STUDY-MODE - Practice Exam 8 Flashcards
When using Atkinson, Morten, and Sue’s (1993) Racial/Cultural Identity Development Model, a person’s stage of identity development is determined by:
Select one:
A. identifying his/her degree of acceptance of the minority and majority cultures.
B. assessing the amount of contact he/she normally has with members of the minority and majority cultures.
C. assessing his/her attitudes toward the minority and majority cultures.
D. evaluating his/her reaction to racial oppression.
Atkinson et al.’s model distinguishes between five stages:
Conformity Dissonance Resistance/immersion Introspection Integrative awareness.
Additional information about these stages is provided in the Clinical Psychology chapter of the written study materials.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Each stage in this model is characterized by a different combination of attitudes toward one’s own minority group, other minority groups, and the majority (dominant) group.
d. Incorrect See explanation for response c.
The correct answer is: assessing his/her attitudes toward the minority and majority cultures.
An African American individual in the immersion substage of the immersion-emersion stage of Cross’s (1991) Black Racial Identity Development Model will exhibit which of the following?
Select one:
A. a lack of interest in race or racial issues
B. identification with the White (dominant) culture
C. functional paranoia
D. intense involvement in African American culture
Cross’s (1991) Black Racial Identity Development Model distinguishes between four stages:
Pre-encounter
Encounter
Immersion-emersion
Internalization
a. Incorrect A lack of interest in race is characteristic of the pre-encounter stage.
b. Incorrect African American individuals in the assimilation substage of the pre-encounter stage have adopted a mainstream (White) identity.
c. Incorrect Ridley (1984) used the term functional paranoia to refer to an unhealthy condition that is characterized by mistrust and suspicion. A person in the immersion-emersion stage is more likely to exhibit cultural paranoia, which Ridley defined as a healthy reaction to racism.
d. CORRECT An African American individual in the immersion substage is immersed in African American culture, which is evident in his/her interests, speech, style of dress, actions, choice of friends, etc. This individual also feels a great deal of rage toward Whites. During the emersion substage, the person’s intense emotions subside but he/she continues to reject White culture and begins to develop a more sophisticated African American identity.
The correct answer is: intense involvement in African American culture
Research by Sue and his colleagues (1991) found that matching therapist and client in terms of race/ethnicity:
Select one:
A. improves treatment outcomes and reduces premature termination for Asian, Hispanic, African American, and Caucasian clients.
B. reduces premature termination for Asian, Hispanic, African American, and Caucasian clients but has no effect for members of these groups on other treatment outcomes.
C. improves treatment outcomes and reduces premature termination for members of some groups but not for others.
D. has no effect on treatment outcomes or premature termination for Asian, Hispanic, African American, or Caucasian clients.
Research by Sue et al. (1991) and others has produced inconsistent results with regard to the impact of therapist-client matching and treatment outcomes.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT For example, Sue et al. found that therapist-client matching in terms of race/ethnicity improved outcomes for Asian and Hispanic clients and reduced premature termination rates for Caucasian clients.
d. Incorrect See explanation for response c.
The correct answer is: improves treatment outcomes and reduces premature termination for members of some groups but not for others.
An African American client feels that the primary obstacle in his life is racism and that there’s nothing he can do to change the problems he is experiencing. As defined by Sue (1978), this individual has an:
Select one:
A. internal locus of control and internal locus of responsibility.
B. external locus of control and internal locus of responsibility.
C. internal locus of control and external locus of responsibility.
D. external locus of control and external locus of responsibility.
Even if you are unfamiliar with Sue’s conceptualization of worldview, you probably could have identified the correct response by considering the information provided in the question.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT This individual has an external locus of responsibility (he can’t do anything about his problems) and an external locus of control (he believes his problems are due to racism).
The correct answer is: external locus of control and external locus of responsibility.
As defined by Gerald Caplan, the target of consultee-centered case consultation is the consultee’s skills, knowledge, abilities, and/or objectivity. Caplan describes which of the following as a potential cause of a consultee’s lack of objectivity?
Select one:
A. projective identification
B. diagnostic overshadowing
C. parallel process
D. theme interference
Caplan distinguishes between four types of mental health consultation: client-centered case consultation, consultee-centered case consultation, program-centered administrative consultation, and consultee-centered administrative consultation.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Caplan defines theme interference as a type of transference that occurs when a consultee’s unresolved conflict related to a particular type of client or situation interferes with his/her current performance with similar clients or in similar situations.
The correct answer is: theme interference
The primary advantage of manual-guided treatment is that the use of manuals:
Select one:
A. standardizes treatment delivery so that, in research, treatment effects can be more clearly ascertained.
B. substantially improves treatment outcomes across different clients, diagnoses, and contexts.
C. reduces the legal liability of clinicians for “treatment errors.”
D. ensures that the procedures used to evaluate treatment effectiveness are valid.
Manual-guided treatments provide manuals that specify the theoretical underpinnings of the treatment and treatment goals and present specific therapeutic guidelines and strategies.
a. CORRECT Treatment manuals were initially developed to standardize treatments so that their effects could be empirically evaluated and to provide training guidelines for therapists.
b. Incorrect The research on this issue is inconsistent and but has generally not found manual guided treatments to have substantially better outcomes than treatments that are not guided by the use of a manual.
c. Incorrect This has not been identified as an outcome of the use of treatment manuals.
d. Incorrect This is not one of the benefits of treatment manuals.
The correct answer is: standardizes treatment delivery so that, in research, treatment effects can be more clearly ascertained.
Providing social skills training to children whose aggressive behaviors have already had a substantial adverse impact on their family and peer relations and school performance is an example of:
Select one:
A. primary prevention.
B. secondary prevention.
C. tertiary prevention.
D. behavioral prevention.
Three types of prevention are distinguished in the literature - primary, secondary, and tertiary.
a. Incorrect Primary preventions are aimed at reducing the development and incidence of mental disorders.
b. Incorrect Secondary preventions target individuals who have just begun to exhibit symptoms of a disorder in order to prevent the disorder from becoming more serious.
c. CORRECT Tertiary preventions are aimed at individuals who have already developed a disorder. Their goal is to reduce the risk for chronicity and relapse and any other problems related to the disorder.
d. Incorrect This is a “made up” term.
The correct answer is: tertiary prevention.
As defined by Minuchin, triangulation is a:
Select one:
A. healthy adaptation by family members to unexpected change.
B. way for family members to avoid dealing with stress or conflict.
C. method used by the therapist to diagnose the family structure.
D. method used by the therapist to reduce stress in the family.
Minuchin described triangulation as a type of rigid triad.
a. Incorrect See explanation for response b.
b. CORRECT Triangulation is occurring when the parents are in conflict and both try to recruit a child to their side as a means of avoiding or reducing the conflict between them.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: way for family members to avoid dealing with stress or conflict.
Why does the most pervasive modern form of supervision tend to be the triangular model?
Select one:
A. Because organizational policies and professional knowledge form the foundation, while the relationship with the supervisor forms the core.
B. Because the relationship with the supervisor and professional experience form the foundation while care of clients forms the core.
C. Because the relationship with the clients and counseling theory form the foundation and the organizational policies form the core.
D. Because the relationship with the organization and the supervisor literature form the foundation and personal experience form the core.
The correct answer is A. One of the common modern forms of supervision is a triangular model where the organizational policies and professional knowledge form the foundation, the supervisor relationship is at the core, and the ultimate emphasis on providing service to the clients. Answers B, C and D are incorrect as these various answer models are not models of supervision based on the triangular model.
The correct answer is: Because organizational policies and professional knowledge form the foundation, while the relationship with the supervisor forms the core.
Virginia Satir’s approach to family therapy emphasizes:
Select one:
A. styles of communication.
B. family projection processes.
C. boundary disturbances.
D. transferences between family members.
Virginia Satir’s emphasis on communication reflects her affiliation with the Mental Research Institute in Palo Alto.
a. CORRECT Satir distinguishes between five communication styles–placater, blamer, super-reasonable, irrelevant, and congruent.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: styles of communication.
A solution-focused therapist is working with a family whose conversations frequently escalate to intense arguments. The therapist will most likely:
Select one:
A. reduce tension during therapy sessions by having family members talk directly to her rather than to each other.
B. appoint one family member to act as “referee” whenever the family fights at home.
C. ask the family members if they can remember a time when they were able to talk to each other for an extended period without arguing.
D. instruct the family members to argue with each other for at least one hour each evening.
Not surprisingly, solution-focused therapists focus on solutions.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Solution-focused therapists use “exceptions” as one way of identifying possible solutions to the family’s problem.
d. Incorrect See explanation for response c.
The correct answer is: ask the family members if they can remember a time when they were able to talk to each other for an extended period without arguing.
Which of the following is LEAST likely to be true about a 55-year-old Asian client?
Select one:
A. When she smiles, this is more likely to indicate confusion or embarrassment than pleasure.
B. She will be uncomfortable discussing personal details about her family relationships.
C. When she avoids eye contact, this will communicate respect rather than inattention or disrespect.
D. She will respond best to an indirect, unstructured therapeutic approach.
It is very important not to overgeneralize the characteristics of members of culturally diverse groups. However, the licensing exam sometimes includes questions like this one that require you to do so.
a. Incorrect Among Asians and Asian Americans, a smile is more likely to signal embarrassment or confusion than pleasure.
b. Incorrect Asians are generally uncomfortable discussing personal details about family members.
c. Incorrect Avoidance of eye contact is a sign of respect in the Asian culture.
d. CORRECT Although not all Asian and Asian American clients will prefer a direct, structured approach (rather than an indirect, unstructured approach), this is often the preferred strategy.
The correct answer is: She will respond best to an indirect, unstructured therapeutic approach.
A cigarette smoker says that she has decided to quit smoking in the next three to four weeks and has started developing a plan for doing so. According to the transtheoretical (stages-of-change) model, this person is in which of the following stages?
Select one:
A. preparation
B. contemplation
C. precontemplation
D. action
The transtheoretical model predicts that an intervention is most effective when it matches the individual’s stage of change.
a. CORRECT From the perspective of the transtheoretical model, a person is in the preparation stage when he/she has a clear intent to take action in the immediate future (usually defined as within the next month).
b. Incorrect A person in the contemplation stage is planning to take steps to change in the more distant future (usually defined as within the next six months).
c. Incorrect A person in the precontemplation stage has no intention of changing in the foreseeable future.
d. Incorrect People in the action phase have already started making changes in their lives.
The correct answer is: preparation
When 11-year old Samantha plays with her 5-year old brother Sam, she often assumes the role of “mother” and teaches Sam how to do things. Sam cooperates by doing what Samantha instructs him to do. The interaction between Samantha and her brother is best described as:
Select one:
A. complementary.
B. symmetrical.
C. parallel.
D. disengaged.
In this situation, Samantha is the “teacher” while her younger brother is the “student.”
a. CORRECT Complementary transactions are transactions between unequals - e.g., between a dominant and a subordinate person.
b. Incorrect Symmetrical transactions occur between equals.
c. Incorrect Parallel transactions are a combination of complementary and symmetrical transactions.
d. Incorrect The term “disengaged” is not used to describe the type of transaction presented in this question.
The correct answer is: complementary.
Research suggests that the underutilization of mental health services by Asian Americans results from:
Select one:
A. cultural values that encourage resolution of problems within the family.
B. a lower incidence of mental health problems.
C. cultural values that stress personal independence.
D. a distaste for the formality involved in therapy relationships.
The research has generally found that Asian Americans underutilize traditional mental health services.
a. CORRECT Asian Americans often adhere to traditional cultural values that encourage the resolution of problems within the family. Reasons for preferring assistance from family members include the stigma associated with mental illness and seeking outside help and a lack of culturally competent mental health services.
b. Incorrect See explanation for response a.
c. Incorrect See explanation for response a.
d. Incorrect See explanation for response a.
The correct answer is: cultural values that encourage resolution of problems within the family.
Howard et al.’s (1986) phase model proposes that a client’s progress in therapy occurs in three predictable phases. These are:
Select one:
A. unfreezing, changing, and refreezing.
B. remoralization, remediation, and rehabilitation.
C. engagement, exploration, and evaluation.
D. contemplation, action, and termination.
For the exam, you want to be familiar with Howard et al.’s (1986) phase model and dose dependent effect, which are both described in the Clinical Psychology chapter of the AATBS written study materials.
a. Incorrect These are the three stages in Lewin’s force field model of organizational change.
b. CORRECT As described by Howard et al.,
1. Remoralization is an improvement in the subjective sense of well-being
2. Remediation is a reduction in symptoms and
3. Rehabilitation involves improvements in overall functioning.
c. Incorrect These are not the phases identified by Howard and colleagues.
d. Incorrect These are three of the six phases of the transtheoretical model of change.
The correct answer is: remoralization, remediation, and rehabilitation.
During the first session with an American Indian family consisting of a grandmother, mother, father, and three children, an Anglo-American therapist would be best advised to:
Select one:
A. refer the family to an American Indian therapist.
B. ensure that she establishes a “value-free” environment.
C. assess each family member’s level of acculturation before developing a treatment plan.
D. treat the family like any other family unless there is a clear reason to do otherwise.
You may have been able to identify the correct response to this question through the process of elimination.
a. Incorrect This may be unnecessary if the therapist has appropriate training or seeks consultation.
b. Incorrect American Indian clients are likely to distrust a therapist who attempts to establish a “value-free” environment.
c. CORRECT An initial step when working with clients from culturally diverse groups is to identify the client’s stage of racial/ethnic identity development, degree of acculturation, and worldview (beliefs, values, attitudes, etc.).
d. Incorrect APA guidelines discourage adopting a “colorblind” approach and, instead, require psychologists to always consider the impact of culture on the therapeutic process.
The correct answer is: assess each family member’s level of acculturation before developing a treatment plan.
What is a unique challenge that comes from using Evidence-Based Therapies in public mental health services settings?
Select one:
A. No universal guidelines provided by the government.
B. No standardized supervision or training literature.
C. No procedures for selecting supervisors or trainers.
D. No testing applications to verify licensing authenticity.
The correct answer is B. A significant portion of the training and supervision literature within the field of clinical psychology does not often address the unique challenges that arise in training in the public mental health service settings. A comprehensive model for providing training in EBTs that can apprise local and larger scale implementation and facilitate training partnerships with publicly funded or community-based agencies and practitioners of EBTs has been demonstrated to be most effective. Answers A, C and D are incorrect as government guidelines, lack of procedures and lack of testing applications are not related to any unique challenges with employing evidence-based therapies in public mental health based settings.
The correct answer is: No standardized supervision or training literature.
In recent years, psychologists have attempted to become more sensitive to the uniqueness of each culture. This sensitivity is most consistent with:
Select one:
A. an emic approach.
B. an etic approach.
C. an etic-emic synthesis.
D. neither an etic nor an emic approach.
An emic approach is characterized by an awareness that each culture possesses unique characteristics.
a. CORRECT An emic approach recognizes cultural differences and the impact of those differences on behaviors, attitudes, etc.
b. Incorrect An etic approach applies universal principles that are derived from one culture to all cultures.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: an emic approach.
A Bowenian therapist would use a genogram to:
Select one:
A. examine family relationships over several generations.
B. identify genetic (biological) contributions to maladaptive behavior.
C. examine interactions between a family and its environment.
D. evaluate the progress and outcome of therapy.
Being familiar with the major concerns and assumptions of Bowen’s extended family systems therapy would have helped you identify the correct answer to this question even if you’re unfamiliar with a genogram.
a. CORRECT As originally described by Bowen, a genogram is a schematic diagram of a family’s relationships and usually includes at least three generations. A primary purpose of a genogram is to identify behavior patterns that recur in the family.
b. Incorrect See explanation for response a.
c. Incorrect This describes an ecomap. Although some authors use the terms ecomap and genogram interchangeably, this question is asking specifically about the use of a genogram by a Bowenian therapist, so response a is the best answer.
d. Incorrect See explanation for response a.
The correct answer is: examine family relationships over several generations.
A therapist can expect that an Asian American client will be LEAST likely to do which of the following?
Select one:
A. use silence as a way of communicating respect
B. use smiling to express disapproval or disagreement
C. avoid expressing strong emotions
D. avoid eye contact when listening to the therapist
Asian Americans are a heterogeneous group and caution must be taken in drawing general conclusions about their behaviors. However, several generalizations are made in the multicultural counseling literature. See, e.g., D. W. Sue and D. Sue, Counseling the culturally different, New York, John Wiley & Sons, 1999.
a. Incorrect Asian Americans tend to demonstrate respect for authorities by “not speaking until spoken to.”
b. CORRECT For some Asian Americans, smiling may demonstrate uneasiness or embarrassment, while, for others, smiling is avoided because it is considered a sign of weakness.
c. Incorrect This is characteristic of Asian Americans.
d. Incorrect This is also characteristic of Asian Americans.
The correct answer is: use smiling to express disapproval or disagreement
During the fourth session, a therapy client says he “is already feeling much better.” Most likely:
Select one:
A. this is simply a transitory placebo effect.
B. this reflects the initial development of insight.
C. the client is beginning to feel more hopeful about his situation.
D. the client is starting to benefit from newly acquired coping skills.
This is a difficult question because you don’t know what research or theory is being asked about. However, responses b, c, and d correspond to the stages identified by Howard et al.’s (1996) phase model of therapeutic effectiveness. Additional information about this model is provided in the Clinical Psychology chapter of the written study materials.
a. Incorrect Although this is a possibility, response b is a better answer since the question specifically mentions that the client’s remark occurs during the fourth session of therapy. A placebo effect could occur at any time during therapy.
b. Incorrect According to the phase model, insight is not achieved until the third stage of therapy (rehabilitation), which usually does not begin until after the 16th therapy session.
c. CORRECT According to Howard and his colleagues, during the first few sessions of therapy, a client experiences an increase in hopefulness. This stage is referred to as REMORALISATION.
d. Incorrect During the second phase of therapy (remediation), the client acquires new coping skills and experiences real symptom relief.
The correct answer is: the client is beginning to feel more hopeful about his situation.
A practitioner of Minuchin’s structural family therapy uses which of the following to alter the hierarchical relationships within a family system or subsystem?
Select one:
A. unbalancing
B. tracking
C. reframing
D. mimesis
For the exam, you want to be familiar with the four techniques listed in the answers to this question.
a. CORRECT Unbalancing is a restructuring technique that is used by structural family therapists to change hierarchical relationships between family members. It may involve affiliating with a family member, ignoring a family member, or entering into a coalition with a family member against another member.
b. Incorrect Tracking is a joining technique and involves following the verbal and nonverbal content of the family’s communications by, for example, asking clarifying questions, showing interest in what they’re saying, and connecting things they’ve said in the past to current interactions.
c. Incorrect Reframing is a paradoxical technique that involves offering an alternative interpretation of the meaning of a behavior or event.
d. Incorrect Mimesis is another joining technique and involves adopting the family’s affective and communication style.
The correct answer is: unbalancing
Interpreting the defenses against anxiety that underlie a client’s current maladaptive behavior patterns would be of most interest to a practitioner of:
Select one:
A. solution-focused therapy.
B. object relations therapy.
C. reality therapy.
D. personal construct therapy.
Defenses are of interest to psychodynamic psychotherapists.
a. Incorrect Solution-focused therapy adopts a here-and-now orientation and focuses on identifying solutions to problems.
b. CORRECT As a psychodynamic therapy, object relations therapy utilizes many traditional psychodynamic strategies. It focuses on the impact of unconscious processes that impact the client’s current relationships and involves identifying and interpreting the client’s defenses and transferences.
c. Incorrect Reality therapy focuses on current issues and current problems.
d. Incorrect 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.
The correct answer is: object relations therapy.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d. CORRECT Krumboltz's emphasis is on social learning -- i.e., modeling and other aspects of the social environment -- and his theory is referred to as the Social Learning Theory of Career Decision Making (SLTCDM). Additional information about Krumboltz's theory is provided in the Industrial-Organizational Psychology chapter of the written study materials. The correct answer is: social learning.