Clinical Psychology

Question 1

The therapies categorized as psychodynamic share which assumptions?

Answer 1

• Human behavior is motivated largely by unconscious processes
• Early development has a profound effect on adult functioning
• Universal principles explain personality development and behavior
• Insight into unconscious processes is a key component of psychotherapy

Question 2

What are the main psychodynamic psyotherapies?

Answer 2

• Freud’s psychoanalysis
• Adlers Individual psychology
• Jung’s analytical psychotherapy
• Various object-relations theorists

Question 3

Worldview underlying Freudian psychoanalysis?

Answer 3

Essentially pessimistic, deterministic, mechanistic, and reductionistic. According to Freud, human beings are determined by irrational forces, unconscious motivations, biological and instinctual needs and drives, and psychosexual events that occurred during the first five years of life

Question 4

Freud’s personality theory

Answer 4

Freud’s personality theory consist of two separate, but interrelated theories: a structural drive theory and a development theory

Question 5

Freuds structural drive theory

Answer 5

Posits the personality with three structures- the id, the ego, and the superego

Question 6

Id

Answer 6

Present at birth and consists of the person’s life and death instincts, which serve as the source of all psychic energy. It operates on the basis of the pleasure principle and seeks immediate gratification of its instinctual drives and needs in order to avoid tension.

Question 7

Ego

Answer 7

Develops at about six months of age in response to the id’s inability to gratify all of its needs and operates on the basis of the reality principle. It defers gratification of the id’s instincts until an appropriate object is available in reality and employs secondary process thinking, which is characterized by realistic, rational thinking and planning.

Question 8

What is the primary task of the ego?

Answer 8

To mediate the often conflicting demands of the id and reality and, once it has developed, the superego.

Question 9

Superego

Answer 9

Emerges when a child is between four and five years of age and represents an internalization of society’s values and standards as conveyed to the child by his or her parents through their rewards and punishments.

Question 10

How does the superego differ from the ego in terms of dealing with the id?

Answer 10

In contrast to the ego, which postpones, gratification of the id’s instincts, the superego attempts to permanently block the id’s socially unacceptable impulses.

Question 11

Freud’s developmental theory

Answer 11

Emphasizes the sexual drives of the id and proposes that an individual’s personality is formed during childhood as the result of certain experiences that occur during five predetermined psychosexual stages of development (oral, anal, phallic, latency, and genital).

Question 12

How does Freud describe anxiety’s function?

Answer 12

To alert the ego to an impending internal or external threat.

Question 13

According to Freud, when are defense mechanisms used?

Answer 13

When the ego is unable to ward off danger through rational, realistic means. They serve to deny or distort reality.

Question 14

What are some basic defense mechanisms?

Answer 14

repression, reaction formation, projection

Question 15

What is the goal of psychoanalytic psychotherapy?

Answer 15

To reduce or eliminate pathological symptoms by bringing the unconscious into conscious awareness and integrating previously repressed material into the personality

Question 16

What is psychic determinism?

Answer 16

The belief that all behaviors are meaningful and serve some psychological function

Question 17

What is the primary technique of psychoanalysis and what does it target?

Answer 17

Analysis; the main targets of analysis are the client’s free associations, dreams, resistances, and transferences.

Question 18

What techniques do analysts use?

Answer 18

Confrontation, clarification, interpretation, an working through

Question 19

Improvement in psychoanalysis is attributed to a combination of what three factors?

Answer 19

Catharsis, insight, and working through

Question 20

Catharsis

Answer 20

The emotional release resulting from the recall of unconscious material; paves the way for the client’s insight into the relationship between his or her unconscious processes and current behaviors

Question 21

Working through

Answer 21

The final and longest stage in psychoanalysis; allows the client to gradually assimilate new insights into his or her personality

Question 22

Confrontation (in psychoanalysis)

Answer 22

Entails making statements that help the client see his or her behavior in a new way

Question 23

Clarification (in psychoanalysis)

Answer 23

Involves clarifying the client’s feelings and restating his or her remarks in clearer terms

Question 24

Interpretation (in psychoanalysis)

Answer 24

Explicitly connecting current behavior to unconscious processes

Question 25

When are interpretation less likely to elicit anxiety and resistance?

Answer 25

When they address motives and conflicts close to a client’s consciousness rather than when they related to material buried deep in the unconscious

Question 26

What characteristics do brief psychodynamic therapies share?

Answer 26

• Time limited
• Target a specific interpersonal problem that is usually identified in the first session
• Begin using interpretation early in the therapeutic relationship
• Emphasize the development of a strong working alliance
• Positive transference is considered more important than negative transference because it promotes a positive therapeutic relationship, maximized the client’s motivation to work toward the achievement of therapeutic goals, and reduces the likelihood that progress in therapy will be slowed down by the development of a full-scale transference neurosis

Question 27

In what ways did Adler agree and disagree with Freud?

Answer 27

While Adler agreed that all behavior is purposeful, he disagreed with Freud’s emphasis on the role of unconscious instinctual/sexual forces in the development of personality and lack of attention to social factors

Question 28

How does Adler’s teleological approach regard behavior?

Answer 28

As being largely motivated by a person’s future goals rather than determined by past events

Question 29

Key concepts in Adler’s individual psychology

Answer 29

Inferiority feelings, striving for superiority, style of life, and social interest

Question 30

When do inferiority feelings begin to develop and what are they the result of? (Adler)

Answer 30

They develop during childhood as the result of real or perceived biological, psychological, or social weaknesses

Question 31

What is striving for superiority according to Adler?

Answer 31

An inherent tendency toward “perfect completion.”

Question 32

The specific ways a person chooses to compensate for inferiority and achieve superiority determine his or her ________________, which unifies the various aspects of the personality.

Answer 32

Style of life

Question 33

How does Adler view maladaptive behavior?

Answer 33

For Adler, mental disorders represent a mistaken style of life, which is characterized by maladaptive attempts to compensate for feelings of inferiority, a preoccupation with achieving personal power, and a lack of social interest

Question 34

While a _____________is characterized by goals that reflect optimism, confidence, and concern about the welfare of others, a _____________ is characterized by goals reflecting self-centeredness, competitiveness, and striving for personal power.

Answer 34

healthy style of life; mistaken style of life

Question 35

___________________ is based on Adler’s approach and assumes that all behavior is goal-directed and purposeful. For instance, the misbehavior of young children is viewed as having one of four goals- attention, power, revenge, or to display deficiency- with each goal reflecting a desire to belong, accompanied by faulty beliefs about what is needed to do so.

Answer 35

Systematic Training for Effective Teaching (STET)

Question 36

What is an effective way to work with many African American clients?

Answer 36

Several authorizes recommend the use of an ecostructural or ecological systemic approach (see Boyd-Franklin’s multisystems model); These address multiple systems, intervene at multiple levels, and empower the family by utilizing strengths

Question 37

What are some issues Walker and LaDue advise mental health practitioners to be aware of when working with American Indians?

Answer 37

• Become familiar with historical events that have affected their lives
• May prefer a therapist who helps them reaffirm the values of their culture
• May be distrustful of a therapist’s attempts to provide therapy in a “value-free” environment

Question 38

In working with American Indians, LaFromboise et al. recommend the use of ______, which incorporates family and community members into the treatment process and situates and individual’s psychological problems within the context of his/her family, workplace, community, and other social systems

Answer 38

Network therapy

Question 39

What type of therapy is often preferred when working with Asian Americans?

Answer 39

A directive, structured, goal-oriented, problem-solving approach that focuses on alleviating specific symptoms; Cognitive-behavioral, solution-focused, and other brief therapies are often effective but may need to be modified so they focus more on the family than on an individual and take into account cultural and social factors.

Question 40

When working with an Hispanic or Latino client, a therapist is usually best advised to be ________ and _________ and to adopt a _____________ approach that focuses on the client’s behavior, affect, cognitions, interpersonal relationships, biological functioning, etc.

Answer 40

active; directive; multimodal

Question 41

What is true about LGBT individuals in terms of certain psychological problems?

Answer 41

As a group, youth who identify as nonheterosexual are more likely than their heterosexual peers to experience depression, anxiety, and substance use and to have a higher risk for suicidality. This is not due to sexual orientation itself but to the prejudice and discrimination that LGBT individuals encounter

Question 42

This occurs when LGBT individuals accept heterosexual society’s negative evaluations of them and incorporate these into their self-concepts

Answer 42

Internalized homophobia

Question 43

Studies investigating the coming out process found that adolescent males had an earlier onset of all milestones except for which of the following:

a) Same-sex attraction
b) self-labeling
c) first same-sex sexual contact
d) first disclosure of sexual orientation to another person

Answer 43

d

Question 44

Sue and Sue describe which three competencies involved in cultural competence?

Answer 44

Awareness (aware of own assumptions, values, and beliefs)
Knowledge (attempts to understand the worldview of culturally diverse clients)
Skills (use therapeutic modalities and interventions that are appropriate for culturally different clients)

Question 45

What are the four categories of acculturation?

Answer 45

Integration (maintains his/her own culture but also incorporates many aspects of the dominant culture)
Assimilation (accepts the majority culture while relinquishing his/her own culture)
Separation (withdraws from the dominant culture and accepts his/her own culture)
Marginalization (does not identify with his/her own culture or with the dominant culture)

Question 46

As defined by Wrenn, therapists are exhibiting cultural encapsulation when they:

Answer 46

Define everyone’s reality according to their own cultural assumptions and stereotypes
Disregard cultural differences
Ignore evidence that disconfirms their beliefs
Rely on techniques and strategies to solve problems
Disregard their own cultural biases

Question 47

Emic

Answer 47

Refers to culture-specific theories, concepts, and research strategies. An attempt is made to see things through the eyes of the MEMBERS of that culture

Question 48

Etic

Answer 48

Refers to phenomena that reflect a universal (culture-general) orientation. Involves viewing people from different cultures as essentially the same

Question 49

As defined by Hall, _________________ is grounded in the situation, depends on group understanding, relies heavily on nonverbal cues, helps unify a culture, and is slow to change. In contrast, _________________ relies primarily on the explicit, verbal part of a message.

Answer 49

high-context communication; low-context communication

Question 50

Landrum and Batts address the effects of racial oppression on the mental health of African Americans and propose that the consequences may take several forms:

Answer 50

1) Internalized oppression: can involve acting out against the system, system blaming, total avoidance of whites, and/or denial of the political significance of race
2) Conceptual incarceration: Involves adopting a White worldview and lifestyle
3) Split-self-syndrome: characterized by polarizing oneself into good and bad components, with the bad components representing one’s African American identity

Question 51

__________________ is a brief manual-based therapy that was originally developed by Klerman and Weissman as a treatment for depression but has since been successfully applied to other disorders including bipolar disorder, bulimia, and substance abuse and dependence.

Answer 51

Interpersonal therapy

Question 52

From the perspective of interpersonal therapy, maladaptive behavior is related to what?

Answer 52

Problems in social roles and interpersonal relationships that are traceable to a lack of strong attachments early in life

Question 53

What is the primary goal of interpersonal therapy?

Answer 53

Although IPT recognizes the contributions of early experience, biological predisposition, and personality to depression and other disorders, its focus is on current social relationships and its primary goals are symptom reduction and improved interpersonal functioning.

Question 54

How are goals achieved in interpersonal therapy?

Answer 54

Symptom reduction is achieved through education about the disorder, instillation of hope, and, when necessary, pharmacotherapy

Interventions used to improve interpersonal functioning target one of more of four primary problem areas- unresolved grief, interpersonal role disputes, role transitions, and interpersonal deficits.

Question 55

Describe the three stages in interpersonal therapy?

Answer 55

In the initial stage, the therapist conducts an assessment to ascertain the client’s diagnosis, the interpersonal context in which the client’s symptoms occur, and the problem areas that will be the focus of tx

During the middle phase, the therapist uses specific strategies that address the proglem areas, which may include encouragement of affect, communication analysis, and modeling and role-playing to establish new ways of interacting.

In the last few sessions, the therapist reviews the client’s progress and discusses termination and methods of relapse prevention.

Question 56

How does Jung describe the conscious?

Answer 56

Oriented toward the external worlk, governed by the ego, and represents the individual’s thoughts, ideas, feelings, sensory perceptions, and ememories

Question 57

How does Jung describe the unconscious?

Answer 57

Made up of the personal unconscious and collective unconscious

Question 58

What is the personal unconscious, according to Jung?

Answer 58

Contains experiences that were unconsciously perceived or were once conscious but are now repressed or forgotten

Question 59

What is the collective unconscious, according to Jung?

Answer 59

The repository of latent memory traces that have been passed down from one generation to the next.

Question 60

What are some of Jung’s archetypes?

Answer 60

Self (which represents a striving for a unity of the different parts of the personality)
Persona (public mask)
Shadow (the dark side of the personality)
Anima or Animus (feminine and masculine aspects of personality)

Question 61

In contrast to Freud, who emphasized the impact of the first six years of life on personality development, Jung viewed development as continuing throughout the lifespan and was most interested in growth after the mid ____’s.

Answer 61

30

Question 62

A key concept in Jung’s personality theory is __________, which refers to an integration of the conscious and unconscious aspects of the psyche that leads to the development of a unique identity.

Answer 62

Individuation

Question 63

What is the primary goal of Jung’s analytical psychotherapy?

Answer 63

To rebridge the gap between the conscious and the personal and collective unconscious.

Question 64

The Jungian approach reflects an _____ view of human nature and emphasizes the ________ aspects of the client’s personality.

Answer 64

optimistic; healthy

Question 65

The focus of Jung’s analytic psychotherapy is primarily on the ___________, with information from the past being sought only when it will hep the client understand the ________.

Answer 65

Here and now, present

Question 66

Who are the main object relations theorists?

Answer 66

Melanie Klein, Ronald Fairbairn, Margaret Mahler, and Otto Kernberg

Question 67

What is the object-relations theory’s view of maladaptive behavior?

Answer 67

It is the result of abnormalities in early object relations; In addition, many object relations theorists believe that, in infancy, there is a natural tendency to split mental representations of the self and others into good and bad, and that inadequate resolution of this splitting is one cause of maladaptive behavior

Question 68

What is the primary goal of therapy for the objects relations therapist?

Answer 68

To bring maladaptive unconscious relationship dynamics into consciousness so that dysfunctional internalized object representations can be replaced with more appropriate ones.

Question 69

What are the humanistic psychotherapies?

Answer 69

Person-centered therapy, Gestalt therapy, existential therapy, reality therapy

Question 70

Rogers’ person-centered therapy is based on what belief?

Answer 70

All people have an innate “self-actualizing”tendency” that serves as the major source of motivation and guides them toward positive, healthy growth.

Question 71

What is Roger’s personality theory?

Answer 71

The central concept of Roger’s personality theory is the notion of the self; Rogers believed that each person has the ability to become self-actualized but, to do so, the self must remain unified

Question 72

What is Roger’s view of maladaptive behavior?

Answer 72

The self becomes disorganized as the result of incongruence between self and experience, which can occur when the individual experiences conditions of worth.

Question 73

What is the primary goal of person-centered therapy?

Answer 73

To help the client achieve congruence between self and experience so that he or she can become a more fully-functioning, self-actualizing person.

Question 74

In Rogerian therapy, the right environment involves providing which three facilitative conditions?

Answer 74

Unconditional positive regard; Genuineness (congruence); Accurate Empathic Understanding

Question 75

Gestalt Therapy

Answer 75

Founded by Fritz Perls and based on the premise that each person is capable of assuming personal responsibility for his/her own thoughts, feelings, and actions and living as an integrated “whole.”

Question 76

What are some main concepts of Gestalt therapy, which are drawn from psychoanalysis, phenomenology, existentialism, and Gestalt psychology?

Answer 76

People tend to seek closure
A person’s gestalts (perceptions of parts as wholes) reflect his/her current needs
A person’s behavior represents a whole that is greater than the sum of its parts
Behavior can be fully understood only in its context
A person experiences the world in accord with the principle of figure/ground

Question 77

According to Perls, the personality consists of the ________ and the _________.

Answer 77

Self; self-image

Question 78

How does Perls describe the self?

Answer 78

The creative aspect of the personality that promotes the individuals inherent tendency for self-actualization, or the ability to live as a fully integrated person

Question 79

How does Perls describe the self-image?

Answer 79

The darker side of the personality which hinders growth and self-actualization by imposing external standards

Question 80

How does Perls view maladaptive behavior in Gestalt therapy?

Answer 80

Considered a growth disorder that involves an abandonment of the self for the self-image and a resulting lack of integration; Neurotic behavior often stems from a disturbance in the boundary between the self and the external environment that interferes with the person’s ability to satisfy his or her needs and maintain a state of homeostasis.

Question 81

What are the four major boundary disturbances (Gestalt therapy)?

Answer 81

Introjection
Projection
Retroflection
Confluence

Question 82

__________ is a term in Gestalt therapy which occurs when a person psychologicall swallows whole concepts; i.e., when the person accepts concepts, facts, and standards from the environment without actually understanding or fully assimilating them. In therapy, results in overly compliant bx.

Answer 82

Introjection

Question 83

__________ is a term in Gestalt therapy which involves disowning aspects of the self by assigning them to other people. Can result in paranoia.

Answer 83

Projection

Question 84

_________ is a term in Gestalt therapy which entails doing to oneself what one wants to do to others.

Answer 84

Retroflection

Question 85

_________ is a term in Gestalt therapy that refers to the absence of a boundary between the self and the environment. It causes intolerance of any differences between oneself and others and often underlies feelings of guilt and resentment.

Answer 85

Confluence

Question 86

What is the major goal of Gestalt therapy?

Answer 86

To help the client become a unified whole by integrating the various aspects of the self

Question 87

How do Gestalt therapists view transference, diagnostic labels, and historical events?

Answer 87

Gestalt therapists avoid diagnostic labels and view historical events as important only when they directly impinge on the client’s current functioning. They regard a client’s transference to be counterproductive and respond to it by helping the client recognize the difference between his/her transference fantasy and reality.

Question 88

What is the “curative factor” in Gestalt therapy?

Answer 88

Awareness, which is defined as a full understanding of one’s thoughts, feelings, and actions in the here-and-now, and they use a variety of ready-made exercises and experiments to lead clients toward greater awareness.

Question 89

_________ therapies share an emphasis on personal choice and responsibility for developing a meaning life and assume that people are not static but, instead, are in a constant state of evolving and becoming.

Answer 89

Existential

Question 90

How do existential therapists view maladaptive behavior?

Answer 90

As the result of an inability to cope authentically with the ultimate concerns of existence

Question 91

What are the ultimate concerns of existence, according to existential therapists?

Answer 91

Death, freedom, existential isolation, and meaninglessness

Question 92

According to existential therapists, while ____________ is considered a normal response to ultimate concerns and can serve as a source of motivation to change and grow, ___________ is frequently the result of an attempt to avoid _____________, is out of proportion to the situation that elicited it, is often outside conscious awareness, and can be immobilizing.

Answer 92

Existential anxiety; neurotic anxiety; existential anxiety

Question 93

What is the goal of existential therapy?

Answer 93

To help clients live in more committed, self-aware, authentic, and meaningful ways. In therapy, clients are helped to recognize their freedom to choose their own destinies and to accept responsibility for changing their own lives.

Question 94

William Glasser’s ___________ is based on ____________, which assumes that people are responsible for the choices they make and focuses on how people make choices that affect the courses of their lives.

Answer 94

Reality therapy; choice/control theory

Question 95

According to Glasser (reality therapy), people have what five basic innate needs that serve as the primary source of motivation?

Answer 95

Survival
Love and belonging
Power
Freedom
Fun

Question 96

Of the five basic innate needs in Glasser’s reality therapy, which is most important?

Answer 96

Love and belonging since relationships with others are necessary to fulfill all other needs

Question 97

A key assumption underlying reality therapy is that mental illness is the result of __________________.

Answer 97

An individual’s choices

Question 98

What is the primary goal of reality therapy?

Answer 98

To help clients identify responsible and effective ways to satisfy their needs and thereby develop a success identity.

Question 99

According to Glasser (reality therapy), when a person fulfills his or her needs in a responsible way - that is, in a conscious and realistic manner that does not infringe on the rights of others to fulfill their needs - the person has adopted a ________________.

Answer 99

Success Identity

Question 100

According to Glasser (reality therapy), when a person is unable to satisfy his/her needs or does so in irresponsible ways, the preson has assumed a ______________, which Glasser believes underlies most forms of mental and emotional disturbances.

Answer 100

Failure identity

Question 101

What is the focus of Kelly’s personal contruct therapy?

Answer 101

How the client experiences the world

Question 102

According to Kelly, what determines a person’s psychological processes?

Answer 102

The way he/she construes (perceives, interprets, and predicts) events with construing involving the use of personal constructs

Question 103

As defined by Kelly, ________________ are bipolar dimensions of meaning (e.g., happy/sad, competent/incompetent, friendly/unfriendly) that begin to develop in infancy and may operate on an unconscious or conscious level.

Answer 103

Personal constructs

Question 104

What are some therapy goals and techniques of Kelly’s personal construct therapy?

Answer 104

Consider the therapist and client to be mutual experts and co-experimenters who work together to derive tasks that will help the client identigy and revise or replace maladaptive personal constructs so that the client is better able to make sense of his/her experiences. Techniques include assessment, self-characterization sketch, and trying on.

Question 105

Solution-focused therapy is based on what assumption?

Answer 105

You get more of what you talk about and focuses on solutions to the client’s problems rather than on the problems themselves

Question 106

How do solution-focused therapists view maladaptive behavior?

Answer 106

They believe that understanding the etiology of problem behavior is irrelevant and focus, instead, on solutions to problems

Question 107

Which type of therapy views the client as the expert while the therapist acts as a consultant/collaborator who poses different types of questions designed to assist the client to recognize and use his/her strengths and resources to achieve specific goals?

Answer 107

Solution-focused therapy

Question 108

What are the three different types of questions posed in solution-focused therapy and what are they?

Answer 108

Miracle question: “Suppose when you go to sleep tonight, a miracle happens and your problem is solved. When you wake up in the morning, how will you know that a miracle has occurred? What will be different?
Exception question: “Can you think of a time in the past week when you did not have the problem (or the problem was not as troublesome)?
Scaling questions: “On a scale from 1 to 10, how did you feel last week?” “On a scale from 1 to 10, how motivated are you?

Question 109

The ________ model of behavior change was derived from recognition that change entails progress through a series of predictable stages.

Answer 109

Transtheoretical

Question 110

What is the difference between cultural and functional paranoia?

Answer 110

A client is exhibiting cultural paranoia, or a healthy reaction to racism, when he/she does not disclose to a white therapist due to a fear of being hurt or misunderstood. A client is exhibiting functional paranoia, an unhealthy condition that itself is an illness, when he/she is unwilling to disclose to any therapist, regardless of race or ethnicity.

Question 111

What are the 10 empirically supported change processes/interventions identified in the transtheoretical model?

Answer 111

Consciousness raisin
Self-liberation
Social liberation
Dramatic relief
Self-reevaluation
Counterconditioning
Environmental reevaluation
Reinforcement management
Stimulus control
Helping/supportive relationships

Question 112

What was the transtheoretical model originally developed for and what other behaviors has it since been applied to?

Answer 112

Cigarette smoking and other addictive behaviors; Weight control, treatment compliance, intimate partner violence, and financial management

Question 113

How does the transtheoretical model view maladaptive behavior?

Answer 113

Does not address the etiology or characteristics of maladaptive bx but, instead, focuses on factors that facilitate behavior change

Question 114

During the __________ stage (transtheoretical model), the individual has little insight into the need for change and does not intend to change. People in this stage may be in denial about their problem, may be uninformed about the problem and its consequences, or may have been unsuccessful in previous attempts to change.

Answer 114

Precontemplation

Question 115

A person in the ______________ stage (transtheoretical model) is aware of the need for change, intends to take action within the next six months, but is not committed to change. The individual is aware of both pros and cons of changing and, as a result, may be ambivalent about change and remain in this stage for an extended period.

Answer 115

Contemplation

Question 116

A person in the __________________ stage (transtheoretical model) plans to take action in the immediate future (usually in the next month) and has a realistic plan of action for modifying his/her behavior.

Answer 116

Preparation

Question 117

During the ____________ stage (transtheoretical model), the individual takes concrete steps to change his/her behavior. This stage often begins with making a public commitment to change.

Answer 117

Action

Question 118

A person in the ______________ stage (transtheoritical model) has maintained a change in behavior for at least six months and is taking steps to prevent relapse.

Answer 118

Maintenance

Question 119

During the ________________ stage, the person feels that he/she can resist temptation and is confident there is no risk for relapse.

Answer 119

Termination

Question 120

True or False: An assumption of the transtheoretical model is that progression through the stages is linear.

Answer 120

False. People may recycle through some or all of the stages several times.

Question 121

What interventions are effective to help clients move from the pre contemplation to contemplation stage of change?

Answer 121

Consciousness raising, dramatic relief, and environmental reevaluation

Question 122

What interventions are effective for people in the action and maintenance stages of change?

Answer 122

Helping relationships, counterconditioning, reinforcement management, and stimulus control

Question 123

_______________________ was developed for clients who are ambivalent about changing their behavior and was first used as a treatment for alcohol abuse and dependence but has since been applied to other problems including cigarette smoking, eating disorders, and pain management.

Answer 123

Motivational interviewing

Question 124

What is the primary goal of motivational interviewing?

Answer 124

To enhance the client’s intrinsic motivation to alter his/her behavior by helping the client examine and resolve his/her ambivalence about changing.

Question 125

What are four general principles that guide the selection of the strategies used in motivational interviewing?

Answer 125

Express empathy
Develop discrepancies between current behavior and personal goals and values
Roll with rather than oppose resistance
Support self-efficacy

Question 126

What specific techniques does the acronym OARS refer to in motivational interviewing?

Answer 126

Open-ended questions
Affirmations that express empathy and understanding
Reflective listening
Summaries

Question 127

How does general systems theory define a system?

Answer 127

As an entity that is maintained by the mutual interactions of its components and assumes that the actions of interacting components are best understood by studying them in their context.

Question 128

Consistent with systems theory, family therapists view the family as primarily an _______________.

Answer 128

Open system

Question 129

The influence of general systems theory is evident in the family therapy concept of ______________, which is the tendency for a family to act in ways that maintain the family’s equilibrium or status quo.

Answer 129

Homeostasis

Question 130

A _______________ feedback loop reduces deviation and helps a system maintain the status quo, while a __________ feedback loop amplifies deviation or change and thereby disrupts the system.

Answer 130

negative; positive

Question 131

The Racial/cultural identity development model distinguishes between five stages that people experience as they attempt to understand themselves in terms of their own cultures. Match the Stage to the correct definition:

a. Conformity
b. Dissonance
C. Integrative Awareness
d. Resistance and immersion
e. Introspection

1. ___ This stage is characterized by uncertainty about the rigidity of beliefs held in Stage 3 and conflicts between loyalty and responsibility toward one’s group and feelings of personal autonomy.
2. ___ This stage is marked by confusion and conflict over the contradictory appreciating and depreciating attitudes that one has toward the self and toward others of the same and different groups.
3. ___ At this stage, people experience a sense of self-fulfillment with regard to their cultural identity and have a strong desire to eliminate all forms of oppression.
4. ___ People in this stage actively reject the dominant society and exhibit appreciating attitudes toward the self and toward members of their own group.
5. ___ This stage is characterized by positive attitudes toward and a preference for dominant cultural values and depreciating attitudes toward one’s own culture.

Answer 131

1. e
2. b
3. c
4. d
5. a

Question 132

Cross’s Black Racial Identity model includes four stages: Pre-encounter, Encounter, Immersion-Emersion, and Internalization. Match the stage to the correct definition:

1. ___ Race and racial identity have high salience during this stage. The person idealizes Blacks and Black culture and feels a great deal of rage toward whites as well as guilt and anxiety about his/her own previous lack of awareness of race.
2. ___ Race and racial identity have low salience during this stage. Individuals have adopted a mainstream identity, wile those in the anti-Black substage have accepted negative beliefs about Blacks and as a result, are likely to have low self-esteem.
3. ___ Race continues to have high salience, and individuals in this stage have adopted one of three identies.
4. ___ Exposure to a single significant race-related event or series of events leads to greater racial/cultural awareness and an interest in developing a Black identity.

Answer 132

1. Immersion-Emersion
2. Pre-encounter
3. Internalization
4. Encounter

Question 133

According to Helms, racism is a central part of being White in America, and her White Racial Identity Development Model proposes that identity development involves two phases: abandoning racism and developing a nonracist white identity. Each status is characterized by a different information-processing strategy (IPS), which refers to the methods the individual uses to reduce discomfort related to racial issues. Match the status and IPS to the correct definition:

a. Immersion-Emersion
b. Pseudo-Independence
c. Contact
d. Disintegration
e. Autonomy
f. Reintegration

g. Obliviousness and denial
h. Hypervigilence and reshaping
i. Selective perception and reshaping reality
j. Suppression of information and ambivalence
k. Flexibility and complexity
l. Selective perception and negative out-group distortion

1. ____ The individual has little awareness of racism and of his/her racial identity and may exhibit unsophisticated behaviors that reflect racist attitudes and beliefs.
2. ____ The individual internalizes a nonracist white identity that includes an appreciation of and respect for racial/cultural differences and similarities.
3. ____ The individual explores what it means to be White, confronts his/her own biases, and begins to understand the ways he/she benefits from White privilege.
4. ____ The individual attempts to resolve the moral dilemmas associated with the disintegration status by idealizing White society and denigrating members of minority groups.
5. ____ increasing awareness of race and racism leads to confusion and emotional conflict. To reduce internal dissonance, the person may over-identify with members of minority groups, act in paternalistic ways toward them, or retreat into White society.
6. ____ A personally jarring event or series of events causes the person to question his/her racist views and acknowledge the role that Whites have had in perpetrating racism.

Answer 133

1. c, g
2. e, k
3. a, h
4. f, l
5. d, j
6. b, i

Question 134

Based on the results of his review of the literature, Eysenck concluded that the apparent benefits of psychotherapy are due to ___________________. His conclusion was based on the finding that 72% of no-treatment control group patients improved, while ____% of patients receiving eclectic therapy and ___% receiving psychoanalytic psychotherapy showed a substantial improvement in symptoms.

Answer 134

Spontaneous remission; 66, 44

Question 135

__________________ was first described by the biologist Ludwig van Bertalanffy and defines a system as an entity that is maintained by the mutual interactions of its components and assumes that the actions of interacting components are best understood by studying them in their context.

Answer 135

General systems theory

Question 136

_________________ was described by a mathematician in the 1940’s and was subsequently applied to family communication processes.

Answer 136

Cybernetics

Question 137

A key feature of cybernetics is its concept of the feedback loop through which a system receives information: A ____________ feedback loop reduces deviation and helps a system maintain the status quo, while a ___________ feedback loop amplifies deviation or change and thereby disrupts the system.

Answer 137

Negative; positive

Question 138

Gregory Bateson applied ideas drawn from systems theory and cybernetics to the treatment of families and is frequently cited for his work on the role of ___________________________ in the development of schizophrenia. It involves conflicting negative injunctions, with one injunction often being expressed verbally and the other nonverbally.

Answer 138

Double-bind communication

Question 139

In this approach to family therapy, Satir described how specific communication styles (placating, blaming, super-reasonable, irrelevant, and congruent) affect family interactions and relationships.

Answer 139

Communication/interaction family therapy

Question 140

In Satir’s communication/interaction family therapy, _________________ communications reflect equality between communicators but may escalate into a competitive one-upmanship” gem in which each participant tries to outdo the other. ______________ communications reflect inequality and maximize differences between communicators which sometimes leads to a pattern of one participant assuming the dominant role while the other assumes the submissive role.

Answer 140

Symmetrical; complementary

Question 141

How do communication/interaction family therapists view maladaptive behavior?

a. They accept a circular model of causality that regards a symptom as both a cause and effect of dysfunctional communication patterns, which include blaming and criticizing, mind reading, and overgeneralizing
b. They believe behavioral disorders are the result of a multigenerational transmission process in which progressively lower levels of differentiation are transmitted from one generation to the next.
c. Family dysfunction is viewed as the result of an inflexible family structure that prohibits the family from adapting to maturational and situational stressors in a healthy way.
d. They emphasize the role of communication in maladaptive behavior, especially how it is used to exert control in a relationship
e. Maladaptive behavior results when a family’s patterns become so fixed that family members are no longer able to act creatively or to make new choices about their lives.
f. Maladaptive behavior, like all behavior, is learned and maintained by its antecedents and consequences.
g. Maladaptive behavior is the result of both intrapsychic and interpersonal factors. A primary source of dysfunction is projective identification, which occurs when a family member projects old introjects onto another family member and then reacts to that person as though he or she actually has the projected characteristics or provokes the person to act inlays consistent with those characteristics

Answer 141

a

Question 142

How do strategic family therapists view maladaptive behavior?

a. They accept a circular model of causality that regards a symptom as both a cause and effect of dysfunctional communication patterns, which include blaming and criticizing, mind reading, and overgeneralizing
b. They believe behavioral disorders are the result of a multigenerational transmission process in which progressively lower levels of differentiation are transmitted from one generation to the next.
c. Family dysfunction is viewed as the result of an inflexible family structure that prohibits the family from adapting to maturational and situational stressors in a healthy way.
d. They emphasize the role of communication in maladaptive behavior, especially how it is used to exert control in a relationship
e. Maladaptive behavior results when a family’s patterns become so fixed that family members are no longer able to act creatively or to make new choices about their lives.
f. Maladaptive behavior, like all behavior, is learned and maintained by its antecedents and consequences.
g. Maladaptive behavior is the result of both intrapsychic and interpersonal factors. A primary source of dysfunction is projective identification, which occurs when a family member projects old introjects onto another family member and then reacts to that person as though he or she actually has the projected characteristics or provokes the person to act inlays consistent with those characteristics

Answer 142

d

Question 143

How do structural family therapists view maladaptive behavior?

a. They accept a circular model of causality that regards a symptom as both a cause and effect of dysfunctional communication patterns, which include blaming and criticizing, mind reading, and overgeneralizing
b. They believe behavioral disorders are the result of a multigenerational transmission process in which progressively lower levels of differentiation are transmitted from one generation to the next.
c. Family dysfunction is viewed as the result of an inflexible family structure that prohibits the family from adapting to maturational and situational stressors in a healthy way.
d. They emphasize the role of communication in maladaptive behavior, especially how it is used to exert control in a relationship
e. Maladaptive behavior results when a family’s patterns become so fixed that family members are no longer able to act creatively or to make new choices about their lives.
f. Maladaptive behavior, like all behavior, is learned and maintained by its antecedents and consequences.
g. Maladaptive behavior is the result of both intrapsychic and interpersonal factors. A primary source of dysfunction is projective identification, which occurs when a family member projects old introjects onto another family member and then reacts to that person as though he or she actually has the projected characteristics or provokes the person to act inlays consistent with those characteristics

Answer 143

c

Question 144

How do extended family systems therapists view maladaptive behavior?

a. They accept a circular model of causality that regards a symptom as both a cause and effect of dysfunctional communication patterns, which include blaming and criticizing, mind reading, and overgeneralizing
b. They believe behavioral disorders are the result of a multigenerational transmission process in which progressively lower levels of differentiation are transmitted from one generation to the next.
c. Family dysfunction is viewed as the result of an inflexible family structure that prohibits the family from adapting to maturational and situational stressors in a healthy way.
d. They emphasize the role of communication in maladaptive behavior, especially how it is used to exert control in a relationship
e. Maladaptive behavior results when a family’s patterns become so fixed that family members are no longer able to act creatively or to make new choices about their lives.
f. Maladaptive behavior, like all behavior, is learned and maintained by its antecedents and consequences.
g. Maladaptive behavior is the result of both intrapsychic and interpersonal factors. A primary source of dysfunction is projective identification, which occurs when a family member projects old introjects onto another family member and then reacts to that person as though he or she actually has the projected characteristics or provokes the person to act inlays consistent with those characteristics

Answer 144

b

Question 145

How do Milan systemic family therapists view maladaptive behavior?

a. They accept a circular model of causality that regards a symptom as both a cause and effect of dysfunctional communication patterns, which include blaming and criticizing, mind reading, and overgeneralizing
b. They believe behavioral disorders are the result of a multigenerational transmission process in which progressively lower levels of differentiation are transmitted from one generation to the next.
c. Family dysfunction is viewed as the result of an inflexible family structure that prohibits the family from adapting to maturational and situational stressors in a healthy way.
d. They emphasize the role of communication in maladaptive behavior, especially how it is used to exert control in a relationship
e. Maladaptive behavior results when a family’s patterns become so fixed that family members are no longer able to act creatively or to make new choices about their lives.
f. Maladaptive behavior, like all behavior, is learned and maintained by its antecedents and consequences.
g. Maladaptive behavior is the result of both intrapsychic and interpersonal factors. A primary source of dysfunction is projective identification, which occurs when a family member projects old introjects onto another family member and then reacts to that person as though he or she actually has the projected characteristics or provokes the person to act inlays consistent with those characteristics

Answer 145

e

Question 146

How do behavioral family therapists view maladaptive behavior?

a. They accept a circular model of causality that regards a symptom as both a cause and effect of dysfunctional communication patterns, which include blaming and criticizing, mind reading, and overgeneralizing
b. They believe behavioral disorders are the result of a multigenerational transmission process in which progressively lower levels of differentiation are transmitted from one generation to the next.
c. Family dysfunction is viewed as the result of an inflexible family structure that prohibits the family from adapting to maturational and situational stressors in a healthy way.
d. They emphasize the role of communication in maladaptive behavior, especially how it is used to exert control in a relationship
e. Maladaptive behavior results when a family’s patterns become so fixed that family members are no longer able to act creatively or to make new choices about their lives.
f. Maladaptive behavior, like all behavior, is learned and maintained by its antecedents and consequences.
g. Maladaptive behavior is the result of both intrapsychic and interpersonal factors. A primary source of dysfunction is projective identification, which occurs when a family member projects old introjects onto another family member and then reacts to that person as though he or she actually has the projected characteristics or provokes the person to act inlays consistent with those characteristics

Answer 146

f

Question 147

How do object relations family therapists view maladaptive behavior?

a. They accept a circular model of causality that regards a symptom as both a cause and effect of dysfunctional communication patterns, which include blaming and criticizing, mind reading, and overgeneralizing
b. They believe behavioral disorders are the result of a multigenerational transmission process in which progressively lower levels of differentiation are transmitted from one generation to the next.
c. Family dysfunction is viewed as the result of an inflexible family structure that prohibits the family from adapting to maturational and situational stressors in a healthy way.
d. They emphasize the role of communication in maladaptive behavior, especially how it is used to exert control in a relationship
e. Maladaptive behavior results when a family’s patterns become so fixed that family members are no longer able to act creatively or to make new choices about their lives.
f. Maladaptive behavior, like all behavior, is learned and maintained by its antecedents and consequences.
g. Maladaptive behavior is the result of both intrapsychic and interpersonal factors. A primary source of dysfunction is projective identification, which occurs when a family member projects old introjects onto another family member and then reacts to that person as though he or she actually has the projected characteristics or provokes the person to act inlays consistent with those characteristics

Answer 147

g

Question 148

Match the main therapy goals with the correct family systems theory:

a. Communication/interaction family therapy
b. Extended family systems therapy
c. Structural family therapy
d. Strategic family therapy
e. Milan systemic family therapy
f. Behavioral family therapy
g. Object relations family therapy

____1. To alter the environmental factors (antecedents and consequences) that are maintaining problematic behaviors.
____2. To help family members see their choices and to assist them in exercising their prerogative of choosing
____3. To alter the interactional patterns that are maintaining the presenting symptoms
____4. To resolve each family member’s attachment to family introjects
____5. On alleviating current symptoms by altering a family’s transactions and organization, especially its hierarchies and generational boundaries.
____6. Restructuring the family
____7. To increase the differentiation of family members

Answer 148

1. f
2. e
3. a
4. g
5. d
6. c
7. b

Question 149

________________________ refers to a person’s ability to separate his or her intellectual and emotional functioning.

Answer 149

Differentiation

Question 150

The term _________________ is used to describe a family whose members are highly emotionally fused.

Answer 150

Undifferentiated family ego mass

Question 151

When a two-person system such as a husband-wife or parent-child experiences instability or stress, a third person may be recruited into the system to increase stability and reduce tension. The lower the level of differentiation in a family members, the greater the probability that this happens.

Answer 151

Emotional triangle

Question 152

The _________________________ is the process by which parental conflicts and emotional immaturity are transmitted to children, which causes a child to have a lower level of differentiation that his or her parents. This often involves the oldest child, the child born during a time of family stress, or the child who is perceived to be “special.”

Answer 152

Family projection process

Question 153

What type of family therapist is most likely to use a genogram as a therapy technique?

Answer 153

Bowenian extended family therapist

Question 154

Which type of family therapy would involve three overlapping steps: joining, evaluating the family structure, and restructuring the family?

Answer 154

Minuchin’s Structural family therapy

Question 155

_______________ is probably best defined as an alteration in memory, perception, and mood in response to suggestion.

Answer 155

Hypnosis

Question 156

True or false: Hypnosis enhances the accuracy of memories and produces accurate memories.

Answer 156

False. Hypnosis does not enhance the accuracy of memories and may actually produce more pseudo memories than accurate memories.

Question 157

What are the three formative stages that Yalom identified?

Answer 157

1. Orientation, hesitant participation, search for meaning, dependency: Members tend to talk directly to the leader rather than to other members and look to the leader for approval and acceptance as well as for answers to their questions
2. Conflict, dominance, rebellion: each member attempts to establish his or her preferred amount of initiative and power and gradually a control hierarchy emerges. Advice giving is replaced by criticism, judgmental statements, and other negative comments, and some members may express hostility toward the therapist as a result of resistance and the realization that they are not going to become the therapist’s “favored child.”
3. Development of Cohesiveness: Unity, intimacy and closeness become the chief concerns; trust and self-disclosure increase; attendance improves; and members show concern whenever a member is absent;

Question 158

Which of the following is not one of the group therapist’s primary tasks, according to Yalom?

a. Activation and Illumination of the Here-and-now
b. Culture Building
c. Closure of relationships
d. Creation and maintenance of the group

Answer 158

c

Question 159

How does Yalom view therapist self-disclosure in group therapy?

a. Therapists should never self-disclose
b. Therapists should disclose regularly
c. Self-disclosure limits participant’s ability to join with one another
d. Self-disclosure is beneficial as long as it is done judiciously and responsibly.

Answer 159

d

Question 160

True or False: Yalom considers concurrent group and individual therapy neither necessary nor beneficial except in certain circumstances- for instance, when a group member is experiencing a crisis or requires individual sessions to ensure that he/she does not drop out of the group prematurely.

Answer 160

True

Question 161

What is the main goal of feminist therapy?

Answer 161

Empowerment, or helping women become more self-defining and self-determining

Question 162

Hypnosis has been found to be effective in treating a variety of conditions. What are some examples?

Answer 162

acute stress disorder and other anxiety disorders, obesity, insomnia, and chronic pain

Question 163

Immunization programs, prenatal nutrition programs for low SES motherrs, and public education programs on drug and alcohol abuse are all examples of what type of method of prevention?

Answer 163

Primary prevention which is aimed at reducing the prevalence of mental and physical disorders by decreasing the incidence of new cases.

Question 164

Using a screening test to identify entering first-graders with reading disabilities so that they can be provided with an educational intervention is an example of which type of method of intervention?

Answer 164

Secondary prevention which attempts to decrease the prevalence of mental and physical disorders by reducing their duration through early detection and intervention

Question 165

Rehabilitation programs, programs that provide alternatives to hospitalization, and education programs designed to improve community attitudes toward former mental patients are examples of what type of method of prevention?

Answer 165

Tertiary prevention which is designed to reduce the duration and consequence of mental and physical disorders

Question 166

According to the ___________________, health-related behaviors are related to a person’s perceptions about his/her susceptibility to illness and the severity of its consequences and an evaluation of the costs and benefits of making a particular response.

Answer 166

Health belief model

Question 167

This type of consultation involves working with the consultee to develop a plan that will enable the consultee to work more effectively with a particular client. The consultant acts as an expert and provides the consultee with relevant information:

a. Client-centered case consultation
b. Consultee-centered case consultation
c. Program-centered administrative consultation
d. Consultee-centered administrative consultation

Answer 167

a

Question 168

The goal of this form of consultation is to enhance the consultee’s performance in delivering services to a particular population or group of clients. The focus is on the consultee’s skills, knowledge, abilities, and/or objectivity.

a. Client-centered case consultation
b. Consultee-centered case consultation
c. Program-centered administrative consultation
d. Consultee-centered administrative consultation

Answer 168

b

Question 169

This form of mental health consultation involves working with one or more administrators (the consultees) to resolve problems related to an existing program

a. Client-centered case consultation
b. Consultee-centered case consultation
c. Program-centered administrative consultation
d. Consultee-centered administrative consultation

Answer 169

c

Question 170

The goal of this type of consultation is to help administrative-level personnel improve their professional functioning so they can be more effective in the future with regard to program development, implementation, and evaluation.

a. Client-centered case consultation
b. Consultee-centered case consultation
c. Program-centered administrative consultation
d. Consultee-centered administrative consultation

Answer 170

d

Question 171

Research by Howard and his colleagues indicates that the relationship between treatment length and outcome levels off at about ____ sessions.

Answer 171

26

Question 172

Research comparing the outcomes of psychotherapy for members of various racial ethnic groups suggest that it has positive effects for members of all groups but that there are some differences. Which of the following are true regarding the effects of psychotherapy on members of diverse populations as demonstrated in a study of outpatient mental health services in Los Angeles county?

a. Clients from all groups were likely to show improvement in GAS scores
b. Hispanics had the best outcomes followed in order by Anglo, Asian, and African American clients
c. Asian clients were least responsive to treatment
d. None of the above

Answer 172

a, b

Question 173

Which statements are true about utilization rates of mental health services among different racial/ethnic groups, type of treatment setting, and type of problem?

a. There are no differences among racial/ethnic groups
b. A smaller proportion of African American than Whites receive mental health services
c. African American individuals receive a disproportionate share of mental health services in the emergency room or psychiatric inpatient settings
d. Asian Americans are underrepresented in both outpatient and inpatient settings
e. A smaller proportion of African Americans and Hispanics than Whites receive treatment for depression, while a larger proportion of African Americans receive treatment for illicit drug use.

Answer 173

b,c,d,e

Question 174

True or false: Members of ethnic and cultural minority groups are less likely than whites to terminate therapy prematurely.

Answer 174

False

Question 175

With regard to prevalence, APA (2002) notes that the most common mental health problems among older adults are, in order of incidence, ___________, ____________, and _____________.

a. Depression, severe cognitive impairment, anxiety
b. Depression, anxiety, bipolar I disorder
c. Anxiety, severe cognitive impairment, depression
d. Dementia, depression, anxiety

Answer 175

c.

Question 176

What is the single best predictor of cessation of battering according to the National Alcohol and Family Violence survey?

Answer 176

family income, with low-income families being the most likely to report continued violence

Question 177

What term was originally used to describe the tendency of health professionals to attribute all behavioral, social, and emotional problems to mental retardation in individuals with this diagnosis?

Answer 177

diagnostic overshadowing

Question 178

The goal of an ____________ intervention is to make changes in the environment so that it better accommodates the individual, while the goal of an ______________ intervention is to change the individual so that h/she is better able to function effectively within his/her environment.

Answer 178

Alloplastic; autoplastic

Question 179

For both men and women, admission rates into psychiatric hospitals are lowest among _____________, intermediate for those who are __________, and highest for those ____________.

Answer 179

widowed, married or divorced/separated, never married

Question 180

For both men and women, the largest proportion of admissions is in the ___ to ___ age range.

Answer 180

25 to 44

Question 181

The most common diagnosis for inpatients in the 18 to 44 age range is ______________.

Answer 181

Schizophrenia

Question 182

For patients aged 65 and older, this is the most common diagnosis for psychiatric inpatients, followed by these types of disorders.

Answer 182

Organic disorder; affective disorder

Question 183

True or false: Men are admitted to inpatient programs more often than women

Answer 183

True

Question 184

True or False: Men are admitted to outpatient programs more often than women

Answer 184

False, the opposite is true

Question 185

True or false: Hispanics represent the majority of admissions to both inpatient and outpatient mental health programs

Answer 185

False; Whites (70%)