Clinical

Question 1

Freud described countertransference as the analyst’s transference to the patient, which may interfere with the analyst’s functioning in therapy. More recently, psychoanalysts have begun to view countertransference as:
Select one:

A.
a detriment to the normal progression of therapy.

B.
a potential source of information about the client.

C.
an analyst’s distortion of the client’s behavior.

D.
an opportunity for the analyst to respond to the client in an authentic way.

Answer 1

The correct answer is B.

Psychoanalysts have broadened their view of countertransference over the past few decades. Most analysts now believe that countertransference reactions originate as much (or more) from the patient as from the analyst. Consequently, countertransference is now viewed as a potentially beneficial way to gain insight into the patient’s inner world (Gabbard, 1995; Langs, 1982).

Answer A: Modern analysts believe that countertransference can positively aid the progression of therapy rather than serving as a detriment to treatment.

Answer C: Freud viewed countertransference as the therapist’s distorted response to the client. However, modern analysts consider countertransference to be a potential source of information about the client that can be an important factor in the curative process.

Answer D: This is not the best answer. Answer B constitutes a more definitive distinction between a modern view and a traditional Freudian view of countertransference in therapy.
The correct answer is: a potential source of information about the client.

Question 2

Researchers interested in evaluating the outcomes of psychotherapy distinguish between effectiveness and efficacy research. In contrast to effectiveness research, efficacy research:
Select one:

A.
has better internal validity but limited external validity.

B.
has limited internal validity but better external validity.

C.
has better internal and external validity.

D.
has limited internal and external validity.

Answer 2

The correct answer is A.

Efficacy studies are conducted in well-controlled conditions, often using a structured manualized session format. In contrast, effectiveness studies are conducted in real-world settings with less experimental control. Therefore, while efficacy studies are useful for determining whether a treatment has beneficial effects under controlled conditions, effectiveness studies are useful for determining if those effects generalize to other conditions. (Note that to identify the correct answer to this question, you not only have to be familiar with efficacy and effectiveness research, but also with internal and external validity, which are described in the Statistics and Research Design chapter of the written study materials.)

Answer B: A criticism of efficacy research is that because many of the crucial elements of what is actually done during the course of delivering psychotherapy are controlled, the results have good internal validity but limited external validity.

Answer C: Efficacy studies are deemed to have good internal validity but limited external validity.

Answer D: Efficacy studies are deemed to have good internal validity but limited external validity.
The correct answer is: has better internal validity but limited external validity.

Question 3

The belief that a child’s misbehavior has one of four goals—i.e., attention, revenge, power, or to display inadequacy—is most consistent with:
Select one:

A.
Beck’s cognitive-behavioral therapy.

B.
Adler’s individual psychology.

C.
Perls’s Gestalt therapy.

D.
Mahler’s object relations theory

Answer 3

The correct answer is B.

Adler believed that all behaviors are goal-directed and purposeful. He further asserted that while misbehavior was intended to meet one of four goals, each goal ultimately was rooted in a desire to belong.

Answer A: This belief is not most consistent with to Beck’s theory.

Answer C: This belief is not most consistent with Perls’s theory.

Answer D: This belief is not most consistent with Mahler’s theory.
The correct answer is: Adler’s individual psychology.

Question 4

Solution-focused therapists utilize all of the following interventions except:
Select one:

A.
the miracle question.

B.
the exception question.

C.
reflective questioning.

D.
scaling questions.

Answer 4

The correct answer is C.

In solution-focused therapy, the therapist acts as a consultant/collaborator who poses different types of questions designed to assist the client in recognizing and using their strengths and resources to achieve specific goals. However, “reflective questioning” is not part of this questioning. This is a made up term.

Answers A, B, and D: Solution-focused therapists utilize all of three of these interventions.
The correct answer is: reflective questioning.

Question 5

For a Gestalt therapist, a primary goal of treatment is to help the client:
Select one:

A.
integrate the present with their past and future.

B.
integrate the various aspects of the self.

C.
develop a success identity.

D.
develop a healthy style of life.

Answer 5

The correct answer is B.

The primary goal of Gestalt therapy is to increase awareness and integration of all aspects of the self. This includes integrating one’s feelings, thoughts, and actions.

Answer A: In Gestalt therapy, the focus is on the present. The founder of Gestalt therapy, Fritz Perls, argued that “nothing exists but the now.”

Answer C: Developing a success identity is the goal of reality therapy.

Answer D: A focus on developing a healthy life is in alignment with Adlerian therapy.
The correct answer is: integrate the various aspects of the self.

Question 6

Carl Jung believed that a client’s transference:
Select one:

A.
is a fantasy that distracts the client from reality.

B.
represents mixed feelings toward the therapist.

C.
is a form of “acting out.”

D.
reflects the client’s personal and collective unconscious.

Answer 6

The correct answer is D.

Jung viewed transference as the projection of both the personal and collective unconscious.

Answer A: Jung did not describe transference as a deviation from reality.

Answer B: Jung did not postulate that transference was rooted in ambiguous feelings toward the clinician.

Answer C: Acting out is a defense mechanism described in psychoanalytic theory.
The correct answer is: reflects the client’s personal and collective unconscious.

Question 7

Replacing a “failure identity” with a “success identity” is a goal of treatment for practitioners of ____________ therapy.
Select one:

A.
Gestalt

B.
reality

C.
solution-focused

D.
Adlerian

Answer 7

The correct answer is B.

Glasser, the founder of reality therapy, viewed identity as a basic psychological need and distinguished between success and failure identities. A person develops a success identity when the person fulfills their needs in a responsible way.

Answer A: This is not a goal of Gestalt therapy.

Answer C: This is not a goal of solution-focused therapy.

Answer D: This is not a goal of Adlerian therapy.
The correct answer is: reality

Question 8

People in which of the following stages of Atkinson, Morten, and Sue’s (1993) Racial/Cultural Identity Development Model begin to question their rejection of all aspects of the dominant culture and absolute loyalty to their own culture?
Select one:

A.
Encounter

B.
Dissonance

C.
Integrative awareness

D.
Introspection

Answer 8

The correct answer is D.

The five stages of the Racial/Cultural Identity Development Model include conformity, dissonance, resistance and immersion, introspection, and integrative awareness. During the introspection stage, the individual begins to question the unequivocal position that they adopted during the previous resistance-immersion stage with regard to their own culture and the dominant culture.

Answer A: The encounter stage is the second stage in Cross’s Black Racial (Nigrescence) Identity Development Model (1991).

Answer B: During the dissonance stage, the individual begins to question conformity to the dominant culture.

Answer C: During the integrative awareness stage, the person bases acceptance or rejection of aspects of the majority and minority cultures on an objective evaluation.
The correct answer is: Introspection

Question 9

A family therapist using the structural approach of Salvador Minuchin would most likely:
Select one:

A.
clarify boundaries between family members in order to reduce enmeshment.
Correct

B.
work initially with the most differentiated family member.

C.
use a multiple-therapist team to prevent any one therapist from becoming “triangulated” into the family system.

D.
issue specific “directives” designed to counteract dysfunctional processes.

Answer 9

The correct answer is A.

As its name implies, structural family therapy focuses on altering the family’s structure in order to change the behavior patterns of family members. Even if you are unfamiliar with Minuchin, you may have been able to guess that structural therapy would be concerned with boundaries. Structural family therapists view family dysfunction as being related to boundaries that are too diffuse (enmeshed) or too rigid (disengaged).

Answer B: This is more characteristic of Bowen’s approach to family therapy.

Answer C: Minuchin’s approach does not involve the use of multiple-therapist teams.

Answer D: The issuance of directives is more characteristic of strategic family therapy than of structural family therapy.
The correct answer is: clarify boundaries between family members in order to reduce enmeshment.

Question 10

According to Freud’s notion of ____________, dreams and slips of the tongue are meaningful goal-directed phenomena.
Select one:

A.
psychic dynamogenesis

B.
reciprocal determinism

C.
psychic determinism

D.
ptyalism

Answer 10

The correct answer is C.

Freud interpreted dreams, slips of the tongue, etc. as manifestations of unconscious material. According to Freud’s doctrine of psychic determinism, behaviors are caused by unconscious phenomena rather than true free will.

Answer A: Dynamogenesis is the principle that motor responses are proportional to sensory activities.

Answer B: Reciprocal determinism proposes that behavior, person, and situation interact and influence each other.

Answer D: Ptyalism refers to the excessive production of saliva, something Pavlov, not Freud, would be interested in.
The correct answer is: psychic determinism

Question 11

The information that family members continuously exchange and that helps minimize deviation and maintain the family’s stability is referred to as ____________ feedback.
Select one:

A.
external

B.
internal

C.
negative

D.
positive

Answer 11

The correct answer is C.

In family systems theory, the information exchange between family members can act as either positive or negative feedback. Negative feedback helps the system return to or maintain its steady state. Thus, a “negative feedback loop” helps minimize deviation and thereby maintains the family’s stability.

Answer A: This term is not relevant to the question posed.

Answer B: This term is not relevant to the question posed.

Answer D: Positive feedback increases deviation from a steady state and, therefore, produces a change in the family’s functioning.
The correct answer is: negative

Question 12

In Berry’s bidirectional acculturation model (1993), ____________ is characterized by low involvement in one’s own minority culture and in the majority culture.
Select one:

A.
moratorium

B.
alienation

C.
separation

D.
marginalization

Answer 12

The correct answer is D.

Berry (1993) distinguishes between two independent dimensions in his discussion of acculturation: involvement in one’s minority culture and involvement in the majority culture. Marginalization occurs when a member of a minority group is uninvolved in both cultures.

Answer A: Moratorium is not one of Berry’s four acculturation status categories.

Answer B: Alienation is not one of Berry’s four acculturation status categories.

Answer C: Berry asserts that separation involves withdrawal from the dominant culture and acceptance of one’s own culture.
The correct answer is: marginalization

Question 13

Studies have shown that psychotherapy research participants in placebo control groups typically show:
Select one:

A.
greater improvement than those in no-treatment or wait-list control groups.

B.
less improvement than those in no-treatment or wait-list control groups.

C.
similar improvement to those in no-treatment or wait-list control groups.

D.
no improvement when compared to no-treatment or wait-list control groups.

Answer 13

The correct answer is A.

Studies have shown that placebo conditions have a substantial impact, with participants in placebo control groups typically showing greater improvement in symptoms than those in no-treatment or wait-list control groups. Lipsey and Wilson, for example, report an average effect size of .67 when treated participants are compared to no-treatment controls, but a smaller effect size of .48 when participants in the treatment group are compared to those in a placebo control group (1993).

Answer B: The opposite is true.

Answer C: Greater improvement is typically noted in psychotherapy research placebo control groups.

Answer D: Improvement is typically noted among psychotherapy research placebo control groups.
The correct answer is: greater improvement than those in no-treatment or wait-list control groups.

Question 14

Asking the “miracle question” is an initial intervention in which type of therapy?
Select one:

A.
Transtheoretical

B.
Interpersonal

C.
REBT

D.
Solution-focused

Answer 14

The correct answer is D.

The “miracle question” is used to help clients identify solutions to their problems. As its name implies, solution-focused therapy focuses on identifying solutions to problems. The miracle question is one of the techniques used by solution-focused therapists to identify solutions and establish therapy goals. It involves asking the client how the client’s life would be if their problems were suddenly resolved.

Question 15

Research on Helms’s White Racial Identity Development Model suggests that a White therapist will usually be most successful when working with a client from an ethnic/racial minority group when the therapist is in which stage?
Select one:

A.
Reintegration

B.
Immersion-emersion

C.
Autonomy

D.
Integrative awareness

Answer 15

The correct answer is C.

Helms’s White Racial Identity Development Model distinguishes between six identity statuses (stages): contact, disintegration, reintegration, pseudo-independence, immersion-emersion, and autonomy. For the exam, you’ll want to be familiar with the characteristics of each stage. A White therapist is likely to be most effective when working with a client from an ethnic/racial minority group when the therapist is in the final stage of Helm’s identity development—i.e., the autonomy stage. A person in this stage has internalized a positive (non-racist) White identity that includes an appreciation of and respect for racial/cultural similarities and differences.

Answers A, B, and D: A White therapist is likely to be most effective when working with a client from an ethnic/racial minority group when the therapist is in the final stage of White identity development.
The correct answer is: Autonomy

Question 16

The primary goal of a newly developed community-based mental health program is to help people recently discharged from a psychiatric hospital adjust to life in the community. This is an example of:
Select one:

A.
primary prevention.

B.
secondary prevention.

C.
tertiary prevention.

D.
crisis intervention.

Answer 16

The correct answer is C.

Prevention programs are often described as primary, secondary, or tertiary, depending on their goals. You are likely to encounter a question or two on prevention on the exam. Tertiary preventions are designed to reduce the prevalence of mental disorders by reducing the duration or preventing the recurrence of mental disturbance.

Answer A: Primary preventions are designed to prevent the development of a mental disorder.

Answer B: Secondary preventions are designed to reduce the prevalence of mental disorders through early identification and intervention.

Answer D: Crisis interventions are designed to reduce the negative consequences of crises.
The correct answer is: tertiary prevention.

Question 17

Culturally sensitive approaches to psychotherapy vary from traditional approaches in that these approaches attempt to understand a client’s experience of an illness within the client’s cultural context. Thus, culturally sensitive approaches are rooted in an ____________ perspective.
Select one:

A.
emic

B.
etic

C.
emetic

D.
endogenous

Answer 17

The correct answer is A.

The terms “emic” and “etic” were originally used by linguistic anthropologists but are now also used by psychologists interested in cross-cultural psychotherapy. Culturally sensitive therapies emphasize an emic, or “view from the inside,” approach.

Answer B: Traditional psychotherapies reflect an etic, or “view from the outside,” approach.

Answer C: The term emetic is a medical term that is not associated with any cultural theory.

Answer D: Endogenous means “originating within.”
The correct answer is: emic

Question 18

Margaret Mahler proposed that the development of a sense of self is related to:
Select one:

A.
separation-individuation.

B.
projective identification.

C.
pseudomutuality.

D.
assimilation-accommodation.

Answer 18

The correct answer is A.

Mahler’s theory of early development focuses on the processes that contribute to the development of a sense of identity. Separation-individuation is triggered by the child’s ability to separate from their primary caregiver. It begins at about 4 to 5 months of age when a child who is being held by their caregiver is able to lean away to scan the environment.

Answer B: Melanie Klein used the term “projective identification” to refer to projecting disliked or undesirable aspects of the internal object (self) onto an external object (caregiver).

Answer C: Pseudomutuality describes a relationship between family members that appears to be healthy (is open and mutually empathic) but is not.

Answer D: Assimilation and accommodation are terms used by Piaget to describe the modification and development of cognitive schemas.
The correct answer is: separation-individuation.

Question 19

Carl Jung believed that a client’s transference:
Select one:

A.
is a fantasy that distracts the client from reality.

B.
represents mixed feelings toward the therapist.

C.
is a form of “acting out.”

D.
reflects the client’s personal and collective unconscious.

Answer 19

The correct answer is D.

Jung viewed transference as the projection of both the personal and collective unconscious.

Answer A: Jung did not describe transference as a deviation from reality.

Answer B: Jung did not postulate that transference was rooted in ambiguous feelings toward the clinician.

Answer C: Acting out is a defense mechanism described in psychoanalytic theory.
The correct answer is: reflects the client’s personal and collective unconscious.

Question 20

Smith, Glass, and Miller’s meta-analysis of the psychotherapy outcome research (1980) found that people receiving therapy are “better off” than about _____% of people who need treatment but do not receive it.
Select one:

A.
45

B.
55

C.
80

D.
95

Answer 20

The correct answer is C.

Smith, Glass, and Miller report an average effect size of .85 for 475 controlled studies of psychotherapy (1980). This means that the mean outcome score of people who receive treatment is higher than the mean outcome score of about 80% of people who need treatment but do not receive it. For the exam, you want to be familiar with the results of the Smith et al. meta-analysis as well as understand what meta-analysis is used for and be able to interpret an effect size. These are described in the Clinical Psychology chapter of the written study materials.

Answers A, B, and D: The correct answer is 80%.
The correct answer is: 80

Question 21

According to Howard et al.’s phase model (1996), which of the following is most likely to be affected during the first few sessions of psychotherapy?
Select one:

A.
Coping skills

B.
Severity of symptoms

C.
Maladaptive behaviors

D.
Feelings of hopelessness

Answer 21

The correct answer is D.

Howard et al.’s (1996) phase model predicts that the effects of therapy vary depending on the number of sessions. The characteristics of the three phases of the model include remoralization, remediation, and rehabilitation. Remoralization occurs during the first few therapy sessions and is characterized by a decline in feelings of hopelessness (K. Howard et al., “Evaluation of psychotherapy: Efficacy, effectiveness, and patient progress,” American Psychologist, 51, 1059-1064, 1996).

Answer A: The second phase, remediation, involves a focus on strengthening coping skills.

Answer B: Reducing symptom severity is a longer-term goal that typically does not occur within the first few sessions.

Answer C: The final phase, rehabilitation, focuses on unlearning maladaptive behaviors.
The correct answer is: Feelings of hopelessness

Question 22

In client-centered case consultation, the consultant’s primary goal is to:
Select one:

A.
help the consultee determine how to work more effectively with a particular client.

B.
help the consultee identify methods for evaluating their own professional services.

C.
help a consultee enhance their skills and knowledge so that the consultee functions more effectively in the future.

D.
work collaboratively with the consultee to jointly deliver an appropriate intervention to a client.

Answer 22

The correct answer is A.

Gerald Caplan (1970) distinguishes between four types of mental health consultation: client-centered case consultation, consultee-centered case consultation, program-centered administrative consultation, and consultee-centered administrative consultation. Client-centered case consultation focuses on a particular client. In this type of consultation, the consultant collects information about the client and makes recommendations to the consultee about the best course of action.

Answer B: This does not accurately describe the primary goal of client-centered case consultation.

Answer C: This describes consultee-centered case consultation.

Answer D: This describes collaboration rather than consultation.
The correct answer is: help the consultee determine how to work more effectively with a particular client.

Question 23

In comparing Asian and Asian-American therapy clients to European American clients, researchers frequently point out that the former:
Select one:

A.
tend to prefer a less directive therapeutic approach.

B.
are grounded more in the here-and-now than in the past or the future.

C.
respond better when goal-setting is delayed.

D.
are more likely to express emotional problems as somatic symptoms.

Answer 23

The correct answer is D.

It is vitally important that clinicians do not make overgeneralizations about members of any particular group and that they maintain awareness of the literature on cross-cultural psychotherapy, which provides some general conclusions about clients belonging to different ethnic/cultural groups. Researchers have suggested that people from Asian cultures ordinarily view the mind and body as inseparable and, as a result, often express mental health problems as somatic complaints such as headaches, fatigue, or sleep problems.

Answer A: This is the opposite of what researchers have found to be true.

Answer B: Researchers have generally found that individuals from Asian cultures often place importance on the relationship of the past to the present.

Answer C: Researchers suggest that it is usually best to identify goals early in therapy (even during the first session) when working with Asian clients.

The correct answer is: are more likely to express emotional problems as somatic symptoms.

Question 24

From the perspective of feminist therapy, therapist self-disclosure is:
Select one:

A.
contraindicated because it puts the client in a passive role.

B.
necessary during the early stages of therapy to encourage the client’s participation.

C.
a means of fostering a special bond between the client and the therapist.

D.
useful for promoting an egalitarian relationship between the therapist and client.

Answer 24

The correct answer is D.

A key characteristic of feminist therapy is its emphasis on an egalitarian relationship, and sharing one’s life experiences with a client is viewed as one way of promoting balance.

Answer A: Promoting client passivity is discouraged in feminist therapy, but appropriate therapist self-disclosure is not considered a contributor to passivity.

Answer B: This describes one use of self-disclosure; however, in feminist therapy, self-disclosure is not described as necessary.

Answer C: Feminist therapists generally discourage developing a “special bond” because doing so can foster the client’s dependence on the therapist.
The correct answer is: useful for promoting an egalitarian relationship between the therapist and client.

Question 25

The first stage in Cross's Black Racial Identity Development Model (2001) is: Select one: A. conformity. B. incorporation. C. contact. D. pre-encounter.

Answer 25

The correct answer is D. The most recent version of Cross's Black Racial Identity Development Model distinguishes between four stages: pre-encounter, encounter, immersion-emersion, and internalization. Cross's model is based on the premise that African American identity development is directly linked to racial oppression. During the initial pre-encounter stage, race has low salience. Answer A: Conformity is the first stage of the Racial/Cultural Identity Development Model. Answer B: Incorporation is not one of Cross's stages. Answer C: Contact is the first stage of Helms's White Racial Identity Development Model. The correct answer is: pre-encounter.

Question 26

Replacing a "failure identity" with a "success identity" is a goal of treatment for practitioners of ____________ therapy. Select one: A. Gestalt B. reality C. solution-focused D. Adlerian

Answer 26

The correct answer is B. Glasser, the founder of reality therapy, viewed identity as a basic psychological need and distinguished between success and failure identities. A person develops a success identity when the person fulfills their needs in a responsible way. Answer A: This is not a goal of Gestalt therapy. Answer C: This is not a goal of solution-focused therapy. Answer D: This is not a goal of Adlerian therapy. The correct answer is: reality

Question 27

Prochaska and DiClemente's stages of change (transtheoretical) model (1982) predicts that a person in the ____________ stage plans to take action within the next six months that will alter their problematic behavior. Select one: A. action B. contemplation C. preparation D. precontemplation

Answer 27

The correct answer is B. The six stages of Prochaska and DiClemente's transtheoretical stages of change model include precontemplation, contemplation, preparation, action, maintenance, and termination. A person in the contemplation stage has not committed to change but intends to take action within the next six months. Answer A: A person in the action stage is currently taking actions to alter their behavior. Answer C: A person in the preparation stage is planning to take action in the near future. This is usually defined as in the next month. Answer D: A person in the precontemplation stage is not planning to change in the foreseeable future. The correct answer is: contemplation

Question 28

People in which of the following stages of Atkinson, Morten, and Sue's (1993) Racial/Cultural Identity Development Model begin to question their rejection of all aspects of the dominant culture and absolute loyalty to their own culture? Select one: A. Encounter B. Dissonance C. Integrative awareness D. Introspection

Answer 28

The correct answer is D. The five stages of the Racial/Cultural Identity Development Model include conformity, dissonance, resistance and immersion, introspection, and integrative awareness. During the introspection stage, the individual begins to question the unequivocal position that they adopted during the previous resistance-immersion stage with regard to their own culture and the dominant culture. Answer A: The encounter stage is the second stage in Cross's Black Racial (Nigrescence) Identity Development Model (1991). Answer B: During the dissonance stage, the individual begins to question conformity to the dominant culture. Answer C: During the integrative awareness stage, the person bases acceptance or rejection of aspects of the majority and minority cultures on an objective evaluation. The correct answer is: Introspection

Question 29

A family therapist using the structural approach of Salvador Minuchin would most likely: Select one: A. clarify boundaries between family members in order to reduce enmeshment. B. work initially with the most differentiated family member. C. use a multiple-therapist team to prevent any one therapist from becoming "triangulated" into the family system. D. issue specific "directives" designed to counteract dysfunctional processes.

Answer 29

The correct answer is A. As its name implies, structural family therapy focuses on altering the family's structure in order to change the behavior patterns of family members. Even if you are unfamiliar with Minuchin, you may have been able to guess that structural therapy would be concerned with boundaries. Structural family therapists view family dysfunction as being related to boundaries that are too diffuse (enmeshed) or too rigid (disengaged). Answer B: This is more characteristic of Bowen's approach to family therapy. Answer C: Minuchin's approach does not involve the use of multiple-therapist teams. Answer D: The issuance of directives is more characteristic of strategic family therapy than of structural family therapy. The correct answer is: clarify boundaries between family members in order to reduce enmeshment.

Question 30

According to Irvin Yalom, ____________ in group therapy is the analogue of the therapist–client relationship in individual therapy. Select one: A. universality B. identification C. cohesiveness D. alliance

Answer 30

The correct answer is C. Yalom uses the term cohesiveness to refer to the various relationships that occur in a group. This includes the relationships between group members, between each member and the therapist, and between each member and the group itself. For Yalom, cohesiveness is the primary mode of change in group therapy, with highly cohesive groups having better outcomes. Cohesiveness in group therapy is thus comparable to the quality of the therapeutic alliance in individual therapy. Answer A: The concept of universality relates to clients' connected pain. Answer B: Identification is not one of Yalom's 11 therapeutic factors. Answer D: Alliance is not one of Yalom's 11 therapeutic factors. The correct answer is: cohesiveness

Question 31

According to Freud's notion of ____________, dreams and slips of the tongue are meaningful goal-directed phenomena. Select one: A. psychic dynamogenesis B. reciprocal determinism C. psychic determinism D. ptyalism

Answer 31

The correct answer is C. Freud interpreted dreams, slips of the tongue, etc. as manifestations of unconscious material. According to Freud's doctrine of psychic determinism, behaviors are caused by unconscious phenomena rather than true free will. Answer A: Dynamogenesis is the principle that motor responses are proportional to sensory activities. Answer B: Reciprocal determinism proposes that behavior, person, and situation interact and influence each other. Answer D: Ptyalism refers to the excessive production of saliva, something Pavlov, not Freud, would be interested in. The correct answer is: psychic determinism

Question 32

The information that family members continuously exchange and that helps minimize deviation and maintain the family's stability is referred to as ____________ feedback. Select one: A. external B. internal C. negative D. positive

Answer 32

The correct answer is C. In family systems theory, the information exchange between family members can act as either positive or negative feedback. Negative feedback helps the system return to or maintain its steady state. Thus, a "negative feedback loop" helps minimize deviation and thereby maintains the family's stability. Answer A: This term is not relevant to the question posed. Answer B: This term is not relevant to the question posed. Answer D: Positive feedback increases deviation from a steady state and, therefore, produces a change in the family's functioning. The correct answer is: negative

Question 33

According to research when working with a Black family, it is important to keep in mind that: Select one: A. Black families are predominantly matriarchal. B. Black husbands are usually less tolerant of the career efforts of their wives than White husbands are. C. Black familial roles may be more flexible than White familial roles. D. Black wives are more willing than White wives to let their husbands make domestic decisions.

Answer 33

The correct answer is C. Historically, researchers (Billingsley, 1969; Boyd-Franklin, 1989; Paniagua, 1994; Sue & Sue, 2003) have found that Black families are generally less likely to follow traditional White family sex-role stereotypes in comparison to Whites. Answer A: Researchers have indicated that the power structure of Black families is not substantially different from that found in many White families. Answer B: This statement is not supported by research regarding Black familial roles. Answer D: A number of investigators have pointed out that Black and White husbands generally exercise the same degree of decision-making power within the family. The correct answer is: Black familial roles may be more flexible than White familial roles.

Question 34

In the context of structural family therapy, the purpose of "reframing" is to: Select one: A. diffuse blame. B. relabel behaviors. C. increase specificity. D. anchor behaviors.

Answer 34

The correct answer is B. Even if you've never heard of "reframing," you probably could have guessed that its purpose is to redefine the situation. Specifically, reframing is done in order to help a client see things from a different perspective. It is often used in a paradoxical way—e.g., telling an adolescent that "your parents' nagging is a sign of their love for you." Answer A: Reframing will not necessarily lead to diffusion of blame. Answer C: Increasing specificity is not the goal of reframing. Answer D: Reframing does involve redefining behaviors, but it does not involve anchoring behaviors. The correct answer is: relabel behaviors.

Question 35

for an object relations theorist interjection refers to a- an alliance between two people against a third person b- integrating aspects of the conscious and unconscious into the self c- projecting ones own characteristics onto the object d- assimilating aspects of an object into the self

Answer 35

d- is the correct answer a child's internalized images of the mother or other object of the self interacting with the object and the emotions associated with the object a- describes a coalition a term used in structural family therapy b- describes Jungs process of individuation c- describes projection not interjection

Question 36

A Freudian psychoanalyst is most likely to describe ___________ as explicitly connecting current behavior to unconscious processes. Select one: A. interpretation B. clarification C. confrontation D. working through

Answer 36

The correct answer is A. Freudian psychoanalysis consists of a combination of confrontation, clarification, interpretation, and working through. The goal of interpretation is to explicitly connect the client's current behavior to unconscious processes and is most effective when it addresses motives and conflicts close to the client's consciousness. Answer B: Clarification involves clarifying the client's feelings by restating his/her remarks in clearer terms. Answer C: Confrontation involves making statements that help the client see his/her behavior in a new way. Answer D: Working through is the final stage of psychoanalysis and allows the client to gradually incorporate new insights into his/her personality.

Question 37

As described by Alfred Adler, a healthy style of life is characterized by: Select one: A. congruence between self and experience. B. awareness of one's thoughts, feelings, and actions in the here-and-now. C. confidence, optimism, and concern about the welfare of others. D. integration of conscious and unconscious elements of the psyche.

Answer 37

The correct answer is C. Style of life is a key concept in Adler's individual psychology. Adler distinguished between a healthy and an unhealthy style of life and proposed that social interest is the factor that distinguishes between the two. A person with a healthy style of life is concerned about the welfare of others. Answer A: This is a Rogerian concept. Answer B: This is the Gestalt definition of awareness. Answer D: This is Jung's definition of individuation.

Question 38

In Freudian psychoanalysis, turning an undesirable impulse into its opposite is referred to as: Select one: A. projection. B. reaction formation. C. secondary process. D. catharsis.

Answer 38

The correct answer is B. All of the terms listed in the answers are associated with Freud, but only one applies to the phenomenon described in this question. Turning an undesirable impulse into its opposite (e.g., hostility into kindness) is the definition of reaction formation, which is one of the defense mechanisms used by the ego to reduce anxiety. Answer A: Projection involves attributing a threatening impulse to another person. Answer C: Secondary process thinking is used by the ego and involves rational thinking and planning. It is contrasted with primary process thinking, which is dominated by the instinctual needs of the id. Answer D: Catharsis is a release of emotions that results from the recall of unconscious material.

Question 39

For Carl Jung, transference involves: Select one: A. a lack of individuation and self-realization. B. projection of the personal and collective unconscious. C. a distortion that the therapist will identify as a fantasy. D. a symbolic manifestation of "disowned" parts of the self.

Answer 39

The correct answer is B. Like Freud, Jung considered transference to be an unconscious process in which feelings the client originally directed toward others are now being projected onto the therapist. For Jung, the unconscious consists of both personal and collective elements and transferences consist of both of these elements. Answer A: Jung did not associate these concepts with transference. Answer C: This represents a Gestaltian view of transference. Answer D: This sounds more Gestaltian.

Question 40

Margaret Mahler traced adult psychopathology to problems related to which of the following? Select one: A. separation-individuation B. congruence between self and experience C. meaning D. separation of one's self and self-image

Answer 40

The correct answer is A. Mahler, an objects relations theorist, viewed the early relationship between the infant and his/her caregiver to be critical for personality development. Mahler described early development as involving several phases and subphases and traced psychopathology in adulthood to problems during the separation-individuation phase. Answer B: This applies to Carl Rogers. Answer C: This applies to Victor Frankl's theory. Answer D: This sounds more like Perls' Gestalt therapy.

Question 41

As described by Jung, __________ are universal, generationally transmitted images that structure how people perceive their experiences. Select one: A. psychic schemata B. basic mistakes C. polarities D. archetypes

Answer 41

The correct answer is D. Jung's archetypes are elements of the collective unconscious and include the anima and animus, the shadow, and the self. Jung described archetypes as "primordial images" that emerge in the form of dreams and visions and cause people to experience and understand certain phenomena in a universal way. Answer A: This is a Freudian concept. Answer B: This is an Adlerian concept. Answer C: Polarities are associated with Kelly's personal construct therapy.

Question 42

The research suggest that which of the following is the most important for ensuring the success of person centered therapy a- the therapists ability to help the client identify and express repressed emotions b- the therapist ability to express genuine approval of the client c- the client's perception that the therapist is authentic d- the client's perception that the therapist is empathic

Answer 42

the answer is D The 3 facilitative factors essential in person centered therapy are genuineness, unconditional positive regard and empathy. The research suggests that of these three factors, empathy is the most important and it is the client's perception of the therapist empathy that is a critical factor.

Question 43

The goals of Gestalt therapy include helping the client recognize and satisfy needs and accept polarities that exist within his/her personality. A psychologist using a Gestalt approach would consider the key to achieving these goals to be which of the following? Select one: A. Congruence B. Awareness C. Unconditional positive regard D. Cognitive restructuring

Answer 43

The correct answer is B. According to Gestalt theory, a well-functioning person is able to see the entirety of his or her immediate experience (i.e., the "gestalt"). According to Gestalt principles, awareness of thoughts, emotions, behaviors, etc. in the "here-and-now" is sufficient to cause desired changes. Answer A: Congruence between self and experience is the goal of client-centered therapy. Answer C: Unconditional positive regard is a therapeutic technique used by client-centered therapists. Answer D: Cognitive restructuring is a focus of cognitive-behavioral therapy.

Question 44

A Gestalt therapist would interpret a client's transference as: Select one: A. a sign of progress. B. a manifestation of resistance. C. the client's fantasy. D. the result of "splitting."

Answer 44

The correct answer is C. Knowing that Gestalt therapists focus on the "here-and-now" (current functioning) may have helped you identify the correct answer to this question. Gestalt therapists consider a client's transferences to be counterproductive and respond to transference by helping the client recognize the difference between his/her "transference fantasy" and reality. Answer A: Gestalt therapists view transference as counterproductive. Answer B: Gestalt therapists view transference as fantasy rather than resistance. Answer D: The concept of splitting is more closely associated with objects relations therapy.

Question 45

George Kelly's (1955) personal construct theory focuses on the role of "personal constructs," which Kelly describes as: Select one: A. bipolar dimensions of meaning. B. primordial images. C. distortions. D. manifestations of the person's "style of life."

Answer 45

The correct answer is A. Kelly's theory focuses on how people construe (perceive, interpret, and predict) events, with construing involving the use of personal constructs. As defined by Kelly, personal constructs are mental templates that consist of a characteristic or other phenomenon and its perceived opposite (e.g., outgoing-shy, interesting-boring). Answer B: Primordial images are associated with Jung's analytic psychotherapy. Answer C: This sounds more Freudian. Answer D: This is an Adlerian concept.

Question 46

According to Carl Rogers, which of the following leads to disorganization of the self? Select one: A. Chronic boundary disturbances B. Incongruence between self and experience C. Inadequate resolution of the splitting of self and object D. An inability to fulfill one's needs in a responsible way

Answer 46

The correct answer is B. The self is a central concept in Rogers's person-centered therapy. Rogers proposed that the self becomes disorganized when the individual experiences incongruence between self and experience, which occurs when he/she is exposed to conditions of worth. Answer A: Boundary disturbances are of concern to Gestalt therapists. Answer C: Splitting is of interest to object relations theorists. Answer D: Reality therapists consider an inability to fulfill one's needs in a responsible way as the cause of a "failure identity."

Question 47

Glasser's (1998) reality therapy identifies which of the following as the primary source of motivation? Select one: A. Basic innate needs B. Striving for superiority C. The drive to become an integrated "whole" D. Unconscious conflicts

Answer 47

The correct answer is A. Reality therapy is based on the premise that everything a person does is for the purpose of satisfying his/her needs. Glasser distinguished between five basic innate needs—survival, love and belonging, power, freedom, and fun. A person's ability to satisfy these needs in a responsible way determines whether he/she develops a success identity or a failure identity. Answer B: This is an Adlerian concept. Answer C: This is a Gestaltian concept. Answer D: This is a psychodynamic concept.

Question 48

Carl Rogers proposed that a person may attempt to relieve anxiety by relying on which of the following? Select one: A. Secondary process thinking B. Distortion or denial C. Introjection D. Assimilation or accommodation

Answer 48

The correct answer is B. Rogers proposed that incongruence between self and experience produces unpleasant physical sensations that are subjectively experienced as anxiety. According to Rogers, a person may attempt to alleviate anxiety by distorting or denying experiences that produced the incongruence that caused the anxiety. Answer A: This concept is associated with psychoanalytic theory. Answer C: This concept is most closely associated with Gestalt theory. Answer D: These terms are more closely associated with Piaget.

Question 49

According to Prochaska and DiClemente Transtheoretical Model a person in the contemplation stage of change with respond to which of the following change process a- social liberation b- environmental control c- rewards d- emotional arousal

Answer 49

Answer is D the transtheoretical model identified change strategies and proposes the optimal combination of strategies for particular client depends on his/her stage of change. In the contemplation stage an individual benefits most from a combination of consciousness raising support and interventions designed to help the person experiences express and evaluate his/her feelings about the problem and possible solutions to it. a- nothing to do with this theory b- sounds like a specific behaviour modification strategy more for action stage c- again a specific behaviour modification strategy more for action stage d- consistent with individuals in the contemplation stage - specifically an effective strategy for exploring the problem and finding potential solutions. Psychodramas, testimonials, role plays

Question 50

Unresolved grief, interpersonal role disputes, role transitions, and interpersonal deficits are the primary targets of: Select one: A. motivational interviewing. B. solution-focused therapy. C. reality therapy. D. interpersonal therapy.

Answer 50

The correct answer is D. Recognizing that the four problems listed in the question are all related to interpersonal relationships would have helped you identify the correct answer to this question. The interventions used in interpersonal therapy address one or more of four problem areas—unresolved grief, interpersonal role disputes, role transitions, and/or interpersonal deficits. Answer A: Motivational interviewing primarily addresses the client's beliefs about his/her ability to change. Answer B: As the name suggests, solution-focused therapy targets solutions to the client's problems. Answer C: Reality therapy assumes that people are responsible for the choices they make and focuses on how people make choices that affect the course of their lives.

Question 51

Kai formerly abused alcohol but has now maintained sobriety for six months and is actively working to avoid relapse. Applying the transtheoretical model, Kai is in which of the following stages of change? Select one: A. Contemplation B. Preparation C. Maintenance D. Termination

Answer 51

The correct answer is C. The transtheoretical model distinguishes between six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. A person in the maintenance stage has maintained a change in behavior for at least six months and is taking steps to prevent relapse. Answer A: A person in the contemplation stage is aware of the need for change, intends to take action within the next six months, but is not committed to change. Answer B: A person is in the preparation stage when s/he has a clear intent to take action within the next month and has a realistic action plan. Answer D: A person in the termination stage feels that s/he can resist temptation and is confident that there is no risk for relapse.

Question 52

The techniques of consciousness raising, social liberation, dramatic relief, self-reevaluation, and reinforcement management are most associated with which of the following? Select one: A. Interpersonal therapy B. Reality therapy C. Transtheoretical model D. Personal construct theory

Answer 52

The correct answer is C. For the exam, you want to be familiar with the basic premises and strategies of the four approaches listed in the answers to this question. The transtheoretical model identifies 10 empirically supported strategies that include those listed in this question and proposes that an intervention is most effective when it matches the strategies used to the client's stage of change. Answer A: IPT is associated with four primary problem areas: unresolved grief, interpersonal role disputes, role transitions, and interpersonal deficits. Answer B: Reality therapy is closely associated with five basic innate needs: survival, love and belonging, power, freedom, and fun. Answer D: Personal construct therapy is associated with personal constructs, fixed-roles, and the repertory grid.

Question 53

During the first therapy session, a therapist asks a client to imagine that she wakes up the next morning and her problem has been solved. He then asks, "When this occurs, what will be the first sign that a miracle has happened?" Apparently, this therapist is a practitioner of: Select one: A. reality therapy. B. personal construct therapy. C. person-centered therapy. D. solution-focused therapy.

Answer 53

The correct answer is D. The therapist in this question has posed the "miracle question." The miracle question is used by solution-focused therapists to help clients envision their lives without the presenting problem and identify ways for resolving that problem. Answers A, B, and C: The miracle question is most closely associated with solution-focused therapy.

Question 54

Motivational interviewing combines the transtheoretical model of change with: Select one: A. psychoanalytic concepts. B. reality therapy. C. a client-centered approach. D. a behavioral approach.

Answer 54

The correct answer is C. As its name implies, motivational interviewing focuses on a client's motivation to change. Motivational interviewing is especially useful for individuals in the precontemplation and contemplation stages (the first two stages proposed by the transtheoretical model of change). It combines a client-centered approach (e.g., emphasizes the importance of empathy) with the transtheoretical model and the concept of self-efficacy. Answers A, B, and D: Of the answer choices listed, only one combines a client-centered approach with the transtheoretical model.

Question 55

A family therapist has been seeing a mother, father and their 3 children in family therapy for 3 months. 2 days after their most recent therapy session the father calls the therapist to talk about a conflict he is having with his wife and attempts to get the therapist to side with him. A few days later the wife calls the therapist and also attempts to get the therapist to see the things from her point of view. From the perspective of Structural Family Therapy this situation can be considered an example of a- scape-goating b- triangulation c- joining d- emotional fusion

Answer 55

The answer is B Recall that Minuchin distinguished between 3 types of Rigid Triad - detouring, stable coalition, and triangulation. This question is asking about an instance that both members of a couple are trying to recruit the therapist to their side. While often referring to parents and a child, it also can refer to involve a third party in their conflict and demand the 3rd party's loyalty. a- is a type of detouring, but doesn't describe what is happening in this situation c- a technique used by structural family therapists who communicate that they understand and accept the family d- term used by Bowenian therapists to describe a lack of differentiation between family members - fusion is not a term used in Structural Family Therapy

Question 56

Bateson and his colleagues (1956) described double-bind communication as a cause of which of the following? Select one: A. Suicide B. Divorce C. Schizophrenia D. Anorexia Nervosa

Answer 56

The correct answer is C. Double-bind communication involves receipt of contradictory messages (often one verbal and one nonverbal) with an inability to comment on those messages. Bateson et al. (1956) identified double-bind communication as an etiological factor in the development of Schizophrenia in a family member. Answers A, B, and D: Bateson et. al did not find that double-bind communication was an etiological factor in the occurrence of suicide, divorce, or the development of anorexia.

Question 57

During an argument, a husband and wife keep trying to outdo one another in terms of insults. This is one of the possible outcomes of: Select one: A. high-context communication. B. low-context communication. C. complementary communication. D. symmetrical communication.

Answer 57

The correct answer is D. For the exam, you want to be familiar with the differences between low- versus high-context communication and between complementary versus symmetrical communication. In symmetrical communication, the communicators have equal status. A possible negative outcome of this type of communication is that it may escalate into a "one-upmanship" game. Answer A: This is not the best answer. High-context communication is grounded in the situation, depends on group understanding, relies heavily on nonverbal cues, helps unify a culture, and is slow to change. Answer B: This is not the best answer. Low-context communication relies primarily on the explicit, verbal part of a message. Answer C: Complementary communication is based on inequality with one partner assuming a dominant role and the other a subordinate position.

Question 58

As defined by Murray Bowen, an "emotional triangle" serves which of the following functions? Select one: A. It alleviates "boundary disturbances" between family members. B. It increases differentiation among family members. C. It reduces anxiety and tension between family members. D. It helps the therapist "join" the family system.

Answer 58

The correct answer is C. Bowen considered an emotional triangle to be a basic building block in a family's emotional system. According to Bowen, when a two-person system such as a husband-wife or parent-child experiences instability or stress, it may form an emotional triangle by recruiting a third person into the system in order to increase stability and reduce tension and anxiety. Answer A: Though the concept of boundary disturbances is more closely associated with Minuchin, these disturbances would not be alleviated by an emotional triangle as emotional triangles are more likely to occur when there is a low level of differentiation among family members. Answer B: Emotional triangles do not increase differentiation. Answer D: The concept of joining is associated with Minuchin's structural family therapy.

Question 59

A structural family therapist would most likely use which of the following techniques when working with a family consisting of a mother and father who constantly argue, a teenage son who is overly dependent on his mother, and a 9-year-old daughter who has asthma and other physical symptoms? Select one: A. Pointing out and discussing problematic interaction patterns as they occur B. Working with two of the family members to increase differentiation C. Becoming therapeutically "triangled" into the spousal dyad to reduce tension and increase stability D. Blending with the family by adopting its language, behaviors, and style

Answer 59

The correct answer is D. A distinctive feature of Minuchin's structural family therapy is its use of "joining." Joining entails blending with the family by adopting its language, behaviors, style, etc. Answer A: This technique is used in communication/interaction family therapy. Answer B: This is a Bowenian technique. Answer C: This is another technique employed by Bowenian family therapists.

Question 60

Paradoxical interventions are often utilized by strategic family therapists for the purpose of: Select one: A. altering the environment. B. relieving symptoms. C. restructuring the family. D. helping the family see their choices.

Answer 60

The correct answer is B. Strategic family therapists use a variety of techniques including paradoxical interventions which are intended to provide symptom relief by ultimately helping the client see the symptom in an alternative way. Answer A: This is the goal of behavioral family therapy. Answer C: This is the primary goal of structural family therapy. Answer D: This is the primary goal of Milan's systemic family therapy.

Question 61

A family therapist has been seeing a mother, father, and their two children in therapy for three months. Two days after a therapy session, the father calls the therapist to talk about a conflict he is having with his wife and tries to get the therapist to side with him. The next day, the wife calls the therapist and tries to get him to see things from her point of view. From the perspective of structural family therapy, this situation can be considered an example of: Select one: A. scapegoating. B. mimesis. C. triangulation. D. detouring.

Answer 61

The correct answer is C. Minuchin, the founder of structural family therapy, distinguished between three types of rigid triads—detouring, stable coalition, and triangulation. Triangulation is one of the rigid triads identified by Minuchin. Though originally defined as involving parents and a child, triangulation can also refer to any triad in which two parties attempt to involve a third party in their conflict and demand the third party's loyalty. Answer A: Scapegoating occurs when family members blame one member (often the "identified patient") for the family's problem. Answer B: Mimesis refers to joining a family system by mirroring (imitating) its style, tempo, and affect. Answer D: Detouring is another rigid triad. It is occurring when parents avoid conflicts between them by focusing on a child.

Question 62

_____________ is based on the premise that illness is due to a blockage of vital life energy. Select one: A. Acupuncture B. Reflexology C. Curanderismo D. Hypnosis

Answer 62

The correct answer is A. For the exam, you want to be familiar with the information provided in the Clinical Psychology chapter on complementary and alternative medicine and indigenous healing practices. Acupuncture is based on the assumption that the body contains a vital life energy (qi) and that blockage of this energy causes illness. Answer B: Reflexology is based on the assumption that areas in the hands and feet correspond to the glands, organs, and other parts of the body. Answer C: Curanderismo is based on the assumption that illness arises from natural and supernatural forces. Answer D: Hypnosis is not based on the assumption described in this question.

Question 63

According to Irvin Yalom, increased willingness to self-disclose by group members is the result of: Select one: A. the development of cohesiveness. B. the development of realistic expectations. C. a by-product of transference. D. the therapist's authority.

Answer 63

The correct answer is A. Yalom describes the first few months of a therapy group as involving three stages. In the third stage, members begin to develop trust and a sense of unity and are increasingly willing to self-disclose. Answers B, C, and D: Yalom attributed increased participation, self-disclosure, adherence to group norms, etc. to be due to the development of group cohesiveness.

Question 64

In feminist therapy, if a client says she feels that the therapist is in a position of power over her, the therapist is most likely to address this concern by: Select one: A. providing empathic support. B. using the power differential to therapeutic advantage. C. acknowledging the inherent power differential. D. reassuring the client that the relationship is egalitarian.

Answer 64

The correct answer is C. A concern for feminist therapists is the power differential that is inherent in the therapist-client relationship. A feminist therapist's first reaction to concerns about the power differential is to acknowledge it and then to work toward minimizing it. Answer A: This would be important but does not address the client's concern. Answer B: Feminist therapists acknowledge the power differential that is inherent to the therapist-client relationship and attempt to minimize it by promoting "power with" rather than "power over." Answer D: Feminist therapists acknowledge the power differential. Invalidating the client's expressed reality would not be in line with feminist theory.

Question 65

In comparison to repressed memories recalled without hypnosis, under hypnosis, you would be most likely to recall: Select one: A. more inaccurate memories than accurate memories. B. more accurate memories than inaccurate memories. C. more vivid memories that are inaccurate. D. less vivid memories that are accurate.

Answer 65

The correct answer is A. Research suggests that using hypnosis to help individuals recall repressed memories can have negative consequences. The studies have found that hypnosis does not seem to enhance the accuracy of memories but may produce more pseudomemories than accurate memories. Answer B: The opposite is true. Answers C and D: While the vividness of memories recalled during hypnosis is likely to vary, research suggests that the accuracy of these memories is unreliable.

Question 66

After a therapy group has been together for several months, its members start criticizing the group leader for not disclosing any information about herself. Yalom would most likely recommend to the therapist that she: Select one: A. explain to group members that self-disclosure on her part would be counterproductive. B. practice self-disclosing at the beginning of each session to foster group cohesion. C. consider responsibly self-disclosing when appropriate. D. refuse to self-disclose as this is a boundary issue.

Answer 66

The correct answer is C. Yalom attributes the tendency of therapists NOT to self-disclose to the traditional psychoanalytic belief that the therapist must remain neutral ("opaque") in order to encourage the development of transference. He argues, however, that other therapeutic factors may be more important. Yalom advocates some self-disclosure, pointing out that by self-disclosing, therapists act as role models and thereby facilitate interpersonal learning. Answer A: Yalom did not believe that appropriate and responsible self-disclosure was counterproductive. Answer B: This is not the best answer. Yalom believed that self-disclosure must be well-timed and made through a "filter of responsibility." Answer D: Yalom would not likely recommend that a therapist refuse to self-disclose.

Question 67

Self-in-relation theory is an approach to feminist object relations theory and differs from traditional object relations theory in: Select one: A. its denial of basic gender differences. B. its incorporation of biological factors into interpersonal explanations for gender differences. C. its explanation of gender differences in terms of same-gender versus opposite-gender influences in the mother-child relationship. D. its minimization of the mother's role in determining gender differences.

Answer 67

The correct answer is C. Self-in-relation theorists (e.g., Okun, 1990) extend traditional object relations theory by emphasizing the differences in socialization that occur because of the same-gender versus opposite-gender relationship between mother and child. According to this view, the mother's socialization practices differ, depending on the gender of her child. Specifically, girls are taught to stay connected (attached) to the mother, while boys are taught to separate. Feminist therapists have discussed how this difference contributes to gender differences in a variety of domains (e.g., achievement, moral development). Answer A: On the contrary, self-in-relation theory emphasizes the role of gender-based differences in socialization. Answer B: Self-in-relation theory focuses on differences inherent to socialization rather than biology. Answer D: The mother's role is emphasized in self-in-relation theory.

Question 68

As described by Gerald Caplan, "theme interference" is: Select one: A. a barrier to primary prevention. B. a type of transference. C. a contributor to family dysfunction. D. a hindrance to positive health behavior.

Answer 68

The correct answer is B. Caplan described theme interference as a type of transference that occurs when a past unresolved conflict related to a particular type of client or situation interferes with a consultant's ability to remain objective in a current situation. Answer A: The concept of theme interference is completely unrelated to prevention strategies. Answer C: The concept of theme interference is related to mental health consultation. It has no relation to family dynamics. Answer D: Theme interference does not pose a barrier to positive health behavior.

Question 69

The Health Belief Model (Becker, 1974) emphasizes the individual's: Select one: A. locus of control. B. level of "hardiness." C. tendency toward optimistic thinking. D. readiness to take action.

Answer 69

The correct answer is D. Becker's (1974) Health Belief Model identifies several factors that influence a person's health-related behaviors. The individual's readiness to take a particular action is one of the factors identified by the Health Belief Model and is affected by the person's perceived susceptibility to an illness and perceived severity of that illness. The other factors addressed by the Health Belief Model are described in the Clinical Psychology chapter of the written study materials. Answer A: Locus of control is the focus of the Health Locus of Control Model. Answer B: Hardiness has been identified as a personality characteristic that is associated with a lower susceptibility to illness and is not part of the Health Belief Model. Answer C: Optimistic thinking is not one of the elements of the Health Belief Model.

Question 70

A prevention program involves identifying children who exhibit early signs of emotional disturbance so they can be provided with special assistance from teacher's aides and other paraprofessionals. This is an example of: Select one: A. primary prevention. B. secondary prevention. C. tertiary prevention. D. developmental intervention.

Answer 70

The correct answer is B. For the exam, you want to be able to distinguish between primary, secondary, and tertiary prevention. Secondary preventions entail the early identification of at-risk individuals who have not yet developed a full-blown disturbance and providing them with an appropriate intervention. Answer A: Primary preventions are aimed at reducing the development and incidence of mental disorders. Answer C: Tertiary preventions are aimed at individuals who have already developed a disorder. Their goal is to reduce the risk for chronicity and relapse and any other problems related to the disorder. Answer D: This is an invented term.

Question 71

Which of the following is an example of consultee-centered case consultation? Select one: A. Helping a teacher recognize the early signs of drug abuse in high school students B. Helping a therapist develop a treatment plan for a client with a disorder the therapist is unfamiliar with C. Helping company managers identify methods for improving their ability to design effective employee training programs D. Helping a school administrator identify ways to improve the effectiveness of a current teacher training program

Answer 71

The correct answer is A. For the exam, you want to be familiar with the four approaches to mental health consultation described by Caplan (1970). In consultee-centered case consultation, the focus is on the skills, knowledge, and objectivity of the consultee, and the goal is to improve the consultee's functioning so that he/she can work more effectively with members of a target group or population in the future. Answer B: This is an example of client-centered case consultation. Answer C: This is an example of consultee-centered administrative consultation. Answer D: This is an example of program-centered administrative consultation.

Question 72

A psychology intern responds to her supervisor in the same way that a new client is responding to her (the intern) in therapy. This is referred to as: Select one: A. projective identification. B. the therapeutic double-bind. C. diagnostic overshadowing. D. parallel process.

Answer 72

The correct answer is D. This question describes parallel process. Parallel process involves a combination of transference, countertransference, and projection in the client-supervisee-supervisor relationship and occurs when a supervisee (e.g., intern) replicates problems in the supervisor-supervisee relationship that are occurring in the supervisee-client relationship. Answer A: Object relations family therapists hold that projective identification occurs when a family member projects old introjects onto another family member. Answer B: Therapeutic double-binds are a paradoxical technique used by systemic family therapists. Answer C: Diagnostic overshadowing occurs when the salience of one disorder or condition "overshadows" diagnostic consideration or recognition of another disorder.

Question 73

A program designed to improve the interpersonal skills of residents of a retirement community would be classified as a "primary prevention" when it is offered: Select one: A. to residents who have been identified by staff as being socially isolated. B. to residents who are currently being treated for depression. C. to residents who obtain low scores on a measure of interpersonal functioning. D. to all residents who want to participate.

Answer 73

The correct answer is D. Primary preventions are designed to intervene before a problem occurs and are offered to all members of a group or population. When a program is offered to all members of a group or population rather than to specific individuals (e.g., to all residents of a retirement community), it is a primary prevention. Answer A: When a program or treatment is provided to specific individuals who have been identified as being at-risk (i.e., as already exhibiting signs of the problem), it is classified as a secondary prevention. Answer B: A program for individuals who are being treated for depression would be a tertiary prevention. The goal of tertiary preventions is to reduce the long-term consequences of an existing problem. Answer C: Offering the program to individuals who have been identified as at-risk by low scores on a measure of interpersonal functioning is an example of secondary prevention.

Question 74

Sue and Sue (2003) describe "worldview" as consisting of two dimensions—locus of control and locus of responsibility. Within this framework, the culture of the White middle class in the United States is best described as reflecting an: Select one: A. internal locus of control and internal locus of responsibility. B. internal locus of control and external locus of responsibility. C. external locus of control and external locus of responsibility. D. external locus of control and internal locus of responsibility.

Answer 74

The correct answer is A. Sue and Sue's model distinguishes between four types of worldview that reflect a different combination of levels of locus of control and locus of responsibility. The dominant culture in the United States (i.e., the culture of the White middle class) exemplifies the IC-IR philosophy through its emphasis on individualism, independence, and self-reliance. Answers B, C, and D: According to Sue and Sue, White middle-class U.S. culture generally reflects worldview based on an internal locus of control and responsibility.

Question 75

______________________ may occur when members of a cultural minority have negative interactions with members of the dominant culture. Select one: A. Cultural encapsulation B. Cultural humility C. Acculturative stress D. Microaggressions

Answer 75

The correct answer is C. According to Berry's (2006) transactional theory, when members of cultural minority groups interact with members of the dominant culture (e.g., White American culture), psychological maladjustment may emerge in part as a function of how much acculturative stress the individual experiences when interacting with the dominant culture. Answer A: Cultural encapsulation occurs when a therapist lacks cultural humility. Answer B: Cultural humility is a lifelong process of self-reflection and self-critique whereby the individual not only learns about another's culture, but starts with an examination of her/his own beliefs and cultural identities. Answer D: Microaggressions are not the result of a negative interaction.

Question 76

Past research suggests that a therapist who adopts the role of ___________ may have more success when working with some Asian identified clients. Select one: A. knowledgeable expert B. egalitarian collaborator C. interested listener D. friendly coach

Answer 76

The correct answer is A. Although it is necessary to avoid stereotypes when providing services to members of ethnic and racial minority groups, generalizations are often made in the literature and you will need to be familiar with these generalizations for the exam. Past research suggests that Asian and Asian-American clients, especially those who have a strong ethnic identity or who have not assimilated into the dominant (mainstream) culture, generally prefer structured goal-oriented approaches to therapy. Thus, the role of knowledgeable expert would best suit a client with this preference. Answer B: According to past research, some Asian clients may expect the therapist to be an expert rather than a colleague. Answer C: "Interested listener" suggests a passive approach, which is not usually the best one when working with Asian clients who expect the therapist to demonstrate expertise. Answer D: Past research suggests that when working with some Asian clients, a more formal approach, especially during initial sessions, is usually most effective.

Question 77

A straight White male therapy supervisor who consistently exhibits favoritism towards a White gay identified male supervisee over a White lesbian identified female supervisee who is equally competent may be demonstrating: Select one: A. heterosexism. B. sexual prejudice. C. sexual stigma. D. sexism.

Answer 77

The correct answer is D. This is a difficult question given that little context is provided. However, given the limited choice options it appears that the supervisor is engaging in discriminatory behavior based on sex. Sexism refers to gender-based discrimination, prejudice, or stereotyping. Answer A: This is not the best answer given that both supervisees identify as gay and lesbian respectively. Answer B: This is also not the best answer as sexual prejudice refers to negative attitudes that are based on sexual orientation. Answer C: This is also not the best answer as sexual stigma is related to sexual orientation.

Question 78

__________ refers to negative attitudes that are based on sexual orientation, whether the target identifies as homosexual, bisexual, or heterosexual. Select one: A. Sexual prejudice B. Sexism C. Heterosexism D. Sexual stigma

Answer 78

The correct answer is A. For the exam you will need to be familiar with the definition of each of the terms listed in the four answer choices. As defined by Herek (2004), sexual prejudice refers to negative attitudes that are based on perceived sexual orientation, regardless of the target's actual identified sexual orientation. Answer B: Sexism refers to prejudice that is based on gender, not sexual orientation. Answer C: Heterosexism refers to cultural ideologies, which are systems that provide the rationale and operating instructions that promote and perpetrate antipathy, hostility, and violence against homosexuals. Answer D: Sexual stigma refers to the shared knowledge of society's negative regard for any nonheterosexual behavior, identity, relationship, or community.

Question 79

A Chinese-American client tells you that he doesn't identify with either Chinese or White culture. In terms of Berry et al.'s (1987) model of acculturation, this client is best described as: Select one: A. separated. B. marginalized. C. alienated. D. encapsulated.

Answer 79

The correct answer is B. Berry and his colleagues describe acculturation status in terms of four categories: integration, assimilation, separation, and marginalization. According to Berry, a person is marginalized when he/she does not accept the characteristics of either culture (his/her own culture or the dominant culture). Answer A: A member of a racial/cultural minority group who adopts the values, attitudes, and customs of his/her own minority culture but withdraws from the dominant culture is labeled as separated. Answer C: This term is not associated with Berry's model. Answer D: According to Wrenn (1985), culturally encapsulated clinicians interpret reality via their own biased cultural lens and disregard both their own bias and existing cultural differences.

Question 80

According to Cross's Black Racial Identity Development Model, an African American individual in the emersion substage of the immersion-emersion stage will exhibit which of the following? Select one: A. Internal conflicts related to his/her attitudes toward Whites B. A lack of interest in race and racism C. Rejection of all aspects of White culture D. Adoption of a multicultural perspective

Answer 80

The correct answer is C. The most recent version of Cross's model (Cross and Vandiver, 2001) distinguishes between four stages of racial identity development: pre-encounter, encounter, immersion-emersion, and internalization. Race and racial identity have high salience during the immersion-emersion stage. A person in the immersion substage idealizes Blacks and Black culture and feels a great deal of rage toward Whites. A person in the emersion substage has less intense feelings but continues to reject all aspects of the White culture and begins to internalize a Black identity. Answer A: This is most representative of an individual in the encounter stage of Cross's model. Answer B: This is most representative of an individual in the pre-encounter stage of Cross's model. Answer D: This is most representative of an individual in the internalization stage of Cross's model.

Question 81

Research has supported Helms's (1995) prediction that White therapists whose attitudes and beliefs are consistent with the ________ status are most effective when working with clients from racial/ethnic minority groups. Select one: A. reintegration B. autonomy C. integrative awareness D. identity commitment

Answer 81

The correct answer is B. Helms's White Racial Identity Development Model distinguishes between six identity statuses (stages): contact, disintegration, reintegration, pseudo-independence, immersion-emersion, and autonomy. Knowing that autonomy is the last status in Helms's model would have helped you identify the correct answer to this question. Research has confirmed that therapists of this status are most effective when working with clients from racial/ethnic minority groups. Answers A, C, and D: A White therapist is likely to be most effective when working with a client from an ethnic/racial minority group when the therapist is in the final stage of White identity development - i.e., the autonomy stage. A person in this stage has internalized a positive (non-racist) White identity that includes appreciation of and respect for racial/cultural similarities and differences.

Question 82

Efficacy studies are most useful for establishing: Select one: A. generalizability. B. feasibility. C. cost-effectiveness. D. treatment effect.

Answer 82

The correct answer is D. Efficacy studies are most useful for establishing whether or not a treatment has an effect, while effectiveness studies are best for assessing clinical utility; i.e., for determining a treatment's generalizability, feasibility, and cost-effectiveness. Answers A, B, and C: Effectiveness studies are used to assess generalizability, feasibility, and cost-effectiveness.

Question 83

An advantage of using treatment manuals in clinical practice is that they: Select one: A. ensure that the clinician incorporates effective nonspecific factors into an intervention. B. reduce the need for training and supervision in the selection and application of empirically supported treatments. C. make it easier for a clinician to adapt a treatment to the individual needs of a client. D. provide the clinician with concrete examples that illustrate the appropriate application of an intervention.

Answer 83

The correct answer is D. The use of treatment manuals in clinical practice continues to be controversial, with experts citing both advantages and disadvantages. Most current treatment manuals provide information on the delivery of empirically supported treatments and include concrete examples. Therefore, of the answers given, this is the best one. See, e.g., M. J. Lambert et al., Compendium of current psychotherapy treatment manuals, in G. P. Koocher, J. C. Norcross, and S. S. Hill (Eds.), Psychologists' desk reference (pp. 202-209), New York, Oxford, 1998. Answer A: One of the criticisms of treatment manuals is that they do not take effective nonspecific factors into account. Answer B: Use of a treatment manual does not eliminate the need for adequate training and supervision. Answer C: Another criticism of treatment manuals is that they reduce a clinician's flexibility in applying an intervention to individual clients.

Question 84

Which of the following individuals is at greatest risk for death by suicide? Select one: A. A 76-year-old widowed man B. A 30-year-old divorced woman C. A 23-year-old married man D. A 39-year-old single woman

Answer 84

The correct answer is A. In general, suicide rates are higher for men, for single, divorced, and widowed (versus married) individuals, and for older people. Therefore, of the individuals listed in the answers, the risk would be highest for a 76-year-old widowed man. Answer B: While being divorced is a risk factor, this individual does not present at a higher risk level than a widowed elderly man (three risk factors). Answer C: Of the individuals listed, this individual presents at the lowest risk level for suicide. Answer D: While being single is a risk factor, this individual does not present at a higher risk level than a widowed elderly man (three risk factors).

Question 85

Based on his review of the psychotherapy outcome studies, Hans Eysenck (1952) concluded that: Select one: A. treated and untreated patients show very little improvement in symptoms. B. treated and untreated patients both show improvement but are indistinguishable in terms of amount of improvement. C. treated patients are consistently "better off" than untreated patients in terms of symptom improvement. D. untreated patients are often "better off" than treated patients in terms of symptom improvement.

Answer 85

The correct answer is D. The debate about the effectiveness of psychotherapy was fueled in the 1950s by the results of Eysenck's study. Eysenck found that 72% of untreated neurotic adults improved, while only 66% of those receiving eclectic therapy and 44% of those receiving psychoanalytic psychotherapy showed a substantial decrease in symptoms. Answers A, B, and C: These statements are not consistent with Eysenck's findings.

Question 86

Howard et al. (1996) found that, after _____ sessions of therapy, approximately 75 percent of therapy patients evidenced a measurable improvement in symptoms. Select one: A. 12 B. 16 C. 26 D. 32

Answer 86

The correct answer is C. Howard and his colleagues found that, up to a point, the longer the duration of therapy, the better its effects. They referred to this as the dose-dependent effect. The results of Howard et al.'s research indicated that, after 26 weeks of therapy, about 75% of patients exhibited measurable benefits, and from there it begins to level off. Answers A, B, and D: Howard and colleagues found that the relationship between treatment outcome and therapeutic effect levels off at about 26 sessions.

Question 87

Research investigating the effectiveness of cognitive-behavioral therapy as a treatment for depression for older adults suggests that: Select one: A. older adults benefit from cognitive-behavioral therapy when its duration is brief (less than 12 sessions). B. older adults benefit from cognitive-behavioral therapy, especially when it is conducted at a slower pace. C. older adults benefit from cognitive-behavioral therapy only when their therapist is the same gender and similar in terms of age. D. older adults are not likely to benefit from cognitive-behavioral therapy.

Answer 87

The correct answer is B. The studies have generally confirmed that older adults benefit from a variety of forms of psychotherapy, including cognitive-behavioral therapy. While older adults generally benefit from cognitive-behavioral therapy, its effects are maximized when it is modified to fit the needs of members of this population. One effective modification is to present therapy at a slower pace. Answer A: Research has found that there is a benefit to slowing the pace of treatment rather than reducing the number of sessions. Answer C: Research does not suggest that therapist matching is necessary for older adults to benefit from CBT. Answer D: Research has found that older adults do benefit from CBT.

Question 88

The first use of meta-analysis to evaluate the effectiveness of psychotherapy is attributed to: Select one: A. Jacobson and Christensen. B. Eysenck. C. Smith and colleagues. D. Howard and colleagues

Answer 88

The correct answer is C. Meta-analysis was originally used by Karl Pearson in 1904 to evaluate the extent to which smallpox inoculation increased survival rates. At that time, the technique was not known as "meta-analysis." It was not until the 1970s that the term "meta-analysis" was introduced by Smith and Glass, who also refined the technique and were the first to apply it to psychotherapy outcome studies. [See Smith and Glass (1977), Meta-analysis of psychotherapy outcome studies, American Psychologist, 1977, 32, 752-760]. Answer A: You may be familiar with the names of these researchers from the Clinical Psychology chapter of your study materials, where they are cited as proponents of both efficacy and effectiveness research. Answer B: One criticism of Eysenck's 1952 study on the effectiveness of psychotherapy is that the study did not utilize meta-analysis. Answer D: Howard and colleagues studied the relationship between treatment length and outcome.

Question 89

Which of the following groups has the lowest psychiatric hospital admission rate? Select one: A. Married persons B. Never married persons C. Divorced persons D. Widowed persons

Answer 89

The correct answer is D. The statistics on psychiatric hospital admission rates vary from study to study. However, as it relates to marital status, the consensus suggests that the highest psychiatric admission rates are among those who have never been married while those who have been widowed have the lowest rates. Answers A, B, and C: For both men and women, admission rates into psychiatric hospitals are lowest among the widowed, intermediate for those who are married or divorced/separated, and highest for the never married.

Question 90

Telepsychology is generally defined as: Select one: A. using the telephone, text, e-mail, chats, interactive tele-video conferencing technologies, or VR for treatment of mental health disorders. B. watching a psychologist on television. C. holding a video-chat session with a therapist who lives in another state. D. texting an anonymous crisis hotline.

Answer 90

The correct answer is A. Telepsychology is broadly defined as the use of the telephone, text, e-mail, chat, interactive tele-video conferencing technologies, or VR for treatment of mental health disorders. Answers C and D: These two responses include examples of telepsychology but do not define what it is. Answer B: This would not be considered telepsychology.

Question 91

Which of the following is NOT a healthcare approach? Select one: A. The private model B. The identity development model C. The Bismarck model D. The Beveridge model

Answer 91

The correct answer is B. The private model, Beveridge model, and Bismarck model are all approaches to healthcare, while the identity development model may refer to racial or sexual identity development. Answers A, C, and D: These models are all healthcare approaches.

Question 92

___________ refers to methods used to encourage healthy behaviors. Select one: A. Resilience B. Bismarck model C. Health promotion D. Evidence-based treatments

Answer 92

The correct answer is C. Health promotion refers to methods that promote and encourage healthy behaviors, including advertisement and online education. Answer A: Resilience is the psychological capacity to cope with socio-environmental challenges. Answer B: The Bismarck model is a healthcare approach. Answer D: While evidence-based treatments may include health promotion, this is not the best answer.

Question 93

Which of the following is not a direct key function of supervision? Select one: A. Administration B. Teaching C. Helping D. Counseling

Answer 93

The correct answer is D. Supervision does not directly involve providing counseling or therapy services to a client. It does, however, involve the administration, teaching, and helping of a supervisee who provides counseling and other therapeutic services. Answers A, B, and C: Most contemporary definitions of supervision include administration, teaching, and helping.