Family Therapy

Question 1

Most approaches to family therapy have their roots in

Answer 1

general systems theory and cybernetic theory.

Question 2

__________theory which family therapy derived from was originally used by biologists to describe the functioning of living and non-living systems. It predicts that all systems consist of interacting components, are governed by the same general rules, and have ___________ that help them maintain a state of stability and equilibrium.

Answer 2

General systems
homeostatic mechanisms

Question 3

______________is concerned with the mechanisms that regulate a system’s functioning and distinguishes between negative and positive feedback loops: Negative feedback loops resist change and help a system _________, while positive feedback loops amplify change and ____________.

Answer 3

Cybernetic theory
maintain the status quo
disrupt the status quo.

Question 4

______________theory was another important contributor to family therapy. _________________were not only among the first to recognize the usefulness of general systems theory and __________for understanding family functioning but also proposed that certain types of repetitive patterns of communication and interaction produce problematic behavior.

Answer 4

Communication
Bateson and his colleagues at the Mental Research Institute
Cybernetics

Question 5

Bateson (1972) linked the development of schizophrenia to __________, which occurs when a person receives two contradictory messages from a family member and is not allowed to ___________.

Answer 5

double-bind communication
comment on the contradiction

Question 6

Bateson also distinguished between ________ and ___________ interactions.

Answer 6

symmetrical
complementary

Question 7

Symmetrical interactions reflect ______ and occur when the behavior of one person elicits a similar type of behavior from the other person. Symmetrical interactions can escalate in intensity and become a _____________.

Answer 7

equality
“one-upmanship game.”

Question 8

In contrast, _________ reflect inequality and occur when the behavior of one person complements the behavior of the other person. A common complementary pattern is for one person to assume a_______, while the other assumes a subordinate role.
Problems occur in families when interactions between family members are ________ symmetrical or complementary.

Answer 8

complementary interactions
dominant role
exclusively

Question 9

Several recent approaches to family therapy are influenced by ____________which challenges the basic premises of general systems theory, including the premise that there are _________that govern systems and can be discovered by scientific research. These approaches adopt a ______________perspective and assume that there are multiple viewpoints and realities. They view family therapy as a ________ in which the therapist forms a collaborative relationship with the family and helps family members identify _________of interpreting and resolving problems.

Answer 9

Postmodernism
universal laws
constructivist or social constructionist
shared process
alternative ways

Question 10

Evidence-Based Couple and Family Therapies: The APA’s Guidelines for Classifying Evidence-Based Treatments in Couple and Family Therapy (Sexton et al., 2011) states that the best couple and family treatments are those that are “based on both science and the accumulated _________knowledge of experienced practitioners in order to most accurately identify both the efficacy _______________ (of the clinical procedure” (p. 13).

Answer 10

reliability) and utility (contextual efficacy)
clinical

Question 11

Apa guidelines also distinguishes between ______levels of evidence for family therapy:
three

Answer 11

Level I consists of evidence-informed interventions that are

supported by pre-existing research (e.g., common factors research) or are linked to evidence-based treatment models. These interventions have not been empirically evaluated themselves and/or have not been evaluated for specific populations or problems. Gottman’s marital therapy and structural family therapy are at this level.

Question 12

Level II evidence for family therapy consists of promising interventions that have preliminary evidence of their effectiveness but

Answer 12

have not been replicated for specific populations or problems. Insight-oriented marital therapy and attachment-based family therapy are in this category.

Question 13

Level III evidence for family therapy consists of evidence-based interventions that are supported by systematic high-quality research that shows they are

Answer 13

effective for the clinical problems they are designed to treat. Level III evidence is further divided into four categories.

Question 14

Name the categories under family therapy:

Answer 14

Category 1
Category 2
Category 3
Category 4

Question 15

What is Category 1 family therapy? What is it compared to? What are some examples?
Category 1 (family therapy) is evidence of an intervention’s efficacy and effectiveness when compared to

Answer 15

no treatment (absolute efficacy). All interventions included in Level III must, at a minimum, meet the criteria for this category. Brief structural family therapy and integrative behavioral couple therapy are examples of interventions in this category.

Question 16

What is Category 2 family therapy? What is it compared to? What are some examples?
Category 2 (family therapy) is evidence of an intervention’s efficacy and effectiveness compared to

Answer 16

alternative treatments (relative efficacy). Behavioral marital therapy and parent management training are examples of interventions in this category.

Question 17

What is Category 3 family therapy? What is it compared to? What are some examples?

Category 3 (family therapy) is evidence of the efficacy and effectiveness of an

Answer 17

intervention’s model-specific change mechanisms (verified mechanisms of action). Behavioral couples therapy and family psychoeducation interventions for schizophrenia are examples of interventions in this category.

Question 18

What is Category 4 family therapy? What is it compared to? What are some examples?

Category 4 (family therapy) is evidence that the intervention has beneficial outcomes for specific

Answer 18

client populations. for specific clinical problems, and for different service delivery systems (contextual efficacy). Multisystemic therapy for adolescent problem behaviors and behavioral couples therapy for alcohol and substance abuse disorders are examples of interventions in this category.

Question 19

What is extended family systems therapy? Who created this therapy?

Answer 19

Bowen’s extended family systems therapy is also known as intergenerational and transgenerational family therapy. Bowen derived his approach from work with children with schizophrenia and their families, which led to his conclusion that the transmission of certain emotional processes from one generation to the next is responsible for the development of schizophrenia in a family member.

Question 20

What is the term differentiation used by Bowen to describe family functioning? What is the difference between intrapersonal vs interpersonal?

Answer 20

Differentiation is both intra- and interpersonal. The intrapersonal aspect is a person’s ability to distinguish between his or her own feelings and thoughts. This ability makes it possible for the person to separate his or her own emotional and intellectual functioning from the functioning of others, which is the interpersonal aspect of differentiation. A person with a low level of differentiation becomes “emotionally fused” with other family members.

Question 21

What is the term emotional triangle mean used by Bowen to describe family functioning? What is the likelihood that an emotional triangle will increase?

Answer 21

According to Bowen, when a family dyad experiences tension, it may recruit a third family member to form an emotional triangle which helps alleviate tension and increase stability. For example, a husband and wife may reduce the conflict between them by becoming overinvolved with one of their children. The likelihood that an emotional triangle will develop increases as the levels of differentiation of family members decrease.

Question 22

What is the term Family Projection Process mean used by Bowen to describe family functioning? How does it effect childrens differentiation?

Answer 22

The family projection process refers to the parents’ projection of their emotional immaturity onto their children, which causes the children to have lower levels of differentiation.

Question 23

What is the term Multigenerational Transmission Process mean used by Bowen to describe family functioning? How is a genogram used?

Answer 23

(d) Multigenerational Transmission Process: The multigenerational transmission process is an extension of the family projection process and refers to the transmission of emotional immaturity from one generation to the next. It occurs when the child most involved in the family’s emotional system becomes the least differentiated family member and, as an adult, chooses a spouse or partner who has a similar level of differentiation. This couple then transmits an even lower level of differentiation to one of its children. This process continues in subsequent generations and eventually results in the development of severe symptoms in a child.
Bowen believed that increasing differentiation in one family member facilitates greater differentiation in other family members. Consequently, Bowenian therapists often see only two family members in therapy – usually the parents – or the individual family member who is most capable of increasing his or her level of differentiation. The primary goal of therapy is to increase each family member’s differentiation, and several strategies are used to achieve this goal: Therapy begins with an assessment that includes constructing a genogram that depicts family relationships and important life events for at least three generations and is used to help family members understand intergenerational patterns of functioning. During therapy, Bowenian therapists ask questions that are designed to defuse emotions and help family members identify how they contribute to family problems. They also teach family members how to interact with their families-of-origin in ways that alter triangulated relationships. Bowenian therapists assume the role of coach and stay connected with family members but remain neutral and avoid becoming involved in the family’s emotional processes. To reduce emotional reactivity, they have family members talk directly to them rather than to each other.

Question 24

Who created structural family therapy?

Answer 24

Minuchin

Question 25

Structural Family Therapy: Minuchin’s structural family therapy is based on the assumption that a family member’s symptoms are related to problems in the family’s structure, and identifies _______ and________ as important aspects of a family’s structure

Answer 25

subsystems
boundaries

Question 26

Minuchin’s Subsystems are smaller units of the entire family system that are responsible for carrying out _________. For instance, the parental subsystem consists of family members who are responsible for caring for the children.

Answer 26

specific tasks

Question 27

How does Minuchin define boundaries? How do they differ?

Answer 27

Boundaries are implicit and explicit rules that determine the amount of contact that family members have with each other. Boundaries differ in terms of degree of permeability and exist on a continuum: At one end of the continuum are boundaries that are overly diffuse and lead to enmeshed relationships; at the other end are boundaries that are overly rigid and lead to disengaged relationships. Midway between the two are clear boundaries that let family members have close relationships while allowing each member to maintain a sense of personal identity.

Question 28

Minuchin identified four rigid family triads, which are boundary problems that help parents obscure or deny their conflicts. Name them.

Answer 28

stable coalition
unstable coalition
detouring-attack coalition
A detouring-support coalition

Question 29

What is a stable coalition vs an unstable coalition according to Minuchin?

Answer 29

A stable coalition occurs when one parent and a child form an inflexible alliance against the other parent.
An unstable coalition is also known as triangulation and occurs when each parent demands that the child side with him or her.

Question 30

What is a devouring-attack coalition vs an devouring-support coalition according to Minuchin?

Answer 30

A detouring-attack coalition occurs when parents avoid the conflict between them by blaming the child for their problems.
A detouring-support coalition occurs when parents avoid their own conflict by overprotecting the child.
For practitioners of structural family therapy (minuchin), maladaptive behaviors are due to a dysfunctional family structure that causes the family to repeatedly respond inappropriately to __________stress.
developmental and situational

Question 31

The primary goals of structural family therapy are to alleviate current symptoms and change the________ by altering coalitions and creating clear boundaries. Therapy focuses on promoting________ rather than insight and consists of three overlapping phases

Answer 31

family structure
behavior change
joining, evaluating, and intervening

Question 32

a) Joining is used by a structural family therapist to establish a therapeutic alliance with the family and relies on what three techniques?

Answer 32

Mimesis involves adopting the family’s affective, behavioral, and communication style
Tracking involves adopting the content of the family’s communications
maintenance entails providing family members with support

Question 33

After a structural family therapist uses joining to establish a therapeutic alliance, the therapist’s next task is to _______ the family’s structure to make a structural diagnosis and identify appropriate interventions.

Answer 33

Evaluation

Question 34

What does Evaluation involve in regards to structural family therapy?

Answer 34

Evaluation includes constructing a family map that depicts the family’s subsystems, boundaries, and other aspects of the family’s structure.

Question 35

What interventions does a Structural family therapist use?

Answer 35

The therapist then uses reframing, unbalancing, boundary making, enactment, and other interventions to achieve therapy goals.

Question 36

What does reframing involve in structural family therapy?

Answer 36

Reframing involves relabeling a problematic behavior so it can be viewed in a more constructive way.

Question 37

What does unbalancing involve in structural family therapy?

Answer 37

Unbalancing is used to alter hierarchical relationships and occurs when the therapist aligns with a family member whose level of power needs to be increased.

Question 38

What does boundary making mean in structural family therapy?

Answer 38

Boundary making is used to alter the degree of proximity between family members.

Question 39

What does enactment mean in structural family therapy?

Answer 39

What does enactment mean in structural family therapy?
And enactment involves asking family members to role-play a problematic interaction so the therapist can obtain information about the interaction and then encourage family members to interact in an alternative way.

Question 40

How created strategic family therapy?

Answer 40

Haley

Question 41

Strategic Family Therapy: Haley’s ________________
therapy is based on the assumptions that struggles for _____________in relationships are ______features of family functioning and that “a ________is a strategy that is adaptive to a current social situation for controlling a relationship when all other strategies have _______(Goldenberg & Goldenberg, 2013, p. 317). It also assumes that power and control are determined primarily by within a family _________ and that maladaptive family functioning is often related to _____________hierarchies.

Answer 41

power and control
core
symptom
failed
hierarchies
unclear or inappropriate

Question 42

In Haley’s ____________the primary goal of therapy is to alter family interactions that are maintaining its ___________. To achieve this goal, strategic family therapists assume an _______and use a variety of strategies that are aimed at __________rather than instilling ________.

Answer 42

Symptoms
active role
changing behavior
insight

Question 43

The initial session for __________ Strategic Family Therapy is highly ______and consists of _____stages. What are they?

Answer 43

Hailey’s
Four
Social Stage,
Problem stage
interactional stage
goal-setting stage

Question 44

In Haley’s ___________During a brief ________, the therapist welcomes the family and observes the family’s interactions. Next is the _______ , in which the therapist elicits each family member’s view of the family problem and its causes. In the ________, family members discuss their different views of the family’s problem, and the therapist observes how family members interact when addressing the problem. In the final __________, the therapist helps family members agree on a definition of the family’s problem and concrete therapy goals that target the problem.

Answer 44

Structured Family Therapy
social stage
problem stage
interactional stage
goal-setting stage

Question 45

During a subsequent sessions in ___________, the therapist uses a combination of straightforward and paradoxical directives which include

Answer 45

Straightforward directives
Paradoxical directives
Prescribing the symptom
Restraining
Ordeal

Question 46

In Haley’s structured family therapy ____________are instructions to engage in specific behaviors that will change how family members interact. ___________help family members realize that they have control over problematic behavior or use the resistance of family members to help them change in the desired way.

Answer 46

Straightforward directives
Paradoxical directives

Question 47

Paradoxical directives in Haley’s Structured family therapy include _________, _____________, ____________.

Answer 47

prescribing the symptom, restraining, and ordeals.

Question 48

______________involves instructing family members to engage in the problematic behavior, often in an exaggerated way.

Answer 48

Prescribing the symptom

Question 49

____________ involves encouraging family members not to change or warning them not to change too quickly.

Answer 49

Restraining

Question 50

And an _______ is an unpleasant task that a family member is asked to perform whenever he or she engages in the undesirable behavior.

Answer 50

ordeal

Question 51

Milan Systemic Family Therapy: Milan systemic family therapy is based on the assumption that “the family as a whole protects itself from change through ________rules and patterns of communication” (Browning & Green, 2003, p. 69). Patterns of communication are referred to as __________, and family games associated with problematic behaviors are rigid, involve power struggles between family members, and are known as “dirty games.”

Answer 51

Homeostatic
family games

Question 52

Leading contributors to systemic family therapy include

Answer 52

Salvini-Palazzoli
Boscolo
Ceechin
and Prata.

Question 53

The primary goal of ___________therapy is to _____the family rules and communication patterns that are maintaining problematic behavior. This involves providing the family with information that challenges family games and helps family members develop communication patterns that increase the family’s ability to _______to change.

Answer 53

Milan Systemic Family
Alter
adapt

Question 54

_______________therapy is distinguished from other family therapies by its use of a therapeutic team and five-part therapy sessions (pre-session, session, intersession, intervention, and post-session) and gaps between therapy sessions of four to six weeks.

Answer 54

Milan systemic family

Question 55

Milan Systemic Family Therapists’ Strategies include hypothesizing, neutrality, circular questioning, positive connotation, and family rituals.
In Milan’s Systemic Family Therapy, Hypothesizing is

Answer 55

a continual interactive process of speculating and making assumptions about the family situation” (Adams, 2003, p. 125). The first hypotheses are based on information obtained in the initial telephone interview, and hypotheses are modified during therapy as new information about the family’s functioning is acquired.

Question 56

In Milan’s Systemic Family Therapy , Neutrality refers to

Answer 56

The therapist’s interest in the family’s situation and acceptance of each family member’s perception of the problem.

Question 57

In Milan’s Systemic Family Therapy , Circular questioning involves:

Answer 57

Asking each family member the same question to identify differences in perceptions about events and relationships and uncover family communication patterns. For example, a therapist might ask each member, “When mom is depressed, what does Dad do?”

Question 58

In Milan’s Systemic Family Therapy Positive connotation is a type of reframing that helps family members view a symptom

Answer 58

as beneficial because it maintains the family’s cohesion and well-being. Its purpose is to change the family’s perception of a symptom from an individual family member’s illness to, instead, a behavior that’s voluntarily controlled and well-intentioned and involves the entire family system.

Question 59

In Milan’s Systemic Family Therapy Family rituals are activities that are carried out by family members between sessions and are designed

Answer 59

to alter problematic family games. For example, when parents are competitive in their control of children’s behaviors or family events, the therapist might instruct the mother to make all family decisions on odd-numbered days and the father to make all family decisions on even-numbered days.

Question 60

Satir’s (1983, 1988) conjoint family therapy is also known as the ____________________and was influenced by __________psychology and communication and ____________approaches to family therapy. According to Satir, family systems seek a state of ________, with family problems arising when balance is maintained by _________expectations, ____________rules and roles, and _________communication.

Answer 60

human validation process model
humanistic
experiential
balance
unrealistic
inappropriate
dysfunctional

Question 61

With regard to the latter, Satir distinguished between four dysfunctional communication styles
Placating involves agreeing with or capitulating to others due to fear, dependency, and a desire to be loved and accepted.

Answer 61

Blaming involves accusing, judging, and bullying others to avoid taking responsibility and to hide feelings of vulnerability and worthlessness.
Computing involves taking an overly intellectual and rational (super-reasonable) approach to avoid becoming emotionally engaged with others.

Distracting involves changing the subject and making inappropriate jokes to distract attention and avoid conflict.
Satir also identified a congruent (or leveling) style, which is a functional style that’s characterized by congruence between verbal and nonverbal messages, directness and authenticity, and emotional engagement with others.

Question 62

The primary goal of Satir’s conjoint family therapy is to enhance the growth potential of family members by increasing their _____________, ____________their problem-solving skills, and helping them communicate ___________.

Answer 62

self-esteem
strengthening
congruently

Question 63

Satir viewed the therapist’s __________as the most important therapeutic tool and proposed that therapists have ______roles when working with clients, including facilitator, mediator, advocate, educator, and role model. She also used several techniques to achieve therapy goals, including family ________(which involves having each family member take a turn positioning other family members in ways that depict his/her view of family relationships) and family _________(which is a type of psychodrama that involves role-playing three generations of the family to explore unresolved family issues and events).

Answer 63

“use of the self”
multiple
sculpting
reconstruction

Question 64

Narrative Family Therapy:
Practitioners of narrative family therapy consider a person’s problems “as arising from, and being maintained by, _________stories which dominate the person’s life” (Carr, 2012, p. 141), and they view these stories as being ___________. They also assume that the problem – not the person – is the problem. In other words, the problem is not internal to the person but is something that exists outside the person. For example, instead of saying that a family member is depressed, a narrative family therapist would say that _____________________________for the person.

Answer 64

Oppressive
socially constructed
depression sometimes causes problems

Question 65

The leading contributors to narrative family therapy include_________.

Answer 65

White and Epston

Question 66

The primary goal of narrative family therapy is to replace problem-saturated stories with ___________that support more satisfying and preferred outcomes.

Answer 66

alternative stories

Question 67

The process of narrative therapy varies somewhat among practitioners but generally involves the following stages (Gehart, 2014):
(a) Meeting family members involves getting to know them separate from their problems by asking them about their ___________and ________activities.

Answer 67

Interests
Everyday

Question 68

(b) Listening involves paying attention to what family members say to identify __________discourses and ________outcomes, which are also known as _________and are experiences that are not consistent with problem-saturated stories.

Answer 68

Dominant
unique
“sparkling moments”

Question 69

(c) Separating family members from their problems involves ____________the problems.

Answer 69

externalizing

Question 70

In narrative Therapy, _______preferred narratives involves identifying_________stories that lead to more satisfying ________ and identities.

Answer 70

Enacting
Alternative
realities

Question 71

In narrative therapy, __________involves strengthening __________stories by, for example, writing letters of support to family members and expanding the family’s network of social relationships to include individuals who will support its new stories.

Answer 71

Solidifying
alternative

Question 72

A narrative family therapist assumes the role of collaborator and uses questions and other techniques to help family members identify current stories and construct alternative, healthier ones: For instance, _____________ are used to help clients view their problems as being outside themselves, while _________ help family members identify unique outcomes.

Answer 72

externalizing questions
opening space questions

Question 73

In narrative therapy, asking a family member what his anger tells him to do is an example of an __________question, and asking family members if there have ever been times when conflicts didn’t control their lives is an example of an question.

Answer 73

Externalizing
opening space

Question 74

Other narrative therapy interventions include:

Answer 74

therapeutic letters
therapeutic certificates
and definitional ceremonies.

Question 75

The therapist writes therapeutic letters to family members to reinforce their _______________stories.

Answer 75

emerging alternative

Question 76

______________are given to family members toward the end of therapy to acknowledge their accomplishments. And ______________provide family members with opportunities to tell others how they overcame their problems and celebrate the changes they’ve made in their lives.

Answer 76

Therapeutic certificates
Definitional ceremonies

Question 77

__________________________is a brief evidence-based treatment that integrates principles of attachment theory, humanistic-experiential approaches, and systems theory. It was originally developed by Greenburg and Johnson (1988) as a treatment for couples but has since been applied to families and individuals. (Note that the terms “emotionally focused therapy” and “emotion-focused therapy” are sometimes used interchangeably but that the two differ, with the latter referring to various therapies that emphasize emotion as the target of change.)

Answer 77

Emotionally focused therapy (EFT)

Question 78

EFT is based on the assumptions that __________are essential to the organization of attachment behaviors and influence how people experience themselves and their partners in intimate relationships

Answer 78

Emotions

Question 79

In EFT, The attachment needs of partners are ______________but problems arise when needs are enacted in the context of attachment-related insecurities and relationship distress is maintained by the ways in which interactions between partners are _________and by the __________________experiences of each partner (Johnson & Denton, 2002).

Answer 79

essentially healthy and adaptive
organized
dominant emotional

Question 80

Practitioners of EFT assume that helping partners _____________________is the fastest and most effective way to solve problems, and the primary goal of therapy is to expand and restructure the emotional experiences partners have with each other so they can develop new interactional patterns and experience attachment security within their current relationship.

Answer 80

express and deal with their emotions

Question 81

EFT Therapy involves three stages:

Answer 81

assessment and cycle de-escalation
changing interactional positions
creating new bonding events, and consolidation and integration.

Question 82

Functional family therapy (FFT) is an evidence-based treatment for _________________(e.g., those who have conduct disorder and/or a substance use disorder) and their families.

Answer 82

at-risk adolescents

Question 83

Functional Family Therapy incorporates ___________________elements of family therapy, and it is based on the assumption that _____________behaviors within a family serve important relationship functions – i.e., they regulate interpersonal __________and relational ____________.

Answer 83

structural, strategic, and behavioral
problematic
connections
hierarchies

Question 84

Consequently, the primary goal of Functional Family Therapy is to replace problematic behaviors with _____________behaviors that fulfill the same relationship functions. Therapy ordinarily involves 8 to 30 sessions over a __________month period, and it consists of ______stages (Sexton & Alexander, 2005).

Answer 84

Nonproblematic
3- to 6-
three

Question 85

In Family Functional therapy, During the _____________________, emphasis is on forming a therapeutic alliance with family members and helping family members reduce feelings of ___________, increase positive expectations for change, and develop a family-focused understanding of its presenting problems. Techniques used during this stage include joining and reframing.

Answer 85

engagement and motivation stage
hopelessness and negativity

Question 86

In FFT, Once family members are engaged and motivated, the ______________ begins. During this stage, immediate and long-term _______________goals are identified and an ___________treatment plan for the family is implemented. Techniques used during this stage include 1-4.

Answer 86

behavior change stage
behavioral
individualized
training in parenting, communication, problem-solving, and coping skills.

Question 87

During the final generalization stage, the focus is on linking family members to _______________and helping them _______their acquired skills to new problems and situations and ___________ways to avoid relapse.

Answer 87

community resources
generalize
identify

Question 88

Multisystemic therapy (MST) is an _________treatment that was originally developed for adolescent offenders at risk for ______________placement and their families, but it has subsequently been adapted for adolescents with other _________clinical problems including psychiatric disturbances, substance abuse, and childhood maltreatment.

Answer 88

evidence-based
out-of-home
serious

Question 89

MST is based on Bronfenbrenner’s (2004) __________model which views individuals as being embedded in and influenced directly and indirectly by __________systems. Consequently, it focuses “on the specific individual, family, peer, school, and social network variables that contribute to a youth’s presenting problems, and on interactions between these factors linked with the presenting problems” (Schoenwald & Henggeler, 2005, p. 107).

Answer 89

ecological
multiple

Question 90

The MST model includes _____treatment principles that are applied using an analytic process (the “MST Do-Loop”) that structures the development, implementation, and evaluation of the treatment plan. The core principles are finding the fit between identified problems and their broader systemic context;

Answer 90

Nine
focusing on positives and strengths;
increasing responsibility;
being present-focused, action-oriented, and well-defined;
targeting behavior sequences;
using developmentally appropriate interventions;
encouraging continuous effort;
stressing evaluation and accountability;
and promoting generalization.

Question 91

MST is provided in the ________and in _____________where problems occur. Interventions are derived from strategic and structural family therapy, behavior therapy, and cognitive-behavior therapy and target ________that are ________problem behaviors. For example, assessment might indicate that the drivers of an adolescent’s daily marijuana use (and targets of treatment) are a high level of family conflict, low parental monitoring of the adolescent’s behavior and ineffective discipline, the adolescent’s poor social skills and friendships with peers who use drugs, opportunities for the adolescent to use drugs at school, and availability of drugs in the adolescent’s neighborhood.

Answer 91

family’s home
community settings
factors
driving

Question 92

MST is delivered by a ___________ team that is tailored to the adolescent’s and family’s _________. For an adolescent with academic and conduct problems, frequent use of marijuana and cocaine, and a recent arrest for cocaine possession, the team might consist of a caseworker, family therapist, substance abuse counselor, and two other individuals who will work with the adolescent in his/her school and neighborhood (Greene & Heilbrun, 2011).

Answer 92

Multidisciplinary
problem behaviors

Question 93

For the exam, you want to be familiar with inclusion and exclusion considerations for group therapy, characteristics of therapy groups, the formative stages of group therapy, and the therapeutic factors provided by group therapy.
1. Inclusion and Exclusion Considerations: Group therapy is most effective for individuals who are “highly _______, active, ___________minded and self-reflective …, [who seize] opportunities for self-disclosure within the group …, [and who have an adequate] capacity for interpersonal relationships” (American Group Psychotherapy Association, 2007, p. 20). In contrast, group therapy is contraindicated for individuals who are actively experiencing _________, who are _______and likely to incorporate the group into their delusions, or who pose a threat to group members because they’re unable to control their _______impulses. In addition, people with antisocial personality disorder do well in groups that are homogeneous with regard to diagnosis but should ordinarily not be included in _________groups (Sadock & Sadock, 2008).

Answer 93

Motivated
psychologically
suicidal ideation
delusional
aggressive
heterogeneous

Question 94

Group Therapy Characteristics: One factor to consider when forming a therapy group is the size of the group. The optimal size depends on the type of group and its purpose. In general, however, the recommended size for an adult outpatient group ranges from _______members (e.g., Vinogradov & Yalom, 1989). When a group has less than _______members, interactions are limited; when it has more than 10 members, it’s hard to _______everyone in the session. There’s also evidence that, the larger the size of a therapy group, the lower its ________and the higher the ________rate (Brabender, Fallon, & Smolar, 2004).

Answer 94

7 to 10
Seven
Involve
Cohesiveness
dropout

Question 95

Another factor is whether the group will be closed or open: ______groups begin with the desired number of members and, if any members drop out, they’re not replaced. These groups usually have specific goals and meet for a __________number of sessions. Advantages of closed groups are that they’re associated with greater group _________. In contrast, open groups maintain the same number of members for their duration by replacing members who drop out. They usually have broader goals than closed groups do and meet __________. An advantage of open groups is that they benefit from the energy and _________provided by new members.

Answer 95

Closed
Predetermined
Cohesiveness
Indefinitely
new input

Question 96

Formative Phases of Group Therapy: According to Yalom and Leszcz (2005), therapy groups usually experience three overlapping formative stages:

Answer 96

1) initial orientation, hesitant participation, search for meaning, and dependency stage

2) conflict, dominance, and rebellion stage
3) development of cohesiveness stage

Question 97

During the initial orientation, hesitant participation, search for meaning, and dependency stage of group therapy, group members are concerned with clarifying the __________of the group and depend on the leader for ________________________to their questions. Interactions between members often focus on _____________symptoms and _______treatments and involve _______and ________advice.

Answer 97

nature and purpose
structure, acceptance, and answers
describing
previous
giving
seeking

Question 98

Next is the conflict, dominance, and rebellion stage of group therapy. In this stage, members ________________and attempt to establish a pecking order. Members tend to be _______of each other, and some may become hostile and resentful toward the therapist as they become aware that they’re not going to become the therapist’s _________
”

Answer 98

compete for power and control
critical
“favorite child.

Question 99

The final formative stage of group therapy is the development of cohesiveness stage. In this stage, conflict between group members ______________, and cohesiveness increases as members begin to trust each other and the therapist. Members may reveal the _________why they have come to therapy and show concern when a member is absent or drops out of therapy. The development of _______marks the beginning of a mature group that can deal effectively with the concerns and problems of group members.

Answer 99

Decreases
real reason
cohesiveness

Question 100

3. Therapeutic Factors: Yalom and Leszcz (2005) describe 11 therapeutic factors that are responsible for the effects of group therapy:

Answer 100

group cohesiveness
instillation of hope
universality
altruism
imparting information
development of socializing techniques
corrective recapitulation of the primary family group
interpersonal learning
imitative behavior
catharsis, and existential factors.

Question 101

Of these factors, ___________________is considered to be the analogue of the therapeutic alliance in individual therapy, is viewed as a ____________for the other therapeutic factors, and has been most consistently found to be a strong predictor of positive group therapy outcomes.

Answer 101

group cohesiveness
precondition