Clinical Psychology

Question 1

Racial/Cultural Identity Development Model

Answer 1

Atkinson, Morten, and Sue’s (1998) Racial/Cultural Identity Development (R/CID) Model describes identity development as consisting of five stages - conformity, dissonance, resistance and immersion, introspection, and integrative awareness.

Question 2

Style of Life

Answer 2

Adler used the term “style of life” to describe the ways in which a person strives for superiority. He also proposed that, because people have an innate social interest, a healthy style of life is guided by goals that reflect concerns for personal accomplishment as well as the welfare of others. In contrast, a mistaken (unhealthy) style of life is guided by goals that reflect self-centeredness and a lack of concern about the well-being of others.

Question 3

Cultural Encapsulation

Answer 3

According to Wrenn (1962), a culturally encapsulated counselor (a) defines reality according to his or her own set of cultural assumptions; (b) is insensitive to cultural variations among individuals; (c) disregards evidence that disproves his or her assumptions; (d) relies on quick, simple, and technique-oriented solutions to problems; and (e) evaluates others based on his or her own perspective.

Question 4

Bender-Gestalt II

Answer 4

The Bender-Gestalt II is a measure of visual-motor integration skills for individuals 4 to 85 years of age. It requires examinees to reproduce geometric designs in two phases - the copy phase and the recall phase. It is considered to be useful as a screening tool for brain damage only when it is used in conjunction with other measures.

Question 5

Thematic Apperception Test

Answer 5

The Thematic Apperception Test (TAT) is based on Murray’s theory of needs and consists of 30 cards that each depict a different scene. The examinee is asked to make up a story for each card that describes the event depicted in the scene, what led to that event, what the people in the scene are thinking and feeling, and what will happen after the event. Murray’s scoring system involves identifying each story’s “hero” and the needs, press, thema, and outcomes expressed in the client’s story.

Question 6

Freud’s Structural Theory

Answer 6

Freud’s structural theory divides the psyche into three components: The id is the source of sexual and aggressive instinctual drives and is governed by the pleasure principle. The ego is governed by the reality principle and attempts to gratify the id’s instincts in ways that are compatible with reality. And the superego serves as the conscience and attempts to permanently block gratification of unacceptable id impulses.

Question 7

Racial Microaggressions

Answer 7

Sue et al. (2007) define racial microaggressions as “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” (p. 271). They distinguish between three types of microaggression: microinsults, microinvalidations, and microassaults.
Turn

Question 8

Symmetrical Versus Complementary Interactions

Answer 8

Communication theory distinguishes between symmetrical and complementary interactions: Symmetrical interactions are based on equality and can lead to competition and conflict, while complementary interactions are based on inequality.

Question 9

Healthy Cultural Paranoia

Answer 9

As described by Ridley (1984), healthy cultural paranoia is a normal (nonpathological) response of African American individuals to oppression and racism. He recommends that, when an African American client’s nondisclosure to a White therapist is due to healthy cultural paranoia, the therapist should help the client bring his or her feelings about Whites into conscious awareness and recognize when it is safe to self-disclose.

Question 10

Individuation

Answer 10

The primary goal of Jung’s analytical therapy is to facilitate the process of individuation, which is the integration of all conscious and unconscious aspects of the self into a unified whole.

Question 11

Success Versus Failure Identity

Answer 11

Realty therapists propose that people are motivated by five innate needs - love and belonging, power, fun, freedom, and survival - and that the ways in which people choose to satisfy these needs determine whether they have a success identity or a failure identity. When a person chooses to fulfill his or her needs responsibly (in effective and realistic ways that do not infringe upon the rights of others), the person has adopted a success identity, but when a person chooses to meet his or her needs in an irresponsible manner, the person has adopted a failure identity.

Question 12

Cognitive Distortions

Answer 12

As described by Beck, cognitive distortions are systematic errors in reasoning. They create the link between dysfunctional schemas and automatic thoughts and occur when incoming information is biased to fit a dysfunctional schema and, as a result, elicits a maladaptive automatic thought. Cognitive distortions include arbitrary inference, selective abstraction, and dichotomous thinking.

Question 13

Self-Report

Answer 13

Self-report consists of data provided by the client themselves via surveys, questionnaires, polls, etc.

Question 14

ABC model (Ellis)

Answer 14

Rational emotive behavior therapy (REBT) is based on an ABC model of emotional disturbance and dysfunctional behavior, in which A is an activating event, B is the person’s beliefs about that event, and C is the emotional and behavioral consequence of those beliefs. In other words, a person’s reaction to an event is due to his or her beliefs about the event rather than the event itself.

Question 15

Beck Hopelessness Scale

Answer 15

The Beck Hopelessness Scale (BHS) measures hopelessness, which has been identified as an accurate predictor of suicide. It contains 20 true/false items that measure attitudes about the future.

Question 16

Stages of Change Model

Answer 16

The stages of change model is also known as the transtheoretical model and proposes that people pass through a predictable sequence of stages when modifying their health-related behaviors - precontemplation, contemplation, preparation, action, maintenance, and termination. Treatment incorporates techniques that promote 10 processes of change (e.g., consciousness raising, interpretation, education) that have been found to contribute to the effectiveness of various types of psychotherapy, and the choice of processes for a particular client depends on his or her stage of change.

Question 17

Therapeutic Factors in Group Therapy

Answer 17

Yalom also identified eleven therapeutic factors that are provided by group therapy: cohesiveness, installation of hope, universality, imparting information, altruism, corrective recapitulation of the primary family group, development of socializing techniques, imitative behavior, interpersonal learning, catharsis, and existential factors. A number of studies have found group cohesiveness to be highly correlated with therapy outcome, and cohesiveness in group therapy is considered to be the equivalent of the therapeutic alliance in individual psychotherapy.

Question 18

Stress Inoculation Training

Answer 18

Stress inoculation training is based on the assumption that, when people learn to cope with mild levels of stress, they are “inoculated” against future stressful situations. It consists of three phases: conceptualization, skills acquisition, and application and follow-through.

Question 19

Countertransference

Answer 19

Countertransference refers to the therapist’s inappropriate reactions (transference) to a client. Freud believed that countertransference impedes the progress of psychoanalysis, but other psychoanalysts subsequently recognized that countertransference can serve a useful purpose in treatment by providing important information about the client and the therapeutic relationship.

Question 20

Rorschach Inkblot Test

Answer 20

The Rorschach Inkblot Test consists of ten bilaterally symmetrical inkblots printed on separate cards, and its administration involves two phases: the free association phase and the inquiry phase. Standardized scoring systems involve considering the examinee’s responses in several categories (e.g., location, determinants, form quality, content, and popularity), and interpretation involves considering the number of responses in each category.

Question 21

Acculturation

Answer 21

According to Berry (1990), a person’s acculturation orientation can be described in terms of four categories that are based on the extent to which the person retains his or her own minority culture and accepts the majority (dominant) culture. The four categories are integration, assimilation, separation, and marginalization.

Question 22

Evidence-Based Treatments

Answer 22

The integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences (APA Policy Statement on Evidence-Based Practice in Psychology, 2005).

Question 23

Self-In-Relation Theory

Answer 23

Self-in-relation theory evolved out of work conducted by feminist scholars at the Stone Center at Wellesley College and incorporates principles of object relations theory. It proposes that 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 - i.e., “the identity of girls is based on a sense of continuity in their relationship with their mothers, whereas boys form their identity by defining themselves as different from their mothers and by developing an identification with their fathers” (Corey, 2005, p. 347).

Question 24

Validity Scales (MMPI-2)

Answer 24

The MMPI-2’s validity scales include the L, F, and K Scales and are used to help determine whether an examinee’s clinical scale scores provide accurate information or reflect a response style or intentional deception. A high L (Lie) Scale score indicates a lack of insight or an attempt to present oneself in a favorable light; a high F (Infrequency) Scale score; suggests significant pathology or an attempt to “fake bad”; and a high K (Correction) Scale score indicates defensiveness or an attempt to “fake good.”

Question 25

Automatic Thoughts

Answer 25

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

Question 26

Object Constancy

Answer 26

Object relations theory proposes that behavior is motivated by a desire for human connection and focuses on the impact of early relationships between a child and significant others (“objects”) in the child’s life. According to this theory, when young children are provided with adequate emotional and physical care, they develop object constancy, which is characterized by integrated and stable internal representations of the self and others.

Question 27

Levels of Prevention

Answer 27

Caplan (1964) identified three levels of prevention: Primary preventions make an intervention available to all members of a target group or population in order to keep them from developing a disorder. Secondary preventions identify and provide interventions to individuals who are showing early signs of a disorder. Tertiary preventions are designed to reduce the duration and negative consequences of a disorder that has already occurred.

Question 28

Interviews

Answer 28

Structured and unstructured interviews involve asking a set of questions for data collection purposes.

Question 29

Double-Bind

Answer 29

Early research on communication theory linked schizophrenia to double-bind communication, which occurs when a person receives contradictory messages from another person and cannot comment on the contradiction.

Question 30

Network Therapy

Answer 30

LaFromboise, Trimble, and Mohatt (1990) suggest using network therapy when working with American Indian clients. It helps empower clients to cope with life stresses by utilizing relatives, friends, and tribal members as a social support system.

Question 31

OARS

Answer 31

OARS is an acronym that refers to the techniques used by practitioners of motivational interviewing: open-ended questions, affirmations, reflective listening, and summaries.

Question 32

Paradoxical Interventions

Answer 32

Haley and other family therapists often use paradoxical interventions (e.g., prescribing the symptom, ordeals) to help resolve a family’s presenting problems. These interventions involve asking family members to do something they are likely to resist and thereby change in the desired way.

Question 33

Multigenerational Transmission Process

Answer 33

As described by Bowen, the multigenerational transmission process is the process by which patterns of differentiation are transferred from one generation to the next. When members of one generation have low levels of differentiation, this process tends to cause even lower levels of differentiation in the next generation and can eventually lead to severe dysfunction.

Question 34

Differentiation of Self

Answer 34

As described by Bowen, differentiation of self refers to a family member’s ability to separate his or her own intellectual and emotional functioning. The higher a person’s level of differentiation, the greater his or her ability to maintain a separate identity while staying connected to other family members.

Question 35

Negative Versus Positive Feedback

Answer 35

According to systems theory, systems are controlled by two types of feedback: Negative feedback consists of information or actions that maintain the system’s status quo, while positive feedback consists of information or actions that cause deviation and produce instability and change.

Question 36

Cycle of Violence

Answer 36

According to Walker (2009), intimate partner violence often involves a cycle of violence that consists of three phases: tension building, acute battering incident, and loving contrition.

Question 37

Boundary Disturbance

Answer 37

A key assumption of Gestalt therapy is that, when people experience a state of imbalance due to an unfilled need, they are motivated to obtain something in the environment that will satisfy the need in order to restore a state of balance (homeostasis). Maladjustment occurs when there’s a boundary disturbance between the person and the environment that impedes the person’s ability to satisfy his or her needs. Introjection is a boundary disturbance that occurs when a person internalizes the beliefs and values of other people without awareness or critical evaluation, which results in inconsistencies in his or her thoughts and feelings.

Question 38

Phase Model

Answer 38

According to Howard et al.’s (1986) phase model, the nature of a therapy client’s improvement over time can be described in terms of three phases: (1) Remoralization occurs during the first few sessions and involves a decrease in feelings of hopelessness. (2) Remediation is characterized by 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 39

Boundaries (Minuchin)

Answer 39

For practitioners of structural family therapy, boundaries are an important component of family structure and are implicit rules that determine the amount and type of contact allowed between family members.

Question 40

Archetypes

Answer 40

Jung divided the unconscious into two components - the personal unconscious and the collective unconscious. The 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” (Carducci, 2009, p. 137). It contains archetypes, which are universal mental structures that predispose people to react to certain external circumstances in specific ways.

Question 41

Joining

Answer 41

Structural family therapy consists of three overlapping stages - joining, formulation, and restructuring. Joining with the family involves 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).

Question 42

Black Racial Identity Development Model

Answer 42

Cross’s Black Racial Identity Development Model describes the process of developing a positive Black identity as involving five stages - pre-encounter, encounter, immersion-emersion, internalization, and internalization-commitment.

Question 43

Formative Stages of Group Therapy

Answer 43

According to Yalom (1985), therapy groups ordinarily pass through three formative stages in the beginning months: (1) orientation, hesitant participation, search for meaning, and dependency; (2) conflict, dominance, and rebellion; and (3) development of cohesiveness.

Question 44

Multisystems Approach

Answer 44

Boyd-Franklin (2003) recommends that therapists use a multisystems approach when working with African American clients. It involves 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 45

Interpersonal Problem Areas

Answer 45

Interpersonal psychotherapy (IPT) is a structured, manualized approach that, when used to treat depression, focuses on one or more of four interpersonal problem areas: role transitions, role disputes, interpersonal deficits, or complicated grief.

Question 46

MMPI-2

Answer 46

The MMPI-2 is a structured personality test that consists of 567 true/false questions that provide scores on ten clinical scales, nine validity scales, and numerous content and supplementary scales. Scores are reported as T- scores that have a mean of 50 and standard deviation of 10, and a T-score of 65 or higher is considered clinically significant. Scores on the clinical scales are usually interpreted using profile analysis, which involves considering the examinee’s two or three highest scores and patterns created by three or more scores.

Question 47

Multi-Informant Reports

Answer 47

Multi-informant reports compile data from several different sources, such as medical history or reports from family members.

Question 48

Beck Depression Inventory-II

Answer 48

The Beck Depression Inventory-II (BDI-II) contains 21 items that address the mood, cognitive, behavioral, and physical symptoms of depression. The total score ranges from 0 to 63, with a score of 0 to 13 indicating minimal depression, 14 to 19 mild depression, 20 to 28 moderate depression, and 29 to 63 severe depression.

Question 49

Targets of Analysis (Freud)

Answer 49

The primary technique of psychoanalysis is analysis, and the primary targets of analysis are the client’s free associations, resistance, dreams, and transference: Free association is used to help lower a client’s defenses and bring unconscious thoughts and feelings into conscious awareness. A client’s resistance provides information about his or her unconscious conflicts and occurs when the client is unwilling or unable to address threatening, anxiety-arousing issues. The use of dream analysis is based on the premise that dreams contain symbols that provide important information about unconscious impulses. An assumption of psychoanalysis is that the 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, and Freud referred to these distorted perceptions as transference.

Question 50

Circular Questioning

Answer 50

Circular questioning is one of the techniques used by Milan systemic family therapists to alter dysfunctional interactions between family members. It involves asking each family member about his or her perceptions of a family relationship or a specific event in order to introduce new information into the system and help family members recognize the similarities and differences in their perceptions.
Turn

Question 51

White Racial Identity Development Model

Answer 51

Helms’s White Racial Identity Development Model consists of two phases, with each phase including three identity statuses. The first phase is abandonment of racism and includes contact, disintegration, and reintegration. The second phase is defining a nonracist White identity and consists of pseudo-independence, immersion-emersion, and autonomy.

Question 52

Eysenck

Answer 52

Based on his review of the research, Eysenck (1952) concluded that 44% and 66% of patients with neurotic disorders who received psychodynamic or eclectic therapy, respectively, showed improvement, while 72% of patients with similar symptoms who did not receive psychotherapy improved. He argued that his results demonstrated that the effectiveness of psychotherapy does not have scientific support.

Question 53

Incongruence

Answer 53

Rogers’s person-centered therapy is based on the assumptions that people have an innate self-actualizing tendency that motivates and guides all behavior and that incongruence between self and experience can impede this tendency. Incongruence can occur, for example, when a child experiences conditions of worth because his mother provides him with affection and approval only when he behaves in certain ways (e.g., when he suppresses his anger or jealousy). Rogers proposed that psychological maladjustment results when a person responds to incongruence by distorting or denying experiences rather than being open to them.

Question 54

Worldview

Answer 54

According to Sue and Sue (2013), a person’s worldview is affected by his or her cultural background and reflects two factors - locus of control and locus of responsibility. Therapy can be affected by the worldviews of the therapist and client. For instance, White middle-class therapists often have an internal locus of control and internal locus of responsibility (IC-IR) and are likely to have problems working with an African American client who has an internal locus of control and external locus of responsibility (IC-ER) and, as a result, challenges the therapist’s expertise and trustworthiness.

Question 55

Etic Versus Emic Perspective

Answer 55

Therapists with an etic perspective believe that mainstream therapies apply equally well to people from all cultural backgrounds, while those with an emic perspective believe therapies that are appropriate for members of one cultural group may not be appropriate for members of another cultural group.

Question 56

Risk Factors for Suicide

Answer 56

Factors that have been linked to a high risk for suicide include a previous suicide attempt, a suicide threat accompanied by a suicide plan, male gender, depression, and feelings of hopelessness.

Question 57

Schemas

Answer 57

According to Beck, schemas are “relatively enduring internal structures of stored generic or prototypical features of stimuli, ideas, or experience that are used to organize new information in a meaningful way, thereby determining how phenomena are perceived and conceptualized” (Clark & Beck, 1999, p. 79). They may be adaptive or maladaptive: Adaptive schemas facilitate efficient information processing and realistic evaluations of events, while maladaptive schemas distort incoming information and lead to inaccurate interpretations and conclusions.

Question 58

Three Core Conditions

Answer 58

To help clients maintain a state of congruence by developing a more flexible self-concept that enables them to respond to new experiences in open, non-defensive ways, person-centered therapists provide clients with three core conditions: empathy (the therapist understands the client’s subjective experience and conveys that understanding to the client); congruence (the therapist is genuine, open, and honest and exhibits consistency in his or her words and actions); and unconditional positive regard (the therapist truly cares about the client, affirms the client’s value as a person, and accepts the client without judgment).

Question 59

Exception Questions

Answer 59

Exception questions are used by solution-focused therapists to identify times when the client’s problem did not exist or was diminished in order to help the client develop a solution orientation (e.g., “Tell me about some times in the recent past when you didn’t feel depressed” followed by “Was there anything you were doing differently during that time?”).

Question 60

Procedures of Analysis (Freud)

Answer 60

The primary procedures of analysis are confrontation, clarification, interpretation, and working through.

Question 61

Smith, Glass, & Miller

Answer 61

Smith, Glass, & Miller;Smith, Glass, and Miller (1980) were the first to use meta-analysis to combine the results of independent psychotherapy outcome studies. Their analysis of 475 studies produced an average treatment effect size of .85, which indicated that the average therapy client was “better off” than 80 percent of patients in no-treatment control groups.

Question 62

Direct Observation

Answer 62

Direct observation involves monitoring and recording a client or participant’s behavior in the natural environment.

Question 63

Parataxic Distortions

Answer 63

Sullivan described the impact of cognitive factors on interpersonal relationships and distinguished between three modes of cognitive experience: prototaxic, parataxic, and syntaxic. He proposed that neurotic behavior is often caused by parataxic distortions, which are due to arrest at the parataxic mode and involve perceiving and evaluating others in the present based on early interpersonal experiences.

Question 64

TelePsychology

Answer 64

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

Question 65

Wisconsin Card Sorting Test

Answer 65

The Wisconsin Card Sorting Test (WCST) evaluates an examinee’s ability to form abstract concepts and shift cognitive strategies in response to feedback and can be administered to examinees 6.5 to 80 years of age. It is sensitive to frontal lobe damage, and impaired performance has been linked to autism, schizophrenia, depression, alcoholism, and malingering.

Question 66

Genogram

Answer 66

A genogram is a visual representation (diagram) of at least three generations that provides information on a number of important characteristics including the family’s structure, relationship dynamics, and significant life events (marriages, divorces, births, deaths, illnesses, etc.). A genogram serves not only as an initial assessment tool but also as a way to help family members gain understanding of family processes.

Question 67

Client-Therapist Matching

Answer 67

Research investigating the impact of client-therapist matching in terms of race or ethnicity has produced inconsistent results, and there’s evidence that the effects depend on the type of outcome measure and the race/ethnicity of the clients. For example, Cabral and Smith’s (2011) meta-analysis found that racial/ethnic matching of clients and therapists had a greater impact on the favorability of a client’s perceptions of his or her therapist than on therapy outcome and that the effect sizes for both measures were larger for African American clients than for Asian American, Hispanic American, and European American clients.

Question 68

Systems Theory

Answer 68

Systems theory focuses on the interrelatedness of elements in a system and incorporates principles and assumptions of general systems theory and cybernetics. It proposes that systems can be described in terms of the degree to which they interact with their environments. An open system has permeable boundaries that allow it to interact with the environment, while a closed system has impermeable boundaries that prevent interactions.

Question 69

Self-Instructional Training

Answer 69

A cognitive restructuring technique that entails identifying and replacing maladaptive cognitions with more adaptive ones. Steps include: cognitive modeling (the client observes as a model performs a task and the client makes self-statements out loud); cognitive participant modeling (the client performs the task as the model verbalizes instructions); overt self-instruction (the client performs the task while instructing him/herself out loud); fading overt self-instruction (the client whispers the instructions while performing the task); and covert self-instruction (the client performs the task while saying the instructions to him/herself). Useful for helping impulsive and hyperactive children slow down their behaviors and guide themselves through tasks.

Question 70

Homeostasis

Answer 70

Homeostasis is an important concept in systems theory and refers to the tendency of a system to maintain a state of stability and equilibrium.

Question 71

Miracle Question

Answer 71

The miracle question is used by solution-focused therapists to help identify therapy goals and requires the client to imagine the absence of his or her problem and the resulting effects (i.e., “If a miracle happened and your problem was solved overnight, how would you know it had been solved and what would be different?”).

Question 72

Mental Health Consultation

Answer 72

Caplan (1964) distinguished between four types of mental health consultation: (a) Client-centered case consultation focuses on helping the consultee work more effectively with a particular client. (b) Consultee-centered case consultation focuses on improving the consultee’s ability to provide services to a particular type of client. (c) Program-centered administrative consultation involves working with administrators to help them resolve problems related to a particular program. (d) Consultee-centered administrative consultation involves working with program administrators to help them acquire the skills they need to develop, implement, and evaluate future programs.

Question 73

Defense Mechanisms

Answer 73

According to Freudian theory, when the ego cannot immediately resolve conflicts between the demands of the id and the superego or reality using realistic means, it employs defense mechanisms, which include repression, reaction formation, projection, and sublimation. Repression is the most basic defense mechanism and underlies all others. It keeps undesirable thoughts, impulses, and conflicts out of conscious awareness.

Question 74

Psychophysiological Measures

Answer 74

Psychophysiological measures collect data on physiological functions, such as perspiration or muscle movement, to provide information on the individual’s emotional state.

Question 75

Awareness

Answer 75

Awareness of the self in the here-and-now is considered to be the primary curative factor in Gestalt therapy. Consequently, the primary goals of therapy are to help clients achieve self-awareness and assume responsibility for their own thoughts, feelings, and actions.

Question 76

Separation-Individuation

Answer 76

Mahler proposed that object constancy develops gradually in early childhood during three stages: normal autistic, normal symbiotic, and separation-individuation. She also proposed that most adult psychopathology can be traced to problems that occur during the process of separation-individuation.

Question 77

Mini-Mental State Exam

Answer 77

The Mini-Mental State Exam (MMSE) is a screening tool for cognitive functioning for older adults and consists of 11 questions that assess six aspects of functioning: orientation, registration, attention and calculation, recall, language, and visual construction. The maximum score is 30, and a score of 24 or lower suggests cognitive impairment.

Question 78

Rigid Family Triads

Answer 78

Minuchin distinguished between three rigid family triads: Triangulation occurs when each parent demands that a child side with him or her during a dispute so that the child is “pulled” in two directions. Detouring occurs when parents reinforce deviant behavior in the child because it takes the focus off the problems they’re having with each other. A stable coalition occurs when two family members consistently “gang up” against another family member.

Question 79

Question ID #6693: The techniques of "externalizing" a problem, relative influence questioning, and bringing an "outside witness" into the therapy session are most associated with
Select one:
A. Structural Therapy
B. Systemic Therapy Incorrect
C. Dialectical Behavioral Therapy
D. Narrative Therapy

Answer 79

Correct Answer is: D
Narrative Therapy is premised on the notion that our identities are based on the stories we tell ourselves about our lives, or our narratives. Narrative therapists work to help people (they reject the term “client’) fully describe these stories, and restructure and reframe their stories and thereby their identities. The therapist adopts a co-operative and egalitarian stance, and works to help the person discover his own narrative rather than imposing one. Some techniques associated with Narrative Therapy include 1) naming the problem, which encourages focus, precision, and control; 2) externalizing the problem, which involves framing the problem as having an effect on, rather than being within, the person (e.g., “depression invaded your life”), the goal being to separate the problem from the person’s identity; 3) relative influence questioning, which involves contrasting the effect the problem has had on the person’s life with the effect that the person’s life has had on the problem (i.e., the control over the problem the person has had); 4) deconstructing unique outcomes, whereby the therapist encourages the person to focus and expand on experiences that are not consistent with a problem-saturated narrative; and 5) outsider witness, in which a third party is brought into the therapy session and the person tells this witness his revised or developing life narrative. Therapy ends when the person’s story is revised to the point that it is rich enough to sustain a healthy future.

Question 80

Question ID #6506: Psychoanalytic theory and ethology both emphasize
Select one:
A. critical periods.
B. psychic determinism.
C. the oedipal complex. Incorrect
D. imprinting.

Answer 80

Correct Answer is: A
A critical period is a discrete time period during which an organism is particularly sensitive to environmental events that could influence its development one way or the other. Both ethology (the study of animals in their natural habitat) and psychoanalytic developmental theory emphasize critical periods. For example, Lorenz’s research found that the critical period for imprinting in geese is 2-3 days after they are born. And in Freud’s theory of development, the different stages (e.g., oral, anal) represent critical periods for successful or unsuccessful resolution of specific psychosexual conflicts.

Question 81

Question ID #6519: Murray Bowen's approach to family therapy was strongly influenced by:
Select one:
A. gestalt therapy
B. psychodynamic theory
C. existentialism
D. communications theory

Answer 81

Correct Answer is: B
Murray Bowen was psychoanalytically trained and his extended family systems therapy was strongly influenced by his analytic training. For example, his transgenerational approach focuses on addressing relationship issues in one’s family of origin and developing insight in order to resolve current problems.

Question 82

Question ID #6605: According to Sue and Sue (2003), what represents an “invisible veil” which operates outside the level of conscious awareness?

Answer 82

Correct Answer is: B
Sue and Sue state that individuals are products of cultural conditioning with their "worldviews," or values and beliefs, representing an invisible veil which operates outside the level of conscious awareness. The resulting assumption is that everyone shares the same reality and truth regardless of race, culture, ethnicity, or gender. This assumption of universality is erroneous yet seldom questioned due to being firmly ingrained in one's worldview, and often results in people operating on misinformation.
"Cultural universality" refers to the assumption that Western concepts of normality and abnormality can be considered universal and equally applicable across all cultures. Cultural relativism, including lifestyles, "class values," "cultural values" and worldviews, affect the expression and determination of deviant behavior. (Sue, D.W., & Sue, D. (2003). Counseling the culturally diverse: Theory and practice (4th ad.). New York: John Wiley.)

Question 83

Question ID #6538: Eysenck’s 1952 study on psychotherapy outcome:
Select one:
A. concluded that individuals who receive psychotherapy are better off than 80% of controls Incorrect
B. concluded that psychologists and psychiatrists are more effective than master’s level clinicians
C. challenged the effectiveness of most psychotherapy treatments
D. led to many other outcome studies, most of which have supported his findings

Answer 83

Correct Answer is: C
Eysenck, in his 1952 study, found that 64% of patients in eclectic therapy and 44% of psychoanalytic patients improved versus a 72% improvement rate for untreated patients. His methodology and findings have been criticized for decades following his report and most studies since then have found psychotherapy to be superior to no treatment.
concluded that individuals who receive psychotherapy are better off than 80% of controls

This choice is one of the conclusions of Smith and Glass’ (1978) meta-analysis.

concluded that psychologists and psychiatrists are more effective than master’s level clinicians

This was not one of Eysenck’s conclusions, and it is also contrary to a finding of Consumer Report’s 1995 study which failed to find a relationship between therapist level of training and outcome.

led to many other outcome studies, most of which have supported his findings

This is partly correct, in that many other outcome studies did follow Eysenck’s study; however, most of these have contradicted his findings. Indeed, even Eysenck modified his conclusion in 1985 by indicating that at least one therapy, behavior therapy, is superior to placebo or no treatment.

Question 84

Question ID #18: From the Freudian perspective, phobias are a means of reducing anxiety stemming from an unresolved conflict. Freud explained Little Hans's fear of horses, for instance, as due to an unresolved conflict that had its origins in the:
Select one:
A. genital stage.
B. phallic stage. Correct
C. anal stage.
D. oral stage.

Answer 84

Correct Answer is: B

Freud described Little Hans’s fear of horses as displacement of anxiety stemming from an unresolved Oedipus conflict.

Question 85

Question ID #35: According to Janet Helms, a White member of a city council meeting, which consists of members from different racial and cultural backgrounds, is most likely to work cooperatively if the member is in which stage of development:
Select one:
A. contact
B. integration Incorrect
C. reintegration
D. autonomy

Answer 85

Correct Answer is: D
Janet Helms developed the White Racial Identity Development Model, which consists of six stages. “Contact”, the first stage, is characterized by ignorance and disregard of any racial differences. The next stage is “disintegration” which involves awareness of racial inequalities which results in moral confusion and conflict. This is followed by “reintegration”, in which Whites are viewed as superior to minorities. “Pseudo-Independence” is marked by dissatisfaction with reintegration. “Immersion-Emersion” follows, during which, people embrace their whiteness without rejecting minorities. “Autonomy”, the last stage, is reached when a person internalizes a nonracist White identity, whereby similarities and differences are acknowledged but are not perceived as threatening.
Note that “Integration” is not one of the stages in Helms’ model; rather, it refers to Berry’s Acculturation Model, in which a minority has a high retention for the minority culture and high maintenance of the mainstream culture.

Question 86

Question ID #33: All of the following are true regarding Feminist Object Relations Theory except:
Select one:
A. it emphasizes the importance of the maternal relationship with the child.
B. it proposes that gender differences are the result of girls being taught to remain attached to their mothers while boys are taught to separate from their mothers.
C. it proposes that girls develop a healthier self-object when raised primarily by their father due to earlier separation from their mother. Correct
D. it proposes that mothering “reproduces itself” since mothers perpetuate the oppressiveness of the division of labor.

Answer 86

Correct Answer is: C
Nancy Chodorow was one of the first to apply a feminist perspective to an Object Relations model. In The Reproduction of Mothering (Berkeley, University of California Press, 1978) she focused on the 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 87

Question ID #6638: Which of the following would most likely be utilized by a therapist whose work is based on Minuchin’s structural family therapy?
Select one:
A. giving homework, enactment, making a family map
B. taking a family history, issuing paradoxical directives, tracking
C. taking a family history, joining the family, making a genogram Incorrect
D. reframing, issuing paradoxical directives, exploring multigenerational transmission processes

Answer 87

Correct Answer is: A
Minuchin’s structural family therapy focuses on modifying aspects of the family structure (e.g., rules, boundaries, coalitions) that underlie family dysfunction. Homework is commonly assigned as a way of bringing about concrete change in the family’s behavior; enactments are role-plays that Minuchin often used to evaluate and modify the family structure; and family maps, or diagrams of the family’s boundaries, are constructed to help families and the therapist understand the family structure.
The other options can be eliminated because they include an intervention that focuses on the family’s past whereas structural family therapy tends to focus on a family’s present functioning.

Question 88

Question ID #6619: During the first of structural family therapy's three steps, which of the following techniques is most useful?
Select one:
A. constructing a family map
B. relabeling and reframing
C. enactment Incorrect
D. tracking and mimesis

Answer 88

Correct Answer is: D
Structural family therapy entails three overlapping steps: joining, evaluating/diagnosing, and restructuring. Joining is the initial step in structural family therapy. Tracking (identifying and using the family’s values, life themes, etc.) and mimesis (adopting the family’s behavioral and affective style) are methods used to join the family system.
Constructing a family map* is a technique used for the structural diagnosis of the family. Relabeling and reframing* are restructuring techniques. Enactment* is used to facilitate diagnosis and restructuring of the family (* incorrect options).

Question 89

Question ID #6628: In the transtheoretical model, “zero temptation and 100% self-efficacy” is:
Select one:
A. an unrealistic expectation of behavioral change. Incorrect
B. the definition of successful behavioral change.
C. the result of complete behavioral change in the termination stage.
D. the result of ‘decisional balance’ in the maintenance stage

Answer 89

Correct Answer is: C
Prochaska and DiClemente’s transtheoretical or stages of change model distinguishes between six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. Many descriptions of the model only include the first five stages because the termination stage of “zero temptation and 100% self-efficacy” is not necessary for success and rare for most behaviors. Maintenance is when a person has maintained action, consolidates the change and is actively working to prevent a relapse. For many, the maintenance stage lasts forever and the model accepts temptation or the potential for relapse, such as an occasional craving for a cigarette or a drink, as normal and an opportunity to learn. At each stage, an individual weighs the pros and cons of adopting a new behavior, Prochaska and DiClemente called this weighing “decisional balance.”

Question 90

Question ID #6627: A new client comes to a session and is very quiet. He is slumped in his chair and holding his arms close to his body. According to neurolinguistic programming (NLP), what should a therapist do in order to build trust with this client?
Select one:
A. use “feeling” words
B. use “thinking” words
C. make eye contact Incorrect
D. adjust his posture to match the client’s

Answer 90

Correct Answer is: D
Adjust his posture to match the client’s is the best choice, because it involves reflecting the kinesthetic presentation of the client, which is emphasized in this question. Neurolinguistic programming (NLP) suggests that a therapist’s ability to communicate effectively with a client will be influenced by his or her ability to identify and then work with the client’s preferred sensory mode; for example, if a client prefers a visual mode, the therapist should use terms such as “I see,” if a client prefers an auditory mode, the therapist should use expressions such as “I hear you.”

Question 91

Question ID #6600: The term "success identity" is associated with:
Select one:
A. Eric Berne
B. William Glasser
C. Fritz Perls
D. Carl Rogers

Answer 91

Correct Answer is: B
According to Glasser’s Reality Therapy, when an individual is capable of fulfilling his or her own needs for survival, power, belonging, freedom and fun, without harming self or infringing on the rights of others, then he or she has developed a “success identity.” When the needs are met irresponsibly then the individual has developed a “failure identity.”
Bern is associated with transactional analysis (TA); Perls is associated with gestalt therapy; and Rogers is associated with client-centered therapy.

Question 92

Question ID #54: From the perspective of psychoanalytic theory, mania represents:
Select one:
A. a biological illness that psychoanalysis can do nothing about.
B. acting-out of libidinous impulses. Incorrect
C. a regression to an infantile state.
D. a defense against depression.

Answer 92

Correct Answer is: D
According to classical psychoanalytic theory, mania occurs as a defense against depression, due to an inability of the person to tolerate or admit to being depressed.