Clinical

Question 1

topographical model

Answer 1

our psyche (mind) is made of 3 levels:
1) conscious level: thoughts, feelings, perceptions, etc. that we are currently aware of
2) preconscious level: lies just below the conscious level and contains material that is not currently in conscious awareness but is readily accessible to consciousness
3) unconscious level: lies beneath the preconscious level and is the largest component of the psyche - contains threatening emotions and memories and other material that is normally unavailable to conscious awareness

Question 2

structural theory

Answer 2

a psychic structure that consists of the id, ego, and superego and proposes that personality is largely the result of interactions between them

Question 3

id

Answer 3

present at birth and consists of all of the basic biological instincts that drive or direct behavior

Question 4

ego

Answer 4

part of the id that has been modified by its interactions with the external world

Question 5

superego

Answer 5

last component to develop
it serves as the conscience, operates at all three levels of consciousness, and evolves primarily from the internalization of parental prohibitions, standards, and values

Question 6

transference

Answer 6

therapist’s neutrality allows the client to project onto the therapist feelings that he or she originally had for a parent or other significant person in the past

Question 7

countertransference

Answer 7

the therapist projects unresolved feelings toward another person onto the client

Question 8

Jung’s structure of the psyche

Answer 8

1) conscious: consists of the ego and contains all thoughts, feelings, etc. of which we are currently aware.
2) personal unconscious: contains our own forgotten or repressed memories and includes complexes, which are collections of thoughts, feelings, and attitudes that are related to a particular concept (e.g., power, inferiority) and that influence behavior.
3) collective unconscious: consists of “general wisdom that is shared by all people, has developed over time, and is passed along from generation to generation across the ages”

Question 9

archetypes

Answer 9

universal mental structures that predispose people to react to certain circumstances in specific ways

Question 10

individuation

Answer 10

an integration of all conscious and unconscious aspects of the self into a unified whole

Question 11

Adler’s Individual Psychology

Answer 11

1) feelings of inferiority: develop during childhood in response to real or imagined disabilities or inadequacies - people motivated to overcome their sense of inferiority by using some type of compensation
2) striving for superiority: innate drive toward competence and effectiveness - term “style of life” to describe how a person strives for superiority
3) mistaken (unhealthy) style of life: overcompensation for feelings of inferiority guided by goals that reflect self-centeredness and a lack of concern about the well-being of others

Question 12

Karen Horney

Answer 12

focused on the impact of early relationships; proposed that certain parenting behaviors (e.g., indifference, overprotection, rejection) cause a child to experience basic anxiety (feeling of helplessness and isolation in a hostile world);
to defend, child adopts certain interpersonal coping strategies (moving toward others, moving against others, moving away from others)

Question 13

Harry Stack Sullivan

Answer 13

a) prototaxic mode: occurs before symbols are used, discrete, unconnected momentary states, inability to differentiate between the self and the external world
(b) parataxic mode: use of private or autistic symbols, ability to differentiate certain aspects of experience and seeing causal connections between events that occur at about the same time but are not actually related
(c) syntaxic mode: use of symbols that have shared meaning and permit logical, sequential thought and meaningful interpersonal communication

Question 14

parataxic distortions

Answer 14

the result of arrest at the parataxic mode due to unsatisfactory early relationship;
involve perceiving and evaluating people in the present based on past interpersonal experiences

Question 15

Erich Fromm

Answer 15

interested in how society prevents individuals from realizing their essential human nature, which is characterized by the capacity to be creative, loving, and productive

Question 16

ego-defensive functions

Answer 16

involved in the resolution of internal conflicts

Question 17

ego-autonomous functions

Answer 17

involved in adaptive, non-conflict laden functions such as learning, memory, comprehension, and perception

Question 18

Object Relations Theory

Answer 18

behavior is motivated by a desire for human connection;
focuses on the impact of early relationships between a child and significant others (“objects”) in the child’s life

Question 19

object constancy

Answer 19

ability to maintain a predominantly positive emotional connection to a significant other independent of one’s need state or the object’s immediate ability to gratify one’s needs

Question 20

object constancy three-stage model

Answer 20

1) initial normal autistic stage: first few weeks of life, infant is aware of only themself
2) normal symbiotic stage: infant becomes aware of the external environment but can’t differentiate between self and others
3) separation-individuation stage: 4 substages during which object constancy gradually develops (5-36 months)

Question 21

Person-Centered Therapy

Answer 21

based on the assumption that people have an innate self-actualizing tendency (capacity to achieve their full potential) that motivates and guides their behavior

Question 22

incongruence

Answer 22

discrepancy between self and experience, which can impede the self-actualizing tendency and lead to psychological maladjustment

Question 23

the self (or self-concept)

Answer 23

how a person currently perceives themself;
person’s beliefs about who they are and what they can do

Question 24

person-centered therapy 3 conditions

Answer 24

1) Empathy: therapist understands the client’s subjective experience and conveys that understanding to the client
2) Congruence: therapist is genuine, open, and honest and exhibits consistency in words and actions
3) Unconditional Positive Regard: therapist truly cares about the client, affirms the client’s value as a person, and accepts the client without judgment

Question 25

Gestalt Therapy

Answer 25

all behavior is motivated by a striving for homeostasis (balance);
when imbalance occurs due to an unfilled physical or psychological need, they are motivated to obtain something in the environment that will satisfy the need to restore homeostasis;
when that need is satisfied, they withdraw from the environment, and this process recurs as new needs arise

Question 26

boundary disturbance

Answer 26

persistent disturbance in the contact boundary between the person and the environment that impedes the person’s ability to satisfy his or her needs

Question 27

types of boundary disturbances

Answer 27

1) introjection: tendency to internalize the beliefs and values of other people without awareness or critical evaluation, resulting in inconsistencies between one’s thoughts and feelings
2) projection: disowning unacceptable aspects of oneself by attributing them to someone else
3) retroflection: doing to oneself what one would like to do to another person
4) deflection: tendency to avoid direct contact with others
5) confluence: blurring of the separation between oneself and others, resulting in a loss of identity

Question 28

existential therapy

Answer 28

views personality and behavior as a reflection of a person’s struggle with the “ultimate concerns of existence,” which include death, isolation, meaninglessness, freedom, and responsibility

Question 29

reality therapy

Answer 29

replace the client’s failure identity with a success identity by helping the client assume responsibility for his or her actions and adopt more appropriate ways to fulfill his or her needs

Question 30

Beck’s CBT

Answer 30

how we feel and act is largely determined by how we think;
maladaptive behavior often due to combination of biological and environmental factors that predispose a person to faulty cognitive patterns

Question 31

cognitive distortions

Answer 31

systematic errors in reasoning that create the link between dysfunctional schemas and automatic thoughts;
occur when incoming information is biased to fit a dysfunctional schema and, as a result, elicits a maladaptive automatic thought

Question 32

types of cognitive distortions

Answer 32

1) Arbitrary inference: drawing a conclusion when there’s no evidence to support it or when the conclusion is contrary to the evidence
2) Selective abstraction: focus on certain (usually negative) details of a situation or event while disregarding other, more salient information
3) Overgeneralization: drawing a conclusion based on a single event and then applying that conclusion to other events
4) Personalization: when a person attributes external events to themself even though the event is not actually in the person’s control
5) Dichotomous (all-or-none) thinking: categorizing experiences in 1 of 2 extremes (complete success or total failure)

Question 33

maladaptive schemas

Answer 33

distort incoming information and lead to inaccurate interpretations and conclusions

Question 34

Rational Emotive Behavior Therapy

Answer 34

people’s emotional and behavioral reactions to events as being mediated by their beliefs about those events

Question 35

A-B-C-D-E model

Answer 35

A: activating (antecedent) event
B: person’s belief about that event
C: emotional or behavioral consequence of that belief
D: disputation of irrational beliefs
E: replacing irrational beliefs with effective rational ones

Question 36

stress inoculation training (SIT)

Answer 36

combines skills training with modification of maladaptive cognitions that interfere with adaptive behaviors b/c when people learn to cope with mild levels of stress, they are “inoculated” against future stressful situations

Question 37

self-instructional training

Answer 37

individuals can modify their own behaviors through the use of appropriate self-talk:
1) Cognitive Modeling: model performs a task while saying instructions aloud
2) Overt External Guidance: client performs the same task with guidance and instructions from the model
3) Overt Self-Guidance: client performs the task while saying the instructions aloud
4) Faded Overt Self-Guidance: client repeats the task while whispering the instructions
5) Covert Self-Instruction: client performs the task again while repeating the instructions covertly (via private speech)

Question 38

problem-solving therapy (PST)

Answer 38

based on the assumption that psychological problems are related to deficits in social problem-solving skills;
primary goals are to help clients develop a positive problem orientation and develop and apply a rational problem-solving style

Question 39

Biofeedback

Answer 39

allows a person to gain control over a physiological response by monitoring the response and providing the person with immediate and continuous feedback about the status of that response with a visual or auditory signal

Question 40

EMG (electromyography) biofeedback

Answer 40

provides information about level of muscle tension (chronic pain, incontinence, and motor impairment)

Question 41

EEG (electroencephalogram) biofeedback

Answer 41

(AKA neurofeedback) - provides information on brain wave activity (depression, anxiety, ADHD, insomnia, seizures)

Question 42

Thermal (temperature) biofeedback

Answer 42

provides information about skin temperature (Raynaud’s, migraine headaches)

Question 43

systems theory concept of families

Answer 43

1) Wholeness: elements of a system produce an entity that is greater than the sum of the individual elements
2) Open vs. Closed Systems: open system has permeable boundaries that allow it to interact with the environment; closed system has impermeable boundaries that prevent interactions
3) Homeostasis: systems tend to preserve a state of stability and resist change
4) Positive vs. Negative Feedback: negative feedback consists of information or actions that maintain the system’s status quo; positive feedback consists of information or actions that cause deviation and produce instability and change
5) Equifinality vs. Equipotentiality: equifinality occurs when different processes have the same outcome; equipotentiality occurs when the same process can have different outcomes

Question 44

communication theory

Answer 44

communication patterns within a family system “shape the operation and function of the system”

Question 45

two levels of communication

Answer 45

1) report level: verbal and conveys the literal meaning (content) of the message
2) command (metacommunication) level: usually nonverbal and expresses the relationship between the communicators

Question 46

symmetrical interactions

Answer 46

based on equality and can lead to competition and conflict (“symmetrical escalation”)
e.g., partners repeatedly respond to each other’s angry remarks with remarks that are more intense in terms of anger

Question 47

complementary interactions

Answer 47

based on inequality (one member assumes the dominant role in conversations while the other member assumes a submissive role, their interactions are complementary)

Question 48

postmodernism perspective

Answer 48

reality is created through social interaction and, consequently, that therapy is a creative process in which the therapist collaborates with family members to deconstruct old views of reality and co-construct new realities

Question 49

differentiation of self

Answer 49

a family member’s ability to separate their intellectual and emotional functioning from others in the family

Question 50

triangles

Answer 50

form when a two-person system becomes unstable due to conflict and recruits a third person into their system to restore stability

Question 51

multigenerational transmission process

Answer 51

the process by which patterns of differentiation are transferred from one generation to the next

Question 52

emotional cutoff

Answer 52

occurs when a family member attempts to distance themself from the family physically and/or emotionally as a way to deal with conflict within the family system and usually indicates that the family member has a low level of differentiation

Question 53

Bowenian Extended Family Systems Therapy

Answer 53

help each family member become more differentiated while remaining connected to other family members

Question 54

Minuchin’s Structural Family Therapy

Answer 54

restructure the family so that it’s better able to respond adaptively to intra- and extrafamilial sources of stress
family structure, boundaries, rigid family triads

Question 55

clear boundaries

Answer 55

firm but flexible and allow family members to maintain a balance between separateness from and connection to other family members

Question 56

rigid boundaries

Answer 56

lead to disengagement between family members and promote isolation

Question 57

diffuse boundaries

Answer 57

lead to enmeshment (manipulative emotional reactivity) and promote excessive dependence

Question 58

3 rigid family triads

Answer 58

1) Triangulation: each parent demands that a child side with them during a dispute so that the child is “pulled” in two directions
2) Detouring: parents reinforce deviant behavior in the child because it takes the focus off the problems they’re having with each other
3) Stable coalition: when two family members consistently “gang up” against another family member

Question 59

Haley’s Strategic Family Therapy

Answer 59

use appropriate strategies to resolve family’s presenting problems;
alter the interactional sequences that maintain problematic behaviors that arose through communication and power

Question 60

2 types of directives

Answer 60

direct: straightforward instructions or advice that family members are likely to agree to follow;
indirect: attempts to influence family members to act in a certain way without directly instructing them to do so (reframing, paradoxical interventions)

Question 61

paradoxical interventions

Answer 61

asking family members to do something they are likely to resist and thereby change in the desired way;
idea is to utilize the energy of resistance to help the couple make changes in their communication patterns

Question 62

5 stages of strategic family therapy

Answer 62

1) social stage: therapist speaks to each family member and observes family interactions
2) problem stage: therapist asks family members questions about the presenting problem
3) interaction stage: therapist asks family members to discuss the presenting problem, which allows the therapist to collect information about their interactions.
4) goal-setting stage: therapist and family members agree on therapy goals
5) task-setting stage: therapist gives the family a directive to complete at home

Question 63

Milan Systemic Family Therapy

Answer 63

the problematic behaviors of family members involve repetitive behavioral interactions (“games”) that maintain the family’s state of homeostasis;
discover, interrupt, and eventually change the rules of their game;
see their problem in an alternative way and identify new ways to interact

Question 64

strategies of systemic family therapy

Answer 64

1) Hypothesizing: collecting data to determine what is maintaining the family’s problem and identify appropriate interventions
2) Neutrality: therapists maintain a neutral position by attending to and accepting the perceptions of all family members
3) Circular Questioning: asking each family member about their perceptions of a family relationship or a specific event
4) Positive Connotation: reframing a problematic behavior as beneficial or good
5) Paradoxical Prescriptions: tasks that require family members to engage in the problematic behavior to help them understand that the behavior is under their control
6) Family Rituals: tasks designed to alter family games by requiring family members to change their behaviors in a specific circumstance

Question 65

behavioral family therapy

Answer 65

all behavior is learned and maintained by antecedents and consequences operating in the family environment;
reduce or eliminate current problematic behaviors and replace them with more adaptive behaviors

Question 66

Solution-Focused Therapy

Answer 66

focuses on the solutions to problems rather than on the problems themselves;
client describes problems, define realistic therapy goals in positive terms, explore times when the problems were absent or less severe as, feedback, encouragement and suggestions, evaluate progress

Question 67

miracle question

Answer 67

used to help identify therapy goals and requires the client to imagine the absence of his or her problem and the resulting effects

Question 68

exception question

Answer 68

used to identify times when the problem did not exist or was diminished in order to help the client develop a solution orientation

Question 69

formula first session task

Answer 69

given to a client to complete before the second therapy session that requires the client to observe what is happening in their life that they would like to continue to have happen

Question 70

Lazarus’s Multimodel Therapy

Answer 70

most psychological problems are multifaceted, multidetermined, and multilayered;
careful assessment of 7 parameters or modalities:
behavior, affect, sensation, imagery, cognition, interpersonal relationships, and drugs, diet, and exercise (biology)
BASIC ID

Question 71

tracking

Answer 71

determining the “firing order” of a client’s modalities (i.e., the modality sequence associated with the client’s problem) to help identify appropriate interventions

Question 72

bridging

Answer 72

attending first to the client’s preferred modality and then transitioning to their least preferred modalities to foster rapport and decrease resistance

Question 73

Prochaska and DiClemente’s Transtheoretical Model

Answer 73

(AKA stages of change model)
proposes that people pass through a predictable sequence of stages when modifying their health-related behaviors

Question 74

6 stages of theoretical model

Answer 74

1) precontemplation stage: unaware that there is a need to change and has no plan to change
2) contemplation stage: recognizes the need to change and, although somewhat ambivalent, plans to change within the next 6 months
3) preparation stage: intends to take action within the next 30 days and may have already started to take small steps towards change
4) action stage: actively engaged in making behavioral changes
5) maintenance stage: been actively changing behavior for at least 6 months and is working to prevent relapse
6) termination stage: not tempted to engage in old behaviors and is 100% confident in their ability to avoid relapse.

Question 75

motivational interviewing

Answer 75

people are ordinarily ambivalent about making changes in their lives so it provides a “client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence”

Question 76

motivational interviewing OARS

Answer 76

Open-ended questions that cannot be answered with “yes” or “no”
Affirmations that compliment the client and recognize their strengths
Reflective listening that restates or adds meaning to what the client has said
Summaries that foster insight or reinforce statements made by the client that support change (“change talk”)

Question 77

Interpersonal Psychotherapy

Answer 77

a) depression is due to a medical illness that is not the client’s fault
(b) it’s related to interpersonal events that trigger or follow the onset of symptoms

Question 78

interpersonal problem areas

Answer 78

role transitions, role disputes, interpersonal deficits, complicated grief

Question 79

Yalom’s 3 formative stages of group therapy

Answer 79

1) Orientation, Hesitant Participation, Search for Meaning, and Dependency: concerned with the rules, structure, and purpose of the group; hesitant; look to leader for approval
2) Conflict, Dominance, and Rebellion: establish place, control hierarchy may occur
3) Development of Cohesiveness: trust, good communication

Question 80

feminist therapy

Answer 80

empowerment of the individual and transformation of society;
challenged traditional male-oriented psychological theory and practice

Question 81

relational-cultural theory
AKA self-in-relation theory

Answer 81

development (esp female development) proceeds through relationship elaboration rather than through separation or disengagement;
mental health is determined by the ability to deepen connections and relationships throughout the life span;
gender-related differences in self-concept, relationality, and other aspects of personality and behavior can be traced to differences in the early mother-daughter and mother-son relationship

Question 82

multicultural counseling

Answer 82

counseling services where relevant cultural traits are incorporated in the context of the counseling process including ethnicity, race, gender, sexual identity, socioeconomic status, disabilities, age, and spirituality

Question 83

etic perspective

Answer 83

(universal) perspective when therapists believe that people from different cultures are essentially the same

Question 84

emic perspective

Answer 84

(culture-specific) perspective when therapists believe that people from different cultural backgrounds differ in important ways and that psychological theories and strategies that are appropriate for individuals from one cultural group may not be appropriate for individuals from other groups.

Question 85

cultural encapsulation

Answer 85

1) defines reality according to their own set of cultural assumptions
2) insensitive to cultural variations among individuals
3) disregards evidence that disproves their assumptions
4) relies on quick, simple, and technique-oriented solutions to problems
5) evaluates others based on their own perspective

Question 86

worldview

Answer 86

how people perceive, evaluate, and react to the situations they encounter

Question 87

4 types of worldview (Sue & Sue)

Answer 87

1) internal locus of control and internal locus of responsibility (IC-IR): believe they are the masters of their own fate and are responsible for their own successes and failures
2) internal locus of control and external locus of responsibility (IC-ER): believe they could shape their own lives if given a chance but that others are responsible for their outcomes
3) external locus of control and internal locus of responsibility (EC-IR): believe they have little control over their lives but assume responsibility for their own failures
4) external locus of control and external locus of responsibility (EC-ER): believe they have little or no control over their lives and are not responsible for their own outcomes

Question 88

acculturation

Answer 88

dynamic and multidimensional process of adaptation that occurs when distinct cultures come into sustained contact which involves different degrees and instances of cultural learning and maintenance that are contingent upon individual, group, and environmental factors

Question 89

4 models of acculturation

Answer 89

1) integration orientation: retain their own culture while also adopting the dominant culture
2) assimilation orientation: reject their own culture and adopt the dominant culture
3) separation orientation: retain their own culture and reject the dominant culture
4) marginalization orientation: reject both their own culture and the dominant culture

Question 90

healthy cultural paranoia

Answer 90

involves distrust and suspiciousness but refers to the normal (nonpathological) response of African American individuals to oppression and racism

Question 91

racial microaggression

Answer 91

brief and commonplace daily verbal, behavioral, or environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative racial slights and insults toward people of color

Question 92

microinsults

Answer 92

nonverbal messages or insensitive remarks that demean the person’s racial or ethnic background

Question 93

microinvalidations

Answer 93

“communications that exclude, negate, or nullify the psychological thoughts, feelings, or experiential reality of a person of color”

Question 94

microassaults

Answer 94

explicit verbal or nonverbal racial derogations that are meant to hurt or harm the intended victim and involve name-calling, avoidant behavior, or intentional discriminatory acts

Question 95

high-context communication

Answer 95

relies heavily on culturally defined meanings, nonverbal messages, and the context in which it occurs and is characteristic of several ethnic/cultural minority groups

Question 96

low-context communication

Answer 96

relies on the verbal message, is independent from the context, and is characteristic of European Americans

Question 97

Racial/Cultural Identity Development (R/CID) Model

Answer 97

5 stages of development that oppressed people experience as they struggle to understand themselves in terms of their own culture, the dominant culture, and the oppressive relationship between the two cultures

Question 98

5 stages of R/CID Model

Answer 98

1) Conformity: prefer the lifestyle and values of the dominant culture, have strong negative feelings about their own minority group and other minority groups that are similar to their own
2) Dissonance: confusion and conflict as the result of encountering circumstances that are inconsistent with their cultural beliefs and attitudes
3) Resistance and Immersion: actively reject the dominant culture, strongly identify with and are committed to their own culture, and may feel guilty and angry about their past negative feelings toward their own group
4) Introspection: conflict between personal autonomy and the rigid constraints of the previous stage - begin to question their unequivocal loyalty to their own culture and absolute rejection of the dominant culture
5) Integrative Awareness: resolved the conflicts of the previous stage, appreciate aspects of their own culture and the dominant culture, and have a positive self-image and strong sense of autonomy

Question 99

Black Racial Identity Development Model (AKA the Nigrescence Model) 5 stages

Answer 99

1) Pre-Encounter: prefer White culture, may have internalized negative stereotypes of Blacks and blame Blacks for their own problems
2) Encounter: important event or series of events challenges the person’s worldview and causes the person to question their positive attitude toward White culture and consider what it means to be a member of a group that is the target of racism
3) Immersion-Emersion: denigrate White culture and glorify Black culture. They actively seek out opportunities to learn about Black history and culture and prefer associating with individuals of their own race
4) Internalization: started to develop a sense of security about their Black identity, their negative feelings about White culture have declined
5) Internalization-Commitment: nternalized a Black identity and are committed to social activism to improve equality for oppressed group

Question 100

Helms’s White Racial Identity Development Model stages

Answer 100

1) Contact: lack of awareness of racial differences, limited contact with members of minority groups, “colorblind”
2) Disintegration: interactions with members of minority groups lead to greater awareness of inequality
3) Reintegration: resolve their conflicts by adopting the position that Whites are superior and minorities are inferior
4) Pseudo-Independence: dissatisfied with their racist views, often as the result of a disturbing event
5) Immersion-Emersion: explore what it means to be “White” and are interested in determining how they can feel proud of their own race without being racist
6) Autonomy: internalize a nonracist White identity that is based on a realistic understanding of the strengths and weaknesses of White culture

Question 101

Troiden’s Model of Homosexual Identity Development

Answer 101

1) Sensitization: begins before puberty and is characterized by feeling different from others
2) Identity Confusion: begins in middle or late adolescence when the person realizes that they feel sexually attracted to same-sex individuals and considers the possibility that they are homosexual
3) Identity Assumption: occurs during or after late adolescence and initially involves being tolerant of a gay or lesbian identity
4) Identity Commitment: internalized their gay or lesbian identity and accepted homosexuality as a “way of life.”

Question 102

multisystems approach

Answer 102

considering the multiple systems that impact individual and family functioning and targets the individual, the immediate and extended family, nonblood relatives and friends, church and community services, social service agencies, and other outside systems

Question 103

cuento therapy

Answer 103

uses Spanish folktales as the basis for role-playing and discussion and has been found to be effective for reducing emotional and behavioral problems and improving ethnic pride in Hispanic children

Question 104

therapy interventions likely to be most successful for African American clients

Answer 104

time-limited and adopts a problem-solving approach, multisystems

Question 105

therapy interventions likely to be most successful for Hispanic American clients

Answer 105

active, goal-oriented, time-limited approach (CBT);
family therapy;
adopt a formal style (formalismo) in initial sessions but a more personal style (personalismo) in subsequent sessions

Question 106

network therapy

Answer 106

helps empower clients to cope with life stresses by utilizing relatives, friends, and tribal members as a social support system

Question 107

therapy interventions likely to be most successful for Asian American clients

Answer 107

brief structured and solution-focused approach;
expect the therapist to be an authority (but not authoritarian) and to suggest specific courses of action while also fostering their participation by encouraging them to help identify therapy goals and solutions to problems;
behavioral approach

Question 108

intersectionality

Answer 108

the unique effects of factors such as race/ethnicity, gender, age, class, religion/spirituality, and disability and the interaction of these effects with the effects of sexual orientation

Question 109

3 levels of prevention

Answer 109

1) primary: implemented before a disorder develops to reduce its incidence (rate of new cases) and are provided to an entire group or population of individuals
2) secondary: providing early intervention to keep a problem from becoming a full-blown disorder and are aimed at individuals who are exhibiting early signs of a disorder
3) tertiary: prevent the recurrence of a disorder and/or reduce its debilitating effects and are aimed at individuals who already have the disorder

Question 110

client-centered case consultation

Answer 110

consultant helps the consultee resolve a problem they are having with a particular client;
assesses the situation to determine the cause of the problem, provides consultee recommendations for resolving the problem

Question 111

consultee-centered case consultation

Answer 111

consultant identifies and addresses deficiencies in the consultee that are interfering with the consultee’s ability to provide effective services to members of a particular group of clients

Question 112

program-centered administrative consultation

Answer 112

consultant works with program administrators to determine why an existing program is not having the desired outcomes

Question 113

consultee-centered administrative consultation

Answer 113

consultant works with program administrators to improve their ability to effectively design, implement, and/or evaluate future performance

Question 114

theme interference

Answer 114

loss of objectivity that occurs when a consultee’s reactions to a particular type of client (e.g., adults with BPD) are affected by the consultee’s previous experience with that type of client

Question 115

behavioral consultation

Answer 115

behavior is learned and current behavior(s) can be replaced with new, more acceptable behavior(s);
indirect service delivery to a client in which the consultant works with the consultee (e.g., teacher or therapist) who is then responsible for providing services to the client (e.g., student or patient)

Question 116

stages of behavioral consultation

Answer 116

1) problem identification: consultant and consultee work together to operationally define the problem behavior.
2) problem analysis: consultant and consultee conduct a functional analysis to identify the antecedents and consequences that are maintaining the problem behavior, then formulate a treatment plan
3) treatment implementation stage: consultant helps the consultee carry out the treatment and collect data on its outcomes
4) treatment evaluation: consultant and consultee analyze the outcome data to determine if the treatment achieved its goals and decide if it should be continued, discontinued, or modified

Question 117

advocacy consultation

Answer 117

set of activities performed by a consultant to further the goals of a disenfranchised group (physical disabilities, poor SES residents);
focuses on bringing about change that will benefit the consultees through use of media or law

Question 118

telepsychology

Answer 118

technological devices, such as telephones or video chatting software, for provision of mental health services

Question 119

telepsychology pros

Answer 119

less expensive to administer, may cover a diverse range of services, conducting sessions with clients with limited mobility, various assessments, consultations, and crisis management

Question 120

telepsychology cons

Answer 120

still relatively new, confidentiality (record keeping, protection of client data, encryption), challenges with providing therapy across state lines, and security against cyber infiltration

Question 121

ethical guidelines for telepsychology

Answer 121

1) competence with the technologies they use, including being aware of any potential impact made on clients or others they work with
2) maintain professional and ethical standards of care (careful review of the benefits and the risks a client may experience, ensuring informed consent is appropriately communicated and documented, storing data with reasonable security, disposing of data in an appropriate manner)
3) follow all laws and regulations relevant to the use of telepsychology, keeping in mind differences across state or regional borders

Question 122

healthcare systems

Answer 122

integrate and coordinate the delivery of services from institutions and professionals to the public

Question 123

Beveridge model approach to healthcare

Answer 123

uses public funds to provide services

Question 124

private model approach to healthcare

Answer 124

uses private funds to provide services

Question 125

Bismarck model approach to healthcare

Answer 125

uses a mixture of private and public funds

Question 126

suicide prevention

Answer 126

evaluating the client’s level of suicide risk and intervening in a manner commensurate with that risk;
the evaluation involves considering the client’s risk and protective factors and integrating information obtained from various sources, including the client, the client’s family, and other healthcare professionals

Question 127

risk factors for suicide

Answer 127

history, warning signs, age, gender, race/ethnicity, marital status, psychiatric diagnosis, hopelessness, physical health
GRWMHAPHP

Question 128

mental disorder with the greatest suicide risk (in order);
teenagers

Answer 128

MDD, a substance use disorder (esp. alcohol), and schizophrenia;
depression is comorbid with conduct disorder, a substance use disorder, or ADHD

Question 129

suicide risk factors that result in hospitalization

Answer 129

previous suicide attempt or frequent and intense suicidal ideation, specific suicide plan that involves access to lethal means, severe mental illness or substance use, hopelessness, poor insight, lack of social support

Question 130

child maltreatment experiences in order

Answer 130

neglect, physical, emotional, and sexual abuse

Question 131

child characteristics that have been linked to an increased risk for physical abuse

Answer 131

low birth weight and prematurity; difficult temperament; chronic or serious physical illness; and physical, cognitive, emotional disabilities, female

Question 132

cycle of violence

Answer 132

Phase 1) Tension Building: escalation of tension with verbal abuse and minor physical abuse and may last for days, weeks, or months. “walks on eggshells” to appease partner and avoid a serious incident of abuse.
Phase 2) Acute Battering Incident: intense violent incident. Women most often seek help during this phase.
Phase 3) Loving Contrition: perpetrator is remorseful and apologetic and promises that violence “will never happen again”

Question 133

intimate partner violence (IPV)

Answer 133

occurs between two people in a close relationship and includes physical violence, sexual violence, stalking, and psychological aggression (e.g., humiliation, coercive control)

Question 134

prevention and intervention of IVP

Answer 134

arrest of the offender, mandated treatment for the offender, and support for the victim is more effective than arrest of the offender alone

Question 135

outcomes of Eysenck (1952)

Answer 135

44% showed improvement with psychodynamic, 66% for ECT, while 72% with no therapy;
concluded that the effectiveness of psychotherapy does not have scientific support;
lots of problems with his methods tho

Question 136

outcomes of Smith, Glass, and Miller (1977, 1980)

Answer 136

first to use meta-analysis
the average therapy client was “better off” than 80% of patients in the no-treatment control group;
psychotherapy can reduce medical costs

Question 137

dose effect model

Answer 137

predictable relationship between number of therapy sessions and probability of improvement:
50% of psychotherapy clients show improvement by the 6th to 8th therapy session;
75% by the 26th session;
85% after a little over a year

Question 138

Howard et al. phase model

Answer 138

1) remoralization: occurs during the first few sessions and involves a decrease in feelings of hopelessness
2) remediation: symptom relief and, depending on the initial severity of symptoms, requires up to 16 additional sessions
3) rehabilitation: occurs in subsequent sessions and involves a gradual improvement in long-standing maladaptive behavior patterns

Question 139

4 common factors of therapy

Answer 139

1) extratherapeutic: client characteristics that include severity of symptoms, motivation, psychological mindedness, resilience, and sources of support (40%)
2) relationship: therapist’s empathy, warmth, and acceptance (30%)
3) expectancy: “placebo effect”, client’s positive expectations about the effects of treatment (15%)
4) techniques: theories and strategies that are unique to specific treatments (15%)

Question 140

efficacy research

Answer 140

randomized clinical trials - controls as many aspects of treatment as possible;
maximizes internal but limits external validity

Question 141

effectiveness research

Answer 141

conducted in the “real world” and does not permit as much experimental control;
good external but lower internal validity

Question 142

triangular model of supervision

Answer 142

integrates the supervisory relationship and organizational policies while emphasizing service delivery to clients

Question 143

Sue et al. (1991) outpatient vs. inpatient outcomes

Answer 143

when compared to White individuals, Asian American and Mexican American individuals were underrepresented in outpatient relative to their proportions inpatient, while African American individuals were overrepresented;
African American clients generally had less positive outcomes than White, Asian American, and Mexican American clients and were more likely to terminate treatment prematurely

Question 144

SAMHSA (2015) outcomes

Answer 144

outpatient mental health services use was highest for White individuals, American Indian/Alaskan Native, African American, Hispanic American, and Asian American individuals;
annual percentage of inpatient mental health services use was highest for American Indian/Alaskan Native individuals, African American, Hispanic American, White, and Asian American individuals

Question 145

client-therapist matching outcomes

Answer 145

racial/ethnic matching of clients and therapists had a greater impact on the favorability of a client’s perceptions of their therapist than on therapy outcome and reduces the risk of premature termination;
therapist’s cultural competence, compassion, and similarity to clients in terms of worldview have a greater impact than racial/ethnic matching on therapy outcomes

Question 146

psychasthenia

Answer 146

was a psychological disorder characterized by phobias, obsessions, compulsions, or excessive anxiety

Question 147

MMPI-2 validity scales

Answer 147

? (Cannot Say): # of unanswered or double-marked items
L (Lie): lack of insight or has attempted to present self in a favorable light
F (Infrequency): malingering, significant pathology, an attempt to “fake bad,” or responding to all items as either T or F
K (Correction): defensiveness or denial, an attempt to “fake good,” or responding “F” to all items
VRIN (Variable Response Inconsistency) and TRIN (True Response Inconsistency): assess response inconsistency, invalid profile
Fp (Infrequency/Psychopathology): “fake bad” even if the examinee is a psychiatric patient
Fb (F Back): responded to items toward the end of the test in a deviant way
S (Superlative Self-Presentation): defensiveness, attempt to “look good”

Question 148

NEO Personality Inventory-3 (NEO-PI-3)

Answer 148

measures the Big Five personality traits and the 6 facets that define each trait

Question 149

Myers-Briggs Type Indicator (MBTI)

Answer 149

based on Jung’s personality typology and provides information on 4 bipolar dimensions: introversion-extraversion, sensing-intuitive, thinking-feeling, and judging-perceiving

Question 150

Thematic Apperception Test (TAT)

Answer 150

identifying each story’s “hero”, includes:
needs (internal determinants of the hero’s behavior),
press (external determinants of the hero’s behavior),
thema (the interaction between needs and press),
outcomes

Question 151

Strong-Campbell Interest Inventory

Answer 151

examinees respond to items that address preferences for occupations, school subjects, activities, people, and characteristics using a five-point scale that ranges from “strongly dislike” to “strongly like”

Question 152

Kuder Occupational Interest Survey

Answer 152

100 items that require examinees to choose their most and least preferred activities from 3 activities

Question 153

Halstead-Reitan Neuropsychological Battery

Answer 153

assess the neurological functioning of individuals ages 15 and older;
separate tests of lateral dominance, psychomotor functions, sensory-perceptual functions, speech and language, visual-spatial skills, abstract reasoning, mental flexibility, and attention and concentration;
0 to 1.0 - score of 0 to 0.2 suggests normal functioning

Question 154

The Luria-Nebraska Neuropsychological Battery

Answer 154

scores on 11 scales that measure specific functions (motor, rhythm, tactile, visual, receptive speech, expressive speech, writing, reading, arithmetic, memory, and intellectual processes) and on scales that are used to help localize brain dysfunction

Question 155

poor performance on WCST linked to

Answer 155

autism, schizophrenia, depression, alcoholism, and malingering

Question 156

poor performance on the Stroop linked to

Answer 156

depression, mania, ADHD, and schizophrenia

Question 157

Tower of London

Answer 157

a measure of higher-order executive functioning and working memory;
poor performance associated with frontal lobe damage, ADHD, autism, and depression

Question 158

Rancho Los Amigos Scale of Cognitive Functioning

Answer 158

method for tracking improvements in cognitive functioning following a head injury

Question 159

Gestalt therapy goals

Answer 159

awareness of the self in the here-and-now is viewed as the “curative factor”;
help the client achieve self-awareness and assume responsibility;
making “I” statements, dream work, the empty chair technique = focus on now

Question 160

choice theory

Answer 160

the choices people make determine the quality of their lives and are the means for both creating and resolving problems

Question 161

success identity

Answer 161

person chooses to fulfill needs responsibly (i.e., in effective and realistic ways that do not infringe upon the rights of others)

Question 162

failure identity

Answer 162

person chooses to meet needs in an irresponsible manner

Question 163

stages of reality therapy

Answer 163

1) W: clients identify wants, needs, and perceptions
2) D: clients identify what they are currently doing and clarify the future direction of their lives
3) E: clients engage in critical self-evaluation to determine the effectiveness of their current behaviors for fulfilling their current and future needs
4) P: clients develop positive plans for improvement and commit to change

Question 164

adaptive schemas

Answer 164

facilitate efficient information processing and realistic evaluations of events

Question 165

schemas

Answer 165

enduring core beliefs that organize categories of information in a meaningful way to determine relationships among them, thereby how they are perceived and conceptualized

Question 166

automatic thought

Answer 166

spontaneous thoughts that arise in response to events and that the person may not be fully aware of;
may lead to dysfunctional emotional and behavioral responses when they are based on maladaptive schemas

Question 167

automatic thoughts and depression

Answer 167

thoughts take the form of a negative cognitive triad: negative thoughts about oneself, the world, and the future

Question 168

CBT therapy goals

Answer 168

help the client identify and replace maladaptive cognitive patterns;
test the client’s thoughts and beliefs

Question 169

irrational beliefs

Answer 169

beliefs that elicit emotions and behaviors that interfere with a person’s goals

Question 170

Double-bind communication

Answer 170

contradiction between report and command levels;
when a person receives contradictory messages from another person and cannot comment on the contradiction

Question 171

ecomap

Answer 171

examine interactions between a family and its environment

Question 172

according to Beck, suicide risk is heightened by

Answer 172

combination of hopelessness and poor problem-solving skills

Question 173

techniques of Bowenian therapy

Answer 173

1) Genograms: initial assessment tool and also to help family members gain understanding of family processes
2) Process Questions: Process questions (e.g., “How do you react to your husband when he criticizes you?”) are used to help family members see how they might contribute to problems and how other members perceive specific situations
3) Relationship Experiments: homework assignments that are designed to help family members practice relating to other members from a more differentiated position

Question 174

3 overlapping stages of structural family therapy

Answer 174

1) joining with the family: building rapport and “blending” with the family by using mimesis (adopting the family’s language, affective range, and behavioral style) and tracking (using the content of family communications to demonstrate interest and understanding)
2) formulation: identifying the family’s dysfunctional repetitive patterns through observation of the family’s interactions and construction of a family map that illustrates the family’s structure
3) restructuring: use of various techniques to alter the family’s repetitive interactions

Question 175

communication and power in strategic family therapy

Answer 175

communication is used to express power;
power: person’s ability to influence and control relationships with others;
power usually determined in families by hierarchies

Question 176

characteristics of systemic family therapy distinguish it from other approaches

Answer 176

(a) provided by a team of 4 therapists, with 1 or 2 therapists meeting with family members and the other therapists observing sessions from behind a one-way mirror
(b) sessions are divided into 5 parts: pre-session team discussion, interview session with the family, discussion of the interview by team members, conclusion of the interview with a task given to the family, and a post-session team discussion of the family’s reaction to the task and formulation of a plan for the next session
(c) once a month for about 10 sessions

Question 177

operant interpersonal therapy

Answer 177

successful and unsuccessful marriages are distinguished by differences in reciprocal positive reinforcement;
uses contingency contracts to increase the number and range of positive reinforcements exchanged by the partners
use reciprocal reinforcement or “quid pro quo”

Question 178

transtheoretical model’s 3 factors that affect a person’s motivation to change

Answer 178

1) decisional balance: person’s beliefs about the pros and cons of changing - important during contemplation stage
2) self-efficacy: level of confidence about being able to change - lowest during early stages of change
3) temptation: intensity of the urge to engage in the behavior - lowest during the later stages of change

Question 179

Selection and Preparation of Group Members

Answer 179

1) group composition: homogeneous vs. heterogenous
2) entry to group: open vs. closed
3) group size: ideal is 7-10
4) inclusion & exclusion criteria
5) premature termination: 30-40% in first few sessions so use prescreening
6) concurrent participation in group therapy and individual therapy

Question 180

best candidate for group therapy

Answer 180

a “highly motivated, active, psychologically minded and self-reflective individual who seizes opportunities for self-disclosure within the group”

Question 181

characteristics associated with early dropout of group therapy

Answer 181

low psychological mindedness, a high degree of defensiveness and denial

Question 182

advantages of co-therapists in group therapy

Answer 182

provide members with a model of a healthy adult relationship, broaden opportunities for transference reactions, allow for a greater observational range

Question 183

disadvantages of co-therapists in group thrapy

Answer 183

co-therapists may be uncomfortable with each other, may differ substantially in terms of style, strategies, or opinions

Question 184

important factors in group therapy (Yalom)

Answer 184

interpersonal learning, catharsis, and cohesiveness***

Question 185

feminist theory empowerment

Answer 185

helping women become more self-defining and self-determining

Question 186

feminist theory transformation

Answer 186

working toward “creating a society in which relationships are interdependent, cooperative and mutually supportive”

Question 187

culturally sensitive counselor

Answer 187

recognizes that culture may play a role in a client’s presenting problems and response to treatment;
has the knowledge and skills needed to work effectively with members of different cultural groups

Question 188

functional cultural paranoia

Answer 188

pathological condition that is characterized by pervasive distrust and suspiciousness of all, regardless

Question 189

prevention

Answer 189

reducing the incidence and/or duration of mental disorders

Question 190

best predictor of risk for a future suicide attempt

Answer 190

a past suicide attempt;
50% who commit suicide have made at least 1 previous attempt;
greater the number of past attempts, the greater the risk

Question 191

age and suicide

Answer 191

suicide rates tend to increase with increasing age;
in recent years, rates for individuals in younger age groups have exceeded those for older age groups

Question 192

race/ethnicity for suicide

Answer 192

whites;
in 2013, American Indians/Alaskan Natives ages 15 through 34 had the highest rates

Question 193

marital status and suicide

Answer 193

highest to lowest risk: divorced individuals, widowed, single, married;
the more recent the divorce, the greater the risk

Question 194

child maltreatment perpetrator characteristics

Answer 194

biological parent(s) followed by, in order, nonbiological parents, parents’ partners, other relatives, and other unrelated adults;
more likely to be women than men;
depression, low SES, marital discord, poor parenting skills

Question 195

evidence-based treatments (EBTs)

Answer 195

integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences

Question 196

projective hypothesis

Answer 196

person’s responses to ambiguous stimuli provide information about their personality, needs, feelings, etc

Question 197

interest inventories

Answer 197

self-report measures that assess an examinee’s preferences with regard to activities and occupations

Question 198

Mini-Mental State Exam (MMSE)

Answer 198

screening tool for cognitive functioning for older adults;
11 questions that assess 6 aspects of functioning: orientation, registration, attention and calculation, recall, language, and visual construction;
most useful for screening for Dementia in older adults

Question 199

Glasgow Coma Scale

Answer 199

assesses level of consciousness following acute brain injury and entails rating an individual on their best response in 3 categories: eye opening, motor response, and verbal response

Question 200

psychiatric disorders among immigrants and refugees

Answer 200

most frequent somewhere between the end of the 1st year through the 3rd year after they immigrate to this country

Question 201

social displacement syndrome

Answer 201

tendency of immigrants to initially experience elation and optimism, followed by a period of frustration, depression, and confusion as the reality of the adjustments required by their new lives sets in

Question 202

core schemas

Answer 202

basic assumptions about oneself and the world

Question 203

psychological phenomena involved in schemas

Answer 203

memory, affect, motivation;
other functions related to perception and information processing

Question 204

psychotherapy research outcomes

Answer 204

therapy is generally effective for children and adults of all backgrounds;
with the exception of certain specific problem areas, all therapies are about equal

Question 205

strongest bond in Hispanic-American families

Answer 205

parent and child, especially the mother-son and father-son relationships

Question 206

crisis theory

Answer 206

people in crisis tend to follow a predictable sequence of responses;
help individuals in crisis learn more effective coping so that they can respond more adaptively when having similar experiences in the future;
views symptoms as expected responses to acute trauma and seeks to return the person to the pre-trauma level of functioning;
emphasize the cognitive and behavioral elements of a crisis
6-8 sessions b/c that’s how long many crises last

Question 207

prevalence of mental disorders in people 65 and older

Answer 207

lower than any other age group;
only cognitive impairment shows a definite age-associated increase in incidence

Question 208

efficacy of biofeedback for pain reduction

Answer 208

as effective as treatments such as relaxation training

Question 209

conversion V pattern (MMPI)

Answer 209

scores on Scale 1 (Hypochondriasis) and Scale 3 (Hysteria) are 65 or higher and at least eight points higher than the Scale 2 (Depression) score;
suggests somatization of psychological problems, a lack of insight, or chronic pain that has an organic basis

Question 210

psychotic V pattern (MMPI)

Answer 210

scores on Scales 6 (Paranoia) and 8 (Schizophrenia) are 65 or higher and at least eight points higher than the Scale 7 (Psychasthenia) score;
suggests the presence of delusions, hallucinations, and disordered thought

Question 211

secondary gain (psychodynamic approach)

Answer 211

benefit a person obtains from an experience in connection with a mental health or physical problem (e.g., concern from family and friends) that reinforces the problem

Question 212

Depression and Anxiety (Beck)

Answer 212

1) in depression, cognitions about hopelessness, low self-esteem, and failure are more common; in anxiety, cognitive themes are usually related to anticipated harm or danger
2) depressed patients are more likely to have absolute thoughts about negative themes, while anxious individuals tend to have questioning thoughts about the uncertainty of future events

Question 213

core principles of feminist therapy

Answer 213

1) belief that “the personal is political”: client’s problems can be traced to societal and political factors
2) commitment to social change: interested in advancing social change as well as change in individual clients
3) need to value and honor the perspective of women and girls: replace “patriarchal ‘objective truth’ with feminist consciousness, which acknowledges a diversity of ways of knowing”
4) view of the therapeutic relationship as egalitarian: feminist therapists recognize the inherent inequality of the therapeutic relationship, strive to provide a collaborative egalitarian relationship (self-disclosing when appropriate, viewing clients as the experts regarding their own circumstances and concerns)
5) reformulation of traditional views of psychological distress: “communication about unjust systems”, reframed as survival mechanisms
6) recognition of all forms of oppression: challenge other forms of oppression (race/ethnicity, physical abilities, sexual orientation, religious beliefs, class)

Question 214

two major roles of a group therapist

Answer 214

1) help keep the group focused on the here-and-now
2) help illuminate process

Question 215

self-reflective loop

Answer 215

group stays focused on the here-and-now but also pauses to examine here-and-now events that just occurred

Question 216

research on the results of sex therapy

Answer 216

vaginismus and erectile dysfunction is highly effective in the short- and long-term (1 to 6 years);
premature ejaculation suggest short-term success but less permanent results;
low sexual desire in men has poor short- and long-term results;
low sexual desire in women has poor long-term results

Question 217

Hofstede’s 5 cultural dimensions

Answer 217

power distance, uncertainty avoidance, individualism, masculinity, and long-term orientation;
US scores high on individualism, low on power distance, moderate to high on masculinity, and moderate scores on uncertainty avoidance

Question 218

phenomenological approach

Answer 218

study of subjective experiences;
attempts to explain experiences from the point of view of the subject via the analysis of their written or spoken words;
basis of person-centered psychotherapy by Carl Rogers

Question 219

Stress-Buffering Hypothesis

Answer 219

a high level of perceived social support can protect a person against the harmful effects of stress on their physical and psychological health

Question 220

multicultural competence

Answer 220

most often attributed to one’s level of awareness, knowledge, and skills

Question 221

NIMH’s TDCRP research project

Answer 221

no differences in outcome were observed between cognitive therapy and antidepressant medication among all patients;
cognitive therapy and antidepressant medication are about equally effective in the treatment of depression;
antidepressants are superior to cognitive therapy in severely depressed patients

Question 222

widely used treatment for MDD

Answer 222

antidepressant medication

Question 223

Heinz Kohut

Answer 223

when a young child’s natural self-love (narcissism) is undermined by a parent’s inevitable failure to satisfy all of the child’s needs, the child develops a protective grandiose self;
the grandiose self is ordinarily modified during childhood through maturation and normal interactions with parents;
however, if a parent consistently responds to the child in very unempathic ways, normal development is thwarted

Question 224

sexual orientation disclosure by lesbians

Answer 224

associated with positive outcomes such as a lower level of anxiety, a lower likelihood of engaging in anonymous socializing (i.e., going to bars) and greater family support following disclosure to family members

Question 225

primary procedures of analysis in psychoanalysis

Answer 225

1) confrontation: making statements that help clients view their own behaviors in a new way
2) clarification: bring the client’s behavior into sharper focus and involves asking questions and making observations
3) interpretation: explicitly linking the client’s conscious behavior to unconscious processes
* repeated interpretations lead to catharsis (emotional release that results from the recall of repressed material) and insight (understanding of the connection between current behavior and unconscious material)
4) working through: slow, gradual process that involves testing, accepting, and assimilating new insights

Question 226

Beck Depression Inventory

Answer 226

21 items assess the intensity of mood, behavioral, cognitive, and physical signs of depression;
0 to 13: minimal depression;
14 to 19: mild depression;
20 to 28: moderate depression
29 to 63: severe depression

Question 227

parallel process

Answer 227

phenomenon in clinical supervision where the therapist in training behaves toward the supervising therapist in ways that mirror how the client is behaving toward the therapist in training

Question 228

elaborative rehearsal

Answer 228

thinking about how new information relates to existing memory

Question 229

pros of countertransference

Answer 229

a therapist’s analysis of his or her own countertransference reactions can help the therapist recognize subtle aspects of the transference relationship and better understand the patient’s experience

Question 230

brief psychodynamically-oriented therapy

Answer 230

positive transferences are encouraged and are viewed as essential to treatment progress;
full-scale transference neurosis is discouraged

Question 231

categories of the Rorschach

Answer 231

1) location: areas of the inkblot the examinee used to derive their response (whole inkblot, common or uncommon detail, white space)
2) determinants: characteristics of the inkblot that determined the examinee’s response (form, color, texture/shading)
3) content: the objects perceived by the examinee (e.g., people, animals, food, nature)
4) popularity: extent to which the examinee’s response is frequently given by examinees or is unusual
5) form quality: degree of similarity between the examinee’s response and the shape of the inkblot

Question 232

Rorschach interpretation

Answer 232

large number of “whole” responses suggests a high degree of abstract thinking and creativity;
large number of popular responses suggests a tendency to conform to other people while a low number may suggest rebelliousness;
extensive confabulation (focusing on and generalizing a single detail to the entire inkblot) may indicate brain injury

Question 233

depressogenic schemata

Answer 233

cognitive distortions

Question 234

Counseling Native American Clients

Answer 234

non-directive, history-oriented, accepting, and cooperative approach;
therapists should be reserved, open, accepting, and willing to listen

Question 235

Network Therapy

Answer 235

recommended as an appropriate intervention for Native American clients;
therapist acts primarily as a catalyst who initiates the process and brings the client’s family, friends, and relatives (i.e. the client’s network) together to implement the therapeutic process

Question 236

worldview of minority groups

Answer 236

internal locus of control, external locus of responsibility

Question 237

diagnostic overshadowing

Answer 237

when a therapist’s ability to recognize or consider other symptoms or conditions is “overshadowed” by one aspect of a client’s symptoms or condition

Question 238

CBT and DID

Answer 238

need to develop a strong therapeutic alliance in the initial stages of therapy

Question 239

one potential complication of concurrent individual and group psychotherapy

Answer 239

clients may hold off on responding to what occurs in group therapy because they prefer to wait for the relative safety of individual sessions;
“the client may interact like a sponge in the group, taking in feedback and carrying it away to gnaw on like a bone in the safe respite of the individual therapy hour”

Question 240

research on client-therapist racial matching

Answer 240

doesn’t have a significant impact on therapy outcome;
for African-American clients, cultural mistrust or suspiciousness of Caucasians is negatively correlated with therapeutic effectiveness;
Caucasian therapists’ own racial identity development is moderately correlated with their multicultural counseling skills

Question 241

Assimilative Integration

Answer 241

therapist has a commitment to one theoretical approach but also is willing to use techniques from other therapeutic approaches

Question 242

Theoretical Integration

Answer 242

integrating concepts from different theoretical approaches (e.g. behavioral and psychoanalytic);
most difficult level to achieve integration as the basic philosophy in each theory may differ

Question 243

Technical Eclecticism

Answer 243

a therapist, rather than adhering to a small number of therapeutic approaches, selects techniques from a wide variety of different therapies depending on what is needed

Question 244

Vivienne Cass process of homosexual identity development

Answer 244

1) identity awareness: conscious of being different
2) identity comparison: believes may be homosexual, acts heterosexual
3) identity tolerance: realizes is homosexual
4) identity acceptance: begins to explore gay community
5) identity pride: becomes active in gay community
6) synthesis: fully accepts self and others

Question 245

cognitive disintegration

Answer 245

the tendency to become disorganized under emotional stress or a decreased ability to tolerate stress leading to anxiety-induced decompensation

Question 246

baseline exaggeration

Answer 246

challenging behavior that exists at a low rate and low intensity may increase dramatically when one has stress or a mental health condition

Question 247

collateral family system or organization

Answer 247

the extended family (e.g., cousins, aunts, uncles, adult siblings) is emphasized and where extended family members rely on each other for support;
more common in non-dominant subcultures, such as African-American, American Indian, and Asian-American, than it is in the dominant culture

Question 248

mimesis

Answer 248

adopting a family’s communication and affective style;
one way of joining the family system

Question 249

autoplastic adaptation

Answer 249

changing or adapting to the environment by altering one’s own behaviors or responses

Question 250

alloplastic adaptation

Answer 250

changing or adapting to the environment by effecting changes in the environment

Question 251

Transactional Analysis (TA)

Answer 251

model of people and relationships that is based on two notions:
1) we have functional ‘ego-states’ to our personality
2) these parts converse with one another in ‘transactions’

Question 252

collaborative empiricism

Answer 252

central technique of Beck’s CBT;
refers to the therapist and client working together to gather evidence and test the logic, or hypotheses, of the client’s thoughts and beliefs

Question 253

reframing

Answer 253

relabeling a behavior to make it more amenable to therapeutic change

Question 254

violence against gays and lesbians (Gregory Herek)

Answer 254

attributable to a combination of psychological (individual) and cultural heterosexism

Question 255

heterosexism

Answer 255

ideological system that denies, denigrates, and stigmatizes among nonheterosexual forms of behavior, identity, relationships, or community

Question 256

interventions to increase compliance with hand hygiene practices

Answer 256

no single intervention has consistently improved handwashing frequency in healthcare workers;
most effective approach is a multifaceted one that includes education, written material, reminders, and continued feedback of performance

Question 257

sexual prejudice (Gregory Herek)

Answer 257

all negative attitudes based on sexual orientation, whether the target is homosexual, bisexual, or heterosexual;
more appropriate term than “homophobia” - which refers to heterosexuals’ dread of being in close quarters with homosexuals and homosexuals’ self-loathing

Question 258

defense mechanisms

Answer 258

conflicts take place in the unconscious and create anxiety, which signals to the ego that a conflict must be resolved;
when the ego is unable to do so using realistic, rational means, it employs one of its defense mechanisms, which operate at an unconscious level and deny or distort reality

Question 259

targets of analysis in psychoanalysis

Answer 259

1) free associations: asking the client to say whatever comes to mind without censure to help lower a client’s defenses and bring unconscious thoughts and feelings into conscious awareness
2) resistance: when the client is unwilling or unable to address threatening, anxiety-arousing issues
3) dreams: dreams contain symbols that provide important information about unconscious impulses which the therapist interprets the true meaning (latent content) of these symbols
4) transference

Question 260

3 types of communications, or transactions, between the three ego states

Answer 260

1) complementary transactions: can occur among any combination of ego states and involve the original communication being met with an appropriate response
2) crossed transactions: involve the original communication eliciting a response from an inappropriate ego state
3) ulterior transactions: involve confusion b/c one of the communicators is giving a dual message - the communication can be coming from one of two different ego states

Question 261

manual-guided treatments

Answer 261

detail the theoretical underpinnings of a treatment, the treatment goals, and specific therapeutic strategies and guidelines;
initially developed to standardize treatments so that their effects could be empirically evaluated and provide guidelines for training therapists

Question 262

Consumer Report’s 1995 study

Answer 262

failed to find a relationship between therapist level of training and outcome

Question 263

ethnic minority clients with a strong affiliation with their own culture

Answer 263

tend to prefer ethnically similar counselors;
some research shows that outcomes for such clients is better when the counselor is ethnically similar

Question 264

empirical criterion keying

Answer 264

items are assessed to determine how well they distinguish between prespecified criterion groups (e.g., between depressed and non-depressed individuals);
items that best distinguish between the groups are maintained for the final version of the scale or the test

Question 265

humanistic school of psychotherapy

Answer 265

person-centered therapy, Gestalt therapy, and transactional analysis;
emphasizes human capacities and potentialities rather than deficiencies;
we have a natural tendency toward self-actualization or personal growth;
neurosis or pathology occurs due to defensive distortions (e.g., blocks to awareness in Gestalt therapy, conditions of worth in person-centered therapy) that prevent this natural tendency from operating

Question 266

the fourth force in psychology

Answer 266

multiculturalism;
one which complements the behavioral, psychodynamic and humanistic explanations of human behavior

Question 267

multiculturalism

Answer 267

Pedersen (1991): “a wide range of multiple groups without grading, comparing, or ranking them as better or worse than one another and without denying the very distinct and complementary or even contradictory perspectives that each group brings with it”;
others advocate attention to the racial/ethnic minority groups within a culture

Question 268

displacement (psychoanalytic)

Answer 268

person redirects sexual or aggressive impulses away from a dangerous or threatening target to a safer target or outlet

Question 269

projection (psychoanalytic)

Answer 269

involves attributing one’s own unacceptable impulses or emotion to someone else

Question 270

reaction formation

Answer 270

person converts an unacceptable wish or impulse to its opposite;
clergyman preaching rabidly against sexual immorality while strongly desiring or engaging in the very behavior he criticizes

Question 271

sublimation

Answer 271

person rechannels socially unacceptable impulses into socially useful activity, such as art or work;
considered the healthiest and most successful defense mechanism

Question 272

tracking

Answer 272

identifying with the family’s values and history;
one way of joining the family system

Question 273

blocking (structural family therapy)

Answer 273

blocking the family from engaging in its normal way of functioning so that it is forced to adopt new interactional patterns

Question 274

George Kelly

Answer 274

perhaps the first cognitive theorist;
“psychology of personal constructs”;
a construct (synonymous with a schema), is a cognitive template through which the world is interpreted

Question 275

determinism

Answer 275

in a situation in which a person makes a certain decision or performs a certain action, it is impossible that he or she could have made any other decision or performed any other action

Question 276

CBT and severe depression

Answer 276

the first goal in therapy is to increase activity level through the use of behavioral tasks;
once active, cognitive procedures are used to identify and modify cognitive distortions

Question 277

undoing

Answer 277

ego defense mechanism in which a person relieves anxiety over a behavior by attempting to make up for it in other areas

Question 278

Feminist Object Relations Theory

Answer 278

relationship between mother and child and how gender differences result from the mother being the primary caretaker;
the division of labor which occurs in families (although less so in recent years), is characterized by women being more involved in affective, interpersonal relationships than men;
this is inevitably passed on to both boys and girls who ‘reproduce’ this sexual and familial division of labor

Question 279

psychodrama

Answer 279

type of group therapy which provides members an opportunity to play roles in a spontaneous performance of their issues and practice new, more effective behaviors and roles

Question 280

CBT and panic disorder

Answer 280

connected to “catastrophic misinterpretations” of bodily sensations, symptoms, and mentation;
the client’s “overcastrophization” of early signs of the attack such as hyperventilation results in a full-blown attack;
thus, at least initially, therapy focuses on identifying and modifying the client’s misinterpretations of symptoms and thoughts immediately before and during the attack

Question 281

Social-Role theorists

Answer 281

individuals in positions of lower power and status are better at reading/perceiving members of higher status groups than are those from higher status groups at reading people from lower status groups

Question 282

somatic therapy

Answer 282

types of treatment involving manipulations of the body;
3 main types:
psychopharmacological or drug therapy (most common);
ECT: administering a muscle relaxant and anesthetizing a patient before passing an electric current through the non-dominant brain hemisphere;
psychosurgery (most extreme form of somatic therapy)

Question 283

Lazarus cognitive appraisal theory

Answer 283

the emotional reaction to a situation follows a cognitive assessment of the situation;
three types of appraisal:
1) primary: one’s perception of the situation (i.e., positive, negative, or irrelevant)
2) secondary: assessment of resources available to deal with the situation
3) re-appraisal: watching the situation and changing the other types of appraisals as necessary

Question 284

Logotherapy

Answer 284

form of existential therapy developed by Victor Frankl that postulates a will to meaning

Question 285

psychoanalytic theory and mania

Answer 285

occurs as a defense against depression, due to an inability of the person to tolerate or admit to being depressed

Question 286

emotional reasoning

Answer 286

cognitive distortion that refers to a person believing that because he or she feels a negative emotion, there must be a corresponding negative external situation

Question 287

best practices

Answer 287

approaches to counseling practice that have empirical evidence to support their effectiveness

Question 288

The Symptom Checklist 90-Revised (SCL-90-R)

Answer 288

90-item self-report inventory that is designed to assess general psychiatric symptoms of anxiety, depression, somatization, obsessive-compulsiveness, and hostility on a Likert scale for individuals 13 and older

Question 289

projective identification

Answer 289

defense mechanism in which one or more parts of the self are falsely attributed to another, which are then unconsciously accepted by the recipient, and the projector then identifies with the projected part in the other

Question 290

tacrine hydrochloride (Cognex) and donepezil hydrochloride (Aricept)

Answer 290

have beneficial effects on memory and reasoning for some patients with mild to moderate Alzheimer’s Dementia;
hypothesized that these drugs prevent the breakdown of ACh and thus increase the availability in the brain;
not considered a cure

Question 291

therapy outcomes with children and adolescents

Answer 291

across treatment approaches, girls respond better than boys, with adolescent girls responding best of all;
this is somewhat contradictory to earlier research, which found that younger children respond better than older children

Question 292

structured learning therapy (SLT)

Answer 292

incorporates “social skills training,” an early approach to the treatment of depression, along with modeling, role-playing, skill instruction, and performance appraisal

Question 293

paralanguage

Answer 293

refers to vocal cues, other than words or language, individuals use to communicate meaning

Question 294

dynamic assessment

Answer 294

variety of procedures involving departure from standardized test administration to obtain additional information about an examinee;
done after the test has been administered using standardized procedures;
used in the assessment of individuals with learning disabilities or mental retardation

Question 295

“testing the limits”

Answer 295

providing cues to see how many are needed to generate successful performance;
the more cues required, the more severe the learning disability

Question 296

conditions of worth

Answer 296

Roger’s person-centered;
mother provides affection and approval only when child behaves in certain ways