Counseling Families, Diagnosis, and Advanced Concepts

Question 1

A married couple brings their two children to counseling for behavioral
problems. The 14-year-old daughter stays out late and
their 17-year-old son is using drugs. According to most marriage
and family therapists the identified patient would be

a. the 17-year-old son.
b. the 14-year old-daughter.
c. the family.
d. both children.

Answer 1

c. the family.

Question 2

You are seeing a husband and wife for marriage counseling.
During one of the sessions you decide to see them separately.
The husband tells you he has seen an attorney because he is
filing for divorce. He has not told his wife and indicates that he
will not do so. You feel the wife has a right to know this because
it will help her plan for the future. You should

a. only tell his wife if he gives you permission.
b. communicate his intent to his wife since ethics guidelines
state you may do so when a member of the couple
is contemplating divorce.
c. not tell the wife since research indicates that women
respond more positively to divorce when they have less
time to think about it.
d. terminate the husband unless he tells her.

Answer 2

a. only tell his wife if he gives you permission.

Question 3

You are supervising a licensing candidate who is primarily interested in marriage and family counseling. You are very attracted to her and have sex with her. According to ethics guidelines

a. this is perfectly ethical, since this is a student and not a
client.
b. this is unethical.
c. this is perfectly ethical, since this is a supervisee and not
a client.
d. a and c are both correct.

Answer 3

b. this is unethical.

Question 4

The fastest growing clientele for professional counselors are
persons

a. experiencing bipolar disorder.
b. experiencing suicidal ideation.
c. experiencing marriage and family problems.
d. who abuse their children.

Answer 4

c. experiencing marriage and family problems.

Question 5

Family counselors generally believe in

a. circular/reciprocal causality (e.g., dynamics of family
members) .
b. linear causality.
c. random causality.
d. dream analysis.

Answer 5

a. circular/reciprocal causality (e.g., dynamics of family

members) .

Question 6

Cybernetics is a concept used by family therapists. It is usually
associated with the work of

a. Freud and Ellis.
b. Norbert Wiener.
c. Virginia Satir.
d. behavioral family therapists and cognitive family therapists.

Answer 6

b. Norbert Wiener.

Question 7

A family that is stable and reaches an equilibrium is in a state
of

a. adaptability.
b. enmeshment.
c. Nonsummativity.
d. homeostasis.

Answer 7

d. homeostasis.

Question 8

Adaptability is the ability of the family to balance

a. ego strength.
b. stability and change.
c. morphostasis and morphogenesis.
d. b and c.

Answer 8

d. b and c.

Question 9

A family wants to see you for counseling; however, they have a
very limited income and can’t afford to pay. You therefore agree
to see the family for free (i.e., pro bono). The term that best
describes your actions would be

a. aspirational ethics.
b. mandatory ethics.
c. empathy.
d. all of the above.

Answer 9

a. aspirational ethics.

Question 10

Experiential conjoint family therapy is closely related to the
work of

a. Virginia Satir.
b. Albert Ellis.
c. Jay Haley.
d. Salvador Minuchin, the father of structural family
therapy.

Answer 10

a. Virginia Satir.

Question 11

Virginia Satir felt that a major goal of therapy was to improve
intrafamily communication (i.e., communication between family
members). According to Satir, four basic patterns prevented
good communication under stress. These defensive postures or stress positions are: placating, blaming, being overly reasonable,
and being irrelevant. Placating means

a. you disagree with all the other family members.
b. you pick a favorite family member and agree with him or
her.
c. you ignore the other family members.
d. you try to please everybody out of a fear of rejection.

Answer 11

d. you try to please everybody out of a fear of rejection.

Question 12

The placater is a people pleaser under stress while the blamer

a. will sacrifice others to feel good about himself.
b. will often say “if it weren’t for you.…”
c. will point the finger at others to avoid dealing with his or
her own issues.
d. all of the above are typical behaviors of the blamer.

Answer 12

d. all of the above are typical behaviors of the blamer.

Question 13

The person who becomes overly reasonable

a. practices excitation.
b. cries a lot during therapy sessions.
c. is likely to engage in the defense mechanism of intellectualization.
d. has a high degree of emotion.

Answer 13

c. is likely to engage in the defense mechanism of intellectualization.

Question 14

According to Satir, the individual displaying an irrelevant style

a. will distract the family from the problem via constantly
talking about irrelevant topics.
b. will become a people pleaser.
c. will analyze the situation more than most.
d. all of the above.

Answer 14

a. will distract the family from the problem via constantly

talking about irrelevant topics.

Question 15

Virginia Satir is considered a leading figure in experiential family
therapy. _______ is sometimes called the dean of experiential
family therapy.

a. Ludwig von Bertalanffy.
b. Gregory Bateson.
c. Carl Whitaker.
d. Murray Bowen.

Answer 15

c. Carl Whitaker.

Question 16

Carl Whitaker’s interaction with the family could best be described as

a. quiet and empathic.
b. joining the family and experiencing it as if he were a family member.
c. a reality therapist.
d. a cognitive behavior therapist.

Answer 16

b. joining the family and experiencing it as if he were a family member.

Question 17

According to Whitaker,

a. a cotherapist is helpful.
b. a cotherapist should never be used.
c. a cotherapist should be used only with blended families.
d. all of the above could be true.

Answer 17

a. a cotherapist is helpful.

Question 18

Psychotherapy of the absurd is primarily related to the work of

a. Virginia Satir.
b. Carl Whitaker.
c. Maxie C. Maultsby, Jr.
d. William Glasser.

Answer 18

b. Carl Whitaker.

Question 19

A behavioristic marriage and family therapist is counseling the
entire family together. She turns to the 18-year-old son who is
attending community college and says, “You must complete
your sociology essay before you can use the family car and go
out with your friends.” Which theorist is primarily guiding her
intervention strategy?

a. David Premack’s principle or law.
b. Ivan Pavlov and John B. Watson
c. B. F. Skinner
d. all of the above

Answer 19

a. David Premack’s principle or law.

Question 20

A behavioristic marriage and family counselor is counseling the
entire family together. She turns to the 18-year-old son who is
attending community college and says, “I know you like to play
golf. Therefore, every time you cut the grass your father will
take you to play golf. I am going to have you and your dad sign
a contract that you agree with this policy.” Which principle is
primarily guiding her strategy?

a. negative reinforcement.
b. thought stopping.
c. shaping with successive approximations.
d. quid pro quo.

Answer 20

d. quid pro quo.

Question 21

A male is supervising a female counselor for state licensing. He
tells her that he will continue to supervise her as long as she has
sex with him. This is an example of

a. quid pro quo.
b. a legal but not an ethical violation.
c. a and b.
d. none of the above.

Answer 21

a. quid pro quo.

Question 22

A behavioristic family counselor suggests that the family chart
the number of times that 6-year-old Billy says “no” when he is
told to do something. The baseline of the chart would refer to

a. the period when positive reinforcement is being implemented.
b. the period when negative reinforcement is being implemented.
c. the period when quid pro quo is being implemented.
d. the period before the behavior modification begins.

Answer 22

d. the period before the behavior modification begins.

Question 23

The family counselor explains to Mrs. Smith that the next time
that 9-year-old Sally hits her little brother she must sit in the
family room by herself. The counselor is using

a. shaping.
b. shaping with successive approximations.
c. reciprocity.
d. time-out, a procedure that most behaviorists feel is a
form of extinction.

Answer 23

d. time-out, a procedure that most behaviorists feel is a

form of extinction.

Question 24

Mrs. Chance tells a family therapist that she pays all the bills, does all the cleaning, and brings in 90% of the family’s income. Moreover, Mrs. Chance is convinced that her husband does not appreciate her or show her affection. According to the behavioristic principle of family therapy known as reciprocity

a. there is a good chance that Mrs. Chance will consider
leaving the marriage.
b. it may seem paradoxical; nevertheless, Mrs. Chance will
be more committed to making the marriage work.
c. it may seem paradoxical; nevertheless, Mr. Chance will
consider leaving the marriage.
d. this situation will have virtually no impact on this couple’s
marriage.

Answer 24

a. there is a good chance that Mrs. Chance will consider

leaving the marriage.

Question 25

A couple is having sexual problems that stem from anxiety.
A marriage counselor who is a strict behaviorist would most
likely

a. dispute the couple’s irrational thinking.
b. prescribe thought stopping.
c. rely on systematic desensitization procedures.
d. rely primarily on paraphrasing and reflection.

Answer 25

c. rely on systematic desensitization procedures.

Question 26

A family counselor notices that the husband in a blended family
is having obsessive sexual thoughts about a woman living down the street. A strict behaviorist would most likely

a. analyze the man’s dreams.
b. have him chart the incidence of the behavior, but do little
else.
c. practice thought stopping.
d. rely primarily on Joseph Wolpe’s systematic desensitization.

Answer 26

c. practice thought stopping.

Question 27

You secure a job as the executive director of a family counseling agency. As you go through your files you discover that five years before you took the job the agency selected 100 families and counseled them using a strict behaviorist model. The agency took the next group of 100 families and counseled them using Satir’s experiential conjoint family therapy model. Each family received 12 sessions of therapy and each family took a before-and after-assessment that accurately depicted how well the
family was functioning. You decide to run a t test to examine
whether or not a statistically significant difference is evident between the two approaches. This is

a. an ex post facto (i.e., after the fact) correlation study.
b. causal-comparative or ex post facto (i.e., after the fact)
research.
c. a true experiment.
d. simple survey research.

Answer 27

b. causal-comparative or ex post facto (i.e., after the fact)
research.

Question 28

All of the techniques listed below would be used by a behavioristic
family therapist except

a. family sculpting.
b. a functional analysis of behavior followed by operant
conditioning.
c. modeling.
d. chaining and extinction.

Answer 28

a. family sculpting.

Question 29

Which statement is true of families?

a. The divorce rate has decreased markedly in the last several
years.
b. Remarriage today is uncommon.
c. Remarriage today is common.
d. The divorce rate in the United States hovers at about
10%.

Answer 29

c. Remarriage today is common.

Question 30

Which statement is true?

a. Single life is short-lived for divorced persons. About 30%
of all divorced persons are remarried within 12 months
of being divorced.
b. Most persons who are divorced do not remarry.
c. Most persons who are divorced wait a minimum of fi ve
years to remarry.
d. Women remarry quickly, however, men do not.

Answer 30

a. Single life is short-lived for divorced persons. About 30%
of all divorced persons are remarried within 12 months
of being divorced.

Question 31

The theory of psychodynamic family counseling is primarily associated with

a. William Glasser.
b. Sigmund Freud.
c. Virginia Satir and Carl Whitaker.
d. Nathan Ackerman.

Answer 31

d. Nathan Ackerman.

Question 32

In psychoanalytic family therapy the word object means

a. a dream.
b. a significant other with whom a child wishes to bond.
c. transference.
d. countertransference.

Answer 32

b. a significant other with whom a child wishes to bond.

Question 33

In psychoanalytic family therapy the term introjects really
means that the client

a. internalizes the positive and negative characteristics of
the objects within themselves.
b. possesses internal verbalizations.
c. possesses a finite number of problem solving options.
d. possesses the internal motivation to solve his or her own
difficulties.

Answer 33

a. internalizes the positive and negative characteristics of

the objects within themselves.

Question 34

Pick the best example(s) of the psychoanalytic concept of splitting.

a. A client who realistically perceives her therapist as a very
empathic person.
b. A client who realistically perceives her therapist as only
having good qualities.
c. A client who sees her therapist as all bad.
d. b and c.

Answer 34

d. b and c.

Question 35

A 72-year-old woman you are counseling in a family reminds
you of your mother and this is bringing up unresolved childhood
issues for you as the counselor. This is an example of

a. positive transference.
b. negative transference.
c. countertransference.
d. ambivalent transference.

Answer 35

c. countertransference.

Question 36

A family actually changes the structure of their family system.
According to Watzlawick, Weakland, and Fisch, the family has achieved

a. second-order change that is more desirable than fi rst-order
change.
b. first-order change that is more desirable than second-order
change.
c. mediation.
d. a Greek chorus.

Answer 36

a. second-order change that is more desirable than fi rst-order
change.

Question 37

A woman sees her husband as all good sometimes and all bad at
others. An analytically trained family therapist who believes in
object relations would see this as

a. ambivalent transference.
b. splitting.
c. dysthymia.
d. psychotic behavior.

Answer 37

b. splitting.

Question 38

Nathan Ackerman is considered
a famous psychoanalytic family
therapist; So are

a. Carl Rogers and Albert Ellis.
b. Arnold Lazarus and Joseph Wolpe.
c. William Glasser and Robert Wubbolding.
d. James Framo and Robin Skynner.

Answer 38

d. James Framo and Robin Skynner.

Question 39

Cloe Madanes and Jay Haley are associated with the _______
school of family counseling.

a. strategic.
b. behavioral.
c. psychodynamic.
d. object relations.

Answer 39

a. strategic.

Question 40

When Haley began investigating psychotherapy he

a. was already trained as a Freudian analyst like so many
other pioneers in the fi eld.
b. was already trained as a behaviorist.
c. had studied REBT with Ellis.
d. had a degree in the arts and communication rather than
the helping professions.

Answer 40

d. had a degree in the arts and communication rather than

the helping professions.

Question 41

Jay Haley believes in giving clients directives. You are counseling a family and during the session the 14-year-old daughter exclaims that she is suicidal. The best example of a directive would be

a. You turn to the 14-year-old daughter and say, “You seem
to be saying that living is too painful.”
b. You turn to the 14-year-old daughter and say, “Could it
be that you want to hurt yourself because your boyfriend
no longer wishes to see you?”
c. You turn to the family and say, “If your daughter threatens
suicide this week I want the entire family—including
your daughter—to stay home and nobody leaves for the
day.”
d. You turn to the family and say, “Could this be a family
problem rather than a diffi culty for your daughter?”

Answer 41

c. You turn to the family and say, “If your daughter threatens
suicide this week I want the entire family—including
your daughter—to stay home and nobody leaves for the
day.”

Question 42

Which of these responses is the best example of the doublebind
concept used in Jay Haley’s strategic therapy? You are trying
to help a client stop smoking:

a. You hypnotize her and tell her she will never smoke another
cigarette again. After you awaken her you admonish
her to smoke as many cigarettes as she can for the fi rst
three days.
b. You recommend that the client chart the number of cigarettes
she smokes.
c. You tell her to mentally visualize herself as a nonsmoker
whenever she has the desire to smoke.
d. All of the above.

Answer 42

a. You hypnotize her and tell her she will never smoke another
cigarette again. After you awaken her you admonish
her to smoke as many cigarettes as she can for the fi rst
three days.

Question 43

The directive or prescription given to the smoker in the previous question could best be described as

a. a paradoxical intervention.
b. a cognitive intervention.
c. an object relations intervention.
d. a behavioristic intervention.

Answer 43

a. a paradoxical intervention.

Question 44

A couple tells a therapist using strategic family therapy that they
have a quarrel at least once every evening. The therapist says, “Between now and the next time I see you I want you to have a serious quarrel at least twice every evening.” This is an example of

a. relabeling, which is commonly used in this form of therapy.
b. refraining, which is commonly used in this form of therapy.
c. prescribing the symptom.
d. a directive that is not paradoxical or a double bind.

Answer 44

c. prescribing the symptom.

Question 45

Strategic family counselors often rely on relabeling or reframing.
A client says his girl friend yells at him every time he engages
in a certain behavior. The best example of reframing or
relabeling would be

a. a counselor who remarks, “Research seems to show that
when she yells at you it is because she loves you so much.
A woman often feels foolish if she hugs or kisses you in a
situation like that.”
b. a counselor who remarks, “Can you tell me about it in
the present moment, as if she is yelling at you this very
minute?”
c. a counselor who remarks, “You are upset by her verbal
assaults.”
d. a counselor who remarks, “Are you really hurt by your girl
friend’s remarks or is it the fact that you are telling yourself
how catastrophic it is that she said these things?”

Answer 45

a. a counselor who remarks, “Research seems to show that
when she yells at you it is because she loves you so much.
A woman often feels foolish if she hugs or kisses you in a
situation like that.”

Question 46

In strategic family counseling the person with the power in the
family

a. has the authority to make rules and enforce them.
b. is usually extremely aggressive.
c. is usually not willing to follow a family therapist’s prescriptions
or directives.
d. is the one who talks the most.

Answer 46

a. has the authority to make rules and enforce them.

Question 47

Psychoanalytic practitioners do not attack symptoms directly.
Strategic therapy

a. does not attack the symptoms directly either.
b. is pragmatic and often focuses on abating symptoms.
c. does not take a position on whether a counselor should
attempt to ameliorate symptoms or not.
d. takes the position that if you can change each family
member’s unconscious, then symptoms will gradually
disappear.

Answer 47

b. is pragmatic and often focuses on abating symptoms.

Question 48

Cloe Madanes insists that symptoms serve a function. A child, for example, sees that her mother is depressed. The daughter throws a glass cup to the floor to break it. This brings her mother out of the depressed state and makes her mother angry and powerful. This is known as

a. symptom substitution.
b. the perverse triangle.
c. incongruous hierarchy.
d. latency.

Answer 48

c. incongruous hierarchy.

Question 49

Madanes advocates pretend techniques that are somewhat paradoxical. An example might be

a. a child who has panic attacks pretends he has a mental
bullhorn in his head and shouts “stop.”
b. a child who has panic attacks pretends in his mind that a
therapist is counseling him.
c. a child who has panic attacks pretends his dad is a therapist
during the actual family therapy session.
d. a child who has panic attacks pretends to have one during
the session and the parents pretend to help him.

Answer 49

d. a child who has panic attacks pretends to have one during

the session and the parents pretend to help him.

Question 50

A strategic family therapist says to a family, “I don’t know what
else you can do to stop the bickering and fighting in your house.” This is an example of

a. restraining.
b. quid pro quo.
c. pretending.
d. interpretation.

Answer 50

a. restraining.

Question 51

A client remarks that her depression is extremely intense. Her strategic counselor remarks, “It is very possible your depression is hopeless. It is possible you will never get over it.” Her comment is an example of

a. a blatant ethical violation.
b. positioning.
c. cohesion.
d. behavioral disputation.

Answer 51

b. positioning.

Question 52

A family counselor treats an Asian-American family exactly like he treats the Hispanic families in his caseload. He also imposes values from his own culture on them. This counselor has been described in the literature as

a. culturally sensitive.
b. lacking cultural sensitivity.
c. culturally encapsulated, a term suggested by counseling
pioneer Gilbert Wrenn.
d. b and c.

Answer 52

c. culturally encapsulated, a term suggested by counseling

pioneer Gilbert Wrenn.

Question 53

Which statement is true of African-American families?

a. They are the largest minority in the United States.
b. Fewer African Americans are getting married than at any
time in history and out-of wedlock births account for two
out of three first births to African-American women under
the age of 35.
c. African Americans are less likely to be concerned about
gender roles (e.g., men and women can cook meals or
work outside of the home).
d. b and c.

Answer 53

d. b and c.

Question 54

When working with an African-American family the best approach would probably be

a. Bowen’s family therapy; Minuchin’s structural family
therapy; or Jay Haley’s strategic family therapy.
b. cognitive family therapy.
c. Ackerman’s psychoanalytic approach to family therapy.
d. a strict reality therapy approach based on the work of
psychiatrist William Glasser.

Answer 54

a. Bowen’s family therapy; Minuchin’s structural family

therapy; or Jay Haley’s strategic family therapy.

Question 55

When counseling Asian-American families the best approach
would most likely be

a. Nathan Ackerman’s psychoanalytic approach.
b. behavioral family therapy.
c. solution focused/problem focused modalities.
d. a, b, and c.
Asian-American families also tend to use community resources
on their own once the therapist has given them the appropriate
information.

Answer 55

c. solution focused/problem focused modalities.

Question 56

Which statement is true of Hispanic families?

a. They have a high unemployment rate, often live in poverty, and rarely earn high school diplomas or college degrees.
b. They have higher than average incomes but usually don’t
finish high school or college.
c. They have college degrees, but still generally live in poverty.
d. They prefer long-term treatment in therapy.

Answer 56

a. They have a high unemployment rate, often live in poverty, and rarely earn high school diplomas or college degrees.

Question 57

A model by Olson, Sprenkle, and Russell suggests that family
functioning can be described in two dimensions—cohesion and
adaptability. The family therapy term cohesion refers to the level
of emotional bonding between family members. Adaptability
refers to

a. a family’s level of enmeshment or disengagement.
b. a family’s ability to adapt to the therapist’s personality.
c. a family’s ability to adapt to the theoretical persuasion of
the therapist.
d. how rigid, structured, fl exible or chaotic the family is.

Answer 57

d. how rigid, structured, fl exible or chaotic the family is.

Question 58

Which statement is true regarding Native-American families?

a. They are a very diverse group as they belong to over 500
state-recognized tribes.
b. Extended family and the tribe are very significant.
c. A high percentage of children have been placed in foster
care homes, residential facilities, or adoption homes that
are non-Native American.
d. All of the above are true.

Answer 58

d. All of the above are true.

Question 59

The statement, “Native Americans have a problem with alcoholism and suicide,” is

a. false.
b. true as far as alcoholism is concerned, however, false
where suicide is concerned.
c. true.
d. true regarding the suicide rate, however, false regarding
their use of alcoholic beverages.

Answer 59

c. true.

Question 60

Murray Bowen is known for his work in intergenerational family
therapy. When Bowen refers to triangulation he means

a. that most people have three ego states (i.e., the Parent,
the Adult, and the Child) in their personality.
b. that most people have a personality structure composed
of the id, the ego, and the superego.
c. when a dyad (i.e., two individuals) is under stress a third
person is recruited to help stabilize the difficulty between
the original dyad. This could even be a child placed in
the middle of the conflict.
d. therapy has three distinct phases.

Answer 60

c. when a dyad (i.e., two individuals) is under stress a third
person is recruited to help stabilize the difficulty between
the original dyad. This could even be a child placed in
the middle of the conflict.

Question 61

One of the primary goals of Bowen’s intergenerational family
therapy is differentiation. Differentiation is

a. the extent that one can separate one’s intellect from one’s
emotional self.
b. the extent that one is different from one’s peers.
c. the extent that one is different from one’s childhood.
d. the same as fusion.

Answer 61

a. the extent that one can separate one’s intellect from one’s
emotional self.

Question 62

Bowen popularized a three-generational pictorial diagram as a therapy tool. This is known as

a. an histogram.
b. a sociogram.
c. a genogram.
d. family sculpting.

Answer 62

c. a genogram.

Question 63

An intergenerational family therapist says she is concerned with the nuclear family emotional system. She is referring to

a. the fact that although the current family in therapy has
an emotional system, this emotional system is influenced
by previous generations whether they are alive or dead.
b. the fact that a genogram should depict a single generation.
c. the fact that emotional discord is a function of the unconscious
mind.
d. the miracle question.

Answer 63

a. the fact that although the current family in therapy has
an emotional system, this emotional system is influenced
by previous generations whether they are alive or dead.

Question 64

Albert Ellis is to REBT as Salvador Minuchin is to

a. the MRI model.
b. structural family therapy.
c. intergenerational family counseling.
d. behavioral family counseling.

Answer 64

b. structural family therapy.

Question 65

An important technique in structural family therapy is joining.
Which statement most accurately depicts this intervention?

a. The therapist meets, greets, and attempts to bond with
the family. The therapist will use language similar to that
of the family and mimesis which means that he or she
will mimic communication patterns.
b. The therapist is professional but distant.
c. The therapist joins the family and sympathizes with their
difficulties.
d. Joining is used during the final session of therapy.

Answer 65

a. The therapist meets, greets, and attempts to bond with
the family. The therapist will use language similar to that
of the family and mimesis which means that he or she
will mimic communication patterns.

Question 66

A family is seeing a structural family therapist because there is a huge argument every time the subject of the 16-year-old daughter’s boyfriend comes up. The therapist says, “Okay, I want you to play like you are at home and act out precisely what transpires when the subject of your daughter’s boyfriend is mentioned.” The structural family therapist is using a technique called

a. joining.
b. reframing (defi ned as an alternative way of describing or
perceiving an event).
c. enactment.
d. cognitive disputation.

Answer 66

c. enactment.

Question 67

When a structural therapist uses the term boundaries he or she
really means

a. the limits of the human mind.
b. the limits of behavior in the family.
c. the separation of the family members from their family
of origin.
d. the physical and psychological entities that separate individuals
and subsystems from others in the family.

Answer 67

d. the physical and psychological entities that separate individuals
and subsystems from others in the family.

Question 68

In Minuchin’s structural approach, clear boundaries are

a. pathological.
b. rigid.
c. also called diffuse boundaries.
d. ideal—firm yet flexible.

Answer 68

d. ideal—firm yet flexible.

Question 69

A woman is having difficulties at her place of employment. Her
husband turns to her in a session and says, “You’re on your own,
I’ve got my own problems.” A structural family therapist would
assert that the boundaries between this couple are

a. rigid.
b. clear.
c. diffuse.
d. a combination of a and c.

Answer 69

a. rigid.

Question 70

A mother insists on accompanying her 20-year-old daughter on a date. A structural therapist would assume that

a. the family has clear boundaries.
b. the family has rigid boundaries.
c. the family has diffuse boundaries.
d. the family supports individuation.

Answer 70

c. the family has diffuse boundaries.

Question 71

Minuchin would often mimic the family’s style. This is known
as

a. cognitive disputation.
b. the structural map.
c. permeable boundaries.
d. none of the above.

Answer 71

d. none of the above.

Question 72

Ackerman is psychodynamic. Haley is strategic. Minuchin is
structural. Bowen is intergenerational. Another well-known intergenerational
family therapist would be

a. Alfred Adler.
b. the Hungarian analytically trained psychiatrist Ivan
Boszormenyi-Nagy (enunciated Naahge).
c. Andrew Salter.
d. Mara Selvini-Palazzoli

Answer 72

b. the Hungarian analytically trained psychiatrist Ivan

Boszormenyi-Nagy (enunciated Naahge).

Question 73

A family member who is emotionally distant is

a. disengaged.
b. enmeshed.
c. an example of equifinality.
d. a placater.

Answer 73

a. disengaged.

Question 74

During the course of a family session you discover that a man
and his 14-year-old boy are putting pressure on mom to quit her job. Mom very much likes her work. In Haley’s theory this set of dynamics would be called

a. reframing.
b. equifinality.
c. the perverse triangle.
d. paradox.

Answer 74

c. the perverse triangle.

Question 75

_______ was a pioneer in the early history of family therapy.

a. Carl Jung.
b. David Wechsler.
c. Alfred Adler.
d. Franz Anton Mesmer.

Answer 75

c. Alfred Adler.

Question 76

Which therapist could best be described as atheoretical?

a. Jay Haley.
b. Carl Whitaker.
c. Alfred Adler.
d. Nathan Ackerman.

Answer 76

b. Carl Whitaker.

Question 77

Solution-Oriented therapy as practiced by William O’Hanlon,
Insoo Kim Berg, Steve de Shazer, and Michelle Weiner Davis focuses primarily on

a. the past.
b. the present.
c. the future.
d. dream analysis.

Answer 77

c. the future.

Question 78

Narrative therapy (NT), which highlights stories in counseling,
is associated with the work of

a. William O’Hanlon.
b. William Glasser.
c. Milton H. Erickson.
d. Michael White, his wife Cheryl White, and David
Epston.

Answer 78

d. Michael White, his wife Cheryl White, and David

Epston.

Question 79

Postmodernist Tom Anderson, a psychiatrist from Norway, became
disenchanted with traditional family therapy. He began
using a radical approach based primarily on

a. a one-way mirror and a reflecting treatment team.
b. three therapists.
c. the gestalt empty chair technique.
d. homework assignments.

Answer 79

a. a one-way mirror and a reflecting treatment team.

Question 80

Feminist therapy criticizes traditional therapies

a. because they are androcentric (i.e., they use male views
to analyze the personality).
b. because they are gendercentric (i.e., they assume that there are two separate psychological developmental patterns—
one for men and one for women).
c. because they emphasize heterosexism and debase samesex
relationships.
d. all of the above.

Answer 80

d. all of the above.

Question 81

The term skeleton keys as used in Steve de Shazer’s brief solution-
focused therapy (BSFT) indicates

a. a standard or stock intervention that will work for numerous problems.
b. a technique where the client goes home to see his or her
family of origin.
c. a technique that works for one specifi c problem, but usually
will not work with other diffi culties.
d. a technique in which the therapist hands the client or
clients a sheet of paper with a compliment on it.

Answer 81

a. a standard or stock intervention that will work for numerous problems.

Question 82

One criticism of using cognitive-behavioral methods like REBT
with families or individuals in multicultural counseling would
be

a. that the theory is not intended to be used with diverse
populations.
b. the theory suggests that the therapist must have ethnic
or racial ties with the client in order for effi cacious treatment
to occur.
c. that it ignores present moment problems.
d. that the cognitive disputation could go against cultural
messages.

Answer 82

d. that the cognitive disputation could go against cultural

messages.

Question 83

Most experts predict that in the 21st century, theories of counseling and psychotherapy will

a. become more integrative, since about 30 to 50% of all
therapists say they are eclectic.
b. become more behavioristic, since this is the approach
that uses statistical outcomes.
c. become more Rogerian, since the world as a whole is becoming
more humanistic.
d. not tolerate eclecticism, since it is not scientifi c.

Answer 83

a. become more integrative, since about 30 to 50% of all

therapists say they are eclectic.

Question 84

Pick the most accurate statement.

a. Brief solution-oriented therapy requires the use of a oneway
mirror with a treatment team behind the mirror.
b. Brief solution-oriented therapy does not utilize a treatment
team behind a one-way mirror.
c. Brief solution-oriented therapy sometimes uses a treatment
team behind a one-way mirror, nevertheless, it is
not required.
d. Brief solution-oriented therapy does not utilize paradoxical
interventions.

Answer 84

c. Brief solution-oriented therapy sometimes uses a treatment
team behind a one-way mirror, nevertheless, it is
not required.

Question 85

A researcher takes a group of clients and gives them a depression
inventory. He then provides each client with two sessions
of brief solution-oriented therapy and gives them the same depression inventory. A t test is used to compare the two sets of
scores on the same people (i.e., the before and after measures
of depression). This would be

a. a between-groups design.
b. a correlation coefficient.
c. a related measures within-subject design.
d. survey research.

Answer 85

c. a related measures within-subject design.

Question 86

A question on the NCE or CPCE regarding a preexperimental
design uses the letters XO. The letters stand for

a. X stands for treatment and O stands for observation,
measurement, or score.
b. X is the mean while O implies that no treatment was given.
c. X is the median while O stands for other group.
d. X stands for treatment while O is the number of observations
taken.

Answer 86

a. X stands for treatment and O stands for observation,

measurement, or score.

Question 87

Another type of preexperimental design is the one-group only
posttest design. This is best depicted by

a. OXO.
b. XO.
c. OX.
d. XX.

Answer 87

b. XO.

Question 88

A time-series design is a quasi-experimental design

a. that utilizes two randomly chosen groups; a control group
and an experimental group.
b. that relies on multiple observations of the dependent
variable (i.e., the thing you are measuring) before and
after the treatment occurs.
c. a and b.
d. is not depicted by any of the answers above.

Answer 88

b. that relies on multiple observations of the dependent
variable (i.e., the thing you are measuring) before and
after the treatment occurs.

Question 89

The Solomon four-group is considered a true experimental design since each group is chosen via a random sample. When using this design

a. all groups receive a pretest.
b. there is no pretest.
c. one control group receives a pre-test and one experimental
group receives a pretest; the other control group and
experimental group do not.
d. there is no posttest.

Answer 89

c. one control group receives a pre-test and one experimental
group receives a pretest; the other control group and
experimental group do not.

Question 90

Which group would most likely avoid eye contact with the counselorcand benefit from assertiveness training?

a. African/Black Americans.
b. Asian Americans.
c. European Americans.
d. All of the above.

Answer 90

b. Asian Americans.

Question 91

The newest career theory would be

a. constructivist and cognitive approaches.
b. the trait-and-factor approach.
c. the developmental and psychoanalytic approaches.
d. the transactional analysis approach.

Answer 91

a. constructivist and cognitive approaches.

Question 92

A popular TWA career counseling model by Renee V. Dawis
and Lloyd Lofquist uses the abbreviation PEC. This stands for

a. Person Emotion Consequence.
b. Person Education Consequence.
c. Person Environment Correspondence.
d. Person Environment Consequence.

Answer 92

c. Person Environment Correspondence.

Question 93

Most experts believe that the number of multigenerational families with a child, a parent, and a grandparent will

a. decrease.
b. increase.
c. remain static.
d. will continue to go up and down on a fairly regular basis.

Answer 93

b. increase.

Question 94

A researcher wants to prove that structural family therapy is the
most effective modality. She conducted a study a year ago using a significance level of .05. Several colleagues felt her significance level needed to come down. She thus ran the same basic experiment again with new people using a significance level of .01. Her chances of making a Type I error or so-called alpha error went down. Now assume you compare her new research
with her old research. What could you say about the possibility that her results will indicate that structural family therapy was not significantly different when in reality it truly is significant?

a. Statistically, nothing.
b. The chance of this occurring will go down when compared
to the first experiment.
c. The chance of this occurring increases when compared
to the first experiment.
d. It would totally depend on the sample size.

Answer 94

c. The chance of this occurring increases when compared

to the first experiment.

Question 95

A question on the NCE asks you to compute the coefficient
of determination. You are given a correlation coefficient of .70.
How would you mathematically accomplish this task?

a. You would subtract .70 from a perfect correlation of
1. 00.
b. You would multiply the mean of the population by .70.
c. You would add .70 to a perfect correlation of 1.00.
d. You would square the .70.

Answer 95

d. You would square the .70.

Question 96

A correlation coefficient between variables X and Y is .60. If we
square this figure we now have the coefficient of determination
or true common variance of 36%. What is the coeffi cient
of nondetermination that shows unique rather than common
variance?

a. There is no such concept.
b. You would subtract 36 from 100.
c. It would still be 36%.
d. It would be 64%.

Answer 96

d. It would be 64%.

Question 97

Krumboltz proposes a _______ model of career development.

a. social learning.
b. trait-and-factor.
c. developmental.
d. psychoanalytic.

Answer 97

a. social learning.

Question 98

Krumboltz’s social learning theory is sometimes referred to as a cognitive theory because it emphasizes beliefs that clients have about themselves as well as the world of work. When Krumboltz speaks of self-observation generalizations he really means

a. generalizations regarding a given occupation and how
successful the client would be in the occupation.
b. Pavlov’s principle of stimulus generalization.
c. Skinner’s principle of operant conditioning.
d. that in career counseling your primary concern is the
manner in which people view themselves and their ability
to perform in an occupation.

Answer 98

d. that in career counseling your primary concern is the
manner in which people view themselves and their ability
to perform in an occupation.

Question 99

SCCT stands for

a. social-cognitive career theory.
b. social-cognitive family therapy.
c. self-control career theory.
d. self-contained career therapy.

Answer 99

a. social-cognitive career theory.

Question 100

Career counselors refer to job shadowing and volunteering as
_______ activities, while reading the job hunting book What
Color Is Your Parachute? would be _______.

a. noninteractive; interactive.
b. interactive; noninteractive.
c. interactive; interactive.
d. noninteractive; noninteractive.

Answer 100

b. interactive; noninteractive.

Question 101

Urie Bronfenbrenner is one of the codevelopers of the National
Head Start Program. He proposed a theory of development that is

a. essentially the same as Piaget’s constructivism.
b. almost identical to Watson’s behaviorism.
c. an ecological systems theory that stresses the microsystem
(any immediate or close relationships or organizations
the child interacts with); the mesosystem (the way
microsystems work together such as family and school);
the exosystem (i.e., the school, church, neighborhood,
parents’ places of employment, in essence other places
the child interacts with but not as often); and the macrosystem
(i.e., the largest and most remote system which
includes, culture, wars, the federal government, and customs).
d. based on 12 discrete stages.

Answer 101

c. an ecological systems theory that stresses the microsystem
(any immediate or close relationships or organizations
the child interacts with); the mesosystem (the way
microsystems work together such as family and school);
the exosystem (i.e., the school, church, neighborhood,
parents’ places of employment, in essence other places
the child interacts with but not as often); and the macrosystem
(i.e., the largest and most remote system which
includes, culture, wars, the federal government, and customs).

Question 102

Before _______ child psychologists studied the child, sociologists studied the family, anthropologists studied society, economists analyzed the economic framework, and political scientists investigated the political structure.

a. James W. Fowler.
b. Daniel Levinson.
c. Urie Bronfrenbrenner.
d. Nancy Chodorow.

Answer 102

c. Urie Bronfrenbrenner.

Question 103

The school psychometrician refers Katie to you for individual
counseling. She indicates that Katie’s IQ is at the 50th percentile. Katie’s IQ

a. is in the mentally retarded range.
b. cannot be estimated based on this statistic.
c. is approximately 100.
d. is well above the norm for children her age.

Answer 103

c. is approximately 100.

Question 104

The psychometrician calls you to tell you that she has another
student who has an IQ that falls near the 84th percentile. This
student’s IQ

a. is somewhere in the gifted range, say 140.
b. is most likely near 105.
c. is approximately 115.
d. is between 75 and 80.

Answer 104

c. is approximately 115.

Question 105

An exam has a mean of 50 and a standard deviation of 20. Phil
has a score of 90. His score would fall

a. at the 40th percentile.
b. at the 5th stanine.
c. near the 98th percentile and the 9th stanine.
d. in the 6th stanine.

Answer 105

c. near the 98th percentile and the 9th stanine.

Question 106

Mrs. Kim wanted her daughter to attend a private school for
gifted children who have very high intelligence. Mrs. Kim’s
daughter took the Otis Lennon IQ test. Her T score was 80.
Kim’s counselor knew that

a. Mrs. Kim would be very upset because her daughter’s
low score would not allow her to be admitted.
b. Mrs. Kim would be elated because her daughter scored
exceptionally high and would be admitted.
c. she could not give Kim mother any feedback since a Tscore
tells you nothing about one’s actual IQ score.
d. a T-score of 80 is very average.

Answer 106

b. Mrs. Kim would be elated because her daughter scored

exceptionally high and would be admitted.

Question 107

The mean score on a new counseling exam is 65. The standard deviation is 15. Tanja scored a 35. This tells us that

a. she had a z score of +1.
b. she had a z score of -1.
c. she had a t score of 40.
d. she had a z score of -2.0.

Answer 107

d. she had a z score of -2.0.

Question 108

Kia was given a new client with a morbid fear of heights. Her
supervisor emphasized that he wanted her to use the most hitech form of treatment available. Kia should use

a. VRT.
b. William Glasser’s new reality therapy with choice theory.
c. Joseph Wolpe’s systematic desensitization (also known
as reciprocal inhibition) a form of behavior therapy that
works well with fears
d. REBT created by Albert Ellis, which was once called
RET.

Answer 108

a. VRT.

Question 109

The DSM provides diagnostic criteria for mental retardation. It
states that

a. the client must have an IQ score of 70 or below on an
individually administered IQ test and the onset of the
condition must be prior to age 18.
b. the client must have an IQ score on any IQ test below
70.
c. The client must have an IQ score on an individually administered
IQ test and the onset of the condition must
be prior to age 21.
d. The client must have an IQ of 85 or below on an individual
or a group IQ test.

Answer 109

a. the client must have an IQ score of 70 or below on an
individually administered IQ test and the onset of the
condition must be prior to age 18.

Question 110

Measures of central tendency are used to summarize data. A
counseling researcher wants to use a measure of central tendency which reacts to every score in the distribution. He will
thus

a. use the median, or middle score when the data are
ranked from lowest to highest. The median divides the
distribution in half since half the scores will fall above the
median, while half the scores will fall below the median.
b. use the mode, which is the most frequently occurring
score or category.
c. use the mean, which has been termed the arithmetic average.
d. use the median or the mode.

Answer 110

c. use the mean, which has been termed the arithmetic average.

Question 111

Which theorist would most likely assert that EQ is more important
than IQ?

a. David Wechsler.
b. Alfred Binet.
c. Charles Spearman.
d. Daniel Goleman.

Answer 111

d. Daniel Goleman.

Question 112

A counseling agency decides to pay their employees once a
week. The agency is using a

a. fixed interval schedule of reinforcement.
b. a variable interval schedule of reinforcement.
c. a fi xed ratio schedule of reinforcement.
d. a variable ratio schedule of reinforcement.

Answer 112

a. fixed interval schedule of reinforcement.

Question 113

As a gambling addiction counselor Laura is well aware that slot machines operate on a

a. variable ratio schedule of reinforcement.
b. variable interval schedule of reinforcement.
c. fi xed ratio schedule of reinforcement.
d. reinforcement system that counselors truly cannot explain.

Answer 113

a. variable ratio schedule of reinforcement.

Question 114

Pick the most accurate statement

a. behavior therapies based on classical conditioning are
used primarily with clients who have bipolar disorder.
Lithium is no longer used.
b. Behavior therapies based on classical conditioning are
much more effective than CBT when treating mood disorders.
c. Behavior therapies based on classical conditioning are
commonly used to treat phobias, but are also utilized for
clients with obsessive-compulsive disorders or OCD.
d. Behavior therapy is never based on classical conditioning

Answer 114

c. Behavior therapies based on classical conditioning are
commonly used to treat phobias, but are also utilized for
clients with obsessive-compulsive disorders or OCD.c. Behavior therapies based on classical conditioning are
commonly used to treat phobias, but are also utilized for
clients with obsessive-compulsive disorders or OCD.

Question 115

Ken’s supervisor told Ken to do a meta-analysis related to treating
children with sleep disorders.

a. Ken can use a correlation coefficient.
b. Ken can set up a true experiment with a control group
and an experimental group.
c. Ken can use a single subject N = 1 intensive design.
d. Ken will use statistics based on numerous studies to investigate
the issue.

Answer 115

d. Ken will use statistics based on numerous studies to investigate
the issue.

Question 116

You gave your client Ester a personality test and then shared
your interpretation of the test with her. Your client was amazed
at how accurate the test results were in terms of depicting her
personality. She readily accepted the interpretation. The next
day you discovered that you had interpreted the wrong test!
The test you were analyzing was not Ester’s but rather belonged
to another client! Ester’s behavior could best be explained by

a. the obvious fact that she is psychotic which means that
she is not in touch with reality.
b. the Barnum effect.
c. negative transference.
d. the placebo effect.

Answer 116

b. the Barnum effect.

Question 117

Approximately 40% of all elementary schools have shortened
recess or student playtime. Counselors

a. are excited about this change because U.S. children are
behind other countries academically and thus need more
study time.
b. believe the change will actually have little or no impact
on the children.
c. are concerned because some research indicates that recess
can have a positive impact since children are less
fi dgety on days when they have recess; especially if they
are hyperactive.
d. are not concerned as boys have better concentration on
days when they do not have recess.

Answer 117

c. are concerned because some research indicates that recess
can have a positive impact since children are less
fi dgety on days when they have recess; especially if they
are hyperactive.

Question 118

In 2005, the American Counseling Association released the first
revision of the ACA Code of Ethics in a decade. One major
change was that

a. the code eliminated the concept of confidentiality.
b. the code bans Internet counseling.
c. the code bans telephone counseling.
d. the code eliminated the phrase “dual relationships.”

Answer 118

d. the code eliminated the phrase “dual relationships.”

Question 119

The new ACA 2005 Code of Ethics forbids sexual or romantic
counselor–client interactions or relationships with current
clients, as did the old code. The old 1995 Code stipulated that
a counselor would need to wait two years after termination before
entering into a romantic relationship with a former client.
The new regulations

a. are virtually identical in this area.
b. changed 2 years to 10 years.
c. changed 2 years to 5 years.
d. changed 2 years to just 1 year.

Answer 119

c. changed 2 years to 5 years.

Question 120

You are counseling a well-known celebrity who dies. According
to the new 2005 ACA Ethical Code

a. Confidentially exists even after she dies.
b. Confi dentiality does not exist after death for any professional
helper. Princess Diana’s therapist was on television
talking about Princess Di’s eating disorder immediately
after her death.
c. The ethics state “a counselor has no obligation to uphold
confidentiality after a client’s death.”
d. The counselor is given no direction since this issue is not
addressed in the guidelines.

Answer 120

a. Confidentially exists even after she dies.

Question 121

Over 7,000 ACA members are now in private practice. The consensus among experts is that

a. most private practitioners will not need to deal with managed
care.
b. managed care companies are becoming increasingly difficult to deal with.
c. managed care companies are becoming easier to work
with.
d. ACA ethics now prohibit practitioners from being on
managed care panels.

Answer 121

c. managed care companies are becoming easier to work

with.

Question 122

Each year, approximately 31,000 U.S. citizens commit suicide
with an alarming 2,000 individuals attempting suicide each day in the United States. Suicide often checks in as the second or third leading killer of teens. Men commit suicide more frequently than women, however, women attempt suicide far more
often than men. It is accurate to say that

a. 10 to 15% of all claims handled by the ACA liability insurance
programs are related to suicide.
b. nearly 100% of the claims handled by the ACA liability
insurance programs are related to suicide.
c. ACA liability insurance will not cover you if a client commits
suicide.
d. African-American females have an extremely high rate of
suicide.

Answer 122

a. 10 to 15% of all claims handled by the ACA liability insurance
programs are related to suicide.

Question 123

The 2005 ACA code addresses end-of-life issues since these issues are getting a high degree of social attention (e.g., the Oregon assisted suicide law and the Terri Schiavo right-to-die case). The new code

a. finally takes a moral stance on abortion and gives counselors
a road map for dealing with this issue.
b. suggests that counselors who are helping terminally ill
clients who are thinking of hastening their own death
must break confidentiality.
c. suggests that counselors who are helping terminally ill
clients who are thinking of hastening their own death
would have the option of breaking or not breaking confidentiality.
d. suggests that a counselor who morally refuses to assist a
terminally ill client who wants to hasten her death (and
hence, wishes to explore end-of-life options) is acting in
an unethical manner.

Answer 123

c. suggests that counselors who are helping terminally ill
clients who are thinking of hastening their own death
would have the option of breaking or not breaking confidentiality.

Question 124

A client suffers from bipolar disorder and takes lithium. According to the DSM she has

a. a mood disorder.
b. an anxiety disorder.
c. schizophrenia, a term coined by Eugen Bleuler in 1911
(a psychotic disorder).
d. a somatoform disorder such as pain disorder.

Answer 124

a. a mood disorder.

Question 125

Matt was diagnosed with somatization disorder which falls under the category of somatoform disorders. It safe to say that

a. Matt is under 21.
b. Matt has never had a physical exam.
c. His symptoms have lasted over six months and his condition
manifested itself prior to age 30.
d. Matt’s only complaint is his back pain.

Answer 125

c. His symptoms have lasted over six months and his condition
manifested itself prior to age 30.

Question 126

Millie has a panic attack whenever she drives across a bridge. She has

a. situationally bound panic attacks.
b. cued panic attacks.
c. a and b.
d. predisposed panic attacks.

Answer 126

c. a and b.

Question 127

Sybil refers to a famous client who had 15 personalities. At the
time Sybil was said to suffer from multiple personality disorder
(MPD). Today her diagnosis would be

a. dissociative identity disorder.
b. a mood disorder.
c. related to RS issues.
d. a personality disorder.

Answer 127

a. dissociative identity disorder.

Question 128

Bulimia is classified as

a. an eating disorder which occurs equally in both men and
women.
b. an eating disorder that occurs primarily in women.
c. an adjustment disorder.
d. a narcissistic personality disorder.

Answer 128

b. an eating disorder that occurs primarily in women.

Question 129

You are seeing a client who is extremely concerned about her
body weight and shape. She vomits to keep her weight down,
nevertheless, she does not engage in binge eating. The most appropriate diagnosis would be

a. anorexia.
b. bulimia.
c. gender identity disorder.
d. eating disorder NOS.

Answer 129

d. eating disorder NOS.

Question 130

When counseling women a counselor can assume that

a. a woman generally makes less money than a man for the
same job.
b. most complaints against counselors for exploitation come
from women complaining about male counselors.
c. women are not as comfortable as men when they are involved
in competitive situations
d. all of the above.

Answer 130

d. all of the above.

Question 131

A hermaphrodite is

a. now referred to as an intersex person.
b. always gay.
c. always homosexual.
d. also called a cross-dresser.

Answer 131

a. now referred to as an intersex person.

Question 132

Gay men and women

a. primarily live the gay or lesbian lifestyle.
b. basically have the same range of gender role behaviors as
do male and female heterosexuals.
c. cannot be characterized in terms of lifestyle due to a distinct
lack of research.
d. are always transgendered.

Answer 132

b. basically have the same range of gender role behaviors as

do male and female heterosexuals.

Question 133

Warren needs to conduct a study. His supervisor wants him to use a parametric inferential statistic. This means that

a. he will need to use random sampling and the distribution
is normal.
b. he will need to use a convenience sample or a volunteer
sample.
c. his distribution will be positively skewed.
d. his distribution will be bimodal.

Answer 133

a. he will need to use random sampling and the distribution

is normal.

Question 134

A counselor has an answering machine in her offi e. Which
statement most accurately depicts the ethical guidelines related to this situation.

a. Ethical guidelines forbid the use of answering machines.
b. Ethical guidelines allow answering machines, but forbid
speaking with clients via a cell phone.
c. Ethical guidelines allow answering machines, but experts
insist that unauthorized staff should not be allowed to
listen or retrieve such messages.
d. Ethical guidelines are clear that a pager should be used
rather than an answering machine.

Answer 134

c. Ethical guidelines allow answering machines, but experts
insist that unauthorized staff should not be allowed to
listen or retrieve such messages.

Question 135

The law requires clinicians to

a. keep process notes.
b. keep progress notes.
c. keep process and progress notes.
d. keep the client’s name and address, but no other information.

Answer 135

b. keep progress notes.

Question 136

A client wants to read her record. Pick the statement which is
not accurate.

a. You should allow her to read the record or a summary of
it because she has an ethical right to do so.
b. You should allow her to read it, however, you should go
back and change things you don’t want her to see; for
example, the fact that you said she was schizophrenic.
c. You should allow her to read the record realizing that it is
best if you enter the information as soon as possible after
the session and then sign and date the entry.
d. Since your agency inputs the client’s record on a computer,
each entry will be dated and have a time on it. You
could then print the document for her perusal.

Answer 136

b. You should allow her to read it, however, you should go
back and change things you don’t want her to see; for
example, the fact that you said she was schizophrenic.

Question 137

A counselor is seeing a client on a managed care plan. Unfortunately,
the client has used up her maximum number of sessions
for the year. The counselor is convinced that the client is in
need of additional counseling, however, the counselor’s agency
will not allow him to see her for any additional sessions. The
best plan of action would be for the counselor to

a. Refer the client for continued counseling to a practitioner
who will see the client whether or not she has managed
care benefits.
b. Empathize with the client, but be sure to explain that she
is catastrophizing (an irrational thought pattern delineated
by Albert Ellis) and use REBT, a cognitive therapy, to
help her cope with the fact that she cannot be seen again
until next year.
c. Threaten to sue the managed care company, since this
would be in violation of ethical care for the client.
d. See the client, but don’t tell your supervisor. This is both
legal and ethical.

Answer 137

a. Refer the client for continued counseling to a practitioner
who will see the client whether or not she has managed
care benefits.

Question 138

A career counselor who relies on the constructivist viewpoint
would emphasize that

a. unconscious conflicts influence career decisions.
b. An individual’s career choice is influenced by his or her
attempt to make meaning out of the world of work.
c. Most career counselors do not give enough career inventories.
d. SCCT is the best theory.

Answer 138

b. An individual’s career choice is influenced by his or her

attempt to make meaning out of the world of work.

Question 139

A homosexual protests that he has been homosexual long enough and wants to lead a heterosexual lifestyle. He tells you that he wants a family and children. You should

a. refer him to a psychiatrist as medicine is necessary.
b. use dialectical behavior therapy (DBT).
c. bring in other members of his family since homosexuality
has its roots in the family system.
d. explain that homosexuality is not a mental disorder that
needs to be changed.

Answer 139

d. explain that homosexuality is not a mental disorder that

needs to be changed.

Question 140

Conversion or reparative therapy is intended to change sexual orientation and behaviors from gay to straight.

a. The literature in scientific and peer reviewed journals
does not indicate that a person’s sexual orientation can be altered from same sex attraction to opposite sex attraction.
b. ACA prohibits counselors from practicing conversion
or reparative therapies although no studies exist in this
area.
c. Longitudinal studies with clients who have been through
reparative or conversion therapy indicate that the treatment
is effective, but it still remains unethical.
d. ACA ethics indicate that a counselor trained in conversion
or reparative therapy can practice these modalities
if the client insists on the treatment.

Answer 140

a. The literature in scientific and peer reviewed journals

does not indicate that a person’s sexual orientation can be altered from same sex attraction to opposite sex attraction.

Question 141

A lesbian client wants to become heterosexual and asks for conversion
or reparative therapy. You explain that you ethically do
not believe in this form of intervention. She asks you to provide
her a referral to a practitioner who will perform this type of
therapy. You should

a. initially comply, since ethical counselors provide an appropriate
referral.
b. initially comply, but you must provide her with at least
three referrals.
c. initially, tell the client you prefer not to refer her to a
therapist who engages in this form of treatment. Discuss
the potential harm and risks with the client emphasizing
that this is an unproven form of treatment.
d. Initially, tell her to secure a consultation with a licensed
physician prior to making a referral.

Answer 141

c. initially, tell the client you prefer not to refer her to a
therapist who engages in this form of treatment. Discuss
the potential harm and risks with the client emphasizing
that this is an unproven form of treatment.

Question 142

The new ACA ethical requirement to have a transfer plan in writing would apply to

a. a situation in which a counselor became disabled.
b. a situation in which a counselor died.
c. a situation where a counselor moved to another state.
d. all of the above.

Answer 142

d. all of the above.

Question 143

You are counseling a 29-year-old man in your private practice who is seeing a primary care physician (PCP) for severe headaches.

a. You are required to contact the PCP.
b. You are not required to contact the PCP; however, attempting
to secure permission to do so from your client
would be considered the ideal course of action.
c. The answer would be no for headaches, but yes if the client
had visited the PCP regarding a mental health complaint.
d. Yes, but only if the client is abusing a child or a senior
citizen.

Answer 143

b. You are not required to contact the PCP; however, attempting
to secure permission to do so from your client
would be considered the ideal course of action.

Question 144

As a private practice counselor your _______ would be most
important in terms of fi ling claims.

a. graduate transcript.
b. undergraduate and graduate transcript.
c. NCC provider number.
d. NPI number.

Answer 144

d. NPI number.

Question 145

A counselor is treating a woman for a mood disorder. The counselor has sex with the woman’s daughter. According to the revised 2005 ACA Code of Ethics this is considered

a. unethical.
b. ethical.
c. ethical only after the counselor terminates the client and
then waits two years.
d. debatable since ACA guidelines fail to deal with sexual
issues of this nature.

Answer 145

a. unethical.

Question 146

You have impeccable training and experience as a counseling
supervisor. Now your brother fi nishes his master’s degree in
counseling and wants you to supervise him. According to ACA
ethics you should

a. accept him as a supervisee since it will be beneficial to
him.
b. cosupervise him with another colleague.
c. refer him to a trusted colleague trained in supervision
who is willing to take your brother.
d. supervise him if it is for licensing, but not if it is for
NCC.

Answer 146

c. refer him to a trusted colleague trained in supervision

who is willing to take your brother.

Question 147

The new ACA ethical guidelines stipulate that a counselor can
refrain from making a diagnosis if the counselor believes the
diagnosis could harm the client or others.

a. Therefore, a counselor could ethically diagnose all clients
as having an adjustment disorder to secure insurance
since this diagnosis is somewhat benign and not
likely to harm the client.
b. A counselor could refrain from making an Axis I or an
Axis II diagnosis if it is in the best interest of the client.
c. A decision to refrain from making a diagnosis is ideally
made in collaboration with the client, although the counselor
has the fi nal say.
d. Choices “b” and “c” are both correct.

Answer 147

d. Choices “b” and “c” are both correct.

Question 148

The agency you work for insists that you diagnose every client. Since this is in violation of the new ACA ethics this would qualify
as “negative conditions.” You could handle this by

a. Meeting with your supervisor and executive director of
the agency and discussing other ways to secure funding
that go beyond DSM reimbursement.
b. Advocate for the client by explaining to the insurance
company asking for the diagnosis that in some cases it is
best that a diagnosis not be given. You could even teach
the client to advocate for herself by having her inform
the insurance company that a diagnosis might not be in
her best interest.
c. Show your supervisor, executive director, or insurance
company/managed care fi rm the actual ACA Code of
Ethics so they can see it in writing that the code stipulates
that “Counselors may refrain from making and/or reporting
a diagnosis if they believe it would cause harm.”
d. All of the above.

Answer 148

d. All of the above.

Question 149

You leave your practice to study mental health treatment in
another country. Dr. Kline, another licensed counselor, is now
the custodian of your records. To conform with current ethical
standards this was clearly explained in your informed consent
brochure given to the client during the first visit. The clients
have Dr. Kline’s contact information. According to the new ethics
regarding transfer plans

a. Dr. Kline should contact each client when he receives
the record.
b. you should contact each client even though you are residing
in another country.
c. the client is totally responsible for contacting Dr. Kline
since he or she was given an informed consent document.
d. neither you nor Dr. Kline would be obligated to contact
the client.

Answer 149

a. Dr. Kline should contact each client when he receives

the record.

Question 150

In terms of the previous question:

a. A certified public accountant or CPA would be preferable
to a mental health professional such as Dr. Kline to
use as a custodian for the records.
b. An attorney would make the best custodian for the records.
c. Using a mental health professional on staff or at another
facility is preferable to using a lawyer or a CPA.
d. A CPA, an attorney, or a mental health professional would
be an excellent choice.

Answer 150

c. Using a mental health professional on staff or at another

facility is preferable to using a lawyer or a CPA.