Counseling Families, Diagnosis, Neurocounseling, And Advanced Concepts Flashcards
(200 cards)
1
Q
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.
A
The family.
Most family counselors believe that the entire family system, which is really a natural social system, is dysfunctional. Hence the entire family is the identified patient and in need of treatment. Traditionally, the identified patient (IP) was seen as the person who was having a problem.
2
Q
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
Only tell his wife if he gives you permission.
According to ethics guidelines counselors must not disclose information about one family member in counseling to another without prior consent.
3
Q
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.
A
This is unethical.
4
Q
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.
A
Experiencing marriage and family problems.
5
Q
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
Circular/reciprocal causality (e.g., dynamics of family members).
6
Q
Cybernetics is a concept used by family therapists. It is usually associated with the work of
a. Sigmund Freud and Albert Ellis.
b. Norbert Wiener.
c. Virginia Satir.
d. behavioral family therapists and cognitive family therapists.
A
Norbert Wiener.
Cybernetics was pioneered in the early 1940s and named (from the Greek word for steersman) by MIT mathematician Norbert Wiener. Wiener was asked to investigate how guns could be aimed to hit moving targets.
7
Q
A family that is stable and reaches an equilibrium is in a state of
a. adaptability.
b. enmeshment.
c. nonsummativity.
d. homeostasis.
A
Homeostasis.
8
Q
Adaptability is the ability of the family to balance
a. ego strength.
b. stability and change.
c. morphostasis and morphogenesis.
d. b and c.
A
B and C.
Morphostasis is the ability of the family to balance stability while morphogenesis refers to the family’s ability to change.
9
Q
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
Aspirational ethics.
Aspirational ethics, on the other hand, describe ideal or optimal practice. Pro bono services would fall into this category because it would be difficult to win an ethics’ violation charge against a counselor because he or she would not see the client for free.
10
Q
Experiential conjoint family therapy is closely related to the work of
a. Virginia Satir.
b. Albert Ellis.
c. Jay Haley.
d. Salvador Minuchin.
A
Virginia Satir.
Satir was a social worker who began seeing families in private practice in 1951. She felt that the family could be healed via love while Minuchin, the father of structural family therapy, felt that family therapy was a science requiring therapeutic interventions well beyond warmth.
11
Q
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.
A
You try to please everybody out of a fear of rejection.
The placating style causes the individual to sacrifice his or her
own needs as a way of dealing with stress.
12
Q
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.
A
All of the above are typical behaviors of the blamer.
The blamer basically asserts that, “It’s your fault I’m the way I am.”
13
Q
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.
A
Is likely to engage in the defense mechanism of
intellectualization.
14
Q
According to Virginia 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
Will distract the family from the problem via constantly talking about irrelevant topics.
15
Q
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
A
Carl Whitaker
Carl Whitaker, who was fond of saying that experience, not education, changes families. Experience goes beyond consciousness, according to Whitaker and the best way to access the unconscious is symbolically.
16
Q
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.
A
Joining the family and experiencing it as if he were a family
member.
17
Q
According to Carl Whitaker,
a. a co-therapist is helpful.
b. a co-therapist should never be used.
c. a co-therapist should be used only with blended families.
d. all of the above could be true.
A
A co-therapist is helpful.
Whitaker felt that a co-therapist can provide meaningful feedback and allows the therapist to be an active participant in the therapy rather than merely a teacher.
18
Q
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.
A
Carl Whitaker.
Whitaker could be wild at times. A couple who was in a power struggle, for example, might be asked to have a tug of war in order to prove who really had control. In today’s world with an attorney’s billboard on every corner, I’d probably not recommend an activity of that nature! Maultsby—the psychiatrist in choice “c”—is noted for creating rational self-counseling that is similar to Ellis’s REBT.
19
Q
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
David Premack’s principle or law.
Behaviorists who practice marriage and family therapy rely on the same theorists as individual practitioners of this persuasion. All of the theorists listed are behaviorists. Premack’s work, nevertheless, suggests that a family member must complete an unpleasant task (known as a low-probability behavior; LPB) before he or she would be allowed to engage in a pleasant task (known as a high-probability behavior; HPB). This is known as Premack’s principle.
20
Q
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 confirming 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.
A
Quid pro quo.
In Latin quid pro quo means “one thing for another,” “something for something,” or “this for that.”
21
Q
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
Quid pro quo.
22
Q
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 the period
a. when positive reinforcement is being implemented.
b. when negative reinforcement is being implemented.
c. when quid pro quo is being implemented.
d. before the behavior modification begins.
A
Before the behavior modification begins.
In behaviorism, a baseline is merely a measure of the behavior prior to the treatment or when treatment is not being implemented. What’s with the A and the B stuff? On some exams the baseline is signified via the upper-case letter A while the behavior modification treatment is written with an upper-case B
23
Q
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.
A
Time-out, a procedure that most behaviorists feel is a form
of extinction.
24
Q
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, there is a good chance Mr. Chance will consider leaving the marriage.
d. this situation will have virtually no impact on this couple’s marriage.
A
There is a good chance that Mrs. Chance will consider leaving the marriage.
Yes, reciprocity can mean that one state accepts another state’s license or credential but that obviously isn’t what it means in this respect. In fact, if that crossed your mind, take a break, you’ve been studying too darn long! The concept of reciprocity in marriage asserts that in most cases two people will reinforce each other at about the same level over time. When this doesn’t happen marital discord may result.
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.
Rely on systematic desensitization procedures.
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 Wolpe’s systematic desensitization.
Practice thought stopping.
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.
Casual comparative or ex post facto (i.e., after the fact)
research.
Since the research occurred in the past and the researcher did not have control over the independent variable this qualifies as causal comparative research.
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.
Family sculpting.
Family sculpting, popularized by Virginia Satir, is an experiential/ expressive technique in which a family member places other family members in positions that symbolize their relationships with other members of the family. Finally, the member places him- or herself. This helps the therapist understand family dynamics that might be missing from a mere discussion of family issues.
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%.
Remarriage today is common.
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 five
years to remarry.
d. Women remarry quickly, however, men do not.
Single life is short-lived for divorced persons. About 30% of all divorced persons are remarried within 12 months of being divorced.
The average divorce takes place after eight years. On average, after the marriage ends the partners will remarry in three or four years.
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.
Nathan Ackerman.
It was Ackerman—an analytically trained child psychiatrist—who as early as 1938, recommended studying the family and not just the child who was brought into treatment as the identified patient. Some experts consider this the true beginning of the family therapy movement.
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.
A significant other with whom a child wishes to bond.
This is the notion that an individual (or the individual’s ego) attempts to establish a relationship with an object—often a person or a part of the body—to satisfy needs. When this does not occur anxiety is manifested.
33
In psychoanalytic family therapy the term introjects really means that the client
a. unconsciously 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.
Unconsciously internalizes the positive and negative characteristics of the objects within themselves.
Eventually, these introjects (taking in personality attributes of others that become part of your own self-image) determine how the individual will relate to others.
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.
B and C.
Splitting occurs when the client sees an object (another person) as either all good or all bad. Splitting allows one to keep anxiety in check by making objects predictable. This tendency begins in childhood, usually by categorizing one’s mother as all good or all bad. Removing dysfunctional introjects from childhood is curative.
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.
Countertransference.
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 first-order change.
b. first-order change that is more desirable than second-order change.
c. mediation.
d. a Greek chorus.
Second-order change that is more desirable than first-order change.
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. persistent depressive disorder.
d. psychotic behavior.
Splitting.
Here is another type of splitting (the first type is depicted in question 934). As a child this woman internalized an image of her mother as all good at times and all bad at others. She now adheres to this pattern as an adult.
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.
James Framo and Robin Skynner.
39
Cloe Madanes and Jay Haley are associated with the ________ school of family counseling.
a. strategic
b. behavioral
c. psychodynamic
d. object relations
Strategic.
Haley is the name we associate most with this area. Haley was impacted by the late great Milton Erickson (not Erik Erikson) who believed in “designing a strategy for each specific problem.” It has been said that Haley helped alter Erickson’s work so that it helped families as much as individuals. Haley actually coined the term strategic therapy to explain Erickson’s method.
40
When Jay 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 Albert Ellis.
d. had a degree in the arts and communication rather than
the helping professions.
Had a degree in the arts and communication rather than
the helping professions.
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 difficulty for your daughter?”
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.”
A directive or prescription is when the therapist tells a client or family what to do.
42
Which of these responses is the best example of the double-bind concept used in 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.
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.
A double bind is a no-win situation characterized by contradictory messages such as never smoke again and then smoke as much as you want. It constitutes a paradox in the sense that the client is told he or she can engage in a behavior that the person wishes to abate.
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.
A paradoxical intervention.
A directive is really a therapeutic task or command. When a person follows a paradoxical directive the symptoms are under therapeutic control.
44
Acoupletellsatherapistusingstrategicfamilytherapythatthey 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.
Prescribing the symptom.
45
Strategic family counselors often rely on relabeling or reframing. A client says his girlfriend 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
girlfriend’s remarks or is it the fact that you are telling yourself how catastrophic it is that she said these things?”
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.”
Reframing occurs when you redefine a situation in a positive context (i.e., make the situation or behavior seem acceptable to the client). The situation is described in a positive light to evoke a different emotional response.
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.
Has the authority to make rules and enforce them.
Jay Haley believes you enhance the power of a family member within the context of therapy by speaking to him or her first during the initial session of therapy.
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.
Is pragmatic and often focuses on abating symptoms.
Haley’s therapy is solution/symptom focused and very action oriented.
48
Cloe Madanes insisted 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.
Incongruous hierarchy.
Madanes believed that one of the keys to family functioning is to help children find more direct ways to help their parents so that their symptoms (in this case breaking one of the family’s cups!) no longer serve a viable purpose. I
49
Madanes advocated 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.
A child who has panic attacks pretends to have one during the session and the parents pretend to help him.
In the pretending, the family enacts a make-believe scenario of the problem. Most experts maintain that the pretend technique is more gentle and less confrontational than traditional paradoxical interventions.
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.
Restraining.
In restraining a therapist may warn the family or individual about the negative consequences of change. The counselor might tell the family to take it very slow or expect a relapse. Restraining helps overcome resistance by suggesting that it might be best if the family does not change!
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. behavioraldisputation.
Positioning.
Positioning occurs when a helper accepts the client’s predicament and then exaggerates the condition. Positioning paints an even more negative picture of the situation for the client than restraining, mentioned in the previous question.
52
A family counselor treats an Asian American family exactly like he treats the Arab American 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.
d. b and c.
B and C.
Cultural encapsulation (a term suggested by counseling pioneer Gilbert Wrenn) results in a counselor imposing goals from his or her own culture on people from another culture. This is a no-no in counseling. Counselors who treat all families the same ignore key cultural differences.
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.
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.
B and C.
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 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.
Bowen’s family therapy; Minuchin’s structural family therapy; or Haley’s strategic family therapy.
Several studies indicate that African American families are less likely to seek professional treatment because they often rely on the extended family and the church for support and guidance. This is viewed as a strength. When family counseling is utilized, problem-focused, brief, or multigenerational approaches mentioned in the first choice seem to fare best.
55
When counseling Asian American families the best approach
would most likely be
a. Ackerman’s psychoanalytic approach.
b. behavioral family therapy.
c. solution-focused/problem-focused modalities.
d. a, b, and c.
Solution-focused/problem-focused modalities.
56
Which statement is true of Latino/a 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.
They have a high unemployment rate, often live in poverty, and rarely earn high school diplomas or college degrees.
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, flexible, or chaotic the family is.
How rigid, structured, flexible, or chaotic the family is.
Adaptability refers to the family’s balance between stability, known as morphostasis and change, known as morphogenesis. According to this model the key factor is that the family should have balance in cohesion as well as adaptability. This is the so-called circumplex family model. A word to the wise: Since a number of popular texts include information on this topic it is likely that you will see a question on one or more of the terms included in this question.
58
Which statement is true regarding Native American families?
a. They are a very diverse group as they belong to over 550 state-recognized tribes, with over 220 in Alaska.
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.
All of the above are true.
59
The statement “Native Americans, also called American Indians in some of the literature, 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.
True.
The Centers for Disease Control and Prevention (CDC) statistics indicate suicide is the second leading cause of death among Native Americans/Alaska Natives between the ages of 10 and 34. Alcohol is involved in 69% of the suicides for all age brackets in this cultural group, topping all other groups tabulated. The high rates of suicide and alcoholism create issues with suicide bereavement (people mourning a suicide are known as “survivors of suicide”), fetal alcoholism, and cirrhosis of the liver.
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.
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.
61
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.
A genogram.
62
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.
The extent that one can separate one’s intellect from one’s emotional self.
It occurs when the intellectual and emotional aspects of the personality merge. A person who does not possess differentiation does not have a clear sense of the self and others.
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.
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.
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.
Structural family therapy.
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.
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.
66
Afamilyisseeingastructuralfamilytherapistbecausethereisa 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.
c. enactment.
d. cognitivedisputation.
Enactment.
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.
The physical and psychological entities that separate
individuals and subsystems from others in the family.
When structural therapists attempt to help the family create healthy boundaries it is known as changing boundaries or the boundary marking technique. In this technique the family seating is often altered and family members are placed at a different distance from each other.
68
In Minuchin’s structural approach, clear boundaries are
a. pathological.
b. rigid.
c. also called diffuse boundaries.
d. ideal—firm yet flexible.
Ideal—firm yet flexible.
Clear boundaries are considered healthy. When boundaries are clear persons in the family are supported and nurtured, but each has the freedom to be his or her own person (i.e., individuate).
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.
Rigid.
Rigid boundaries are characterized by individuals or subsystems being disengaged. What will the wife do in this situation? Well, according to this theory she will seek support outside of the family system.
70
A mother insists on accompanying her 20-year-old daughter on a date. A structural therapist would assume that the family
a. has clear boundaries.
b. has rigid boundaries.
c. has diffuse boundaries.
d. supports individuation.
Has diffuse boundaries.
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.
None of the above.
The correct term is mimesis and it implies that the therapist copies the family’s style. This helps the therapist join the family and helps the family accept him or her as a helper.
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. Ivan Boszormenyi-Nagy (enunciated Naahge).
c. Andrew Salter.
d. Mara Selvini-Palazzoli.
Ivan Boszormenyi-Nagy (enunciated Naahge).
Boszormenyi-Nagy—thank your lucky stars you need not know how to spell it for the exam—is a Hungarian analytically trained psychiatrist who discusses the importance of give and take fairness or relational ethics in the family.
73
A family member who is emotionally distant is
a. disengaged.
b. enmeshed.
c. an example of equifinality.
d. a placater.
Disengaged.
74
During the course of a family session you discover that the man and his 14-year-old son 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.
The perverse triangle.
The perverse triangle is a situation when two members who are at different levels of the family hierarchy (usually a coalition between parent and a child) team up against another family member. The alliance between the parent and the child may be overt or covert. In any event, the alliance against the other parent undermines his or her power and authority.
75
________ was a pioneer in the early history of family therapy.
a. Carl Jung
b. David Wechsler
c. Alfred Adler
d. Franz Anton Mesmer
Alfred Adler
76
Which therapist could best be described as atheoretical?
a. Jay Haley .
b. Carl Whitaker.
c. Alfred Adler.
d. Nathan Ackerman.
Carl Whitaker.
Whitaker asserted that theory is often used as an excuse to keep therapists emotionally distant from the family. Whitaker promoted “craziness” (not a typo!) and creativity of family members.
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.
The future.
This approach puts little or no emphasis on understanding the problem. The therapist’s verbalizations center on the future. The therapist co-formulates a plan of action with the client or family. There may be more than one appropriate course of action.
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.
Michael White, his wife Cheryl White, and David Epston.
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.
A one-way mirror and a reflecting treatment team.
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 same- sex relationships.
d. all of the above.
All of the above.
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 specific problem, but usually will not work with other difficulties.
d. a technique in which the therapist hands the client or clients a sheet of paper with a compliment on it.
A standard or stock intervention that will work for numerous problems.
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 efficacious treatment to occur.
c. that it ignores present moment problems.
d. that the cognitive disputation could go against cultural
messages.
That the cognitive disputation could go against cultural
messages.
Another criticism is that Albert Ellis views dependency as unhealthy and some cultures see interdependence as a positive attribute.
83
Most experts predict that in the twenty-first century, theories of counseling and psychotherapy will
a. become more integrative, since about 30–50% 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 scientific.
Become more integrative, since about 30–50% of all therapists say they are eclectic.
84
Pick the most accurate statement.
a. Brief solution-oriented therapy requires the use of a one- way 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.
Brief solution-oriented therapy sometimes uses a treatment
team behind a one-way mirror, nevertheless, it is not
required.
This therapy often relies on paradox; hence, choice “d” is incorrect. On brief strategic/family therapy questions on your exam, the term ecosystems refers to the fact that larger systems often impact client and family functioning (e.g., the schools, church, or health care system). An ecosystemic approach always takes these larger systems into account.
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.
A related measures within-subject design.
In the within-subjects design, each subject acts as his or her own control. The between-groups design (which relies on separate people in the control and experimental groups) is a much more popular form of research. When a single group is used in research or two groups that are not equivalent, your exam will probably refer to this situation as a pre-experimental design.
86
A question on the NCE or CPCE regarding a pre-experimental design uses the letters XO. The letters stand for
a. treatment (X) and observation, measurement, or score (O).
b. the mean (X) and no treatment was given (O).
c. the median (X) and other group (O).
d. treatment (X) and the number of observations taken (O).
Treatment (X) and observation, measurement, or score (O).
87
Another type of pre-experimental design is the one-group only posttest design. This is best depicted by
a. OXO.
b. XO.
c. OX.
d. XX.
XO.
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. without randomly chosen control and experimental groups, which 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.
Without randomly chosen control and experimental groups, which relies on multiple observations of the dependent variable (i.e., the thing you are measuring) before and after the treatment occurs.
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 pretest and one experimental
group receives a pretest; the other control group and
experimental group do not.
d. there is no posttest.
One control group receives a pretest and one experimental
group receives a pretest; the other control group and
experimental group do not.
In this design one pair of control/experimental groups receives a pretest while the other pair does not. This design helps weed out the impact of a pretest.
90
John Gottman is known for
a. setting the level for intoxication driving while under the influence (DUI) or driving while intoxicated (DWI) at .08 or higher in most states.
b. creating a paradigm to predict which marriages would likely end in divorce.
c. demonstrating that physical biomarkers of older adults can be reversed if they are placed in an environment from the past and told to act like they are living in the past.
d. popularizing the notion of propinquity.
Creating a paradigm to predict which marriages would likely end in divorce.
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.
Constructivist and cognitive approaches.
Career experts wonder if traditional theories are applicable now since the majority of theories were based on research using white, middle-class males, which is hardly representative of the work market today that includes more people of color, a large number of women and teens, and more persons from lower socioeconomic classes.
92
A popular TWA career counseling model by René 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.
Person environment correspondence.
93
Most experts believe that the number of multigenerational families with a child, a parent, and a grandparent living together will
a. decrease.
b. increase.
c. remain static.
d. will continue to go up and down on a fairly regular basis.
Increase.
The number of families of this ilk nearly doubled between 1980 and 1990. When the economy goes into a recession and young adults can’t afford to live on their own they often live with their family. In addition, as more people live longer, the number will go up since many of the older folks are incapable of caring for themselves. And just in case your exam asks, the number of single adults in the United States is also increasing.
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 reduced. Now assume you compare her new research to 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.
The chance of this occurring increases when compared to the first experiment.
The situation described in this question is a Type II error or so- called beta error. When the chance of making a Type I error goes down (as stated in the question) then the probability of making a Type II error goes up. Type I and Type II errors are like a see-saw—as one goes up the other goes down. Why do you think I called this section advanced?
95
A question on your comprehensive exam 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.
You would square the .70.
The coefficient of determination is computed by squaring the correlation coefficient. Thus, in this case the variance would be 49%.
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 coefficient 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%.
It would be 64%.
You subtract the coefficient of determination from 100.
97
John Krumboltz proposes a ________ model of career
development.
a. social learning behavioristic
b. trait-and-factor
c. developmental
d. psychoanalytic
Social learning behavioristic
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. in career counseling your primary concern is the manner in which people view themselves and their ability to perform
in an occupation.
In career counseling your primary concern is the manner in which people view themselves and their ability to perform
in an occupation.
99
SCCT stands for
a. social cognitive career theory.
b. social cognitive family therapy.
c. self-control career theory.
d. self-contained career therapy.
Social cognitive career theory.
100
Career counselors refer to job shadowing and volunteering as ________ activities, while reading the job hunting book What Color Is Your Parachute? is ________.
a. noninteractive;interactive
b. interactive;noninteractive
c. interactive;interactive
d. noninteractive;noninteractive
Interactive;noninteractive
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.
d. based on 12 discrete stages.
An ecological systems theory.
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 Bronfenbrenner
d. Nancy Chodorow
Urie Bronfenbrenner
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. indicates she has an intellectual disability.
b. cannot be estimated based on this statistic.
c. is approximately 100.
d. is well above the norm for children her age.
Is approximately 100.
Note that the 50th percentile is directly in the middle of the normal curve. Since an average IQ is approximately 100, this would be the best answer.
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.
Is approximately 115.
Here again, take a look at the normal curve. The 84th percentile is about a standard deviation above the mean. A standard deviation above the mean is roughly 15 IQ points above the mean, thus 100 plus 15, so an IQ of 115. Again I ask you, why do you think we call it the advanced section?
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.
Near the 98th percentile and the 9th stanine.
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’s mother any feedback since a t-score tells you nothing about one’s actual IQ score.
d. a t-score of 80 is very average.
Mrs. Kim would be elated because her daughter scored exceptionally high and would be admitted.
Take a look at the normal curve and wow, Mrs. Kim’s daughter blew the lid off the test with a superb IQ score of nearly 150. Since a gifted or very superior IQ is generally around 130 you can bet your bottom dollar she will be admitted to the school.
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.
She had a z-score of -2.
The z-score is the same as the standard deviation. In this case Tanja scored 2 standard deviations below the mean.
108
Kia was given a new client with a morbid fear of heights. Her supervisor emphasized that he wanted her to use the most high- tech 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.
VRT.
Virtual reality therapy (VRT) has been dubbed in many sources as “the next best thing to being there.” Clients are hooked to a computer by wearing headgear. The computer simulates a real- life situation such as being high up in a glass elevator (or whatever the problem is). This is termed virtual reality. Dr. Barbara Rothbaum created this behavioristic approach.
109
The DSM-5 provides diagnostic criteria for intellectual disability
(ID), formerly billed as 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. The client’s ability to adapt to normal life in school, work, or family at home must also be impaired.
b. the client must have an IQ score below 70 on any group administered IQ test.
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 score of 70 or below on an individually administered IQ test.
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. The client’s ability to adapt to normal life in school, work, or family at home must also be impaired.
Contrary to popular belief, intellectual disability is not always present throughout the life span. Training is capable of raising IQ scores. Exam reminder: Group IQ tests are not considered as accurate as individually administered tests. The individual IQ test is the gold standard; however, IQ testing is a very controversial topic.
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.
Use the mean, which has been termed the arithmetic average.
The mean is the only measure of central tendency which reacts to every score in the distribution.
111
Which theorist would most likely assert that EQ is more important than IQ?
a. David Wechsler
b. Alfred Binet
c. Charles Spearman
d. Danie Goleman
Danie Goleman
EQ, incidentally, stands for emotional intelligence. EQ would encompass traits such as empathy, impulse control, motivation, and the ability to love. According to Daniel Goleman in his popular book Emotional Intelligence: Why It Can Matter More Than IQ, it is EQ rather than IQ that determines success.
112
A counseling agency decides to pay their employees once a week. The agency is using a
a. fixed interval (FI) schedule of reinforcement.
b. a variable interval (VI) schedule of reinforcement.
c. a fixed ratio (FR) schedule of reinforcement.
d. a variable ratio (VR) schedule of reinforcement.
Fixed interval (FI) schedule of reinforcement.
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. fixed ratio schedule of reinforcement.
d. reinforcement system that counselors truly cannot explain.
Variable ratio schedule of reinforcement.
Another good old typical reinforcement question. Since the slot machine does not operate on time (e.g., it won’t pay out every 20 minutes) then it is not an interval scale. Instead, it is based on the opposing or ratio scale.
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 (OCD).
d. Behavior therapy is never based on classical conditioning.
Behavior therapies based on classical conditioning are commonly used to treat phobias, but are also utilized for clients with obsessive-compulsive disorders (OCD).
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.
Ken will use statistics based on numerous studies to
investigate the issue.
Meta- analysis or meta-research occurs when several studies on the same topic are utilized in order to examine a hypothesis. The results of several studies—or tons of studies if they are available—are then synthesized. The technique was originally used to overcome the severe limitations of a small sample size that often occurs when a researcher performs a single experiment. Needless to say, the drawback to this technique is that it may be relying on a glut of poorly designed studies which in turn will yield inaccurate results.
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.
The Barnum effect.
In psychometrics, the Barnum effect (which can also be dubbed the Forer effect after the psychologist who discovered it, Bertram R. Forer) refers to the fact that clients will often accept a general psychological test report, horoscope, or palm reading and believe it applies specifically to them!
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 fidgety 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.
Are concerned because some research indicates that recess can have a positive impact since children are less fidgety on days when they have recess; especially if they are hyperactive.
118
Neuroscience supports
a. the analytic notion that focusing on negative emotions is helpful.
b. the medical model, and thus it is not truly relevant to counselors.
c. the notion that the concept of neuroplasticity is merely a myth.
d. the notion that empathy and exercise could benefit depressed individuals.
The notion that empathy and exercise could benefit depressed individuals.
119
Neuroscience seems to show that
a. cognitive therapy does not impact one’s brain.
b. cognitive therapy could raise serotonin, the feel good chemical
in the brain, just like antidepressant pharmaceuticals.
c. cognitive therapy raises cortisol to an extremely high level.
d. cognitive therapy has virtually no impact on the frontal
cortex.
Cognitive therapy could raise serotonin, the feel good chemical
in the brain, just like antidepressant pharmaceuticals.
Cognitive therapy (as set forth by Albert Ellis and Aaron T. Beck) works like a prescription medicinal and raises serotonin without the side effects! Cortisol has been dubbed the stress hormone, and we would not want to increase it through cognitive therapy.
120
Which statement best reflects the position of neurogenesis?
a. A 76-year-old man signs up for a course in chess and generates more neurons.
b. A 9-year-old girl falls off her bicycle and now has a learning disability.
c. A 32-year-old man uses temperature/thermal biofeedback to help ward off headaches.
d. A 32-year-old man uses EMG biofeedback to help ward off headaches.
A 76-year-old man signs up for a course in chess and generates more neurons.
Learning, such as counseling, generates neurons even in older adults.
121
__________ seemingly is related to serotonin in the brain. Deficits of serotonin are thought to cause depression.
a. Vitamin B5, also known as pantothenic acid,
b. L-Arginine, an amino acid,
c. Tryptophan, an amino acid,
d. Omega 3 from sources such as fish oil, krill oil, or algae,
Tryptophan, an amino acid,
When tryptophan is removed from the diet memory, anxiety, sleep, and mood go south. Aggression, on the other hand rises.
122
At the last count, approximately 43,000 U.S. citizens committed suicide during a single year making suicide the tenth leading cause of death. Worldwide the figure is an alarming 800,000 per year. Suicide often checks in as the second- or third-leading killer of young people in the 15–24-year-old age bracket. Men commit suicide more frequently than women, however, women attempt suicide far more often than men. It is accurate to say that
a. 10–15% 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.
10–15% of all claims handled by the ACA liability insurance programs are related to suicide.
123
Statistically speaking, males typically use ________________ and females use _________ to commit suicide.
a. poison;firearms
b. heroin;alcohol
c. firearms; poison
d. heroin; jumping off a building or bridge
Firearms; poison
124
Neurocounseling research indicates that the _______________
is dominant ___________.
a. left hemisphere; in most people
b. right hemisphere; in most people
c. left hemisphere; in right-handed people
d. left hemisphere; in 50% of the population
Left hemisphere; in most people
The left hemisphere of the brain is dominant in over 95% of the population. Although the percentage is higher in right-handed persons, it is still dominant in most left-handers. Damage to the left hemisphere often results in issues with the right side of the body.
125
Matt was diagnosed with a somatic symptom disorder (SSD), with predominant pain. It is safe to say that
a. Matt is at least 40 years of age.
b. Matt has never had a physical exam in regard to his pain.
c. no physiological basis or medical condition can be found to
explain his reaction.
d. Matt’s pain can be carefully traced to a precise physical
cause.
No physiological basis or medical condition can be found to
explain his reaction.
Somatic symptom disorders must have a physical exam in order for the SSD diagnosis to be valid. The key factor here is that emotional factors can cause somatic (bodily) complaints and health concerns.
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.
A and B.
Simply put: situationally bound or cued attacks have a cue or an environmental trigger. In this case it is obviously the bridge. On the other hand, an uncued or unexpected attack seemingly occurs out of nowhere and no internal or external trigger can be identified. Women experience panic attacks more often than men.
127
Sybil was 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.
Dissociative identity disorder.
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 anxiety disorder.
d. a narcissistic personality disorder.
An eating disorder that occurs primarily in women.
Bulimia is more prevalent. Statistically speaking, about 90% of anorectics and bulimics are female. The onset of these disorders often occurs in adolescence.
129
Binge-eating disorder (BED)
a. is not a valid DSM diagnosis.
b. occurs mainly in men.
c. results in vomiting and extreme bouts of exercise.
d. is the most common type of eating disorder.
Is the most common type of eating disorder.
130
A counselor can assume that, in general
a. women make less money than men 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.
All of the above.
131
Intersexuality
a. describes an individual with male and female sexual characteristics and possibly male and female internal or external sex organs.
b. describes a person who is always gay.
c. describes a person who is always heterosexual.
d. describes a person who is a cross-dresser.
Describes an individual with male and female sexual characteristics and possibly male and female internal or external sex organs.
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 transgender.
Basically have the same range of gender-role behaviors as
do male and female heterosexuals.
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.
He will need to use random sampling and the distribution is normal.
By definition, parametric statistics are used when the distribution is normal (i.e., the mean, the median, and the mode are the same) and random sampling has been utilized.
134
A counselor has an answering machine in her office. 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.
Ethical guidelines allow answering machines, but experts
insist that unauthorized staff should not be allowed to listen or retrieve such messages.
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.
Keep progress notes.
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.
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.
This choice is incorrect since a counselor cannot alter documented information in a client’s file after it has become part of the record.
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 the company’s policy 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.
Refer the client for continued counseling to a practitioner who will see the client whether or not she has managed care benefits.
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 personal story and attempt to construct meaning out of the world of work.
c. most career counselors do not give enough career
inventories.
d. SCCT is the best theory.
An individual’s career choice is influenced by his or her personal story and attempt to construct meaning out of the
world of work.
139
A gay male protests that he is unhappy with his sexual preference 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.
Explain that homosexuality is not a mental disorder that
needs to be changed.
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.
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.
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 refer her to a practitioner who will perform this type of therapy. You should
a. comply, since ethical counselors provide an appropriate referral.
b. comply, but you must provide her with at least three referrals.
c. 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. tell her to secure a consultation with a licensed physician prior to making a referral.
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.
142
The 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.
All of the above.
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.
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.
144
As a private practice counselor your ________ would be most important in terms of filing claims.
a. graduate transcript
b. undergraduate and graduate transcript
c. NCC provider number
d. NPI number
NPI number
The National Provider Identifier (NPI) number would be required to file claims electronically or even by mail. HIPAA rules stipulate that the NPI is your standard unique identifier as a health care provider.
145
A counselor is treating a woman for a mood disorder. The counselor has sex with the woman’s daughter. This is considered
a. unethical.
b. ethical.
c. ethical only after the counselor terminates the client’s
sessions and then waits two years.
d. debatable since ACA guidelines fail to deal with sexual
issues of this nature.
Unethical.
146
You have impeccable training and experience as a counseling supervisor. One of your supervisees comes in for her session and she is crying uncontrollably because her boyfriend told her he was breaking up with her. It is clear counseling would be beneficial and she asks you for counseling. You should
a. provide appropriate crisis counseling and then assist her in finding an appropriate counselor.
b. begin counseling her immediately as she needs it, but refer her to another supervisor.
c. assist her in finding an appropriate counselor.
d. begin counseling her immediately as she needs it, but make her sign a statement saying there could be issues and if she begins to feel the sessions are exploitative in any way, you
will refer her to another colleague.
Assist her in finding an appropriate counselor.
Ethical guidelines are clear that supervisors do not provide
counseling services to supervisees. Case closed!
147
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 a 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 final say.
d. Choices “b” and “c” are both correct.
Choices “b” and “c” are both correct.
148
The agency you work for insists that you diagnose every client. Since this is in violation of the newer 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 firm 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.
All of the above.
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. 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. Ethically
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.
Dr. Kline should contact each client when he receives the record.
150
In terms of the previous question:
a. A certified public accountant (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.
Using a mental health professional on staff or at another
facility is preferable to using a lawyer or a CPA.
151
During a counseling session Mrs. Sander’s 13-year-old daughter Jamie tries to speak. Mrs. Sanders says, “I told you not to say anything.” Her daughter wants to know why she cannot talk. Mrs. Sanders replies, “Because I’m the parent, end of discussion young lady.” According to the parenting typology of Diana Baumrind, Mrs. Sanders is
a. an authoritative parent.
b. an authoritarian parent.
c. a permissive parent.
d. a nonpunitive parent.
An authoritarian parent.
152
A counselor identifies herself as an ABA practitioner. The technique she would be least likely to use would be
a. VR reinforcement.
b. FR reinforcement.
c. asking the client to talk about his dreams as if the dream is
occurring in the present.
d. thinning.
Asking the client to talk about his dreams as if the dream is
occurring in the present.
153
A counselor is working with a client suffering from post-traumatic stress disorder (PTSD). Which counselor would be most concerned about inducing REM/EM during the sessions?
a. A counselor who is performing systematic desensitization as set forth by Joseph Wolpe.
b. A counselor who is using Francine Shapiro’s EMDR.
c. A counselor who is using existential strategies popularized
by Irvin Yalom.
d. A counselor who relies on brief strategic therapy (BST).
A counselor who is using Francine Shapiro’s EMDR.
EMDR (eye movement desensitization and reprocessing) is a popular modality for helping those with PTSD. The technique attempts to produce rapid eye movement/eye movement (REM/ EM) during the actual course of the sessions.
154
A counselor is using the memory device: IS PATH WARM? He is most likely working with
a. a client with bipolar disorder.
b. a client with test anxiety.
c. a client diagnosed on the autism septrum disorder.
d. a client whom he feels could be suicidal.
A client whom he feels could be suicidal.
This one (IS PATH WARM?) was created via the American Association of Suicidology (AAS) to assist folks in terms of assessing the risk of suicide: I = ideation, S = substance abuse, P = purposelessness, A = anxiety, T = trapped, H = hopelessness, W = withdrawal, A = anger, R = recklessness, M = mood changes.
155
Child-centered play therapy (CCPT) is experiencing rapid growth in popularity and spawning research. This modality was created by
a. Virginia Mae Axline, an associate of Carl R. Rogers who penned Dibs In Search of Self.
b. Carl R. Rogers, who created client-centered/person- centered counseling.
c. Gerard Egan, author of the well-known text, the Skilled Helper.
d. Anna Freud, daughter of Sigmund Freud.
Virginia Mae Axline, an associate of Carl R. Rogers who penned Dibs In Search of Self.
156
In a children’s career counseling group, the group will help the children
a. have a sense of belonging.
b. share feelings and ideas.
c. engage in desirable peer interaction.
d. in all the ways listed above.
In all the ways listed above.
157
In terms of adolescents and career group counseling
a. the literature indicates such groups just don’t work.
b. such groups are cost effective and promote peer
identification.
c. textbook authors such as Dr. Samuel T. Gladding insist
that adolescents can only be assisted in individual sessions.
d. it may be true that such groups work, but they do not help
adolescents with other aspects of their lives.
Such groups are cost effective and promote peer identification.
158
The concept of universality (also called mutuality) applies to group treatment. In career groups we can safely say
a. the group allows the members to see that others can be struggling with similar issues related to work, vocation, and career.
b. these terms are rarely, if ever, utilized.
c. other members of the group are in similar situations.
d. choices a and c are both correct.
Choices an and c are both correct.
Mutuality/universality is a curative factor in counseling as well as career counseling groups
159
If you compare group career counseling to noncounselor
interventions
a. you will discover that group career counseling is more effective.
b. you should know this is not a valid question. Because there is no counselor in noncounselor interventions, career counseling cannot take place! The question defies common sense.
c. you will find out that no studies exist in this area.
d. you will find that they are equal in terms of helping persons
who are wrestling with career and vocational issues.
You will discover that group career counseling is more effective.
Noncounselor implies a counselor is not present for the session. A meta-analysis (i.e., looking at a boatload of studies in the field) clearly reveals that career counseling with a warm body (it could be you!) is more effective.
160
When you conduct group career counseling
a. unstructured groups work best.
b. structured groups work best.
c. gestalt groups work best.
d. the group must be based on the concepts set forth by
motivational interviewing.
Structured groups work best.
Structured career counseling groups and structured career
counseling workshops seem to be superior.
161
Special career counseling groups can be set up. Some examples include a group with displaced homemakers or persons receiving public assistance. Groups of this nature
a. are discriminatory and are not recommended.
b. have been used, but are rarely desirable.
c. can be very helpful.
d. are never a good choice if individual sessions are available.
Can be very helpful.
Special career counseling groups for specific populations work
quite well.
162
Group career counseling
a. is an international phenomenon. It is used in China with college students.
b. is not used in any other country except the U.S. We are clearly the world leader in this area.
c. is more expensive to conduct than providing individual sessions.
d. is rarely used in the U.S. for college students; however, it is used with K-12 students.
Is an international phenomenon. It is used in China with college students.
Group career counseling is an international modality.
163
The main purpose of a career group is
a. to promote insight.
b. to provide catharsis related to job and career issues.
c. to release pent up emotions related to frustrations
surrounding work-related issues.
d. to provide information to participants.
To provide information to participants.
Since you have literally wrestled with over 1,050 questions, I thought I’d throw in an easy one. Another key purpose is to help folks explore vocations and to enhance their decision-making
skills.
164
According to expert John Krumboltz
a. career groups with a psychodynamic slant are the most effective.
b. group career counseling is important, but will not have an impact on your happiness.
c. career decision issues are crucial in terms of one’s happiness.
d. career groups should focus primarily on developmental issues.
Career decision issues are crucial in terms of one’s happiness.
165
An advantage of group career counseling over individual career counseling is
a. other clients in the group can help you to rev up your motivation.
b. you get to help other clients and they get to help you.
c. participants can role-play situations such as how to answer
questions during a job interview.
d. All of the above statements are correct.
All of the above statements are correct.
166
Richard Nelson Bolles penned the bestselling job hunting manual in history titled What Color Is Your Parachute? The book, updated yearly, has sold over 10 million copies and is
published in over 20 languages.
a. Bolles champions the idea of securing a network of persons who can help you with your job search.
b. Bolles likes groups if the group uses the trait-and-factor theory.
c. Bolles likes groups if the group uses Donald Super’s theory.
d. Bolles likes groups if the group uses the concepts set forth
by Nathan Azrin.
Bolles champions the idea of securing a network of persons who can help you with your job search.
Surprisingly, when I interviewed Dick Bolles for my book Therapy’s Best he told me he was not really enamored with any of the existing career theories. Bolles is a major fan of networking. If possible, your clients should try to pick the job he or she will enjoy the most.
167
Nathan Azrin studied with B. F. Skinner. His job club groups are based on
a. REBT.
b. narrative therapy.
c. behaviorism based somewhat on positive reinforcement.
d. DBT.
Behaviorism based somewhat on positive reinforcement.
The fact that Azrin studied with Skinner should have tipped you off that he is a behaviorist.
168
Career groups are often considered a theme group. The best
intervention in a structured career group would be
a. promoting psychodynamic insight.
b. paraphrasing as often as possible.
c. using activities such as a game.
d. changing the client’s internal verbalizations as stressed by
REBT, the model created by Albert Ellis.
Using activities such as a game.
None of the answers would be entirely wrong. That said, the question tells you very little and the only technique that you can be sure is structured is using a game as part of the career sessions.
169
You create a career group to examine the clients’ roles in life as a child, student, citizen, homemaker/parent, worker, citizen, and time spend participating in leisure activities (leisurite). You should use
a. the MBTI based on the work of psychiatrist Carl Jung.
b. Nathan Azrin’s job club model, based on behaviorism.
c. John Holland’s SDS or so-called Self-Directed Search.
d. Donald Super’s life career rainbow.
Donald Super’s life career rainbow.
The career rainbow helps group members answer the question: Where have you been in life and where are you going? It opens the door to discuss a career crisis such as a layoff.
170
According to the fetal origins hypothesis, adult heart disease, some emotional disorders, and type 2 diabetes could be related to
a. lack of stimulation (i.e., nurture) during the first year of life.
b. nature.
c. in utero malnutrition
d. undiscovered factors related to the human genome.
In utero malnutrition
Experts believe that “fetal origins” my be the “third arm” or missing link in the longstanding nature–nurture debate. Or to put it a different way, genetic endowment and environmental influences after birth, along with what happens to the fetus during gestation (conception to birth), determine our behavior and risks for developing physical diseases and emotional disorders. In utero merely means in the womb, should you see it on your exam.
171
According to the human growth and development notion of plasticity every client you see
a. can alter his or her traits at any point in the life span.
b. has his or her behavior governed by critical periods.
c. must be aware of the fact that change is not an ongoing
process.
d. must be aware that most processes of change are merely
random.
Can alter his or her traits at any point in the life span.
The concept of plasticity drives home the point that every trait within a given individual can be altered throughout the course of the life span.
172
Two 18-year-olds are given the exact same dosage of an antidepressant medication. One indicates that the medicine makes her feel “great” while the other insists the intervention makes her “very tired.” This can most likely be attributed to
a. differential sensitivity.
b. the fact that medical practitioners, including psychiatrists,
overmedicate and should use smaller doses of
antidepressants.
c. the fact that both clients are impacted by the placebo effect.
d. the fact that antidepressants are intended to make clients
extremely tired, but do help with mood disorders.
Differential sensitivity.
The term illuminates the idea that some people are more vulnerable than others to a particular experience, yes even prescription pharmaceuticals, due to genetic differences.
173
You are conducting a program evaluation (PE) for your 501(c)(3) nonprofit counseling agency. You should begin by
a. getting the support of the staff, administration, and clients.
b. writing a grant to fund the study.
c. asking United Way for help.
d. taking the steps in choices b and c.
Getting the support of the staff, administration, and clients.
174
Program evaluation (PE) helps agencies, organizations, and centers make wiser decisions. PE takes place in a natural, rather than a laboratory or controlled, setting and helps _________ answer questions posed via __________.
a. researchers;staff
b. programs;researchers
c. programs;staff
c. staff;researchers
Programs;staff
175
A cost–benefit analysis (CBA) answers the question:
a. Should the counseling organization become a private practice or a 501(c)(3) nonprofit?
b. Should a counseling center opt to do brief strategic therapy?
c. Was the money wisely spent or does the counseling center need a new program?
d. Which clients should receive pro bono services?
Was the money wisely spent or does the counseling center need a new program?
Counselors often find it difficult to talk about CBA because it deals with the issue of whether or not it is worth the price to assist people. As counselors, we routinely take the position that you can’t put a price tag on helping others.
176
You are the owner of a counseling practice. You make the sole decision which counselor receives the new referrals. According
to new ACA ethics on fee splitting
a. you can charge counselors 50% of the agency counseling fee for office space.
b. you can charge counselors one third of the agency counseling fee for office space, but it must never exceed one third.
c. fee splitting is totally ethical and the director could set the fee split at any cost he or she feels is appropriate.
d. although many counselors believe this is controversial, it is unethical based on the fact that charging a percentage of the payment rate per client appears to be a kickback scheme similar to accepting a referral fee.
Although many counselors believe this is controversial, it is unethical based on the fact that charging a percentage of the payment rate per client appears to be a kickback scheme similar to accepting a referral fee.
177
You are supervising a counselor-in-training and focusing on the OARS core skills. You are teaching her how to perform
a. psychodynamic group therapy.
b. gestalt therapy created by Fritz Perls.
c. motivational interviewing (MI) created mainly by William
Miller and Stephen Rollnick.
d. career counseling using directive techniques.
Motivational interviewing (MI) created mainly by William Miller and Stephen Rollnick.
Motivational interviewing is really hot right now, especially in the area of addictions, since the strategy was initially used with problem drinkers. It is even used beyond the borders of the U.S. Most experts see it as an offshoot of Rogerian counseling, though to be sure it is much more goal directed. OARS, by the way, stands for Open questions (e.g., how is your gambling addiction impacting your life?), Affirmations (any positive factors the counselor sees in the client’s life such as awards, achievements, or successes), Reflection (you know this one by now), and Summaries (again, you’ve got this one down).
178
The order of the four processes that MI uses is
a. engaging, focusing, evoking, and planning.
b. engaging, evoking, focusing, and planning.
c. evoking, focusing, engaging, and planning.
d. planning, engaging, focusing, and evoking.
Engaging, focusing, evoking, and planning.
Engaging is used first to create a relationship with the client. In MI the counselor is not intended to be an expert, but rather a partner. Focusing simply means that the conversation should be limited to the patterns of behavior the client wishes to change. Evoking stresses the client should use his or her own motivation to make changes, and planning is the act of creating a smart, measurable plan (if possible!) that works.
179
According to existential therapist Irvin D. Yalom
a. most therapists do a superb job of interacting with clients who bring up the topic of death.
b. most therapists are afraid of their own mortality and avoid the topic of death.
c. discussing dreams related to death is not very therapeutic.
d. helping the client put death out of one’s mind aids the
client’s growth.
Most therapists are afraid of their own mortality and avoid the topic of death.
180
Pick the most accurate statement regarding patients diagnosed with cancer.
a. Since January 1, 2015 there is official recognition that a diagnosis of cancer will affect a patient’s mental health.
b. Physicians are required by law to give all cancer patients a referral for counseling or psychotherapy.
c. Paradoxically, although a diagnosis of cancer is often very serious there is virtually no evidence that cancer patients have any more mental health issues than prior to the diagnosis.
d. Counselors have always been the primary workers in the medical system when compared to social workers and psychologists and thus traditionally have counseled most patients diagnosed with cancer.
Since January 1, 2015 there is official recognition that a diagnosis of cancer will affect a patient’s mental health.
181
Transgender individuals have an attempted suicide rate which is approximately 25 times higher than the rate for the general population. A high percentage of transgender youth experience oppression and are physically assaulted. A transgender does not identify with the gender they were given at birth or the person’s
expression differs from societal expectations. What is cisgender?
a. All females.
b. All males.
c. The same as genderfluid.
d. A person who identifies with the gender they were assigned
at birth and hence by definition this person is not a transgender individual.
A person who identifies with the gender they were assigned
at birth and hence by definition this person is not a transgender individual.
182
A correlation/association between variables x and y is .50. According to the notion of effect size (ES)
a. the correlation is medium.
b. the correlation is small.
c. the correlation is large.
d. the correlation would not be applicable to this statistic.
The correlation is medium.
A small association is .20 or less; medium is .50 or less; and large, strong, or big (yes all these terms are used) checks in at .80 or higher.
183
You conduct a true experiment. The results between the several groups are statistically significant. You have rejected the null hypothesis.
a. You should still provide an effect size (ES) statistic.
b. You would not need to provide the effect size (ES) since
the data indicate there is a statistical significance.
c. You would not need to provide the effect size (ES) since the ES only applies to correlations and this is a true
experiment.
d. You could provide the effect size (ES), but since it is a true
experiment this information could be very misleading.
You should still provide an effect size (ES) statistic.
184
A major meta-analysis (a term coined by researcher Gene V. Glass) of 375 outcome studies using effect size (ES) by Mary Lee Smith, Gene V. Glass, and Thomas I. Miller revealed that
a. psychotherapy is approximately as effective as antidepressants, about .31.
b. psychotherapy is less effective than antidepressants, about .22.
c. psychotherapy was too hard to define to come up with an ES statistic.
d. psychotherapy had a strong or so-called big effect, checking in at a .85.
Psychotherapy had a strong or so-called big effect, checking in at a .85.
185
According to the DSM-5
a. pathological gambling is not a disorder.
b. pathological gambling is a disorder and is listed with
Obsessive-Compulsive and Related Disorders just like
trichotillomania (now called hair pulling).
c. pathological gambling is a disorder and is listed with
Substance-Related and Addictive Disorders.
d. pathological gambling is a conduct disorder.
Pathological gambling is a disorder and is listed with
Substance-Related and Addictive Disorders.
Disorders of this nature are often called impulse disorders. Gambling addiction, nevertheless, is listed with Substance-Related and Addictive Disorders. Since gambling addiction is often treated via addiction and substances abuse centers, this makes logical sense to a lot of counselors.
186
All of the statements below are true about bullying except:
a. More girls are bullied than boys.
b. More whites are bullied than minorities.
c. Fewer students claim they are being bullied in recent years.
d. More students are harassed in the hallways than on social
media.
More students are harassed in the hallways than on social
media.
Cyber-bullying usually takes place via unwanted text messages and to a lesser degree via Internet posts that contain negative or hurtful information. One surprise is that some research indicates that sibling bullying is a more common variety of school bullying.
187
Wilderness therapy falls under the auspices of adventure-based therapy. There is no one set model for wilderness therapy. All of the statements below are true about wilderness therapy except:
a. Effective wilderness therapy occurs when a boot camp model is used in the wilderness.
b. Most counselors believe stricter regulations should be put in place to avoid abuses.
c. Effective wilderness therapy settings use little or no force, confrontation, or point level systems.
d. Reports of abuse and even death of youth have surfaced.
Effective wilderness therapy occurs when a boot camp model is used in the wilderness.
188
The 1974 Family Educational Rights and Privacy Act (FERPA) could be called the Buckley Amendment on your exam since Senator James K. Buckley was a strong supporter. All of these
facts are true regarding FERPA except:
a. Parents have access to a minor child’s educational records. Children over age 18 can view their own records.
b. A parent is able to have the educational record amended.
c. A counselor working in a private educational institution which does not receive federal funding would still be
required to follow FERPA guidelines.
d. In situations involving imminent danger, a counselor could
release information to protect the client, others, or ward off harm.
A counselor working in a private educational institution which does not receive federal funding would still be
required to follow FERPA guidelines.
189
Mr. Donald is seeing you for a gambling addiction problem. Several years ago he won a huge amount of money at the casino from a slot machine. As soon as he pulled the handle he snapped his fingers. Now he always snaps his fingers after he pulls a slot machine handle. His superstition can best be explained by
a. accidental reinforcement.
b. contingent reinforcement.
c. shaping with successive approximations. d. the fact that he has savant tendencies.
Accidental reinforcement.
190
Pick the incorrect statement.
a. Men commit suicide more than women.
b. Women suffer from depression more than men.
c. Alcoholism occurs more in women than men.
d. Autism occurs more in men than women.
Alcoholism occurs more in women than men.
191
You are supervising a graduate student. The client she is discussing was raped and robbed several days prior to your session with this student. When you ask your supervisee for more information she says, “Well, I’m certain the fact that she was carrying a very expensive handbag and wearing tight clothes was an issue.” Based on gestalt psychologist Fritz Heider’s concept of attribution theory
a. your supervisee is relying on situational attributions.
b. your supervisee is relying on dispositional attributions.
c. paradoxically, the expensive handbag and tight clothes
would ward off crime.
d. the tight clothes were an issue, but not the expensive
handbag.
Your supervisee is relying on dispositional attributions.
Attribution theories assign a cause, explanation, or reason for a behavior or outcome of an event. When the cause or outcome is generated by the person it is said to be a dispositional or internal attribution.
192
Based on the information in the previous question, the best example of a fundamental attribution error (also called a fundamental attribution bias) would be:
a. The graduate student blames the woman for carrying an expensive handbag and wearing tight clothes.
b. The graduate student blames the man who committed the rape and the robbery.
c. The graduate student blames the police force for not patrolling the area better.
d. The graduate student becomes so emotional, she cannot discuss the incident with you as her supervisor.
The graduate student blames the woman for carrying an expensive handbag and wearing tight clothes.
The fundamental attribution error occurs when a person attempts to look at somebody else’s negative behavior, failure, or undesirable event (never your own!) and come up with an explanation.
193
According to attribution theory and the self-serving bias, if you
pass your exam _________ and if you fail your exam ___________.
a. it is because of external issues; it is because of internal issues
b. it is because of situational issues; it is because of dispositional issues
c. it is because of dispositional issues; it is because of situational issues
d. you lucked out; the authors of the exam chose poor exam questions
It is because of dispositional issues; it is because of situational issues.
This tendency is called the self-serving bias. A positive event occurred because you are so wonderful etc.! A negative event occurred because of the situation or external circumstances! It had nothing to do with you.
194
You are performing career counseling with a client. This client is extremely depressed. The client goes on a job interview and doesn’t get the job. Based on research related to attribution theory
a. in most instances this client will begin having suicidal ideation within 24 hours.
b. the client’s view of reality will be swayed due to his depression and thus he will insist that the interviewer was a total jerk.
c. he will blame himself for his poor performance during the interview.
d. he will make a joke out of the fact that he did not get the job.
He will blame himself for his poor performance during the interview.
A depressed client will typically do the opposite of a person who is not depressed and will blame himself. In a situation like this the self-serving attribution bias would not apply.
195
A counselor is using telephone coaching with a client. The counselor is most likely to base her treatment on
a. William Glasser’s reality therapy with choice theory.
b. REBT as set forth by Albert Ellis.
c. DBT as set forth by Marsha M. Linehan.
d. systematicdesensitization.
DBT as set forth by Marsha M. Linehan.
When DBT is adapted to a setting or situation where it is not possible to use all four modes, the term DBT-informed is used. As a simple example, if a counselor was only going to use telephone coaching due to time restraints or cost restrictions, then the term “DBT-informed” would be appropriate. So you will hear helpers talk about standard DBT (the entire kit and caboodle with all four steps) or abbreviated DBT-informed practices.
196
A counselor is utilizing a thought log—also known as a thought record—with an anxious client. She is practicing
a. psychodynamic therapy.
b. career counseling based on the work of Donald Super.
c. cognitive behavior therapy (CBT).
d. the transtheoretical model which draws from all of the
available theories to help the client change.
Cognitive behavior therapy (CBT).
197
You are conducting a session using CBT; however, you are incorporating mindfulness as well as ACT into the session. Strictly speaking you are
a. performing second wave CBT.
b. third wave CBT.
c. first wave CBT.
d. operantconditioning.
Third wave CBT.
First wave treatments were based on operant and classical conditioning such as the work of B. F. Skinner and Ivan Pavlov. Second wave interventions focused heavily on cognitions depicted by the work of Albert Ellis and Aaron T. Beck. Third wave or contemporary approaches incorporate DBT, motivational interviewing, and ACT (pronounced just like the word act), which stands for acceptance and commitment therapy.
198
A counselor is performing CBT. He believes his client is not dealing with the real or core issue causing the difficulty. The most effective ploy would be to
a. change his approach to narrative therapy.
b. give the client a projective personality test.
c. use the downward arrow technique, created by David D.
Burns, M.D.
d. prescribe rational imagery (RI), often advocated by Albert
Ellis.
Use the downward arrow technique, created by David D. Burns, M.D.
The downward arrow technique is highly recommended to ferret out what the client is truly upset about and make the client aware of this issue.
199
Classical conditioning is based on paired learning, whereas operant conditioning is predicated on rewards or punishment. In a classical conditioning experiment a dog was trained to salivate to a bell which was originally presented about 0.5 second before the meat. The bell is
a. a CS or conditioned stimulus.
b. an NS or neutral stimulus.
c. a UR or unconditioned response.
d. a CR or conditioned response.
A CS or conditioned stimulus.
200
Your supervisor insists you rely on a teleological approach with a client. Pick the correct statement.
a. You would simply talk to the client about her childhood.
b. You would prescribe a homework assignment related to
her childhood.
c. You would focus exclusively on the here and now.
d. You would focus on the client’s goal to become a stock
broker in four years when she finishes her business degree.
You would focus on the client’s goal to become a stock
broker in four years when she finishes her business degree
Some approaches are historic and dwell on the past. Others are present moment oriented and focus on the here and now. And still others are said to be teleological in the sense that a future event is responsible for the client’s current behavior.
