clinical flashcards
1
Q
What is the most effective treatment for smoking cessation?
A
Nicotine replacement therapy AND Behavioral intervention
2
Q
What clinical test was developed on the basis of empirical
criterion keying? What is empirical criterion keying?
A
MMPI-2; Empirical criterion keying is a method of choosing
items for a test on the basis of the items ability to distinguish
between groups (i.e., depressed vs. nondepressed)
3
Q
Diagnostic Overshadowing
A
Therapist tendency to attribute all of pt’s problems to
diagnosis
4
Q
What is the greatest risk factor for childhood depression?
A
Parental depression
5
Q
Directed Awareness
A
From Perls, the technique emphasizing increasing the client’s
awareness of psychological needs, feelings, and physical
processes. Awareness in and of itself is therapeutic
6
Q
Health Belief Model
A
Health s are influenced by: 1. Readiness to take action =
perceived susceptibility to the illness & perceived severity of
the consequences; 2. Evaluation of costs and benefits of
making a response; 3. Internal & external cues to action that
trigger response
7
Q
Double-Bind Communication
A
Communication characterized by contradictory aspects of the
same message; e.g., a contradiction between verbal
communication and body language.
8
Q
What is the most effective way for the police to deal with
domestic violence?
A
Arresting the perpetrator results in the lowest rate of
recidivism
9
Q
4 stages of Homosexual Identity Development Model
(Troiden
A
4 Stages: 1. Sensitization 2. Identity Confusion 3. Identity
Assumption 4. Identity Commitment
10
Q
Relationship of psychology to cancer onset and recovery
A
Unrelated to onset but positively related to recovery and
quality of life
11
Q
Effects of Psychotherapy Stages (Howard et al)
A
- Remoralization 2. Remediation 3. Rehabilitation
12
Q
Dose Dependent Effect (Howard et al)
A
26 sessions = 75% show improvement 52 sessions = 85%
13
Q
Dose Dependent Effect (Howard et al
A
26 sessions = 75% show improvement 52 sessions = 85%
14
Q
Stages of change
A
1.) Precontemplation - no change considered; 2.)
Contemplation - aware of need but not committed; 3.)
Preparation - clear intent to take action; 4.) Action
Maintenance
15
Q
Dose Dependent Effect (Howard et al)
A
26 sessions = 75% show improvement 52 sessions = 85%
16
Q
Stages of change
A
1.) Precontemplation - no change considered; 2.)
Contemplation - aware of need but not committed; 3.)
Preparation - clear intent to take action; 4.) Action
Maintenance
17
Q
CBT approach to panic disorder
A
Identifying and modifying interpretation of attacks and
associated physical symptoms
18
Q
Relationship between therapy and outcome
A
Moderate overall, but stronger when the symptoms are
severe
19
Q
White Racial Identity Development Model (Helms)
A
6 Stages: 1. Contact 2. Disintegration 3. Reintegration 4.
Pseudo-independence 5. Immersion-Emersion 6. Autonomy
20
Q
Sexual Prejudice & Heterosexism (Herek
A
Sometimes referred to as the “third force,” humanistic
schools of psychology emphasize the individual’s inherent
capacity for growth, creativity, and self-actualization. The
focus is usually on the person’s here-and-now state.
21
Q
Parallel Process
A
Parallel process is a 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.
22
Q
Use: CPI (California Psychological Inventory
A
Broad personality test for non-pathologic individual
23
Q
reaction formation
A
Defense in which an anxiety provoking impulse is replaced
by its opposite. Ex: hatred by oversolicitude. Typical of
obsessive disorders
24
Q
In the symmetrical pattern of communication
A
there is equality between the two parties (which can result in
competition and conflict
25
Existential Therapy
Struggle between individual and "ultimate concerns" of
existence (death, meaninglessness, etc.) Two types of
anxiety: normal (existential) anxiety and neurotic anxiety
26
Primary Prevention
Interventions, usually on a community-wide scale, aimed at
preventing disorders by reducing the incidence of new cases.
27
Projection
Defense attributing unacceptable wishes to another. Includes
prejudice and hypervigilance: the other person carries the
guilt
28
In the complimentary pattern of communication…
In the complimentary pattern of communication…
29
In the complimentary pattern of communication…
Interventions, usually on a community-wide scale, aimed at
preventing disorders by reducing the incidence of new cases.
30
Fixation
Defense: Return to an earlier stage of development under
stress
31
projective identification
efense: projection of unwanted aspects of self onto another
creating a sense of onenes
32
Transactional Analysis: Who, What, How
WHO = Eric Berne. WHAT = Ego States: child, parent,
adult. Interactions (transactions) are primarily between ego
states. Strokes: positive or negative recognition from others.
Scripts: person's life plan, characteristic pattern of giving and
receiving strokes. 4 Life Positions: 1) I'm OK - You're OK;
2) I'm OK - You're not OK, etc. All children begin in 1st life
position, then modified by parenting. Transactions:
Complementary, Crossed (adult:child), Ulterior (dual
message) Games: Ulterior transactions ("Now I've Got You,
You SOB"). HOW = Alter maladaptive life positions and life
scripts and integrate three ego states
33
According to psychotherapy outcome research, what
percentage of therapy clients shows measurable
improvement?
75%
34
The incidence of OCD is: A.) The same for males and
females across all ages. B.) About twice as common in males
than females. C.) Higher among boys but about equal among
adult males and females. D.) Higher among girls but about
equal among adult males and females.
C: Males: peak onset is between ages 6-15 Females: peak
onset is between 20-29.
35
A man is referred for psychotherapy by his physician after
ruling out sleep apnea and other medical conditions. The
patient reports having vivid frightening dreams, restless
sleep, chronic fatigue, and a history of alcohol abuse. His
diagnosis is likely: A.) Narcolepsy, B.) Insomnia, C.)
Alcohol-induced sleep disorder, D.) Persistent
alcohol-induced sleep disorder
C: Sleep can be disturbed as a result of both alcohol
intoxification and alcohol withdrawal. Initially, alcohol
produces a sedative effect with increased sleepiness.
However, after 3-4 hours of sleep, there is an increase in
wakefulness, restless sleep, and REM, often accompanied by
a vivid anxiety-laden dream for the remainder of the sleep
period. Primary insomnia is not due to the direct effects of a
substance and is not typically associated with vivid
frightening dreams. Choice D is not a DSM-IV diagnosis.
36
Although considered to be an effective treatment for severe
and treatment-resistant depression, ECT often produces
adverse side effects including: A.) temporary retrograde
amnesia B.) permanent retrograde amnesia C.) patchy
anterograde amnesia D.) patchy anterograde amnesia and
temporary retrograde amnesia
D: the anterograde amnesia can last up to 6 months and the
retrograde amnesia is usually limited to the events that
occurred several months prior to the ECT.
37
Research on Asians show the best predictor of higher
achievement is:
fear of failure
38
What do most psychotherapists report as the primary source
of stress from their work
lack of therapeutic success
39
According to Kohlberg's theory of moral development,
individuals who reach stage 5 base their moral judgments on:
A.) Empathy, B.) Autonomous morality, C.) Democratic
laws, D.) Universal ethical principles
C: Stage 5 begins the post-conventional level of moral devt.
A person in this stage seeks to uphold
democratically-determined laws, but recognizes that laws
can be ignored or changed for a valid reason. Choice D is
more characteristic of Stage 6 in Kohlberg's model in which
morality transcends legal standards. Choice B (Autonomous
morality) is used by Piaget denoting the stage when children
recognize that rules are determined by agreement and are
alterable
40
Kernberg's account of BPD
Results from failure to develop appropriate introjects as a
result of parental psychopathology or abuse. Characterized
by splitting, aggression and unstable self-image
41
Types of Self-Control Techniques
1.) Self-Monitoring = (minor and short-term effects) & 2.)
Stimulus Control = modifying existing S-R relationship, or
creating a new one; examples: narrowing, cue strengthening,
competing responses. Most useful when implemented at the
beginning of a response chain.
42
Research shows that new immigrants to the US are most
likely to experience symptoms of psychiatric disorders at
what point:
About one or two years after they arrive in the US (related to
the "social displacement syndrome")
43
Symmetrical vs. Complimentary Communication
Communication patterns can be characterized as either
symmetrical or complimentary. In symmetrical
communication there is equality between the partners,
however, this can result in competition and conflict. In the
complimentary communication pattern there is inequality,
with one partner taking a dominant role and the other a
subordinate role.
44
What are the 3 factors involved in Hypnotherapy?
Three factors involved: 1) absorption, 2) dissociation, 3)
suggestibility. Individuals have greater confidence in
memories retrieved under hypnosis, but memories are likely
to be distorted. Used for: dissociative disorders, PTSD, habit
or self control disorders (smoking, overeating, substance
use), phobias, and generalized anxiety. Contraindicated for:
psychotic disorders, paranoid and suspicious patients, OCD
traits. Also, severely depressed and manic patients are hard
to hypnotize. Few studies comparing with other treatments.
45
When is Biofeedback most successful?
Used for psychophysiological disorders (e.g., hypertension,
headaches, ulcers). For many problems, not much more
effective than relaxation training. However, it's the treatment
of choice for fecal incontinence and Raynaud's disease. EMG
biofeedback for tension headaches. Skin Temperature
biofeedback for migraines.
46
Tertiary Prevention
Elimination or amelioration of the residual disability after
the onset of the illness.
47
CBT techniques: Paradoxical Intention
Instructing clients to do or wish for the things they fear.
Prescribing the symptom. Purpose is to circumvent
anticipatory anxiety. Most commonly used to treat insomnia.
Results are mixed.
48
Therapy Outcome Studies
Research on the differences among various treatments for
specific disorders, and the interactive variables which predict
therapy success, such as the necessity for a working alliance,
therapist variables, patient variables, and the patient-therapy
interaction.
49
Weitz found in his research on therapy outcomes for children
& adolescents:
therapy is more beneficial for adolescents than children,
especially among girls
50
During an initial session with an adult client, you realize that
you are already treating her mother. The primary problem
with continuing to see this new client has to do with: A.)
Confidentiality, B.) Multiple relationships, C.) Conflict of
interest, D.) Countertransference
C: Conflict of interest. Multiple relationships refers to having
more than one type of relationship with the same person, for
example, if a psychologist were to see one of his current
students in psychotherapy.
51
Stages in Prochaska and DeClemente's Transtheoretical
Model of Change
1) Precontemplation: little insight of need for change 2)
Contemplation: considering change (in the next 6 months)
but not committed to it. 3) Preparation: clear intent to take
action within the next month; may have begun taking small
steps. 4) Action: considerable time and energy devoted to
change; obvious to others 5) Maintenance: change has lasted
6 months, person consolidating change and taking steps to
prevent relapse. May last as long as a lifetime.
52
A couple comes to therapy complaining that all their
conversations end in arguments. This is characteristic of
which pattern of communication? Symmetrical
Complimentary Pseudohostility Mystification
A: Symmetrical. Communication patterns can be
characterized as either symmetrical or complimentary. In
symmetrical comm. there is equality between the partners,
however, this can result in competition and conflict. In
complimentary comm. there is inequality and one partner
takes the dominant role and the other a subordinate role.
Pseudohostility presents as superficial bickering in order to
avoid real conflicts. In mystification, the person uses denial
to mask what is really going on
53
Biofeedback exerts its relaxing effect on which system
parasympathetic nervous system
54
Goal: Bowen's extended systems therapy
Differentiation of self
55
Motivational Interviewin
Miller and Rollnick Based on Prochaska and DeClemente's
Transtheoretical Model of Change Goal: help individuals
move from precontemplation stage through contemplation,
toward commitment to change. Five basic principles: express
empathy, develop discrepancy, avoid argumentation and
direct confrontation, roll with resistance, and support
self-efficacy for change.
56
A candidate for the psychology licensing exam wants to
maximize his long-term memory of all the study materials.
The most effective strategy would be to use: A.) Spaced
Practice, B.) Massed Practice, C.) Elaborative Rehearsal, D.)
Maintenance Rehearsal
C: Elaborative rehearsal, in which a person thinks about the
meaning of new information and its relation to information
already in memory, resulting in deeper learning and is
considered superior to all forms of mindless repetition.
Spaced practice is also generally more effective than massed
practice.
57
A high school student, interested in an acting career, is afraid
of disappointing his father who always wanted his son to
follow in his footsteps by becoming a doctor. After little
deliberation, the young man announces to his family that he
will become a doctor. According to Marcia, his decision is
an example of: A.) Identity diffusion, B.) Identity
foreclosure, C.) Identity moratorium, D.) Identity placation
B: Identity foreclosure: a commitment to an identity that is
not a result of an identity crisis, but rather, the suggestions of
a parent or another person is called identity foreclosure.
Identity diffusion describes young people who have not
undergone an identity crisis nor have committed to an
identity. Identity moratorium occurs when a person is
confused, having an identity crisis, and actively exploring
different options
58
From a humanistic perspective, pathology is due to
defenses that interfere with one's natural tendency toward
personal growth
59
Research on therapists who became sexually involved with
their clients showed that:
The therapist violated other boundaries before the sexual
involvement began.
60
A shortcoming of most curriculum-based suicide prevention
programs for adolescents is that: A.) They are based on a
stress model of suicide. B.) They are based on a mental
illness model of suicide. C.) They tend to stigmatize suicide.
D.) They minimize the extent of the problem.
A: Most curriculum-based suicide programs for adolescents
tend try to reduce the stigmatization of suicide by attributing
it to stressful life events rather than (more correctly) to
mental illness.
61
Locke and Latham's goal-setting theory focuses primarily on:
A.) Ability and effort, B.) Perceived effort and performance,
C.) Expectations and effort, D.) Intentions and effort
D: Intentions and effort: goal-setting theory proposes that
when people accept goals, they intend to achieve them and,
therefore, are willing to put forth effort to do so.
62
Multiple aptitude batteries such as the DAT & GATB asses
skills, abilities, or aptitudes, and allows a counselor to help a
client choose an educational or vocational course of act
63
Research using a "dismantling" strategy suggests that the
most critical component of systematic desensitization is: A.)
Counter-conditioning, B.) Gradual exposure, C.) Classical
extinction, D.) Operant extinction
C: Classical extinction: repeated exposure to the CS without
the presence of the US is responsible for systematic
desensitization's positive effects.
64
Research using a "dismantling" strategy suggests that the
most critical component of systematic desensitization is: A.)
Counter-conditioning, B.) Gradual exposure, C.) Classical
extinction, D.) Operant extinction
C: Classical extinction: repeated exposure to the CS without
the presence of the US is responsible for systematic
desensitization's positive effects.
65
Deficits on the Stroop test indicate
Loss of rsponse inhibition following frontal lobe damage
66
Stages of crisis intervention
1.) Formulation: crisis identification, 2.) Implementation:
assessment of prior life, setting of short term goals, and
implementation of goals, & 3.) Termination: progress
assessment, discussion of termination, and beyond
67
How was the MMPI developed
empirical criterion keying: retention of items differentiating
psychiatric from non-psychiatric populations
68
Research suggests that __________is the single best
treatment for Agoraphobia.
Research suggests that __________is the single best
treatment for Agoraphobia.
69
Therapies for the elderly
Validation therapy: acknowledges feelings whether or not
they are reality-based; 2.) Reminiscence Therapy: reviewing
important life events with client; 3.) Reality Orientation:
reversing/preventing cognitive impairments & maximizing
remaining capabilities
70
Thermal biofeedback for migraine headaches is mediated by
the _____________nervous system. Biofeedback to induce
relaxation is mediated by the ______________nervous
system
Thermal biofeedback for migraine headaches is mediated by
the sympathetic nervous system. Biofeedback to induce
relaxation is mediated by the parasympathetic nervous
system
71
Research comparing patients with schizophrenia from
non-Western developing countries to those from Western
industrialized countries has found that they differ in terms of:
A.) Symptoms, B.) Age and gender, C.) Gender and
prognosis, D.) Course and outcome
D: Course and outcome: patients from developing countries
more often exhibit acute onset of sx, shorter clinical course,
and a complete remission of sx. No differences were found
in regards to age, gender, or type of sx.
72
What is parallel process?
A 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.
73
Cognex & Aricept are used to treat Alzheimer's by:
increasing ACh levels
74
Which is more pronounced in aggressive children in regards
to social interactions: the primacy or recency effect?
Recency effect: aggressive children are likely to focus on
cues that occur at the end of the social interaction than the
beginning.
75
A therapist is most likely to exert _________ type of power
over a client.
Referent: based on the person's attraction to or desire to be
like the holder of power. (Expert power is another good
answer)
76
Individuals who retrieve memories under hypnosis,
compared to non-hypnotized individuals:
Tend to have more confidence in their memories, but be less
accurate in recalling memories
77
Reciprocity hypothesis
people tend to like others who like them
78
Matching hypothesi
Proposes that people of approximately equal physical
attractiveness are likely to select each other
79
In psychotherapy outcome research, factors that appear most
responsible for lack of improvement are:
Client factors
80
The police inform you that they have a warrant out on one of
your clients who is suspected of several felony charges of
grand theft auto. They want you to provide them with the
client's address and phone number. You should:
Refuse to provide them with info and notify your client since
there is no indication that your client is in imminent danger
to self or others. However, you should notify the client of
this info and discuss the option of turning himself in to the
police
81
A quiet, lonely, introverted, overly sensitive teenager with
few friends is at high risk for suicide, with this risk
increasing when these characteristics are combined with: A.)
Physical health problems, B.) Phobic anxiety, C.) Antisocial
behavior, D.) Academic underachievement
C: suicide risk is increased in adolescents who are depressed,
hostile, aggressive, or exhibit other antisocial behaviors,
and/or substance abuse.
82
Stages of the minority development model (MID)
1.) Contact: lack of; 2.) Disintegration: confusing racial
awareness; 3.) Reintegration: prejudice; 4.)
Pseudo-independence: thoughtful revisiting of prejudice; 5.)
Immersion-emersion: separate and equal, racially proud but
not racist; 6.) Autonomy: integration; non-racist identity;
seek interaction. Model designed to help therapists
understand inter-racial tension
83
Masters and Johnson found that their version of sex therapy,
which incorporates education about sexuality, training in
communication skills, and the technique known as sensate
focus, is most effective for treating: A.) Premature
ejaculation, B.) Impotence, C.) Sexual aversion, D.)
Orgasmic disorder
A: Premature ejaculation
84
Considerations in treating Hispanic clients
er an active goal-orientation. Stress personal contact and
attention. Consider family
85
Considerations in treating Native American clients
Importance of tribe and family. Approach: non-directive,
history-oriented, accepting, cooperative. Goals: happiness,
wisdom, peace with nature. Therapist attitude: reserved,
open, accepting, listening
86
Considerations in treating Asian clients
Approach: direct, structured, short-term; address problem as
academic or vocational. Education about therapy process
87
What is the method of loci?
A mnemonic device where you visualize names or objects to
be remembered in familiar locations.
88
MMPI 1990 revision
Updated norms Addition of new content scales Change of
cutoff from 70 to 65 Clinical scales unchanged
89
Research comparing the relationship between age and
therapy outcome has produced mixed results. However, in
their most recent meta-analysis, Weisz and his colleagues
found:
Therapy is more beneficial for adolescents than children,
especially among girls and when the counselor is a
professional or student (not a paraprofessional).
90
om the perspective of Bandura's social learning theory,
"functional value" refers to
Anticipated consequences.
91
According to Theodore Millan, people with Narcissistic
Personality Disorder rely primarily on which of the defense
mechanisms
When narcisstic people experience personal failure and
public humiliation, they first rely on: REPRESSION and if
that doesn't work: RATIONALIZATION PROJECTION
92
In implosive therapy, a client is: A: Gradually exposed,
though the imagination, to a feared stimulus, one step at a
time. B: Immediately exposed, through the imagination, to a
feared stimulus at its maximum intensity. C: Gradually
exposed, in vivo, to a feared stimulus, one step at a time. D:
Immediately exposed, in vivo, to a feared stimulus at its
maximum intensity
B
93
Regarding the relationship between bipolar disorder and
environmental factors, environmental factors are likely to
have a ________ impact during the early stages of the
disorder
Regarding the relationship between bipolar disorder and
environmental factors, environmental factors are likely to
have a ________ impact during the early stages of the
disorder
94
Desc: SCL-90
Symptom CheckList is a self report measure of general
psychiatric symptoms such as depression, anxiety,
somatization, obsessive-compulsiveness and hostility
Question rated on a scale of 1-5
95
Risk factors for adolescent suicide
Depression, use of drugs and alcohol, anti-social behavior
96
semantic paralexia
Dyslexic reading error in which the child responds with
something semantically similar to the stimulus (eg dog in
response to cat)
97
According to research on sex-role determinants, the
characteristic that is most related to genetics as opposed to
socialization is: A.) Sociability, B.) Dependency, C.)
Aggression, D.) Anxiety
C
98
state dependence
Memory is maximized if we are in the same emotional state
during learning and recall
99
Self instruction is most useful for:
Hyperactive/impulsive children (form of CBT which
encourages focusing on their self statements & altering their
self-defeating statements)
100
Based on Schachter's work, one would treat a client with
obesity by: A.) Manipulating the external cues. B.) Changing
the client's self-attributions. C.) Changing the social
reinforcers for food consumption. D.) Manipulating the
internal cues.
A
101
Individuals with antisocial personality are most influenced
by:
Money
102
Treatment of choice for agoraphobia
Flooding, with 75% long term improvement
