Counseling Families, Diagnosis, Neurocounseling, And Advanced Concepts Flashcards
A married couple brings their two children to counseling for behavioral problems. The 14-year-old daughter stays out late and their 17-year-old son is using drugs. According to most marriage and family therapists the identified patient would be
a. the 17-year-old son.
b. the 14-year-old daughter.
c. the family.
d. both children.
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.
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.
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.
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.
This is unethical.
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.
Experiencing marriage and family problems.
Family counselors generally believe in
a. circular/reciprocal causality (e.g., dynamics of family members).
b. linear causality.
c. random causality.
d. dream analysis.
Circular/reciprocal causality (e.g., dynamics of family members).
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.
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.
A family that is stable and reaches an equilibrium is in a state of
a. adaptability.
b. enmeshment.
c. nonsummativity.
d. homeostasis.
Homeostasis.
Adaptability is the ability of the family to balance
a. ego strength.
b. stability and change.
c. morphostasis and morphogenesis.
d. b and c.
B and C.
Morphostasis is the ability of the family to balance stability while morphogenesis refers to the family’s ability to change.
A family wants to see you for counseling; however, they have a very limited income and can’t afford to pay. You therefore agree to see the family for free (i.e., pro bono). The term that best describes your actions would be
a. aspirational ethics.
b. mandatory ethics.
c. empathy.
d. all of the above.
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.
Experiential conjoint family therapy is closely related to the work of
a. Virginia Satir.
b. Albert Ellis.
c. Jay Haley.
d. Salvador Minuchin.
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.
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.
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.
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.
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.”
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.
Is likely to engage in the defense mechanism of
intellectualization.
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.
Will distract the family from the problem via constantly talking about irrelevant topics.
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
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.
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.
Joining the family and experiencing it as if he were a family
member.
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 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.
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.
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.
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.
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.
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.
Quid pro quo.
In Latin quid pro quo means “one thing for another,” “something for something,” or “this for that.”
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.
Quid pro quo.
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.
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
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.
Time-out, a procedure that most behaviorists feel is a form
of extinction.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
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.
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!
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
A family member who is emotionally distant is
a. disengaged.
b. enmeshed.
c. an example of equifinality.
d. a placater.
Disengaged.
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.
________ 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
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.
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.
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.
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.
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.
