Ch 5 Helping Relationship Flashcards
Practice Exam 1
A client in individual counseling exhibits a propensity for defense mechanisms, such as denial and sublimation. Defense mechanisms are considered primarily to be a reaction to:
Select one:
A. guilt
B. anxiety
C. instinct
D. societal expectations
The Correct Answer is: B
The key word here is “primarily.” Traditionally, defense mechanisms are considered first and foremost to be reactions to anxiety. Guilt, instinct, and societal expectations may be imbedded in the person’s defense mechanism but they are not as integral a part of the mechanism as anxiety.
The correct answer is: anxiety
A family reports a marked lack of communication between family members. Two of the children resent the mother and rarely speak to her. Another child resents the father and barely speaks to him. The mother and father have trouble communicating with each other. This family is experiencing:
Select one:
A. differentiation
B. homeostasis
C. enmeshment
D. disengagement
The Correct Answer is: D
Disengagement, a term associated with Minuchin’s structural family therapy, refers to a lack of communication, or isolation, between family members. Disengagement is clearly what is going on here. Enmeshment, another Minuchin term, refers to overly diffuse or unclear boundaries, which is not indicated here.
The correct answer is: disengagement
You are currently treating a large family that presented with communication and discipline problems. You assess the family as having an enmeshed style and a weak executive subsystem. Your overall goal is to define clearer boundaries within the system. It is likely that you would agree with all of the following except:
Select one:
A. both the family’s present and its past will be examined in therapy
B. the focus of treatment should be on changing the family’s maladaptive transactional patterns
C. dysfunctional patterns in the family can be altered through the use of directive techniques
D. the focus should be on the individual and how family members feel about and interact with each other
The Correct Answer is: D
The assessment and goal with this family is indicative of a structural family therapy approach. You needed to choose the statement which is NOT true about structural family therapy. The key word here is “individual”–the focus of structural family therapy is not on the individual, but on triads, coalitions, subsystems, etc. In addition, while the second part of the answer could be true for structuralists, the emphasis on “feeling” has more of a psychodynamic or experiential/humanistic flavor. The other choices are statements which could be true about structural family therapy. Although the focus of therapy is not on multigenerational issues, as in a Bowenian approach, the structural approach does examine the past and the present–i.e., how the family’s present structure is carried over from past transactional patterns. For example, structuralists are interested in the developmental stages of the family life cycle and how a particular family can restructure to accomplish developmental tasks. Also, structuralists do work to change maladaptive transactional patterns. Structural family therapy works by opening alternative patterns of family interaction in order to modify family structure. The therapist helps to activate certain structures, which can then become reinforcing and eventually change the structure of the family. In addition, structural therapists use a number of directive techniques, including reposturing, enactment of family transactional patterns, utilizing symptoms, manipulating mood, and escalating stress.
The correct answer is: the focus should be on the individual and how family members feel about and interact with each other
Yalom (1980) identified which of the following as “ultimate concerns of life” that are addressed in existential psychotherapy?
Select one:
A. morality, ethics, character, and responsibility
B. death, freedom, existential isolation, and meaninglessness
C. vocation, family, and faith
D. existence, valor, and courage
The Correct Answer is: B
You may have been able to deduce, or make a good guess about, the correct answer without being familiar with Yalom’s book (Yalom, I. D. [1980]. Existential Psychotherapy. New York: BasicBooks) by virtue of a general understanding of existential psychotherapy.
B. CORRECT Existential psychotherapy holds that personality is an outgrowth of the struggle between the individual and the “ultimate concerns” of existence, including death, isolation, meaninglessness, and the fact that we are ultimately responsible for our own lives.
The correct answer is: death, freedom, existential isolation, and meaninglessness
A client relates the factual information about his experience without including any information about his affective state. This is an example of:
Select one:
A. reaction formation
B. rationalization
C. intellectualization
D. suppression
The Correct Answer is: C
Intellectualization is a defense mechanism. This is a form of displacement onto a small detail and represents an attempt to avoid objectionable impulses or affects by escaping from the world of emotions into a world of intellectual concepts and words.(a) and (b) also refer to defense mechanisms. (a) Reaction formation occurs when a person avoids an anxiety-evoking instinct by expressing its opposite. (b) Rationalization entails explaining one’s unacceptable behaviors in ways which make them appear rational and socially acceptable.
The correct answer is: intellectualization
A man, who is a recovering alcoholic and who recently divorced, comes to see you. He used to abuse his wife and daughter. He tells you that now that he has been in AA for 60 days, “all that abusive stuff with my family is behind me.” He is most likely:
Select one:
A. drunk
B. in denial
C. not even an alcoholic
D. also a drug addict
The Correct Answer is: B
Since this man is recently sober, he is very likely using the same defense mechanisms he used when he was drinking. He has just admitted he is an alcoholic and may not be ready to also admit that he is an abuser. Thinking that he is now sober and will no longer be abusive, appears to be denying his problem. He may be minimizing his problem, but since minimizing is not a choice, this is the best answer.
The correct answer is: in denial
A(n) _________________ model of consultation would most likely be used when the personal attitudes or feelings of the consultee are interfering with his or her work:
Select one:
A. mental health
B. educational
C. systems
D. process
The Correct Answer is: A
Both the Mental Health Model and the Psychodynamic Model focus on producing psychological change in the consultee and are used specifically when the personal attitudes and feelings of the consultee are at the base of his or her problem with work. (b) The Educational Model operates under the assumption that work-related problems arise out of a lack of skill or knowledge. Some of the techniques used in this model are direct instruction, modeling, and homework assignments. (c) The Behavioral Model operates under the same assumption as the Educational Model. This model focuses on behavioral change through modeling, shaping, role playing with feedback, and assigning homework. (d) The Process Model is guided by three assumptions: (1) social systems shape people’s wants, self-concepts, and behavior; (2) many mental health difficulties arise out of unhealthy social systems; and (3) acting on social systems offers a promising, indirect method of ameliorating mental illness. Process consultants focus on improving interpersonal skills among consultees.
The correct answer is: mental health
For followers of Carl Rogers, heart palpitations, hyperventilation, tension headaches, and nausea are considered:
Select one:
A. symptoms of a physical disorder
B. manifestations of denied threats to the self-concept
C. a result of overwhelming environmental stress
D. the consequence of being unable to fulfill one’s own needs
The Correct Answer is: B
For Rogers, personality and behavioral problems arise when an individual’s natural tendency toward growth and actualization is disrupted by an incongruence between the self and experience. Incongruence results when the evaluations made by others are inconsistent with one’s self-concept. One way in which this incongruence is dealt with is to deny the external experience by saying it doesn’t exist or by distorting it. Rogers believed that such denial doesn’t really work: For instance, the denied objects or events can emerge as visceral symptoms associated with anxiety.
The correct answer is: manifestations of denied threats to the self-concept
A family reports that there are unclear or inappropriate boundaries between family members. Family members are able to communicate with each other, but not in a healthy and appropriate way. Which of the following terms best describes what is happening within this family:
Select one:
A. enmeshment
B. disengagement
C. implosion
D. homeostasis
The Correct Answer is: A
A Enmeshment, a term coined by Minuchin, refers to overly diffuse or unclear boundaries, which are often inappropriate. Disengagement (B) refers to the other extreme - a lack of communication, or isolation, between family members.
The correct answer is: enmeshment
Which of the following conditions would Carl Rogers say produces psychological maladjustment in a person?
Select one:
A. incongruence between the concept of the self and experience
B. unresolved conflicts from childhood
C. inability to satisfy ones basic needs of survival
D. lack of strong attachments early in life
The Correct Answer is: A
The correct answer is A. Carl Rogers wrote (in Client-Centered Therapy: Its Current Practice, Implications, and Theory, 1951, p. 511):
Psychological maladjustment exists when the organism denies to awareness significant sensory and visceral experiences, which consequently are not symbolized and organized into the gestalt of the self-structure. When this situation exists, there is a basic or potential psychological tension.
The correct answer is: incongruence between the concept of the self and experience
A client is being seen at a social services agency. Their oncologist referred them. Their only mental health coverage is through Medicare. Your work with them should focus on:
Select one:
A. whatever their physician has directed
B. helping them work through the stages of grief such as: denial, anger, bargaining, depression, and acceptance
C. conducting a thorough intake to determine the clients needs
D. determining what Medicare covers for psychotherapy for cancer patients
The Correct Answer is: C
The correct answer is C. There is some superfluous information contaminating this question. Answer C is applicable for all clients but if you didn’t choose it, you may have been distracted by the information provided in the question. A physician is not responsible for an NCC’s treatment plan, as offered in answer A. Answer B would have you believe that all clients referred by oncologists need to work through these stages. This might not be true about this client. The information about mental health coverage is important - Answer D - but the question is asking about “focus.”
The correct answer is: conducting a thorough intake to determine the clients needs
A woman, married for ten years, calls a shelter hotline afraid for her own life. Her husband has beaten her many times over the years, and, earlier that evening, he hit her repeatedly with his fists and threw objects at her. He then left the house, and the woman is alone at the time of the call. She says she has a car, wants to come to the shelter, and asks how to get there. The shelter staff member directs her to drive immediately to a public pay phone and call the shelter back, at which time she will be given directions to the shelter. The woman calls back two hours later and says she has changed her mind and will not be coming to the shelter after all. The woman’s change of mind is MOST likely attributable to which of the following:
Select one:
A. since the initial phone call, there has been an increase in tension in her relationship with her husband, which she is now trying to defuse
B. since the initial phone call, the womans husband has apologized and expressed remorse for his behavior
Incorrect
C. since the initial phone call, it has dawned on the woman that she will not be able to support herself if she leaves her husband
D. during the initial phone call, the shelter worker should have been more directive, either giving the woman the directions or offering to come to her home and bring her to the shelter
The Correct Answer is: D
The correct answer is D. Greater direction from the shelter worker might have prevented this woman from having an opportunity to change her mind. In fact, it is common for shelter workers to instruct callers to leave their homes and go to a pay phone or other safe location to receive further instructions on how to get to the shelter. This plan of action gets the caller out of her house and keeps the shelter’s location a secret from others. This question addresses Lenore Walker’s (1984) “cycle of violence.” Walker has identified a three-stage cycle of abuse that seems to describe about two-thirds of abusive acts occurring between couples in intimate relationships: (1) In the initial “tension building” stage, which may last from a few hours to days, weeks, and even years, the woman usually attempts to defuse tension by giving in to the demands of the batterer. (2) In the next stage, an “acute battering incident” occurs. The abuse can last from a few minutes to a few hours and serves to discharge the batterer’s tension. (In this case, an acute battering incident has just occurred.) (3) The battering incident is followed by a “honeymoon” stage, in which the batterer is loving and apologetic toward his partner and assures her that he will never abuse her again. Although answer A describes a stage of Walker’s cycle, her model suggests that immediately following an acute battering incident, the husband would express remorse and promise to never beat his wife again. The tension-building phase is likely to resume after this. See the explanation for response B. Answer B would be the “best” answer, were it not for the piece of information the caller gave - “Her husband has beaten her many times over the years.” Research shows that the time between the battering incident and the “honeymoon” stage increases over the years with the batterer feeling justified in his behavior. If the question did not indicate the length of time they had been together or the statement she made about their battering history, then this would be the best answer. Although some research indicates that many women decide to stay with an abusive partner because they are unable to support themselves, B is a better response than C because the cycle has been found to describe the majority of abusive acts between adult partners. You would have to be a mind reader to know what “dawned” on the woman.
The correct answer is: during the initial phone call, the shelter worker should have been more directive, either giving the woman the directions or offering to come to her home and bring her to the shelter
A couple is divorcing. To reduce the adverse effects of the divorce on their three school-age children, it will be MOST important for the couple to:
Select one:
A. allow the children to decide which parent to live with after the divorce
B. make sure all three children live with the same parent after the divorce
C. keep open conflicts in front of the children to a minimum
D. spend extra time with the children
The Correct Answer is: C
The correct answer is C. Frequent hostility and open conflicts between the parents following a divorce are predictive of behavioral problems in the children. The research has shown that continuous open conflict between the parents has negative consequences on the children of both intact and divorced families. Answer A can be eliminated because much research indicates that it is not a good idea to let children make this decision since it puts them in a position of having to “choose sides.” School-age children could indicate children ranging in age from 5 to 17. More adolescent children are involved in “choosing” which parent they want to live with. Answer B might indicate a good choice in some cases; there is no evidence that it is a critical factor for this case. Answer D was certainly tempting because you might know it is true that newly-divorced parents often do spend less time with their children, spending more time is probably less important than minimizing open conflict, and the actual effects of more time would depend on what happens during the time the parent and child spend together.
The correct answer is: keep open conflicts in front of the children to a minimum
Memory related to procedural knowledge and skills:
Select one:
A. is called declarative memory and is part of short-term memory
B. is called declarative memory and is part of long-term memory
C. is called nondeclarative memory and is part of short-term memory
D. is called nondeclarative memory and is part of long-term memory
The Correct Answer is: D
Nondeclarative memory refers to a person’s procedural knowledge. It is sometimes called “knowing how.” Declarative memory refers to a person’s knowledge of facts and events. It is sometimes called “knowing what.” Both are part of long-term memory.
The correct answer is: is called nondeclarative memory and is part of long-term memory
Your adolescent client says, “You treat me just like my father does.” This is an example of:
Select one:
A. projection
B. transference
C. countertransference
D. cathexis
The Correct Answer is: B
THE CORRECT ANSWER IS “B”
Transference is a therapeutic process that occurs when the client’s experience of feelings and attitudes toward the counselor represent feelings and attitudes the client has toward significant other’s in his or her past. The example in this question illustrates the concept of transference. Projection (“a”) is a defense mechanism that involves attributing undesirable impulses to the external world. Countertransference (“c”) refers to the counselor’s unconscious emotional responses to the client. Cathexis (“d”) is the attachment of psychic energy onto a person, object, or idea.
The correct answer is: transference
