therapeutic modalities

Question 1

Most likely to be enhanced by the strategies of putting the pt at ease, finding the pt’s pain and expressing compassion, evaluation pt’s insight, and showing expertise: (5x)

Answer 1

RAPPORT

Question 2

The factor most consistently associated with therapy outcome in psychotherapy research: (3x)

Answer 2

STRENGTH OF THERAPEUTIC ALLIANCE

Question 3

A set of feelings that a patient reenacts in the therapeutic relationship are called: (x2)

Answer 3

TRANSFERENCE

Question 4

Business executive hospitalized for bleeding ulcer repeatedly argues with a well-liked head nurse and threatens to leave AMA. Best action for C&L psychiatrist is: (2x)

Answer 4

LISTEN TO PT’S COMPLAINTS ACKNOWLEDGE HIS DISCOMFORT WITH THE PASSIVE POSITION THAT HE IS UNACCUSTOMED TO

Question 5

Common theme in psychotherapy in the elderly: (2x)

Answer 5

LOSS

Question 6

As opposed to long-term psychotherapy, time-limited therapy more likely to: (2x)

Answer 6

SELECT CENTRAL ISSUE AS FOCUS

Question 7

For the treatment of pts with compulsive sexual behavior, the best results have been seen with which of the following approaches? (2x)

Answer 7

TWELVE STEP GROUPS

Question 8

Two most powerful predictors of outcome in any form of psychotherapy are: (2x)

Answer 8

EMPATHY AND THERAPEUTIC ALLIANCE

Question 9

The best response to a pt who reports a fixed false belief that his neighbor is poisoning his dog and sitting all day at the window monitoring is: (2x)

Answer 9

EMPATHIZE WITH THE PT, BUT AVOID DIRECT CONFRONTATION ABOUT THE DELUSION

Question 10

Psychotherapy where pts realistically evaluate their interactions w others & therapist offers direct advice/helps pts make decisions/ignores transference issues. (2x)

Answer 10

INTERPERSONAL PSYCHOTHERAPY (IPT)

Question 11

Most likely represents an acceptable boundary crossing by a therapist as opposed to a boundary violation: (2x)

Answer 11

RECEIVING COOKIES AS AN EXPRESSION OF GRATITUDE BY A PT NEAR TERMINATION.

Question 12

Therapeutic empathy is best described as the therapist’s ability to: (2x)

Answer 12

GRASP PT’S INNER EXPERIENCE FROM PT’S PERSPECTIVE

Question 13

Motivational interviewing often used as part of the treatment of which conditions? (2x)

Answer 13

SUBSTANCE ABUSE

Question 14

Therapeutic technique where therapist instructs the patient to hold onto a symptom: (2x)

Answer 14

PARADOXICAL INTERVENTION

Question 15

Without evident distress, pt calmly reports to the psychiatrist, “Since I was last here, my significant other dumped me.” The doctor responds by pointing out the discrepancy between the pt’s affect and the content described. This response is an example of: (2x)

Answer 15

CONFRONTATION

Question 16

Psych resident dislikes alcoholic pts and avoids working with them. In discussing the problem, says that pts are hopeless and unmotivated and she can’t empathize with them. Example of? (2x)

Answer 16

COUNTERTRANSFERENCE

Question 17

Catharsis is: (2x)

Answer 17

VERBAL EXPRESSION OF SURPRESSED TRAUMATIC EXPERIENCES AND FEELINGS

Question 18

barrier to widespread use of telepsychiatry

Answer 18

PHYSICIAN DISSATISFACTION

Question 19

Example of behavioral analysis strategy

Answer 19

AT WHAT POINT DURING THE DAY DID YOU FIRST NOTICE YOU WERE THINKING ABOUT CUTTING
Pt BIB police to ED with disorganized behavior. Pt askes are you a real psychiatrist?” Best response?

Question 20

Recent meta- analyses have suggested what with regard to the use of psychotherapy to treat depression?

Answer 20

OTHER PSYCHOTHERAPIES HAVE EFFICACY COMPARABLE TO CBT

Question 21

Psychiatrist’s mind wanders during sessions, what should the psychiatrist do?

Answer 21

EXAMINE INNER THOUGHTS AND FEELINGS

Question 22

What theory is the basis of mentalization-based therapy?

Answer 22

BOWLBY’S ATTACHMENT THEORY

Question 23

During initial psych interview, pt tearfully discusses painful ending of romantic relationship. What should Dr. say to establish therapeutic alliance?

Answer 23

IT SOUNDS LIKE THIS HAS BEEN VERY DIFFICULT FOR YOU.

Question 24

Psychiatrist behavior of raising eyebrows, leaning towards pt, saying “Uh-huh”

Answer 24

FACILITATION

Question 25

Redirecting discussion by talking about irrelevant stuff

Answer 25

RESISTANCE

Question 26

During a clinical interview, the physician recapitulates what the pt has said so far and says to pt "I just want to make sure that I've got everything right up to this point". This is an example of:

Answer 26

SUMMATION

Question 27

When psychiatrist asks about mania, pt responds, "that sounds exactly like my cousin," and proceeds to tell long story about cousin but doesn't answer the psychiatrist's request. This is an example of:

Answer 27

TANGENTIALITY

Question 28

In initial psych interview, pt frustrated that his last psychiatrist had brief visits & "just gave me another pill every time." Interviewing psychiatrist responds "so you would like your psychiatrist to listen & understand you before adjusting your meds."

Answer 28

CLARIFICATION

Question 29

Pt who had difficult childhood calls therapist mother's name and quickly corrects error. What is this an example of?

Answer 29

PARAPRAXIS

Question 30

Pt w/ BMD who has been making progress in long-term psychodynamic psychotherapy enters session obviously distraught. After listening to scattered seemingly unimportant details of recent daily life, therapist asks if pt is avoiding something too uncomfortable to talk about. Pt responds w intense anger/distress. "I just heard you are getting a divorce, I am sick about it. Here I am counting on you to help me sort out my chaotic life and messed-up relationships, and you can't even keep your own marriage together! What are you, some kind of hypocrite? I think I should leave and find someone who knows what they're doing!" Best response for the therapist to make?

Answer 30

I AM GOING TO NEED A MOMENT TO THINK ABOUT WHAT YOU'VE SAID AND ARE FEELING BEFORE I CAN RESPOND.

Question 31

8yr old evaluated for asthma, found to have ADHD symptoms, put on stimulant, behavioral problems continue, sent to psychiatrist and psychologist, this is an example of what level of collaborative care?

Answer 31

SHARED (INTEGRATED) CARE

Question 32

17 y/o receiving counseling for school truancy. Student understand truancy is not a desirable behavior and is discusses ways to improve school attendance. What stage of change is student in?

Answer 32

PREPARATION

Question 33

College student in therapy, the Dean calls therapist requesting info about the student's therapy due to recent reports from a dorm supervisor. Therapist should:

Answer 33

REFUSE THE DEAN'S REQUEST FOR INFORMATION

Question 34

An important counter-transference issue in an interethnic psychotherapeutic relationship is:

Answer 34

DENIAL OF DIFFERENCES

Question 35

Abstinence compliance increases with random UDS. This is ex of:

Answer 35

PARTIAL REINFORCEMENT

Question 36

A new pt asks therapist, "are you Christian?" What is best response?

Answer 36

ARE YOU CONCERNED THAT IF WE ARE NOT OF THE SAME RELIGION, I WON'T BE ABLE TO TREAT YOU PROPERLY?' Exchange during initial interview after pt's former therapist closed his practice: pt expresses concern about new therapist being too young/inexperienced, states she doubts new therapist can provide any new insights. Best response to further goal of getting to know pt, establish whether therapy w new therapist would be appropriate IT CAN BE VERY HARD TO START OVER WITH A NEW THERAPIST. HOW HAVE YOU BEEN FEELING ABOUT HAVING TO END YOUR TREATMENT WITH DR. BROWN?"

Question 37

A patient repeatedly becomes distressed after what seems, even to the pt, to be minor disappointments. The patient also seems to suffer from extreme narcissistic vulnerability. A therapist utilizing self-psychology would be most likely to interpret this due to which of the following factors?

Answer 37

A LACK OF DEVELOPMENTALLY APPROPRIATE EMPATHY FROM CAREGIVERS

Question 38

Treating a much older pt who asks about therapist's age. Best response:

Answer 38

MAYBE YOU'RE CONCERNED ABOUT WHETHER I AM EXPERIENCED ENOUGH TO TREAT YOU?

Question 39

Pt seeing new psychotherapist weekly x3 wks hesitantly complained about being able to overhear much of what pt in the preceding session was saying. Pt assured therapist that he had tried not to listen and had left the waiting room to wait outside until the other pt had left. Which is best response?

Answer 39

APOLOGIZE FOR THE LACK OF PRIVACY AND INDICATE THAT FURTHER MEASURES, SUCH AS MUSIC SYSTEM IN THE WAITING ROOM, WILL BE UTILIZED

Question 40

MD sees psychiatrist w increasing sense of dislike for a blaming, externalizing pt who pits family members against the MD. What should psychiatrist discuss w MD?

Answer 40

COUNTERTRANSFERENCE

Question 41

A pt with h/o lifelong depression & failed relationships complains (very angry) (after several weeks of therapy) that she is expected to trust the Dr. without even knowing anything about him (credentials or personally) what should the Dr say?

Answer 41

EMPATHIZE WITH THE PT'S FEARS OF TRUST AND FEELING OF BEING AT A DISADVANTAGE

Question 42

Psychotherapy technique for children with Tourette's syndrome.

Answer 42

HABIT REVERSAL

Question 43

62 y/o with lung cancer, weight loss, fatigue, and persistent cough. Pat refuses to accept Dx of cancer and states will "get over this infection." Pt refuses all further testing and asks for antibiotics to "recover in peace." C&L psychiatrist's role is:

Answer 43

EVALUATE PT'S COPING STYLE AND HELP THE MEDICAL TEAM SEE THE PT'S RESPONSES IN THE CONTEXT OF HER UNIQUE PERSONALITY AND LIFE CIRCUMSTANCES

Question 44

Young female starting cognitive therapy with a female resident asks for a hug. Resident should first:

Answer 44

EXPLAIN WHY PHYSICAL CONTACT IS AVOIDED

Question 45

C&L psychiatrist uses all therapeutic approaches except:

Answer 45

EXPLORATORY PSYCHODYNAMIC

Question 46

Psychiatrist is treating an older pt who is a successful executive. Pt feels grateful for the help w/ his depression and offers some tips on investing to the psychiatrist. What is the most appropriate action at this point from the psychiatrist?

Answer 46

EXPLORE PT'S MEANINGS AND FEELINGS ABOUT THE OFFER

Question 47

Female psych resident says pt saw resident in town over weekend. Followed her around. Thought she could later shop at same stores and eat at same restaurants as her greatly admired therapist. Nothing wrong in pt's bx or material suggesting she is dangerous. Pt apologizes convincingly, says will not do again. Hopes therapist will not fire her. What is next best step?

Answer 47

INTERPRET PT'S LONGING TO IDENTIFY W THE PSYCHIATRIST

Question 48

What if pt asks whether you're still in training during intake interview?

Answer 48

INFORM THE LEVEL OF TRAINING

Question 49

Midway through psychotherapy session, a psychiatrist's mind wanders despite repeated refocus. Best immediate action:

Answer 49

EXAMINE OWN INNER FEELINGS ABOUT THE PATIENT

Question 50

Pt sees therapist and makes threats and becomes agitated. Therapist feels uneasy, the next step is to:

Answer 50

INTERRUPT INTERVIEW TO GET HELP

Question 51

Young pt in therapy returns to school, announces to therapist that he can pass classes, will graduate. Best response:

Answer 51

OFFERING CONGRATULATIONS

Question 52

Beginning therapist feels great empathy for depressed pt fails to maintain sufficient distance to observe self-destructive patterns. To avoid this pay attention to:

Answer 52

OVERIDENTIFICATION WITH PATIENT

Question 53

Social skills training for those with persistent mental illness is an essential part of:

Answer 53

PSYCHIATRIC REHABILITATION

Question 54

Therapist is working w family of schizophrenic. Strategies include informing about illness, social support, management guidelines. Therapist encourages calm problem solving approach/facilitates stress and stigma reduction when possible. Which model is therapist using?

Answer 54

PSYCHOEDUCATIONAL

Question 55

Biofeedback usually helps pts with which medical syndrome?

Answer 55

RAYNAUD'S SYNDROME

Question 56

What interventions are consistent w the theoretical assumptions of crisis Tx?

Answer 56

REASSURANCE, BRIEF HOSPITALIZATION, PSYCHODYNAMIC INSIGHT, TREATMENT WITH PSYCHOTROPIC MEDICATIONS (NOT FOCUSING ON PAST RELATIONSHIPS)

Question 57

During last session of successful psychodynamic psychotherapy, pt warmly expresses gratitude for everything, saying that the help the therapist has given has made a big difference. Appropriate response?

Answer 57

RESPOND BY SAYING YOU TOO HAVE ENJOYED THE WORK

Question 58

What is an example of a boundary violation?

Answer 58

INVESTING IN A PT'S BUSINESS

Question 59

After attending several sessions of individual psychotherapy for anxiety and depression, 24 y/o M revealed his homosexuality to his heterosexual male psychiatrist. Therapist realizes he is uncomfortable when pt expresses longings for a male. Therapist also tends to overemphasize any material that might represent pt's heterosexual wishes. The next best step for the psychiatrist would be to:

Answer 59

SEEK CONSULTATION TO DISCUSS COUNTERTRANSFERENCE ISSUES

Question 60

Pt w/ mild MR in program designed to develop new behaviors by modeling/reinforcement, then practice them.

Answer 60

SOCIAL SKILLS TRAINING

Question 61

Therapist preoccupied w/ patient. Acknowledges this but unable to shake feeling

Answer 61

TALK TO SUPERVISOR

Question 62

15 y/o male bib parents, does not want to speak with psych

Answer 62

THANK HIM FOR COMING IN AND ASK HIM IF HE'D LIKE TO BE SEEN ALONE OR WITH HIS PARENTS

Question 63

What was most important factor in determining tx outcomes in National Institute of Mental Health Treatment of Depression Collaborative Research Program (1996)?

Answer 63

THERAPEUTIC ALLIANCE

Question 64

While assessing for DV, examiner says to pt/spouse, "The tension that builds up between you must be incredibly stressful. It's not unusual that people who are stressed out can have trouble controlling themselves or can do things they didn't intend, like screaming at or even hitting their partner. Has anything like that happened to you?" Which technique is this?

Answer 64

NORMALIZATION

Question 65

Pt repeatedly redirecting discussion by talking about irrelevant topics is example of:

Answer 65

RESISTANCE

Question 66

Core principle of motivational interviewing that is used to treat addictive behaviors:

Answer 66

DEVELOP DISCREPANCY

Question 67

Individual psychotherapy for alcoholics most effective when it focuses on:

Answer 67

INTERACTIONS WITH PEOPLE

Question 68

Programmed practice, or exposure therapy, is an indicated treatment for what disorder?

Answer 68

AGORAPHOBIA

Question 69

Pt with multiple social fears is terrified of public speaking. As the next step in treatment, the therapist arranges for the pt to give 15 minutes talk to clinical staff. This is an example of:

Answer 69

FLOODING

Question 70

Exposure and flooding together with response prevention are techniques of behavioral therapy aimed at which of the following?

Answer 70

HASTENING THE EXTINCTION OF A CONDITIONED FEAR OR ANXIETY RESPONSE

Question 71

Elements common to both CBT and eye movement desensitization and reprocessing in the treatment of patients with PTSD include:

Answer 71

CONTROLLED EXPOSURE TO TRAUMA RELATED TRIGGERS

Question 72

Pt w fear of heights. Pt instructed to visualize crossing a bridge. What is the therapeutic technique?

Answer 72

IMAGINAL EXPOSURE

Question 73

Meta-analysis suggests which of the following for psychotherapy to treat depression?

Answer 73

OTHER PSYCHOTHERAPIES HAVE EFFICACY COMPARABLE TO CBT

Question 74

During an initial office evaluation, the pt tells the psychiatrist, "my spouse told me I had to be evaluated." Which of the following would be the most empathic response?

Answer 74

HOW DO YOU FEEL ABOUT THAT?

Question 75

The concept of the identified patient in therapy refers to:

Answer 75

ONE FAMILY MEMBER WHO HAS BEEN LABELED THE PROBLEM BY THE FAMILY

Question 76

Psychosocial therapy that has shown efficacy in some studies in improver cancer survival rates:

Answer 76

GROUP THERAPY WITH OTHER CANCER PATIENTS

Question 77

Comprehensively researched therapy for mood d/o's

Answer 77

INTERPERSONAL PSYCHOTHERAPY

Question 78

Therapeutic focus on the on pt's current social functioning is most characteristic of:

Answer 78

INTERPERSONAL PSYCHOTHERAPY

Question 79

26 y/o pt with depressed mood and dissatisfaction with life, feeling isolated and having few friends who is not under undue stress and historically copes well with personal problems would benefit from what type of psychotherapy?

Answer 79

INTERPERSONAL THERAPY

Question 80

Which psychotherapy would therapist be inclined to gratify pts' dependency needs?

Answer 80

SUPPORTIVE

Question 81

Pt enters psychotherapy because of problems in his relationship with his wife. During the sessions, pt talks about his family of origin, his boss, and his problems at work, but never discusses details about his wife. This is an example of which of the following?

Answer 81

RESISTANCE

Question 82

Principle of confrontation:

Answer 82

I THINK YOU'D RATHER TALK ABOUT YOUR JOB THAN FACE THE SADNESS YOU FELT IN OUR LAST SESSION

Question 83

Example of empathic comment

Answer 83

YOU MUST FEEL TERRIBLE RIGHT NOW.

Question 84

Recovering addict in relapse prevention therapy, and has many risk factors. Rather than developing a coping strategy for each risk factor, do what?

Answer 84

FOCUS ON SKILL TRAINING, COGNITIVE REFRAMING, AND LIFESTYLE INTERVENTIONS

Question 85

In psychotherapy a pt states that he still feels devalued by criticism of father. Therapist comment: It must hurt when you are treated that way. This is example of:

Answer 85

EMPATHIC VALIDATION

Question 86

Therapy technique of prescribing a pre-existing sx behavior in relationship therapy

Answer 86

PARADOXICAL INTENT

Question 87

The doctor and patient relationship is described as fiduciary relation is:

Answer 87

BASED ON TRUST

Question 88

When you mentioned your sibling's problem, your voice cracked and, for a moment, I thought I heard anger in your voice. Which interviewing technique does psychiatrist use here?

Answer 88

FACILITATION, REFLECTION

Question 89

The purpose of reflective statements during patient interview is for

Answer 89

IS TO ENSURE WHAT THE PATIENT SAID IS UNDERSTOOD

Question 90

What characteristic is associated with better adaptation in individuals >65?

Answer 90

UNCRITICAL ACCEPTANCE OF IDEAS

Question 91

Which Tx modalities provides care for seriously mental ill pts in community via a multidisciplinary Tx team:

Answer 91

ASSERTIVE COMMUNITY TREATMENT

Question 92

Which controlling for health status, which of the following best describes the relationship between retirement and subsequent mortality risk?

Answer 92

NO INCREASE IN MORTALITY RISK

Question 93

Pt in long term psychodynamic psychotherapy attacks therapist for being controlling and uncaring. This is an example of what?

Answer 93

TRANSFERENCE