are ranked from lowest to highest. The median divides the distribution in half since half the scores will fall above the median while half the scores will fall below the median
b. use the mode, which is the most frequently occurring score or category
c. use the mead, which has been termed the arithmetic average
d. use the median or the mode
c. mean is the only measure of central tendency which reacts to every score in the distribution
median would generally be superior to the mean when you have a skewed distribution
117
Which theorist would most likely assert that EQ is more important than IQ?
a. David Wechsler
b. Alfred Binet
c. Charles Spearman
d. Daniel Goleman
d. Goleman - EQ
118
A counseling agency decides to pay their employees once a week. The agency is using a
a. fixed interval schedule of reinforcement
b. a variable interval schedule of reinforcement
c. a fixed ratio schedule of reinforcement
d. a variable ratio schedule of reinforcement
a.
119
As a gambling addiction counselor Laura is well aware that slot machines operate on a
a. variable ratio schedule of reinforcement
b. variable interval schedule of reinforcement
c. fixed ratio schedule of reinforcement
d. reinforcement system that counselors truly cannot explain
a.
120
Pick the most accurate statement
a. behavior therapies based on classical conditioning are used primarily with clients who have bipolar disorder. Lithium is no longer used
b. behavior therapies based on classical conditioning are much more effective than CBT when treating mood disorders
c. behavior therapies based on classical conditioning are commonly used to treat phobias, but are also utilized for clients with obsessive-compulsive disorders or OCD
d. behavior therapy is never based on classical conditioning
c. one of the most popular form of bx therapy is Wolpe's systematic desensitization has its roots in Pavlov's classical conditioning
121
Ken's supervisor told Ken to do a meta-analysis related to treating children with sleep disorders
a. Ken can use a correlation coefficient
b. Ken can set up a true experiment with a control group and an experimental group
c. Ken can use a single subject N=1 intensive design
d. Ken will use statistics based on numerous studies to investigate the issue
d. meta-analysis
122
You gave your client Ester a personality test and then shared your interpretation of the test with her. You client was amazed at how accurate the test results were in terms of depicting her personality. She readily accepted the interpretation. The next day you discovered that you had interpreted the wrong test! The test you were analyzing was not Ester's but rather belonged to another client. Ester's bx could best be explained by
a. the obvious fact that she is psychotic which means that she is not in touch with reality
b. the Barnum effect
c. negative transference
d. the placebo effect
b. Barnum effect - refers to the fact that clients will often accept a general psychological test report, horoscope, or palm reading
123
Approximately 40% of all elementary schools have shortened recess or student playtime. Counselors
a. are excited about this change b/c US children are behind other countries academically and thus need more study time
b. believe the change will actually have little or no impact on the children
c. are concerned b/c some research indicates that recess can have a positive impact since children are less fidgety on days when they have recess; especially if they are hyperactive
d. are not concerned as boys have better concentration on days when they do not have recess
c.
124
In 2005 the American Counseling Association released the first revision of the ACA Code of Ethics in a decade. One major change was that
a. the code eliminated the concept of confidentiality
b. the code bans Internet counseling
c. the code bans telephone counseling
d. the code eliminated the phrase "dual r/s"
d.
125
The new 2005 ACA Code of Ethics forbids sexual or romantic counselor-client interactions or r/s with current clients, as did the old code. The old 1995 Code stipulated that a counselor would need to wait two years after termination before entering into a romantic r/s with a former client. The new regulations
a. are virtually identical in this area
b. changed 2 years to 10 yrs
c. changed 2 yrs to 5 yrs
d. changed 2 yrs to 1 yr
c.
126
Over 7,000 ACA members are now in private practice. The consensus among experts is that
a. most private practitioners will not need to deal with managed care
b. managed care companies are becoming increasingly difficult to deal with
c. managed care companies are becoming easier to work with
d. ACA ethics now prohibit practitioners from being on managed care panels
c.
127
You are counseling a well-known celebrity who dies. According to the new 2005 ACA Ethical Code
a. Confidentiality exists even after she dies
b. Confidentiality does not exist after death for any professional helper. Princess Diana's therapist was on tv talking about Princess Di's eating disorder immediately after her death
c. The ethics state "a counselor has no obligation to uphold confidentiality after a client's death."
d. The counselor is given no direction since this issue is not addressed in the guidelines.
a.
128
Each year, approximately 31,000 US citizens commit suicide with an alarming 2,000 individuals attempting suicide each day in the US. Suicide often checks in as the second or third leading killer of teens. Men commit suicide more frequently than women, however, women attempt suicide far more often than men. It is accurate to say that
a. 10 to 15% of all claims handled by the ACA liability insurance programs are related to suicide
b. nearly 100% of the claims handled by the ACA liability insurance programs are related to suicide
c. ACA liability insurance will not cover you if a client commits suicide
d. African-American females have an extremely high rate of suicide
a.
129
The 2005 ACA code addresses end-of-life issues since these issues are getting a high degree of social attention
a. finally takes a moral stance on abortion and gives counselors a road map for dealing with this issue
b. suggests that counselors who are helping terminally ill clients who are thinking of hastening their own death must break confidentiality
c. suggests that counselors who are helping terminally ill clients who are thinking of hastening their own death would have the option of breaking or not breaking confidentiality
d. suggests that a counselor who morally refuses to assist a terminally ill client who wants to hasten her death (and hence, wishes to explore end-of-life options) is acting in an unethical manner
c. state laws takes precedence
130
A client suffers from bipolar disorder and takes lithium. According to the DSM she has
a. a mood disorder
b. an anxiety disorder
c. schizophrenia, a term coined by Eugen Bleuler in 1911
d. a somatoform disorder such as pain disorder
a.
131
Matt was diagnosed with somatization disorder which falls under the category of somatoform disorders. It is safe to say that
a. Matt is under 21
b. Matt has never had a physical exam
c. His sxs have lasted over six months and his condition manifested itself prior to age 30
d. Matt's only complaint is his back pain
c.
132
Millie has a panic attack whenever she drives across a bridge. She has
a. situationally bound panic attacks
b. cued panic attacks
c. a and b
d. predisposed panic attacks
c. environmental trigger
133
Sybil refers to a famous client who had 15 personalities. At the time, Sybil was said to suffer from multiple personality disorder (MPD). Today her dx would be
a. dissociative identity disorder
b. a mood disorder
c. related to RS issues
d. a personality disorder
a.
134
Bulimia is classified as
a. an eating disorder which occurs equally in both men and women
b. an eating disorder that occurs primarily in women
c. an adjustment disorder
d. a narcissistic personality disorder
b. 90% female, binge eating, and then purging, fasting or excessive exercise, avg of two binge eating episodes per week for at least 3 months
135
You are seeing a client who is extremely concerned about her body weight and shape. She vomits to keep her weight down, nevertheless, she does not engage in binge eating. The most appropriate dx would be:
a. anorexia
b. bulimia
c. gender identity disorder
d. eating disorder NOS
d. does not fit neatly into any eating disorder category
136
When counseling women a counselor can assume that
a. a women generally makes less money than a man for the same job
b. most complaints against counselors for exploitation come from women complaining about male counselors
c. women are not as comfortable as men when they are involved in competitive situations
d. all of the above
d.
137
A hermaphrodite is
a. now referred to as an intersex person
b. always gay
c. always homosexual
d. also called a cross-dresser
a. intersex - has male and female genitalia
138
Gay men and women
a. primarily live the gay or lesbian lifestyle
b. basically have the same range of gender role bx as do male and female heterosexuals
c. cannot be characterized in terms of lifestyle due to a distinct lack of research
d. are always transgendered
b.
transgender - a person who does not identify with his or her birth sex
139
Warren needs to conduct a study. His supervisor wants him to use a parametric inferential statistic. This means that
a. he will need to use random sampling and the distribution is normal
b. he will need to use a convenience sample or a volunteer sample
c. his distribution will be positively skewed
d. his distribution will be bimodal
a. parametric statistics are used when distribution is normal (i.e. the mean, the median, and the mode are the same), and random sampling has been utilized
140
A counselor has an answering machine in her office. Which statement most accurately depicts the ethical guidelines related to this situation
a. Ethical guidelines forbid the use of answering machines
b. Ethical guidelines allow answering machines, but forbid speaking with clients via a cell phone
c. Ethical guidelines allow answering machines, but experts insist that unauthorized staff should not be allowed to listen or retrieve such msgs
d. Ethical guidelines are clear that a pager should be used rather than an answering machine
c.
141
The law requires clinicians to
a. keep process notes
b. keep progress notes
c. keep process and progress notes
d. keep the client's name and address, but no other info
b.
142
A client wants to read her record. Pick the statement which is not accurate
a. You should allow her to read the record or a summary of it because she has an ethical right to do so
b. You should allow her to read it, however, you should go back and change things you don't want her to see; for example, the fact that you said she was schizophrenic
c. You should allow her to read the record realizing that it is best if you enter the info as soon as possible after the session and then sign and date the entry
d. Since your agency inputs the client's record on a computer, each entry will be dated and have a time on it. You could then print the doc for her perusal.
b.
143
A counselor is seeing a client on a managed care plan. Unfortunately, the client has used up her max number of sessions for the year. The counselor is convinced that the client is in need of additional counseling, however, the counselor's agency will not allow him to see her for any additional sessions. The best plan of action would be for the counselor to
a. Refer the client for continued counseling to a practitioner who will see the client whether or not she has managed care benefits
b. Empathize with the client, but be sure to explain that she is catastrophizing (an irrational thought pattern delineated by Albert Ellis) and use REBT, a cognitive therapy, to help her cope with the fact that she cannot be seen again until next year.
c. Threaten to sue the managed care company, since this would be in violation of ethical care for the client
d. See the client, but don't tell your supervisor. This is both legal and ethical
a.
144
A career counselor who relies on the constructivist viewpoint would emphasize that
a. unconscious conflicts influence career decisions
b. an individual's career choice is influenced by his or her attempt to make meaning out of the world of work
c. Most career counselors do not give enough career inventories
d. SCCT is the best theory
b.
145
A homosexual protests that he has been homosexual long enough and wants to lead a heterosexual lifestyle. He tells you that he wants a family and children. You should
a. refer him to a psychiatrist as medicine is necessary
b. use dialectical bx therapy (DBT)
c. bring in other members of his family since homosexuality has its roots in the family system
d. explain that homosexuality is not a mental disorder that needs to be changed
d.
146
Conversion or reparative therapy is intended to change sexual orientation and bx from gay to straight
a. The literature in scientific and peer reviewed journals does not indicate that a person's sexual orientation can be altered from same sex attraction to opposite sex attraction
b. ACA prohibits counselors from practicing conversion or reparative therapies although no studies exist in this area
c. Longitudinal studies with clients who have been through reparative or conversion therapy indicate that the tx is effective, but it still remains unethical
d. ACA ethics indicate that a counselor trained in conversion or reparative therapy can practice these modalities if the client insists on the tx
a.
147
A lesbian client wants to become heterosexual and asks for conversion or reparative therapy. You explain that you ethically do not believe in this form of intervention. She asks you to provide her a referral to a practitioner who will perform this type of therapy. You should
a. initially comply, since ethical counselors provide an appropriate referral
b. initially comply, but you must provide her with at least three referrals
c. initially, tell the client you prefer not to refer her to a therapist who engages in this form of tx. Discuss the potential harm and risks with the client emphasizing that this is an unproven form of tx
d. initially, tell her to secure a consultation with a licensed physician prior to making a referral
c.
148
The new ACA ethical requirement to have a transfer plan in writing would apply to
a. a situation in which a counselor became disabled
b. a situation in which a counselor died
c. a situation where a counselor moved to another state
d. all of the above
d.
149
You are counseling a 29-year old man in your private practice who is seeing a PCP for severe headaches
a. You are required to contact the PCP
b. You are not required to contact the PCP; however, attempting to secure permission to do so from your client would be considered the ideal course of action
c. The answer would be no for headaches, but yes if the client had visited the PCP regarding a mental health complaint
d. Yes, but only if the ct is abusing a child or a senior citizen
b.
150
As a private practice counselor your _______ would be most important in terms of filing claims.
a. graduate transcript
b. undergraduate and graduate transcript
c. NCC provider number
d. NPI number
d. National Provider Identifier (NPI)
151
A counselor is treating a woman for a mood disorder. The counselor has sex with the woman's daughter. According to the revised 2005 ACA Code of Ethics this is considered
a. unethical
b. ethical
c. ethical only after the counselor terminates the client and then waits two years
d. debatable since ACA guidelines fail to deal with sexual issues of this nature
a.
152
You have impeccable training and experience as a counseling supervisor. Now your brother finishes his master's degree in counseling and wants you to supervise him. According to ACA ethics you should:
a. accept him as a supervisee since it will be beneficial to him
b. cosupervise him with another colleague
c. refer him to a trusted colleague trained in supervision who is willing to take your brother
d. supervise him if it is for licensing, but not if it is for NCC
c.
153
The new ACA ethical guidelines stipulate that a counselor can refrain from making a dx if the counselor believes the dx could harm the client or others.
a. Therefore, a counselor could ethically diagnose all clients as having an adjustment disorder to secure insurance since this diagnosis is somewhat benign and not likely to harm the client
b. a counselor could refrain from making an Axis I or an Axis II dx if it is in the best interest of the client
c. A decision to refrain from making a dx is ideally made in collaboration with the client, although the counselor has the final say
d. Choices "b" and "c" are both correct
d.
154
The agency you work for insists that you dx every client. Since this is in violation of the new ACA ethics this would qualify as "negative conditions". You could handle this by
a. Meeting with your supervisor and executive director of the agency and discussing other ways to secure funding that go beyond DSM reimbursement
b. Advocate for the client by explaining to the insurance company asking for the dx that in some cases it is best that a dx not be given. You could even teach the client to advocate for herself by having her inform the insurance company that a dx might not be in her best interest
c. Show your supervisor, executive director, or insurance company/managed care firm the actual ACA Code of Ethics so they can see it in writing that the code stipulates that "Counselors may refrain from making and/or reporting a dx if they believe it would cause harm"
d. all of the above
d.
155
You leave your practice to study mental health tx in another country. Dr. Kline, another licensed counselor, is now the custodian of your records. To conform with current ethical standards this was clearly explained in your informed consent brochure given to the client during the first visit. The clients have Dr. Kline's contact info. According to the new ethics regarding transfer plans
a. Dr Kline should contact each client when he receives the record
b. you should contact each client even though you are residing in another country
c. the client is totally responsible for contacting Dr Kline since he or she was given an informed consent document
d. neither you nor Dr. Kline would be obligated to contact the client
a.
156
In terms of the previous question
a. A certified public accountant or CPA would be preferable to a mental health professional such as Dr Kline to use as a custodian for the records
b. An attorney would make the best custodian for the records
c. Using a mental health professional on staff or at another facility is preferable to using a lawyer or a CPA
d. A CPA, an attorney, or a mental health professional would be an excellent choice
c.
