Counseling Families, Diagnosis, and Advanced Concepts II Flashcards
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
c
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
a.
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
b.
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
c.
Family counselors generally believe in
a. circular/reciprocal causality (e.g., dynamics of family members)
b. linear causality
c. random causality
d. dream analysis
a.
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
b. Wiener - family has feedback loops to self-correct a family system
A family that is stable and reaches an equilibrium is in a state of
a. adaptability
b. enmeshment
c. nonsummativity
d. homeostatsis
d. homeostatsis - maintaining a balanced state
This concept suggests that any system including the family is greater than the sum of its parts (the individuals in it) and therefore it is necessary to examine patterns rather than merely each individual’s behavior.
nonsummativity
Adaptability is the ability of the family to balance
a. ego strength
b. stability and change
c. morphostasis and morphogenesis
d. b and c
d. morphostasis is the ability of the family to balance stability while morphogenesis refers to the family’s ability to change
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
a. mandatory - rigid and clear cut
aspirational - describe ideal
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
a. Satir - family could be healed via love - clashed with Minuchin who advocated scientific interventions
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
d. placating style causes the individual to sacrifice his or her own needs as a way of dealing with stress
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 bx of the blamer
d.
The person who becomes overly reasonable
a. practices excitation
b. cries a lot during therapy session
c. is likely to engage in the defense mechanism of intellectualization
d. has a high degree of emotion
c. emotionally detached
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
a.
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
c. Whitaker - experience, not education, changes families - experiential symbolic family therapy
Who developed the systems theory model?
a. Ludwig von Bertalanffy
b. Gregory Bateson
c. Carl Whitaker
d. Murray Bowen
a. a biologist
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
b.
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
a. cotherapist could provide meaninful feedback
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
b.
Psychiatrist noted for creating rational self-counseling that is similar to Ellis’s REBT is
a. Virginia Satir
b. Carl Whitaker
c. Maxie C. Maultsby, Jr.
d. William Glasser
c.
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
a. Premack’s work suggests that a family member must complete an unpleasant task (LPB) before he or she would be allowed to engage in a pleasant task (HPB)
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, “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
d. quid pro quo - latin for “one thing for another”
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
a.
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
d.
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
d.
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.
a.
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
c. Wolpe’s systematic desensitization
A family counselor notices that the husband in a blended family is having obsessive sexual thoughts about a women living down the street. A strict behaviorist would most likely
a. analyze the man’s dreams
b. have him chart the incidence of the bx, but do little else
c. practice thought stopping
d. rely primarily on Joseph Wolpe’s systematic desensitization
c.
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 strict behavioristic model. The agency took 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/after assessment that accurately depicted how well the families were 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 correlation study
b. causal-comparative or ex post facto research
c. a true experiment
d. simple survey research
b. occurred in past, researcher did no have control over independent variable, t test eliminates correlation
All of the techniques listed below would be used by a behavioristic family therapist except
a. family sculpting
b. a functional analysis of bx followed by operant conditioning
c. modeling
d. chaining and extinction
a. Family sculpting - Satir experiential approach
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 US hovers at about 10%
c. 25% of all marriages are getting remarried, divorce rate is 50%
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 five years to remarry
d. Women remarry quickly, however, men do not.
a.
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
d. Ackerman - analytically trained child psychiatrist, concerned with the internal feelings and thoughts of each individual as well as the dynamics between them
In psychoanalytic family therapy the word object means
a. a dream
b. a significant other with whom a child withes to bond
c. transference
d. countertransference
b. individual’s attempt to establish a r/s with an object to satisfy needs
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 problems solving options
d. possesses the internal motivation to solve his or her own difficulties
a. internalizes (taking in personality attributes of others that become part of your own self-image)
Pick the best examples 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
d.
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
c. unconscious reaction to the family
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 first-order change
b. first-order change that is more desirable than second-order change
c. mediation
d. a Greek chorus
a. first order change can be defined as changes that are superficial - ameliorates sxs
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
b. splitting
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
d. Framo - believes that important objects often fuel “love-hate” feelings in kids, Skynner - kids who had poor role models as children possess protective systems
What model? Rogers Ellis Glasser Lazarus Wolpe
Rogers - person-centered Ellis - rational emotive behavior therapy Glasser - reality therapy Lazarus - BASID ID, multimodal therapy Wolpe - systematic desensitization
Cloe Madanes and Jay Haley are associated with the _______ school of family counseling
a. strategic
b. behavioral
c. psychodynamic
d. object relations
a. Haley - strategic therapy, impacted by Milton Erickson
When Haley began investigating psychotherapy he
a. was already trained as a Freudian analyst like so many other pioneers in the field
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.
d.
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 difficulty for your daughter?”
c. a directive is when the therapist tells a client or family what to do
Which of these responses is the best example of the double-bind 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 first 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
a.
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
a.
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. reframing, which is commonly used in this form of therapy
c. prescribing the symptom
d. a directive that is not paradoxical or a double bind
c. paradoxical strategy
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 remark or is it the fact that you are telling yourself how catastrophic it is that she said these things?”
a. redefine a situation in a positive context
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
a.
Psychoanalytic practitioners do not attack sxs directly. Strategic therapy
a. does not attack the sxs directly either
b. is pragmatic and often focuses on abating sxs
c. does not take a position on whether a counselor should attempt to ameliorate sxs or not
d. takes the position that if you can change each family member’s unconscious, then sxs will gradually disappear
b. solution/sxs focused and very action oriented
Cloe Madanes insists that sxs serve a function. A child, for example, sees that her mother is depressed. The daughter throws a glass cup tot he 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
c. Madanes believes to help children find more direct ways to help their parents so that their sxs no longer serve a viable purpose. Incongruent - b/c daughter is in control.
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
d.
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
a. restraining - warn family or individual about the negative consequences of change
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
b. positioning occurs when a helper accepts the client’s predicament and then exaggerates the condition
Strategic techniques include: (4 paradoxical interventions)
restraining, positioning, prescribing the sxs and relabeling/reframing are all examples of paradoxical interventions since they defy common sense
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
d. cultural encapsulation - results in a counselor imposing goals from his or her own culture on ppl from another culture
Which statement is true of African-American families?
a. They are the largest minority in the US
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
d. b and c
d.
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
a. problem focused, brief, or multigenerational approaches fare best
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
c.
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 tx in therapy
a. less education, high poverty rate - short-term/structural approaches appear to work well
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, flexible or chaotic the family is
d.
