Exam #1

Question 1

17. Which of the following would most indicate malingering (i.e., an attempt to “fake bad”) on the MMPI-2?high K score
    high F score
    low F score
    high L score

Answer 1

The Correct Answer is “B”

An elevated F score, particularly within the range of 80 to 99 suggests malingering (“faking bad”), exaggeration of difficulties, resistance to testing, or significant psychopathology. All of the other choices, i.e., high K, high L, and low F scores indicate the reverse, that is, an attempt to be viewed in an overly favorable light (“faking good”). (G. Groth-Marnat, Handbook of psychological assessment, 2nd ed. New York, John Wiley, 1990).

Question 2

18. Howard et al.’s (1993) phase model of psychotherapy change does NOT include:remoralization
    reexamination
    remediation
    rehabilition

Answer 2

The Correct Answer is “B”

B. The phase model of psychotherapy, an extension of the dose-response model of treatment response, was first proposed by Howard et al. in 1993 and is a client stage model that outlines a progressive, 3-stage sequence of change. The first phase, remoralization, focuses on the client’s subjective well-being and occurs during the first few sessions. The second phase, remediation, focuses on symptom reduction and generally occurs between the 5th and 15th sessions. The third and final phase is rehabilitation which focuses on life functioning gains and emerges more gradually. According to this model, effective courses of treatment are initially characterized by a restored subjective sense of well-being then, as a function of this improvement, the client may benefit from interventions to provide symptom reduction or relief (e.g., decrease difficulty concentrating or sleep disruption) and finally, is able to either resume their former level of role functioning (e.g., doing well at work) or initiate new roles (e.g., obtaining a new job). (See: Howard, K. I., Lueger, R. J., Maling, M. S., & Martinovich, Z. (1993). A phase model of psychotherapy outcome: Causal mediation of change. Journal of Consulting and Clinical Psychology, 61, 678–685. and K. Howard et al., Evaluation of psychotherapy: Efficacy, effectiveness, and patient progress, American Psychologist, 51, 1059-1064, 1996.)

Question 3

23. The Mini Mental Status Exam (MMSE) is especially useful for:assessing reality testing in individuals with a Psychotic Disorder
    assessing level of consciousness in individuals with Delirium
    screening for Mental Retardation in children and adolescents
    screening for Dementia in older adults

Answer 3

The Correct Answer is “D”

D. The Mini Mental Status Exam (MMSE) is a screening tool for cognitive functioning that assesses five areas of cognitive functioning: orientation, registration, attention and calculation, recall, and language. It is most useful for screening for Dementia in older adults.

Question 4

34. Brief dynamic therapy is least likely to involvea focus on specific problems.
    an emphasis on restoring the person to a previous level of normal functioning.
    an attempt to engender insight into the unconscious.
    the use of techniques such as free association and dream interpretation.

Answer 4

The Correct Answer is “B”

B sounds more like the goal of crisis intervention than that of brief psychotherapy. Brief dynamic therapy is focused on specific symptoms; whereas, the goal of long-term psychodynamic therapy is usually global personality change. These symptoms are usually viewed as pathological; in other words, the emphasis is on altering the normal level of functioning rather than returning the person to it. C and D both describe possible aspects of brief dynamic therapy. Techniques of long-term dynamic therapy, such as free association and dream interpretation, may be used. In addition, there may be an attempt to engender insight into the unconscious, but (unlike as in long-term therapy) the patient is left to assimilate this insight on his or her own.

Question 5

40. An individual’s symptoms of tension headaches, nausea, hyperventilation and heart palpitations would be most likely to be interpreted by a client-centered therapist as relating to:overwhelming environmental stress
    being unable to fulfill one’s own needs
    unresolved intrapsychic conflicts
    denied threats to the self-concept

Answer 5

The Correct Answer is “D”

D. According to client-centered therapy, when an individual’s natural tendency toward growth and actualization is disrupted by incongruence between the self and experience (e.g., others’ evaluations differing from one’s self-concept), personality and behavioral problems arise. Denying or distorting the experience is one way of dealing with the incongruence. According to Rogers, denial and distortion leads to anxiety which may result in visceral symptoms such as those listed in the question.

Question 6

52. A client expresses anger at his therapist for being unsupportive rather than acknowledge feelings of hostility toward an unsupportive spouse. This is an example of the defense mechanism called:sublimation
    projection
    undoing
    displacement

Answer 6

The Correct Answer is “D”

D. Displacement is a defense mechanism in which an uncomfortable impulse is expressed toward a safe target, rather than the true target, of the impulse. Sublimation (a.) is the transformation of unwanted impulses away from destructive acts into something that is socially acceptable and/or creatively effective. Projection (b.) is a defense mechanism in which one attributes to others one’s own unacceptable or unwanted thoughts or/and emotions. Undoing (c.) is an ego defense mechanism in which a person relieves anxiety over a behavior by attempting to make up for it in other areas.

Question 7

54. Which of the following statements is true regarding electromyograph (EMG) biofeedback?It is more effective in treating tension headaches than migraine headaches.
    It is more effective in treating migraine headaches than tension headaches.
    It is equally effective in treating tension headaches and migraine headaches.
    It is ineffective in treating tension and migraine headaches.

Answer 7

The Correct Answer is “A”

Overall, biofeedback works equally well for tension and migraine headaches. However, a different modality of biofeedback is used for each of these conditions. EMG biofeedback, in which the person is trained to decrease muscle tension of the facial and/or neck muscles, is the most commonly used modality for biofeedback treatment of tension headaches; this is why A is the best answer. For migraine headaches, thermal hand warming biofeedback, whereby the person is trained to warm his or her hands, is the most commonly used modality.

Question 8

61. Cultural differences and factors have an influence on the manifestation of client symptoms. If a psychologist assumes an Asian client’s somatic complaints are really reflective of a mental disorder it is an example of: 
	demand characteristics
	diagnostic overshadowing
	the fundamental attribution bias
	self-perception bias

Answer 8

The Correct Answer is “B”

B. Diagnostic overshadowing is a term to describe when a therapist’s ability to recognize or consider other symptoms or conditions is “overshadowed” by one aspect of a client’s symptoms or condition. Demand characteristics (a.) are unintentional cues in the experimental environment or manipulation that allow participants to guess the hypothesis and, as a result, participants may behave differently than they would under normal conditions. The fundamental attribution bias (c.) refers to the tendency to overestimate dispositional (personality) factors and underestimate situational factors in explaining the behavior of others. Self-perception bias (d.) refers to an individual inferring what their internal state is by perceiving how they are acting in a given situation.

Question 9

100. A social-role theorist might contend that minority clients drop out of treatment more readily when matched with a white therapist, because:

the therapist indicates discomfort
higher power or status groups are more adept at reading or perceiving members of lower status groups than those from lower status groups reading people from higher status groups.
lower power or status groups are more adept at reading or perceiving members of higher status groups than those from higher status groups reading people from lower status groups.
the client lacks awareness of the differences in power and status.

Answer 9

The Correct Answer is “C”

C. Social-Role theorists assert that individuals in positions of lower power and status are better at reading/perceiving members of higher status groups than are those from higher status groups at reading people from lower status groups. Thus, for example, women may be more adept at attending to men, than men are at attending to the feelings and experiences of women. Similarly white therapists may be less familiar with the culture and life experience of minority clients than are minority therapists with white clients (See: Sue, S. & Zane, N. (1987). The role of culture and cultural techniques in psychotherapy: A critique and reformulation. American Psychologist, 42, 37-45.)

Question 10

87. The Treatment of Depression Collaborative Research Program (TDCRP), conducted by the National Institute of Mental Health, compared Cognitive Therapy, antidepressant medication, pill placebo, and interpersonal psychotherapy treatments in depressed outpatients. The results of this study found:cognitive therapy is more effective than the other treatments for mild to moderate depression
    cognitive therapy is more effective than the other treatments for moderate to severe depression
    no difference in observed outcome between cognitive therapy and antidepressant medications (ADMs) for mild to moderate depression.
    no difference in observed outcome between cognitive therapy and antidepressant medications (ADMs) for moderate to severe depression.

Answer 10

The Correct Answer is “C”

C. Findings of the NIMH’s TDCRP research project indicate no differences in outcome were observed between CT and ADM among all patients. In other words, overall, cognitive therapy (CT) and antidepressant medication are about equally effective in the treatment of depression. In a secondary analysis of more severely depressed patients, however, ADM outcomes were superior to both cognitive therapy and placebo. Antidepressant medications (ADMs) are the most widely used treatment for major depressive disorder (MDD) in the United States and evidence supports the efficacy of ADMs, particularly among more severely depressed patients, as first-line therapy for patients with moderate to severe MDD. (See: DeRubeis, R.J., Hollon, S.D., Amsterdam, J.D., Shelton, R.C., Young, P.R., Salomon, R.M., O’Reardon, J.P., Lovett, M.L., Gladis, M.M., Brown, L.L., & Gallop,R. (2005) Cognitive Therapy vs Medications in the Treatment of Moderate to Severe Depression. Archives of General Psychiatry.62(4):409-416.)

Question 11

105. Which of the following statements is most consistent with Troiden’s (1989) model of gay and lesbian identity development?

Identity confusion and identity assumption begin somewhat earlier for females than males, but identity commitment begins earlier for males than females.
Identity confusion, identity assumption, and identity commitment begin somewhat earlier for males than females.
Identity confusion, identity assumption, and identity commitment begin somewhat earlier for females than males.
There are no gender differences in the age of onset for homosexual identity development.

Answer 11

The Correct Answer is “B”

Troiden’s (1989) model of homosexual identity development describes four stages: Sensitization, identity confusion, identity assumption, and identity commitment. Sensitization begins before puberty and consists of homosexual feelings or experiences without an understanding of them in terms of self-identity. Identity confusion, which usually develops in adolescent males around 17 years and in females around 18 when they realize that they may be homosexual. During identity assumption, the individual comes out as a homosexual – typically from 19–21 years for males and 21–23 for females. Identity commitment is characterized by the individual adopting a homosexual lifestyle – which usually occurs from 21–24 years for males and 22–23 for females [The formation of homosexual identities, Journal of Homosexuality, 17(1/2), 43-73].

Question 12

112. Recent research on psychotherapy outcome indicates:

28% of therapy clients show marked improvement in symptoms after the 8th session
72% of therapy clients show marked improvement in symptoms after the 8th session
53% of therapy clients show marked improvement in symptoms after the 26th session
75% of therapy clients show marked improvement in symptoms after the 26th session

Answer 12

The Correct Answer is “D”

Howard et al. (1986) reviewed the benefits that clients experienced due to attending therapy sessions as a function of the dosage of therapy sessions. Performing a meta-analysis of 15 previous outcome studies, their results verified that the longer patients remain in therapy, the greater their gains. They found that 15% of patients improve between intake and the first session (presumably due to spontaneous remission and the ameliorative effects of having sought treatment), 50% improve after eight sessions, and 75% improve after 26 sessions. Consistent with these findings, research by Kafta et al. (1994) found approximately 75% of the psychotherapy clients showed an alleviation of acute symptoms after the 28th session. (See: Howard, K. I., Kopta, S. M., Krause, M. S., and Orlinsky, D. E. (1986). The dose-effect relationship in psychotherapy. American Psychologist, 41, 159-164; Kopta, S. M., Howard, K. I., Lowry, J. L., and Beutler, L. E. (1994). Patterns of symptomatic recovery in psychotherapy. Journal of Consulting and Clinical Psychology, 62, 1009-1016.)

Question 13

123. In children, positive outcome following a traumatic event is most likely if the child:

has adequate social support and a high level of skill in at least one activity.
has a high level of intelligence.
is male.
has experienced a traumatic stressor.

Answer 13

The Correct Answer is “A”

In both children and adults, high levels of social support is one of the best predictors of positive psychological outcome following a traumatic event. Having skill in at least one activity is associated with self-efficacy beliefs, which are also associated with positive outcome following a trauma in both children and adults.

Question 14

198. In brief psychodynamically-oriented therapy:
     positive transferences are encouraged and are viewed as essential to treatment progress.
     positive and negative transferences are encouraged early in treatment to ensure that a transference neurosis develops.
     positive and negative transferences are both discouraged because of the here-and-now focus of the treatment.
     negative transferences are encouraged because they are more likely than positive transferences to produce useful information for interpretation.

Answer 14

The Correct Answer is “A”

Brief and long-term psychodynamic psychotherapy share a number of characteristics. A primary difference is that, in brief psychotherapy, a full-scale transference neurosis is discouraged. However, positive transference is seen as an important contributor to therapy progress.

Question 15

5. Eysenck’s 1952 study on psychotherapy outcome:concluded that individuals who receive psychotherapy are better off than 80% of controls
   concluded that psychologists and psychiatrists are more effective than master’s level clinicians
   challenged the effectiveness of most psychotherapy treatments
   led to many other outcome studies, most of which have supported his findings

Answer 15

The Correct Answer is “C”

Eysenck, in his 1952 study, found that 64% of patients in eclectic therapy and 44% of psychoanalytic patients improved versus a 72% improvement rate for untreated patients. His methodology and findings have been criticized for decades following his report and most studies since then have found psychotherapy to be superior to no treatment. Choice “A” is one of the conclusions of Smith and Glass’ (1978) meta-analysis. Choice “B” was not one of Eysenck’s conclusions, and it is also contrary to a finding of Consumer Report’s 1995 study which failed to find a relationship between therapist level of training and outcome. Choice “D” is partly correct, in that many other outcome studies did follow Eysenck’s study; however, most of these have contradicted his findings. Indeed, even Eysenck modified his conclusion in 1985 by indicating that at least one therapy, behavior therapy, is superior to placebo or no treatment.

Question 16

24. Murray Bowen’s approach to family therapy was strongly influenced by:gestalt therapy
    psychodynamic theory
    existentialism
    communications theory

Answer 16

The Correct Answer is “B”

Murray Bowen was psychoanalytically trained and his extended family systems therapy was strongly influenced by his analytic training. For example, his transgenerational approach focuses on addressing relationship issues in one’s family of origin and developing insight in order to resolve current problems.

Question 17

46. Ethnic minority clients with a strong affiliation with their own culture tend tonot benefit from therapy.
    drop out of therapy prematurely.
    prefer ethnically similar therapists and counselors.
    respond to therapy in the same way as non-minority clients, regardless of the therapist.

Answer 17

The Correct Answer is “C”

Research supports the notion that ethnic minority clients with a strong affiliation with their own culture tend to prefer ethnically similar counselors, and some research show that outcome for such clients is better when the counselor is ethnically similar.

Question 18

54. Someone advocating an emic rather than an etic approach to cross-cultural psychology would argue that the study of a cultureshould be undertaken from a detached and objective position.
    should be undertaken from within the culture itself.
    should involve a comparison across different cultures.
    should use the history of the culture being studied as a reference point.

Answer 18

The Correct Answer is “B”

The emic/etic distinction was first made by an anthropologist named Pike in 1954 and has since been applied to cross-cultural psychology. The etic approach to the study of a culture involves studying it from the outside, using universally accepted means of investigation. The emic approach, by contrast, involves studying the culture from the inside and trying see it as its own members do.

Question 19

60. From the perspective of rational emotive therapy (RET), emotional disturbances are maintained primarily byself-indoctrination.
    environmental consequences.
    social pressure.
    denial.

Answer 19

The Correct Answer is “A”

Ellis, the founder of RET, viewed behavioral disorders as stemming from both biological predisposition and early life experiences but argued that their maintenance was due primarily to self-indoctrination. Specifically, during early childhood, children tend to internalize the critical attitude of their parents and then perpetuate that attitude as they grow older.

Question 20

65. When a therapist shifts the perspective of looking at an individual’s behavior from an intrapersonal to an interpersonal definition of the individual’s problem, the therapist is:relabeling.
    reframing.
    schema restructuring.
    cognitive restructuring

Answer 20

The Correct Answer is “B”

B. Reframing is a technique of family therapy, especially structural and strategic, that involves redefining a problem behavior in order to get the family to see it in a new light with the purpose being to increase the family’s compliance with treatment. For example, a therapist may tell parents that their child who often “talks back” is expressing a need for love and insecurity rather than anger and disrespect. Reframing the situation may then increase the parents’ willingness to change their own behavior, rather than focusing only on the child, or identified patient. Relabeling (a.), involves substituting a benign label for a pathological label a family attaches to a problem in order to change the meaning. Schema restructuring (c.) is the kind of learning that involves fundamental changes in the nature of the schema itself. Cognitive restructuring (d.), involves replacing maladaptive thought patterns with constructive and adaptive thoughts and beliefs

Question 21

88. Hand washing frequency by health care workers is low despite the importance of compliance for reducing rates of hospital-acquired infection. Research indicates the most effective interventions for increasing hand washing include:continued performance feedback and written materials
    education, continued performance feedback and reminders
    automated sinks, education and availability of moisturizing soap
    automated sinks, written materials and reminders

Answer 21

The Correct Answer is “B”

B. Studies on interventions to increase compliance with hand hygiene practices have found that no single intervention has consistently improved handwashing frequency in healthcare workers. Individual intervention findings indicate: one-time educational interventions and performance feedback on compliance rates are associated with a short-term influence; distribution of written materials and strategically placed reminders had a modest but more sustained effect; automated sinks increased the quality of handwashing however decreased the frequency; and the availability of moisturizing soaps had little or no effect on frequency. Research suggests the most effective approach is a multifaceted one that includes education in combination with written material, reminders and continued feedback of performance. The availability of an alcohol-based hand gel, when added to the multifaceted approach also appears to result in a modest improvement in compliance. (See: Naikoba, S. & Hayward, A. (2001). The effectiveness of interventions aimed at increasing handwashing in healthcare workers - a systematic review. Journal of Hospital Infection. 47, 173-180.)

Question 22

111. Which of the following variables is most strongly related to a preference for therapists of the same racial group in African-American psychotherapy clients?

education
IQ score
racial/cultural identification
presenting issue

Answer 22

The Correct Answer is “C”

Research shows that the stronger a client’s identification is with his or her racial or cultural background, the more likely he or she is to prefer a therapist from a similar background.

Question 23

119. According to Prochaska and DiClemente’s Stages of Change Model, which stage best applies to a man who is aware of his drinking problem, recognizes the benefits of getting sober, and plans to quit drinking on his birthday in three months?

Minimization
Precontemplation
Contemplation
Preparation

Answer 23

The Correct Answer is “C”

Prochaska and DiClemente described five Stages of Change in their model – which applies to many types of behaviors – not just substance abuse. The first stage is “Precontemplation,” characterized by denial, resistance, and no plans to change. In the second stage, “Contemplation,” a person begins to recognize the benefits of change and, although somewhat ambivalent, plans to change within the next 6 months. This best describes the person in this question. In the third stage, “Preparation,” a person has decided to take action within the next 30 days and may have already begun to take small steps towards change. In the next stage, “Action,” the person is actively engaged in making changes or acquiring new behaviors. The final stage is the “Maintenance” stage, in which the person has maintained action for at least 6 months and is actively working to prevent a relapse.

Question 24

126. Manual-guided treatment is to used to:

reduce “treatment errors” and legal liability of practitioners
ensure validity of procedures used to evaluate effectiveness of treatment
improve treatment outcomes for diverse populations and diagnoses
ascertain treatment effects in research by standardizing treatment delivery

Answer 24

The Correct Answer is “D”

Initially, treatment manuals were developed to standardize treatments so that their effects could be empirically evaluated and provide guidelines for training therapists. Manual-guided treatments detail the theoretical underpinnings of a treatment, the treatment goals, and specific therapeutic strategies and guidelines. Research on manual-guided treatment outcome (response “C”) is inconsistent but has generally not found it to have substantially better outcomes than treatments not guided by the use of a manual. (See: Beutler, L. E., et al. (2000). Therapist variables, in M. Lambert (ed.), Bergin and Garfield’s Handbook of Psychotherapy and Behavior Change (pp. 227-306), New York: John Wiley & Sons.)

Question 25

131. An individual who is in the contemplation stage of change is:

unaware of a problem.
aware of a problem, thinking of change.
intending to change.
working on modifying their behavior.

Answer 25

The Correct Answer is “B”

B. Prochaska and DiClemente’s transtheoretical, or stages of change, model is an eclectic model that integrates interventions from various theories of psychotherapy and distinguishes between six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. Many descriptions of the model only include the first five stages because the termination stage of “zero temptation and 100% self-efficacy” is not necessary for success and rare for most behaviors. At each stage, an individual weighs the pros and cons of adopting a new behavior, which Prochaska and DiClemente called “decisional balance.” The first stage is “Precontemplation,” characterized by denial, resistance, and no plans to change. In the second stage, “Contemplation,” a person begins to recognize the benefits of change and, although somewhat ambivalent, plans to change within the next 6 months. This best describes the person in this question. In the third stage, “Preparation,” a person has decided to take action within the next 30 days and may have already begun to take small steps towards change. In the next stage, “Action,” the person is actively engaged in making changes or acquiring new behaviors. The final stage is the “Maintenance” stage, in which the person has maintained action for at least 6 months and is actively working to prevent a relapse.

Question 26

134. Self-in-Relation theory suggests that:

the self progresses from infantile dependence to mature independence
one's self depends on how one connects to others
people prefer to be right rather than happy
the relationships between siblings is the most important influence in the development of the self

Answer 26

The Correct Answer is “B”

Self-in-Relation theory is a feminist theory which emphasizes the importance of one’s connections with others, particularly a daughter’s relationship with her mother. The development of the self is viewed as progressing from infantile dependence towards a mature state of interdependence. This is in contrast to the traditional Western view of human development (A) – a progression from infantile dependence towards a state of greater and greater separation, individuation, and independence. Choice C refers to Self Verification theory which proposes that people need and seek confirmation of their self-concept, regardless of whether their self-concept is positive or negative.

Question 27

150. When scores on the MMPI scales 1 and 3 are higher than on scale 2, this pattern is referred to as a:

defensive profile
passive-aggressive V
conversion V
psychotic V

Answer 27

The Correct Answer is “C”

C. A conversion V pattern on the MMPI-2 occurs when the scale 2 (depression) score is significantly lower than scores on scales 1 (hypochondriasis) and 3 (hysteria). This pattern is characteristic of individuals with a tendency to somaticize psychological problems, have chronic pain with an organic etiology, have conversion disorder or other somatoform disorder. In the defensive profile (a.) pattern, the F scale score is significantly lower than scores on the L and K scales and indicates an attempt to present in a favorable light. In the psychotic V, or paranoid valley, (d.) pattern, the scale 7 score is significantly lower than scores on scales 6 and 8. In the passive-aggressive V (b.) pattern, the scale 5 score is significantly lower than scores on scales 4 and 6.

Question 28

161. Research on the impact of therapist experience on therapy outcome suggests that

there is a strong positive relationship between experience and outcome.
there is a moderate relationship between experience and outcome, with the relationship being strongest when the client's symptoms are mild to moderate.
there is a moderate relationship between experience and outcome, with the relationship being strongest when the client's symptoms are severe.
there is, contrary to what might be expected, no predictable relationship between experience and outcome.

Answer 28

The Correct Answer is “C”

Most research studies report a moderate relationship between a therapist’s experience and the outcomes of therapy for the client overall, but a somewhat stronger relationship when the client’s symptoms are severe. This makes sense: Experience would seem to be more important for very troubled clients. See A. Roth and P. Fanagy, What Works for Whom? A Critical Review of the Psychotherapy Research, New York, Guilford Press, 1996. Note that in the Clincal Psychology section, we report that there is little relationship between therapist experience and outcome. This finding is based on older research, and you should use the newer information included in this explanation.

Question 29

168. _________________ is a present-oriented, structured and time-limited treatment that integrates biological and psychosocial approaches.

Motivational interviewing
Solution-focused therapy
Interpersonal psychotherapy
Reality therapy

Answer 29

The Correct Answer is “C”

C. Interpersonal psychotherapy (IPT) is a manualized psychotherapy first designed for the treatment of nonbipolar, nonpsychotic major depression with the focus on the problems of depression and interpersonal distress. IPT focuses on interpersonal aspects of depression and uses the biopsychosocial model which frames depression as a medical illness occurring in a social context The goal of IPT is to alleviate symptoms with interpersonal relationships as a point of intervention. IPT has been found to be effective for the treatment of depression patients from adolescence to late life, for women with postpartum depression and for patients with medical comorbidity (See: Weissman, M.M., Markowitz, J.W., Klerman, G.L. (2000). Comprehensive guide to interpersonal psychotherapy. New York, Basic Books.)

Question 30

175. Solution-focused brief therapists in group work:

utilize questioning
focus on identifying an individual's problem
use a directive, expert stance.
emphasize insight as the main mechanism of change.

Answer 30

The Correct Answer is “A”

A. Solution-focused brief therapy, also referred to as solution focused or brief therapy, is a form of psychotherapy based on social constructionist philosophy that focuses on solutions rather than problems or their causes. Underlying this approach is the assumption that clients possess the resources needed to achieve their goals. The solution-focused therapist works with people to generate solutions to their problem using direct and indirect compliments and future-oriented questions such as the miracle question.

Question 31

197. The use of the technique known as self-instruction with hyperactive children involves

programmed learning.
having the children write down their daily goals in advance.
having the children make self-statements.
having the children do the their schoolwork by themselves.

Answer 31

The Correct Answer is “C”

Donald Meichenbaum developed the technique of self-instruction as a means of helping impulsive and hyperactive children to perform tasks more successfully. The technique involves teaching the subject to make appropriate self-statements while performing a desired task.

Question 32

215. According to this type of psychotherapy, feelings are acknowledged and accepted as uncontrollable and the focus is on taking constructive action, not the alleviation of discomfort or the attainment of some ideal feeling state.

Naikan therapy
Network therapy
Morita therapy
Rational-emotive therapy (RET)

Answer 32

The Correct Answer is “C”

C. Morita Therapy, sometimes referred to as the psychology of action, is a Japanese therapeutic intervention developed by Japanese psychologist Shoma Morita in the early part of the twentieth century originally to treat anxiety and neurosis. Morita therapy doesn’t deal with the past, inner dynamics, or with emotions directly as a prerequisite to change. Emphasis is on learning to accept the internal fluctuations of thoughts and feelings and ground behavior in reality and the purpose of the moment. The focus is on the external environment, behavior, and distinguishing what is and is not controllable. All emotions are accepted as valid, pain is inevitable and there is no attempt to control or govern feelings. Concrete effort to take action, with or without success and despite the accompanying emotions, is encouraged. Progress is measured by degree of responsiveness to behavioral demands and in the effort for self improvement. Like cognitive behavioral therapy, Morita therapy deals with changing behaviors and dysfunctional cognitive processes through reframing the meaning of anxiety, focusing on attitudinal blocks to behavior and taking personal responsibility for behavior. Another Japanese approach, Naikan Therapy (a.), or the psychology of reflection, is based on clients asking themselves three questions: what have I received from? What have I given to? What troubles or difficulties have I caused to? Through such self-reflection, a client’s awareness of the role they play in the relationship or situation, the amount of support they’ve received, and an appreciation for others is said to be increased. It is often combined with use of Morita Therapy. In Network Therapy (b.), the client’s family, friends, and relatives (i.e. the client’s network) are brought together, through the therapist’s initiative, to implement the therapeutic process. Rational-emotive therapy (d.), views irrational thoughts as the cause of clients? problems and that the maintenance of problems is due primarily to self-indoctrination. (See: Ishiyama, F. I. (1990). A Japanese perspective on client inaction: Removing attitudinal blocks through Morita therapy. Journal of Counseling and Development, 68, 566-570. and Goddard, K. (1991) Morita therapy: A literature review. Transcultural Psychiatric Research Review. 28(2); 93-115.)

Question 33

221. Classical psychoanalytic theory and the object-relations theories both emphasize

the interaction between the id, the ego, and the superego.
the importance of separation and individuation in childhood.
the need for a therapist to "re-parent" the patient.
the role of early childhood experiences in personality development.

Answer 33

The Correct Answer is “D”

Both Freudian theory and object-relations theory stress the role of early childhood experience in personality development. Freud believed that adult personality hinges to a large extent on how conflicts (e.g., the oedipal conflict) are resolved in childhood, while the object-relations theorists posit that a child’s early experiences determine the development of his or her introjects (mental representations of self and others), which determine personality functioning as an adult. Choice A applies to Freudian theory, and choices B and C apply to object-relations theory.

Question 34

225. Client-therapist matching of ethnicity is a good predictor of

treatment length.
treatment outcome.
both treatment length and outcome.
neither treatment length nor outcome.

Answer 34

The Correct Answer is “A”

While the findings are not entirely clear, overall there is a greater impact on premature termination rather than outcome, due to ethnic matching. It also seems that some groups are more likely to benefit than others. When there are benefits, they are usually related more to dropout rates than to treatment effectiveness.

Question 35

12. The term “success identity” is associated with: 
	Eric Berne
	William Glasser
	Fritz Perls
	Carl Rogers

Answer 35

The Correct Answer is “B”

B. According to Glasser’s Reality Therapy, when an individual is capable of fulfilling his or her own needs for survival, power, belonging, freedom and fun, without harming self or infringing on the rights of others, then he or she has developed a “success identity.” When the needs are met irresponsibly then the individual has developed a “failure identity.” Bern (a.) is associated with transactional analysis (TA); Perls (c.) is associated with gestalt therapy; and Rogers (d.) is associated with client-centered therapy.

Question 36

29. Meta-analysis was first used in psychological research by:Binet
    Smith and Glass
    Eysenck
    Horn and Cattell

Answer 36

The Correct Answer is “B”

Gene Glass coined the term “meta-analysis” in 1976 and Smith and Glass first used the technique in their psychotherapy outcome studies in 1977. A prior version of the technique was actually developed by Karl Pearson in 1904 (who is better known for his correlation coefficient); however, it was Smith & Glass’ classic study which modified and popularized the technique. The benefit of meta-analysis is that it allows researchers to statistically compare the results of several independent studies to yield a single effect size indicating the magnitude of an independent variable’s effect

Question 37

43. Which of the following is NOT true regarding the Halstead-Reitan Neuropsychological Test Battery?It provides information on a range of cognitive strengths and weaknesses.
    It can usually be completed within 45 to 60 minutes.
    It must be administered by a highly trained examiner.
    The results are reflected in a combined score known as the Impairment Index.

Answer 37

The Correct Answer is “B”

The Halstead-Reitan Neuropsychological Test Battery is a set of tests designed to assess attention, language, memory, abstract thinking, motor speed, and spatial reasoning (A). The purpose of the test is to provide an overall assessment of brain function. The battery must be administered by a highly trained examiner (C). The results of each subtest are combined into an Impairment Index (D). However, contrary to choice B, the battery usually requires 4 to 5 hours to administer.

Question 38

47. A person who takes the MMPI-2 obtains a score of 62 on the depression scale. This means thatthe person is probably clinically depressed.
    the test results are not valid.
    the person’s score is 1.2 standard deviation units above the mean.
    the person’s score is 12 raw score points above the mean.

Answer 38

The Correct Answer is “C”

A T-score is a standardized score, which means that it indicates how many standard deviation units a given raw score is above or below the mean. The T-score distribution has a mean of 50 and a standard deviation of 10. This means that a score of 62 – 12 T-score points above the mean – is 1.2 standard deviations above the mean, since 10 X 1.2 is 12.

Question 39

50. Wolfgang Kohler, a founder of the gestalt school of learning and thought, is known for applying gestalt learning principles to the development ofunfinished business.
    insight.
    integration of all parts of the psyche.
    awareness of psychological boundaries.

Answer 39

The Correct Answer is “B”

Kohler, a founder of the gestalt school of psychology, studied insight learning. In one of his experiments, a chimpanzee had to get some food placed outside his cage. He had two sticks but they were too short to reach the food. As he was sitting with the two sticks in his hand, the chimp had what Kohler called an “a-ha experience”: He quickly fit the sticks together and was able to get the food. This a-ha experience – a sudden, novel solution to the problem – is the basis of insight learning. According to Kohler, insight learning cannot be explained by traditional behavioral theories of learning, which are based on reinforcement and associations between stimuli.

Question 40

65. BASIC ID is utilized by which of the following to assess what interventions will work for a particular client?Rational emotive therapy
    Multimodal therapy
    Eye movement desensitization and reprocessing
    Cognitive behavioral modification

Answer 40

The Correct Answer is “B”

B. BASIC ID is an acronym that represents the seven areas of the client’s life that are examined in Lazarus’s multimodal therapy: behavior, affective responses, sensations, images, cognitions, interpersonal relationships, drugs, biological functions, nutrition and exercise. Rational emotive therapy (RET) (a.) is a form of cognitive-behavioral therapy (CBT) in which the primary focus proposes changes in thinking will lead to changes in behavior, thereby alleviating or improving symptoms. The emphasis is on changing irrational thinking patterns that cause emotional distress into thoughts that are more reasonable and rational. Eye movement desensitization and reprocessing (EMDR) (c.) is therapeutic technique which combines techniques from cognitive-behavioral and other treatment approaches with lateral eye movements. Clients receiving EMDR are asked to recall anxiety-provoking memories and are then instructed to track the therapists’ fingers which are moved from side to side. This process is repeated until the clients’ anxiety is extinguished.

Question 41

86. During the first of structural family therapy’s three steps, which of the following techniques is most useful?constructing a family map
    relabeling and reframing
    enactment
    tracking and mimesis

Answer 41

The Correct Answer is “D”

D. Structural family therapy entails three overlapping steps: joining, evaluating/diagnosing, and restructuring. Joining is the initial step in structural family therapy. Tracking (identifying and using the family’s values, life themes, etc.) and mimesis (adopting the family’s behavioral and affective style) are methods used to join the family system. Constructing a family map (a.) is a technique used for the structural diagnosis of the family. Relabeling and reframing (b.) are restructuring techniques. Enactment (c.) is used to facilitate diagnosis and restructuring of the family.

Question 42

89. Meyer’s (2003) minority stress model identifies distal and proximal factors that contribute to mental health outcomes in gay, lesbian, and bisexual populations. A proximal stressor from the model is:homonegativism
    internalized homophobia
    minority group status
    discrimination and violence

Answer 42

The Correct Answer is “B”

B. Meyer’s minority stress model distinguishes between distal factors, which are external, objective events and conditions, and proximal factors, which are an individual’s perceptions and appraisals of events and conditions. The minority stress model identifies three proximal stressors –– expectations of rejection, concealment of sexual orientation, and internalized homophobia (b.). Minority group status (c.) and exposure to “prejudice events” such as discrimination and violence (d.) are identified as a distal events or as an “environmental circumstance” in Meyer’s model. Prejudice, discrimination (d.) and stigma were linked with mental health problems. Homonegativism (a.) refers to the beliefs and values of prejudiced individuals and is not part of the minority stress model. [Meyer, I.H. (2003) Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence, Psychological Bulletin, 129(5), 674-697.]

Question 43

115. A family seeks therapy due to on-going conflicts between the parents and their 16-year-old daughter. A solution-focused therapist would LEAST likely:

use direct and indirect compliments
tell them to solve the conflict by themselves
work with the family to generate solutions to the conflict
ask future-oriented questions

Answer 43

The Correct Answer is “B”

Solution-focused therapy is a form of brief therapy that focuses on solutions rather than problems or their causes. Underlying this approach is the assumption that clients possess the resources needed to achieve their goals. However, contrary to Choice B, a solution-focused therapist would not likely tell clients to solve the conflict by themselves. Rather, the therapist would work with them to generate solutions to their problem (C). Solution-focused therapists also use direct and indirect compliments (A) and future-oriented questions (D) – such as the miracle question.© Academic Review

Question 44

118. You are seeing a family consisting of a mother, a father, and a daughter in therapy. Every time the mother says something, the father and the daughter argue with whatever she says. The behavior of the father and the daughter can be best described by the term

triangulation.
fusion.
coalition.
joining.

Answer 44

The Correct Answer is “C”

All of these choices sound good, so to answer the question, you have to understand what each of these terms mean in the language of family therapy, and also not miss the fact that the question is asking about the behavior of the father and the daughter (as opposed to the behavior of the father and the mother). In family therapy, the term coalition refers to an alliance of two family members against a third. According to Minuchin, dysfunctional families are sometimes characterized by stable coalitions of a parent and a child against the other parent.
The other terms in the question don’t apply to the behavior of the father and the daughter. Triangulation refers to a situation in which another family member is brought into a conflict that actually exists only between two members, such as when two parents constantly try to get their child to take their side in a conflict the parents are having with each other. Fusion, a term used by Bowen, refers to an inability to separate intellectual from emotional functioning, or an inability to separate one’s own thoughts and feelings from those of other family members. And joining is a technique described by Minuchin that involves adopting the family’s affective style in order to help establish a working relationship, gain greater understanding of the family structure, and gain more leverage in bringing about family change

Question 45

137. Which of the following best describes the purpose of reframing in family therapy?

It is a paradoxical technique designed to harness the family's resistance in the service of positive behavioral change.
It is designed to increase the family's compliance with the therapist's directives and the treatment plan in general.
It is designed to restore the family's homeostasis, or "balance."
It is designed to increase the family's ability to differentiate intellectual from emotional functioning.

Answer 45

The Correct Answer is “B”

Reframing is a technique of family therapy, especially structural and strategic family therapy. It involves relabeling or redefining a problem behavior in order to get the family to see it in a new light. For example, a therapist might tell a family that a child who frequently “talks back” is expressing insecurity and the need for love, rather than anger and disrespect. The purpose of reframing is usually to increase the family’s compliance with treatment. In the example given, reframing might increase the family members’ willingness to make changes in their own behavior, rather than focusing only on the identified patient.

Question 46

169. Which of the following practices is not a behavioral technique?

A client practices drink refusal skills with her therapist.
A client visualizes herself as a successful, non-drinking person.
A client drives home a different way to avoid the places she used to drink.
A client writes down what, how much, and with whom she drinks.

Answer 46

The Correct Answer is “B”

B. Visualizing oneself as a non-drinking person is useful, but it is not, technically, a behavioral technique. Behavioral techniques are directly observable.

Question 47

173. A business executive parent and artistic adolescent child come to a solution-focused family therapist for help dealing with conflicts in their relationship. Which of the following techniques are most likely to be used?

Miracle and scaling questions
Joining and restructuring
Non-directive listening and interpretation
Paradoxical directives and reframing

Answer 47

The Correct Answer is “A”

A. Solution-focused therapists use a variety of techniques designed to identify solutions to client’s problems. Two such techniques are the miracle and scaling questions. The miracle question invites the client to imagine what it would be like if his/her problem was suddenly gone. The scaling question invites each family member to rate a situation to see how the problem is perceived by others. Joining and restructuring (b.) are used by structural family therapists. Non-directive listening and interpretation (c.) are used by object relations family therapists. Paradoxical directives and reframing (d.) are used by strategic family therapists.

Question 48

174. A therapist typically conceptualizes cases from a psychodynamic theoretical framework and uses related techniques however uses an empty chair technique in a therapy session. The therapist’s use of this technique is consistent with:

theoretical integration.
assimilative integration.
technical eclecticism.
common factors.

Answer 48

The Correct Answer is “B”

B. An openness to various ways of integrating diverse theories and techniques characterizes psychotherapy integration. What differentiates psychotherapy integration from an eclectic approach is that in an eclectic approach, a therapist chooses interventions based on what works without considering a theoretical basis for using the technique, while psychotherapy integration attends to the relationship between technique and theory. Assimilative Integration is an approach to psychotherapy integration in which the therapist has a commitment to one theoretical approach but also is willing to use techniques from other therapeutic approaches.

Question 49

192. Which of the following is not one of the dimensions in Hofstede’s theory of culture?

power distance
uncertainty avoidance
conscientiousness
masculinity/femininity

Answer 49

The Correct Answer is “C”

C. Hofstede’s five cultural dimensions are power distance (a.), uncertainty avoidance (b.), individualism, masculinity (d.), and long-term orientation. Research findings indicate the United States scores high on individualism, low on power distance, moderate to high on masculinity and moderate scores on uncertainty avoidance.

Question 50

201. The development of depressive symptomology according to Beck’s cognitive theory, a diathesis-stress model, proposes _____________ serves as the vulnerability.

a genetic predisposition
depressogenic schema
exposure to a negative event
a negative attributional style

Answer 50

The Correct Answer is “B”

B. Diathesis-stress models state that illness is the result of diathesis (vulnerability) combined with stress, with the nature of the vulnerability depending on the type of theory. Beck’s theory of depression identifies the source of vulnerability as cognitive factors. His cognitive diathesis-stress model of depression suggests some people, when exposed to a negative life event (stress), are vulnerable to experiencing depression as they have depressogenic schemata (dysfunctional attitudes). A negative attributional style (d.) or types of attributions such as internal, stable, and global attributions are recognized as the diathesis in Abramson, Metalsky, and Alloy’s (1989) hopelessness model of depression

Question 51

221. An 18-year-old high school student is referred to you for personality assessment due to behavioral problems. Which of the following assessment instruments would be most appropriate to use?

MMPI-A
MMPI-2
WAIS-III
Halstead-Reitan

Answer 51

The Correct Answer is “A”

Knowing that the MMPI-A is recommended for use with ages 14 to 18, while the MMPI-2 is recommended for individuals 18 years and older, may have left you a bit stumped about which to use for an 18-year-old. The MMPI-A manual acknowledges this period of overlap and recommends choosing the instrument on a “case by case basis,” but it also suggests using the MMPI-A for high school students. Furthermore, in a recent study comparing the MMPI-A and MMPI-2 administered to 18-year-olds, the researchers concluded that the MMPI-2 tended to overpathologize and the MMPI-A tended to underpathologize. Due, in part, to the concern with overpathologizing individuals, the researchers recommended using the MMPI-A with 18-year-olds. But to optimally gain sensitivity to psychopathology, they also recommended using T-score cutoffs of 60 instead of 65 on the MMPI-A [T. M. Osberg and D. L. Poland, Comparative accuracy of the MMPI-2 and the MMPI-A in the diagnosis of psychopathology in 18-year-olds, Psychological Assessment, 2002, 14(2), 164-169].

Question 52

223. All of the following are generally considered to be characteristic of brief psychotherapy, except:

time limited therapy
lack of theoretical orientation
effective for acute symptoms
encourages the development of a positive transference between the client and the therapist.

Answer 52

The Correct Answer is “B”

There are many different approaches to brief therapy including psychodynamic, cognitive-behavioral, and eclectic to name a few; however, brief therapy is always based on theory. Brief therapy, as its name implies, is time limited and effective for acute symptoms. A positve transferance is also generally considered to be essential to the success of brief therapy.