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1

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

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

2

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

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

3

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

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

4

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

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

5

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

A. self-indoctrination.
Ellis, the founder of RET, viewed behavioral disorders as stemming from both biological predisposition and early life experiences but argued that their maintenance was due primarily to self-indoctrination. Specifically, during early childhood, children tend to internalize the critical attitude of their parents and then perpetuate that attitude as they grow older.

6

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

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

7

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

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

8

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

B. heavy reliance on nonverbal (versus verbal) messages.
The terms "high context" and "low context" have been used to describe cultural differences in communication. A high-context style is characterized by reliance on nonverbal and culturally-shared cues and is characteristic of a number of cultural/racial minority groups including African-, Hispanic-, and Asian-Americans.

9

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

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

10

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

C. Countertransference can help the therapist identify subtle aspects of the transference and better understand the patient's experience.
Countertransference refers to the therapist's transference responses to the patient. According to current psychoanalytic thought, a therapist's analysis of his or her own countertransference reactions can help the therapist recognize subtle aspects of the transference relationship and better understand the patient's experience.

11

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

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

12

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

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