EPPP Practice Questions: Clinical Psychology Big 6

Question 1

A therapy client who has angry, hostile feelings for his soon-to-be ex-wife begins to
verbally attack his supportive therapist for no reason. The client’s behavior illustrates
which of the following defense mechanisms?
a. reaction formation
b. projection
c. sublimation
d. displacement

Answer 1

d. displacement
Displacement involves redirecting undesirable sexual or aggressive feelings toward one
person onto a safe or vulnerable substitute.

Question 2

According to Margaret Mahler, which of the following is key to the development of object
relations?
a. healthy narcissism
b. separation-individuation
c. mirroring
d. syntaxic cognitive expression

Answer 2

b. separation-individuation
Mahler describes early development as involving several stages. It is during the
separation-individuation stage (which begins at about four months of age) that the
development of object relations occurs.

Question 3

From the perspective of Gestalt therapy, transference:

a. represents confusion between fantasy and reality.
b. represents projection of disowned parts of the self.
c. is an attempt to avoid strong feelings.
d. is a manifestation of regression.

Answer 3

a. represents confusion between fantasy and reality
A Gestaltian views a client’s transference as a form of fantasy and, to get the client back in the
here-and-now, helps him/her distinguish between that fantasy and reality (e.g., “I’m your
therapist, not your mother!”).

Question 4

__________ attributed individual differences in personality and behavior to differences in
the way that people “construe” (anticipate, perceive, interpret, and predict) events. For
example, one person may perceive a new task at work as “interesting,” while another
person may perceive the same task as “boring.”
a. George Kelly
b. Fritz Perls
c. Carl Rogers
d. William Glasser

Answer 4

a. George Kelly
According to Kelly, a person’s psychological processes are determined by the way he or she
“construes” events, with construing involving the use of personal constructs, which are
bipolar dimensions of meaning (e.g., interesting/boring) that begin to develop in infancy and
may operate on an unconscious or conscious level.

Question 5

Prochaska, Norcross, and DiClemente’s (1994) transtheoretical model distinguishes
between 10 change processes and proposes that the most effective combination of
processes depends on the client’s stage of change. For example, they recommend
consciousness raising, supportive relationships, self re-evaluation, and emotional arousal
as the optimal combination for clients in the __________ stage.
a. maintenance
b. conformity
c. action
d. contemplation

Answer 5

d. contemplation
Prochaska, Norcross, and DiClemente identify the change processes listed in the question as
the optimal combination of processes for clients in the contemplation stage.

Question 6

During the first therapy session with a husband and wife who are experiencing marital
problems, a therapist requests that, during the next week, they identify things in their
relationship that they want to continue. Most likely, this therapist is a practitioner of:
a. psychoeducational family therapy.
b. behavioral marital therapy.
c. interpersonal therapy.
d. solution-focused therapy.

Answer 6

d. solution-focused therapy
The therapist has given the couple a task that will help them focus on the positive aspects of
their relationship. In the context of solution-focused therapy, this assignment is an example of
a “formula task.” Its purpose is to help the couple identify positive aspects of their
relationship that, in turn, can lead to solutions to their marital difficulties.

Question 7

Role disputes, role transitions, unresolved grief, and interpersonal deficits are the
primary targets of:
a. reality therapy.
b. solution-focused therapy.
c. narrative therapy.
d. interpersonal therapy.

Answer 7

d. interpersonal therapy.
Interpersonal therapy (IPT) is a brief structured manual-based therapy that was originally
developed as a treatment for depression but has since been applied to other disorders. Its
primary targets are the four problem areas listed in this question.

Question 8

The information that family members continuously exchange and that helps minimize
deviation and maintain the family’s current state of equilibrium is referred to as ________
feedback.
a. external
b. internal
c. negative
d. positive

Answer 8

c. negative
The information exchange between family members can act as either positive or negative
feedback. Negative feedback helps the family system return to or maintain its current state of
equilibrium (homeostasis) and thereby helps minimize deviation and change.

Question 9

A family therapist notices that, whenever the mother talks, the father and son contradict
what she says and criticize her. As described by Minuchin, the father and son’s behavior is
an example of:
a. triangulation.
b. a stable coalition.
c. positive feedback.
d. scapegoating.

Answer 9

b. a stable coalition
Minuchin uses the term stable coalition to describe a relationship between two family
members that involves the consistent joining of those members against a third member,
which sounds like what’s going on in the situation described in this question. (As defined by
Minuchin, stable coalition and triangulation are both types of rigid triangles that serve to
reduce stress. However, triangulation occurs when each parent demands that the child side
with him/her so that the child is being pulled in two directions.)

Question 10

A practitioner of Minuchin’s structural family therapy uses which of the following to
alter the hierarchical relationships within a family system or subsystem?
a. unbalancing
b. tracking
c. reframing
d. mimesis

Answer 10

a. unbalancing
Unbalancing is a restructuring technique that is used by structural family therapists to
change hierarchical relationships between family members. It may involve affiliating with a
family member, ignoring a family member, or entering into a coalition with a family member
against another member.

Question 11

Howard et al.’s (1986) phase model proposes that a client’s progress in therapy occurs
in three predictable phases. These are:
a. unfreezing, changing, and refreezing.
b. remoralization, remediation, and rehabilitation.
c. engagement, exploration, and evaluation.
d. contemplation, action, and termination.

Answer 11

b. remoralization, remediation, and rehabilitation.
As described by Howard et al., remoralization is an improvement in the subjective sense of
well-being, remediation is a reduction in symptoms, and rehabilitation involves improvements
in overall functioning.

Question 12

Data published by Hans Eysenck in 1952:
a. confirmed the effectiveness of behavioral treatments for a variety of psychological
disorders.
b. confirmed the “Dodo bird” hypothesis, which predicts that various types of treatment
are equally effective for a variety of psychological disorders.
c. challenged the notion of “spontaneous remission.”
d. challenged the effectiveness of conventional psychotherapeutic interventions.

Answer 12

d. challenged the effectiveness of conventional psychotherapeutic interventions
Eysenck’s 1952 publication sparked research on psychotherapy outcomes. In that article, he
reported that 66% of patients in eclectic therapy and 44% in psychoanalytic psychotherapy
improved versus 72% of those with similar problems who did not receive therapy.

Question 13

Efficacy studies are:

a. useful for determining a treatment’s cost-effectiveness.
b. conducted under well-controlled conditions.
c. better than effectiveness studies for evaluating a treatment’s generalizability.
d. no longer conducted because of their limited usefulness.

Answer 13

b. conducted under well-controlled conditions.
Efficacy studies are conducted in well-controlled conditions, often using a structured
manualized format. In contrast, effectiveness studies are conducted in applied (clinical)
settings with less experimental control. Efficacy studies are considered useful for establishing
whether or not a treatment has significant effects, while effectiveness studies are better for
assessing a treatment clinical utility (i.e., for determining the treatment’s generalizability,
feasibility, and cost-effectiveness).

Question 14

A psychologist who is an expert in the field of geriatrics is hired by the designers of a
retirement facility to make recommendations regarding the design of shared (community)
spaces so that the social isolation of residents will be minimized. This is an example of:
a. tertiary prevention.
b. secondary prevention.
c. primary prevention.
d. strategic prevention.

Answer 14

c. primary prevention
The goal of a primary prevention is to reduce the likelihood that a mental disorder or other
problem will occur. Designing a retirement facility in a way that reduces social isolation is an
example of primary prevention.

Question 15

A therapist familiar with the impact of cultural factors on symptom expression assumes
that an Asian client’s somatic complaints are actually indicative of a mental disorder. This
is an example of:
a. the fundamental attribution bias.
b. demand characteristics.
c. diagnostic overshadowing.
d. the parallel process.

Answer 15

c. diagnostic overshadowing
Diagnostic overshadowing occurs when one aspect of a client’s symptoms or condition
“overshadows” the therapist’s ability to consider or recognize other symptoms or conditions.
Although the term was originally used to describe diagnostic errors for individuals with
mental retardation, it has since been applied to other diagnoses and situations.

Question 16

Smith, Glass, and Miller’s (1980) meta-analysis of studies investigating the outcomes of
psychotherapy found that, at the end of therapy, the average client “is better off than ___
percent of those who need therapy but remain untreated.”
a. 50
b. 65
c. 80
d. 95

Answer 16

c. 80
Smith, Glass, and Miller’s meta-analysis (1980) included 475 outcome studies published
between 1941 and 1976 and produced an effect size of .85, which means that the mean for
the treatment groups was .85 standard deviations above the mean for the control (no
treatment) groups – or, put another way, the average treated patient was better off than about
80% of those who needed treatment but did not receive it.

Question 17

Research on Helms’s White Racial Identity Development Model has found that a white
therapist is most effective when working with clients from culturally-diverse groups when
the therapist is in which of the following stages?
a. identity integration
b. internalization
c. reintegration
d. autonomy

Answer 17

d. Autonomy
Not surprisingly, the research has found that a white therapist is most effective in
cross-cultural counseling situations when the therapist is in the final stage of identity
development – i.e., the autonomy stage.

Question 18

A therapist adopting an etic approach:

a. believes that psychological principles are universally applicable.
b. views different cultures in relativistic terms.
c. focuses on environmental factors that affect individual functioning.
d. is equally comfortable in multiple cultures.

Answer 18

a. believes that psychological principles are universally applicable
Etic is contrasted with emic. The former refers to universal (culture-general) approaches,
while the latter refers to culture-specific approaches.

Question 19

According to Berry’s acculturation model, a member of a culturally-diverse (minority)
group is exhibiting marginalization when she or he:
a. has rejected the mainstream (dominant) culture.
b. has rejected her/his own minority culture.
c. is uninvolved in both the mainstream and minority culture.
d. is highly involved in the minority culture but uninvolved in the mainstream culture.

Answer 19

c. is uninvolved in both the mainstream and minority culture
Berry describes acculturation in terms of two independent dimensions: involvement in one’s
minority culture and involvement in the mainstream (majority) culture. A marginalized
person is uninvolved in both cultures.

Question 20

According to Cross, an African-American adult in which of the following stages of
identity development is likely to say that racial oppression is not a contributor to his
problems and that he prefers to see a white therapist?
a. disintegration
b. pre-encounter
c. emersion
d. pseudo-independence

Answer 20

b. pre-encounter
Cross’s Nigrescence Identity Development Model distinguishes between four stages –
pre-encounter, encounter, immersion-emersion, and internalization. According to this model,
race has low salience for people in the pre-encounter stage. African-Americans in this stage
are likely to deny the existence of racism and to prefer a white therapist.

Question 21

During the first therapy session with a White female therapist, an African American
male client says he’s concerned that he’ll feel uncomfortable talking about racial issues in
therapy since she’s not African American. In response, the therapist says, “I understand
how you feel. As a woman, I’ve also experienced discrimination.” As described by Sue and
his colleagues (2007), the therapist’s response is an example of which of the following?
a. diagnostic overshadowing
b. microaggression
c. cultural encapsulation
d. ethnocentrism

Answer 21

b. microaggression
Sue and his colleagues define racial microaggression as “brief and commonplace daily verbal,
behavioral, and environmental indignities, whether intentional or unintentional, that
communicate hostile, derogatory, or negative racial slights and insults to the target person or
group” (p. 273). They also distinguish between three types of microaggression: microassaults
(explicit racial aggression that involves a violent verbal or nonverbal attack), microinsults
(behaviors and verbal remarks or comments that are insensitive and demean the person’s
racial heritage or identity), and microinvalidation (verbal comments and behaviors that
negate or nullify the thoughts, feelings, or experiences of a person of color). The therapist’s
response to the client’s comment is an example of a microinvalidation. (Racial
microaggressions in everyday life: Implications for clinical practice, American Psychologist,
62, 271-286, 2007).

Question 22

According to Sue (1978), most middle-class European Americans have:

a. an internal locus of control and an internal locus of responsibility.
b. an internal locus of control and an external locus of responsibility.
c. an external locus of control and an internal locus of responsibility.
d. an external locus of control and an external locus of responsibility.

Answer 22

a. an internal locus of control and an internal locus of responsibility.
Sue (1978) describes a person’s worldview in terms of two dimensions – locus of control and
locus of responsibility According to Sue, most middle-class European Americans have an
internal locus of control and an internal locus of responsibility and, consequently, value
personal responsibility and success and attribute their successes to their own efforts.