Pocket Prep 5 Flashcards
Which of the following would be characteristic of a Rogerian approach to the unconscious?
Rogerians believe in actively engaging with the unconscious
Rogerians believe in denying unconscious urges
Rogerians do not believe in the unconscious
Rogerians believe in suppressing unconscious thoughts
Correct answer: Rogerians do not believe in the unconscious
Carl Rogers’ Person-Centered Humanistic Therapy can be differentiated from older treatment perspectives by its nonbelief in the unconscious, at least as a driver of behavior. It is the Rogerian belief that human beings are in control of their behavior.
Rogerians do not believe in active engagement with the unconscious or denying unconscious urges or suppressing unconscious thoughts.
What is an ideal length of time for outpatient counseling group sessions with adults?
Two and a half hours
90 minutes
One hour
30 minutes
Correct answer: 90 minutes
When forming a group, the counselor should be sure to take into consideration the duration that the group will run and how long sessions will be, depending on the group membership. For outpatient group sessions with adults, usually an hour and a half is an appropriate length of time. Inpatient adult group sessions may be shorter, and those for children may be even shorter
Which statement is consistent with narrative therapy?
Reality is a construction based on a personal story
Reality is a function of one’s stage of life
Reality is a construct of one’s environment
Reality is an objective truth
Correct answer: Reality is a construction based on a personal story
Social constructivist theories suggest that reality is not so much an objective truth but a construction based on a personal story about objective truth. The story or narrative that a person constructs about themselves and their circumstances dictates the world in which they live, for better or worse; this is the basic statement of narrative therapy.
Narrative therapy would not suggest reality is objective truth, a construction of the environment, or a function of life stages.
All of the following violate the rights of a group member except which one?
The counselor tells a group member that unless he wants his family to know about his infidelity, he’d better keep coming to the group
A group member becomes emotionally overwhelmed, and the counselor prevents him from exiting
The counselor requests that a group member who has been monopolizing the discussion wait and let others speak
When group members opt to discuss community agencies that they have found helpful, the counselor comments that the group is not for talking about resources but for discussing feelings
Correct answer: The counselor requests that a group member who has been monopolizing the discussion wait and let others speak
There are many rights that group members are entitled to, such as freedom from undue pressure, voluntary participation, freedom of exit, and the right to use the group’s resources. The counselor is responsible for managing the group’s interactions and balancing participation, so it is not a violation of the group member’s rights for the counselor to request that he or she allow others to speak.
Which of the following would be characteristic of a solution-focused brief therapy (SBFT) intervention?
“Have you noticed any patterns in your thinking when you are depressed?”
“Tell me about your family of origin.”
“I understand you are depressed; are there times when you feel good?”
“How are you eating and sleeping?”
Correct answer: “I understand you are depressed; are there times when you feel good?”
Solution-focused brief therapy (SBFT) focuses on small, achievable gains. In therapy, clients are often asked about exceptions to their undesirable circumstances, such as, “I understand you are depressed; are there times when you feel good?”
Delving into family-of-origin issues, physical self-care patterns, and the cognitive study of thinking patterns would be less like SBFT.
Which level of consciousness encompasses all aspects of present awareness?
Postconscious
Unconscious
Conscious
Preconscious
Correct answer: Conscious
Consciousness is sometimes considered to exist in three phases. The conscious mind contains all of which a person is presently aware.
The preconscious mind is the conscious mind’s “library,” holding accessible information that is not a part of ongoing consciousness but available for recall. The unconscious mind holds everything the mind is not currently aware of and all that cannot easily be brought to consciousness. Postconscious is a fabricated term.
Which level of consciousness contains items of which the mind is not currently aware that are not available to the conscious mind for recall?
Deep conscious
Conscious
Unconscious
Preconscious
Correct answer: Unconscious
Human consciousness is sometimes understood to have three levels. The unconscious mind, in this schema, contains all of the mind’s contents that are neither part of current awareness nor available to the mind on command.
The preconscious mind contains items that are not immediately part of awareness but can be called upon when needed. The conscious mind is considered to be that of which the mind is currently aware. Deep conscious is a fabricated term.
What are defense mechanisms?
Means by which emotions are released
Means by which the psyche achieves self-actualization
Means by which trauma is understood
Means by which the psyche wards off anxiety
Correct answer: Means by which the psyche wards off anxiety
Defense mechanisms are unconscious processes by which powerful and threatening emotions are suppressed and anxiety is warded off by the psyche. The mind forms a defense in order to protect itself and maintain homeostasis. Defenses vary by person, but each serves this function.
Defense mechanisms are not means of self-actualization, understanding trauma, or releasing emotions. In fact, emotions and trauma are often suppressed by defense
A counselor leads a group for parents of young children with chronic illnesses. One group member in particular tends to change topics in the middle of a discussion and criticizes other group members for “complaining.” What role is this group member assuming?
A maintenance role
A blocking role
A building role
A facilitative role
Correct answer: A blocking role
Group members tend to assume a variety of different roles that can impact the group dynamics. The person in a blocking role attempts to hinder any accomplishment of group goals or group formation by engaging in negative and distracting behaviors. The maintenance role encourages social and emotional bonding of group members. The facilitative, or building, role helps group cohesion by contributing to positive and constructive group functioning.
Geraldine is under a profound amount of stress at work, where she has an accounting role for a company in financial trouble. If she engages in regression, which of the following behaviors is likely?
Engaging in substance use
Speaking in a childlike voice
Insisting she is okay
Accusing others of being too stressed
Correct answer: Speaking in a childlike voice
Defense mechanisms are ways in which the mind protects itself from unwanted feelings or threats to its equilibrium. Regression is a movement toward mannerisms or behavior consistent with an earlier and less troubled time of life. In this case, speaking in a childlike voice would be one possibility.
During a session, a client comments that he likes to watch a particular movie because it brings back happy childhood memories. The counselor comments that the movie is one of her favorites, too. This counselor is using the technique of:
interpretation
self-disclosure
restatement
paraphrasing
Correct answer: self-disclosure
Self-disclosure occurs any time a counselor reveals some information about themselves. This can be as simple as the counselor’s affect, or it can refer to specific information about the counselor’s experiences. Self-disclosure should be used judiciously and only when the counselor believes it will be helpful for the therapeutic relationship with the client.
Which of the following is the best description of the goal of Bowenian family counseling?
To better organize the family system and various members’ roles
To solve a specific family problem within a short amount of time
To increase distance between family members and strengthen boundaries
To improve dysfunctional patterns that exist in family systems and are often passed down from one generation to the next
Correct answer: To improve dysfunctional patterns that exist in family systems and are often passed down from one generation to the next
Murray Bowen is well known for his contributions to the field of family counseling, as he diligently developed a comprehensive and thoughtful theory that is helpful to many family counselors. The goal of Bowenian family therapy is to identify dysfunctional patterns that exist within family systems and then alter and improve these patterns so they are not passed on to the next generation.
Which of the following is true about the ideal group size for children as opposed to adults?
Clinical groups for children should be larger
Group therapy is not indicated for children
There is no meaningful difference in ideal group size
Clinical groups for children should be smaller
Correct answer: Clinical groups for children should be smaller
Although individual groups show considerable variation, to provide the best balance of clinical attention, leader focus, and engagement, clinical group sizes should be smaller than those intended for adults.
Group therapy is often used with children and can be clinically indicated.
Steve de Shazer used the analogy of a skeleton key to describe how he helped clients develop interventions that they could use to solve many different problems. What type of philosophy did de Shazer use in his therapeutic approach?
Cognitive behavior
Social constructionist
Narrative
Feminist
Correct answer: Social constructionist
The social constructionist perspective operates from the viewpoint that we use language to construct a common reality with others, and that there are no objective “functional” family dynamics that apply to all family systems. Steve de Shazer’s philosophy is one that focuses on solutions rather than problems and underlying causes of those problems. Social constructionists assume that clients know how to solve their own problems but need help in constructing a new way to use the knowledge they already have. De Shazer also introduced the concept of therapists equipping clients with “skeleton keys,” interventions that can be used to solve many problems.
Which of the following would be a likely treatment for a person with dissociative identity disorder?
Medication to address identity
Psychotherapy to integrate personalities
Implosive therapy to merge personalities
Family therapy to deal with past trauma
Correct answer: Counseling to integrate personalities
Dissociative identity disorder (DID) is characterized by more than one distinct, discontinuous personality expressed within an individual. Although cases are rare, some treatment recommendations have emerged; it seems that counseling is most effective, with the aim of integrating the various personalities.
Implosive therapy and family therapy are not considered front-line treatments for DID. Medication is perhaps effective in treating ancillary symptoms such as anxiety or depression related to the disorder.
Jack has had a fear of heights his entire life. He has enrolled in a process of systematic desensitization. He has learned to control his body’s responses to heights, intellectualized his fear of heights by forming a hierarchy of what frightens him most, and imagined being in high places with the aid of his therapist.
Which of the following would be the next therapeutic stage?
Visualizing being on an airplane
Controlling his breathing when thinking of heights
Thinking about his fear of various things related to being in a high place
Going to the top floor of a building
Correct answer: Going to the top floor of a building
Systematic desensitization deals with a person’s systematically reduced anxiety when exposed to a certain stimulus. It is generally seen as proceeding through four stages.
Relaxation training to gain control of one’s responses
Construction of anxiety hierarchy to gain intellectual knowledge of one’s fear
Imaginative desensitization to explore one’s fear in safe circumstances
In vivo sensitization to gain control over the feared stimulus
The progression is necessarily stepwise and iterative. In this case, the first three stages have been completed, and the next stage should be to confront the fear directly in some form, such as going to the top floor of a building.
Controlling his breathing, intellectualizing his fear, and visualization would all belong to earlier stages of the process.
Which of the following would be characteristic of someone in the precontemplation stage of change?
Someone who has been going to therapy for six months
Someone who is not sure whether they need therapy
Someone who does not believe they need therapy
Someone who has scheduled a therapy appointment
Correct answer: Someone who does not believe they need therapy
According to the work of Prochaska, change can be described as going through stepwise, discrete stages. In the first, precontemplation, the person likely does not see the need for change; thus, a person who does not believe they need therapy would most closely match this stage.
A person who is not sure about therapy would be in the next stage, contemplation. Preparation characterizes someone who is generating ideas about change. Someone who has scheduled a therapy appointment would be in the action phase, and someone who has been going to therapy would be in the maintenance stage of change.
According to research, how much therapeutic benefit is a function of the therapeutic relationship?
50%
20%
70%
30%
Correct answer: 30%
The importance of rapport and a positive therapeutic relationship to overall therapeutic results has been researched. Although more research is necessary, it seems that about 30% of the therapeutic gain is directly related to the nature of the therapeutic relationship.
Which of the following is the most important reason to be aware of culture-bound values in counseling?
They may cause conflict
They affect funding sources
They may mask pathology
They are widely misunderstood
Correct answer: They may cause conflict
One of the ways in which issues of cultural sensitivity directly impact treatment settings is how different values may cause conflict. If there is conflict in treatment, then progress in treatment is at risk. One’s culture-bound values require examination, as well as an effort to understand those of the patient in treatment.
Culture-bound values may or may not mask pathology or be misunderstood in a specific context. Culture-bound values might or might not influence funding sources.
What is the best way for a counselor to screen potential group members?
Conduct conference calls where the counselor can explain the purpose of the group to many people at once
Conduct face-to-face interviews of potential clients to assess for motivation and certain characteristics
Send out a mass email listing criteria for group membership and the dates and times of group meetings
At the first group session, the counselor should speak with each individual in front of the group to determine whether that person is a good fit
Correct answer: Conduct face-to-face interviews of potential clients to assess for motivation and certain characteristics
When leading groups, counselors must carefully spend time screening group members to ensure a proper and appropriate fit. Typically, screening is done during a face-to-face interview, when the goals and purpose of the group are discussed. Counselors should pay attention to cognitive functioning, personalities, backgrounds, and potential group members’ own goals as they work to form a cohesive group that will work well together.
Conference calls eliminate the opportunity to speak individually with each potential group member, as does mass email communication. The counselor should speak with each group member before the group begins, not at the first group session.
Which of the following statements would be characteristic of logotherapy?
“Which of the following words alarms you the most?”
“What would be a more logical approach to this problem?”
“What gives you a sense of meaning in life?”
“Let’s talk about your relationships.”
Correct answer: “What gives you a sense of meaning in life?”
Logotherapy deals with addressing a client’s sense of meaning in life as the focus of therapy. This existential way of treatment comes from the work of Viktor Frankl; as a concentration camp survivor during the Second World War, he found a valid means of survival in those circumstances by finding a larger meaning to his life.
The other statements are not characteristic of logotherapy, as they are not concerned with meaning.
Which of the following would be characteristic of interpersonal leadership in a group therapy context?
Addressing a group member’s ambivalence about the group
Having group members complete an assignment
Eliciting feedback about the group from each group member in turn
Helping a group member understand their grief
Correct answer: Having group members complete an assignment
Although in practice a group leader tends to fluctuate from one to the other, group leadership can be described in one of two general ways. One is interpersonal leadership, which has the group leader facilitating interactions that call upon the group at the same time to be completing an activity, such as having group members complete assignments together. The other form of group leadership is intrapersonal leadership, which describes any group activity that focuses on one individual at a time.
The other examples do not have the group working together at the same time on the same task.
Counselors are often called on to handle crisis situations. What has been the response of CACREP to this need?
CACREP requires counselor training standards for disaster, trauma, and crisis counseling
CACREP has developed a specific curriculum to address this need
CACREP is working on a specific curriculum to address the need for disaster, trauma, and crisis counseling
CACREP leaves this issue to state-level accreditation agencies
Correct answer: CACREP requires counselor training standards for disaster, trauma, and crisis counseling
Crisis situations can occur at any time, particularly in the mental health field. Counselors should be aware of how to address these types of situations and how to handle clients in crises. The response of CACREP (Council for Accreditation of Counseling and Related Educational Programs) has been to require counselor training standards for disaster, trauma, and crisis counseling.
CACREP has not left his issue to state-level accreditation agencies, nor is it working on a specific curriculum to address the need for disaster, trauma, and crisis counseling. CACREP has not defined a specific curriculum on this issue.
Why is mediation usually recommended for couples going through a divorce?
It lessens the long-term impacts of divorce on children
It is a good option for couples who are physically violent toward each other
It is easier than going through the courts when one of the spouses is missing
It presents solutions that may not be acceptable unless they are presented by a third party
Correct answer: It presents solutions that may not be acceptable unless they are presented by a third party
Mediation is one intervention that is often recommended for couples going through a divorce in order to avoid court involvement. Mediation uses a third party, a trained professional, to develop solutions that both sides can find acceptable.
Though mediation can help reduce hostility between parties, it is unclear whether it lessens the long-term impacts of divorce on children. Both parties must be present in order for mediation to occur. Mediation may not be a good option for couples with domestic violence issues, as legal involvement may better protect both parties from harm.
What is the difference between a counseling group and group therapy?
A counseling group is more likely to address deeper issues
Group therapy is less clinical and less likely to address pathology
Group therapy is more clinical and more likely to address pathology
The terms are equivalent
Correct answer: Group therapy is more clinical and more likely to address pathology
Although certain terms are often used interchangeably, there is a difference between group therapy and a counseling group. In general, group therapy is more clinical and more likely to address a pathology. A clinical treatment modality of some kind is almost guaranteed in actual group therapy.
A counseling group may or may not use a clinical approach; these groups are more likely to address items related to personal growth and development than the deeper issues explored in group therapy.
Which of the following did Jacob Moreno contribute to the field of group psychotherapy?
The concept of different levels of leadership functions
Various means of achieving group cohesion
The importance of altruism to the group dynamic
The psychodrama technique
Correct answer: The psychodrama technique
Jacob Moreno is known for developing the technique of psychodrama in the early 20th century. This therapeutic approach, outlined in Moreno’s The Theater of Spontaneity, focuses on the current moments and interactions. The goal of psychodrama is to reorganize the individual’s perceptions and allow for insight and reality testing. The psychodrama includes a stage, and group members are assigned roles, such as representations of people and the audience.
Free association and dream interpretation are techniques that would most likely be used by a counselor who believes in which major counseling theory?
Self psychology
Psychoanalytic theory
Individual psychology
Object relations theory
Correct answer: Psychoanalytic theory
Sigmund Freud is known as the father of psychoanalytic theory, in which the client is seen as the product of his or her childhood. Proponents of psychoanalytic theory believe that certain personalities exist because of the conflicts between impulses and the restraint of these impulses. Techniques often used in psychoanalysis include dream interpretation and free association as means of accessing the unconscious drives and motivations of clients.
Which of the following clients would be a good candidate for EMDR?
A client with longstanding intractable depression
A client with thought disorder
A client with an alcohol problem
A client with a traumatic past
Correct answer: A client with a traumatic past
Eye movement desensitization and reprocessing (EMDR) is a therapeutic technique pioneered by Francine Shapiro in which eye movements are used to “rewire” traumatic memories in an individual. It seems to be most appropriate for persons who have disturbing episodes of trauma in their past that bring on present anxiety.
Clients with thought disorders, intractable depression, and alcohol problems would not be considered good candidates for EMDR.
Which of the following would be an example of family sculpting?
Having a family member draw how things can be different
Having family members suggest changes for each other
Having a family member arrange the family spatially
Having a family member suggest changes for themselves
Correct answer: Having a family member arrange the family spatially
The therapeutic technique of family sculpting refers to a form of psychodrama or role-playing, in which a family member illustrates an important idea about a family through the physical arrangement of family members in a therapeutic context. Having a family member arrange the family spatially would be a good example.
The technique does not involve explicit changes suggested by family members, and it would not use descriptive art to illustrate an ideal.
Virginia Satir is best known for her contributions to which model of counseling?
Humanistic
Strategic
Social constructionist
Structural
Correct answer: Humanistic
Virginia Satir is widely known for her development of the humanistic model of family counseling. Satir believed that family members often take on one of five styles of communication: placater, blamer, superreasonable, irrelevant, and congruent communicator. Satir saw herself as a coach and teacher of families, and worked intimately with families by joining with them and sharing in the experience of being a family member.
Which of the following is the best example of a primary group?
A group for individuals whose spouses have recently died
A group for sexual abuse perpetrators run by former victims of child abuse
A psychoeducational group for teenagers who are at risk of developing depression
A support group for women in the military who have just returned from combat
Correct answer: A psychoeducational group for teenagers who are at risk of developing depression
Primary, secondary, and tertiary prevention groups may all address similar problems but do so in different ways. Primary groups emphasize preventing problems and developing healthy behaviors. For example, educational groups about the causes and symptoms of depression. Secondary groups focus on reducing the severity of a specific problem and include preventative and remedial elements, such as adjusting to a loss. Tertiary groups involve rehabilitation and focus on returning individuals to healthy functioning.
Which of the following is the goal of Gestalt therapy?
To help individuals in therapy become whole beings
To help individuals in therapy repair dysfunctional relationships
To help individuals in therapy progress to self-actualization
To help individuals in therapy deal with past trauma
Correct answer: To help individuals in therapy become whole beings
Fritz Perls’ Gestalt therapy comes from existential ideas about genuineness, personal congruence, and responsibility. The goal of Gestalt therapy is to help individuals in therapy become whole (gestalt) beings and reduce the fractionation of identity and personality as they get their needs met in the environment.
The goal of Gestalt therapy is not to help individuals in therapy deal with past trauma, progress to self-actualization, or repair dysfunctional relationships.
Which of the following would be the proper response to a painful current situation using the idea of distress tolerance?
To experience it fully and describe it
To experience it fully without evaluation
To experience it fully and change it
To experience it fully and evaluate it properly
Correct answer: To experience it fully without evaluation
In Linehan’s dialectical behavior therapy (DBT), distress tolerance is one of the modules taught to clients. It teaches that the proper response to a painful current situation is to experience it fully without evaluation or intellectualization.
Although describing a situation is important at a later stage of one’s experience, and change is essentially the point of any therapeutic mode, distress tolerance does not encourage further engagement than total and unequivocal awareness.
During counseling sessions with clients, a counselor focuses on clients’ needs by encouraging them to pay attention to their feelings and relive experiences. The counselor often uses the two-chair technique and role plays to help clients identify these needs and how to meet them. This counselor is using which therapy approach?
Cognitive behavioral therapy
Gestalt therapy
Rational emotive behavior therapy
Dialectical behavior therapy
Correct answer: Gestalt therapy
Gestalt therapy is based on existential principles, and the goal of individuals in therapy is to integrate all of their needs to become a whole person. Clients are encouraged to attend to their emotions and to relive experiences. Counselors working from a gestalt approach often use the two-chair technique, role playing, and dream work.
On an inpatient psychiatric unit, patients earn points throughout the day for participating in activities and engaging in treatment. Each day in the afternoon, patients are allowed to “spend” their points on items such as toiletries and snacks in the canteen. What type of reinforcement system is being used?
Fixed ratio
Process oriented
Negative reinforcement
Token economy
Correct answer: Token economy
There are several techniques counselors can use to modify behavior. A token economy uses points, or other types of reinforcements, to reward individuals who exhibit desired behaviors. These points can then be used to purchase goods and privileges.
Which of the following personal qualities will likely produce identification with group members?
Their goals and power
Their attractiveness and power
Their attractiveness and coping skills
Their goals and relationships
Correct answer: Their attractiveness and power
Many factors are involved in the configuration and clinical process of group work. Group cohesion tends to take place in the same way across groups, regardless of culture, composition, or focus, at least as far as what attracts group members to a group. In general, people want to be part of groups where other group members are identified as having attractiveness and power. Group members tend to identify with these individuals and increase group cohesion.
Group members are often less attracted to goals, relationships, and coping skills.
Which of the following characterizes the group stage of termination?
Working on new group issues
Ending the business of the group
Resolving conflict within the group
Forming connections within the group
Correct answer: Ending the business of the group
Groups can go through discrete stages: an initial stage of acquaintance, followed by a stage of conflict, then a stage where productive work is done, and finally a termination stage when the group’s main function is to end the business of the group.
It is not the time to form new connections, address new issues, or engage in conflict resolution.
Which of the following accurately states the research basis supporting Rogerian factors in treatment?
Rogerian factors are linked with positive outcomes for certain diagnoses
Rogerian factors are not linked with positive outcomes in research
Rogerian factors are linked with positive outcomes in research
Rogerian factors are linked with positive outcomes for traumatized individuals
Correct answer: Rogerian factors are not linked with positive outcomes in research
Carl Rogers, considered the founder of the humanist school of psychotherapy, suggested that factors such as unconditional positive regard and congruence were necessary conditions for effective psychotherapy. However, the research does not show that these specific factors are necessarily linked with positive outcomes for clients in any presentation.
Which of the following is false regarding family counseling?
Family counseling leads to stronger and healthier families
Family counselors believe that the power of relationships can heal and stabilize the family unit
Nuclear families make the best family counseling clients
Family counseling aims to increase communication between family members
Correct answer: Nuclear families make the best family counseling clients
Family counseling can include nuclear family units, extended family, and anyone who impacts the family unit. There is no evidence to show that nuclear families are more successful than or preferable to other types of families. Family counseling goals typically include increased communication, improved dysfunctional patterns, and the use of relationships to heal and stabilize the family.
The Drama Triangle, developed by Stephen Karpman, is helpful when understanding destructive interactions that occur between individuals in conflict. What three roles are included in the Drama Triangle?
Victim, persecutor, and rescuer
Talker, listener, and ignorer
Ego, superego, and id
Helper, enabler, and perpetrator
Correct answer: Victim, persecutor, and rescuer
Karpman’s ideas about why drama-intense relationships continue can be helpful for counselors working with clients. The Drama Triangle forms when three individuals take on the roles of victim, persecutor, and rescuer. Karpman’s theory suggests that conflict arises when one person takes on the role of victim or persecutor, and others step in to fill other roles due to each person’s unmet psychological needs.
A counselor operates from the viewpoint that clients’ difficulties often result from problems with interpersonal relationships that originate in the first three years of life. What theory best matches this counselor’s approach?
Transactional analysis
Person-centered theory
Object relations theory
Gestalt theory
Correct answer: Object relations theory
Object relations theory is based on psychoanalytic concepts, including the belief that early childhood is incredibly relevant to how clients operate within relationships in the present day. Object relations theories teach that, in the first three years of life, infants have the opportunity to develop significant relationships with primary caretakers that will shape their interactions with people throughout their lives.
Judith Jordan and others are credited with developing the self-in-relation theory. The principal components of this theory are used to support what general topic?
Neo-Freudian theory
Cultural identity
Women’s development
Social learning theory
Correct answer: Women’s development
In the early 1990s, Judith Jordan and others presented the self-in-relation theory, a developmental theory of women. Central concepts of this theory are that people grow into relationships throughout life, positive relationships include mutual respect and empathy, engagements need to be authentic in order for relationships to grow, and mature functioning is characterized by meaningful connections, among other points. The self-in-relation theory is currently known as relational-cultural theory.
Operant and classical conditioning techniques would belong to which of the following schools of counseling?
Existential counseling
Transactional analysis
Person-centered counseling
Cognitive and behavioral counseling
Correct answer: Cognitive and behavioral counseling
Cognitive and behavioral counseling comes from the behaviorist school of psychology, which suggests that behavior is learned and can be shaped. Thus, techniques such as operant and classical conditioning would belong to this school.
Existential counseling, transactional analysis, and person-centered counseling do not use conditioning techniques.
Belinda has thoughts about her motives she does not like. She believes she is greedy and petty. In her life and in her relationships, she commonly ascribes greediness and pettiness to others.
Is Belinda experiencing the defense mechanism of projection, and why or why not?
Yes, as she is ascribing her negative motives to others
Yes, as she is ascribing the opposite motive to others
No, as her motives cannot affect those of others
No, as she has not consciously ascribed her motives to others
Correct answer: Yes, as she is ascribing her negative motives to others
Defense mechanisms are ways the mind attempts to preserve homeostasis and prevent inner conflict as much as possible. These take various forms, one of which is projection, or assigning one’s distasteful or undesirable motives or ideas to others.
Projection does not involve ascribing the opposite motive to others and has nothing to do with the effect one’s motives have on those of others. Defense mechanisms are largely unconscious rather than conscious.
In practice, is rewarding or punishing seen as more effective?
Neither
Rewarding
Both
Punishing
Correct answer: Rewarding
The behaviorist school of counseling and psychotherapy deals extensively with rewards and punishments to shape behaviors. In practice, it seems that reward is more effective in altering behavior than punishment, which can induce aggression and confer only temporary benefits at best.
Circumstances differ, and both reward and punishment can be effective in the short-term; however, positive strategies such as rewards are seen as more so.
Which of the following would be the most likely intervention used in neobehaviorism?
A person engaging in dream analysis
A person modeling competence in a desired behavior
A person describing a traumatic event
A person getting hypnotized to resolve a habit
Correct answer: A person modeling competence in a desired behavior
The school of neobehaviorism, connected with the work of Albert Bandura, suggests that human beings are both producers and products of conditioning. Bandura and this school stress the importance of social learning as an influence and driver of human behavior. In a therapeutic context, this might manifest as a person modeling competence in a desired behavior.
The other choices do not deal with social learning and are more concerned with internal processing, which is uncharacteristic of neobehaviorism.
What is the ideal size of a clinical group?
No ideal size
One to four members
Six to eight members
Three to six members
Correct answer: Six to eight members
Clinical groups function best when there is a balance of time available for all who wish to contribute, as well as avoiding too much or too little clinical focus on individuals. The ideal size is generally considered to be six to eight members.
For which of the following populations would paradoxical interventions be contraindicated?
Homicidal and/or suicidal clients
Clients with severe depression
Clients in marriage therapy
Clients in family therapy
Correct answer: Homicidal and/or suicidal clients
Paradoxical interventions can be described as therapeutic modalities that run counter to the expectations of the client. One example is prescribing the symptom, in which the client is asked to exaggerate the symptom from which they are suffering to help the client understand their level of control. Paradoxical interventions can be controversial, as they seek to disrupt productively what the client likely expects from treatment.
However, these modalities should not be used with homicidal and/or suicidal clients. This is true both in terms of the specific pathology presented and the acuity of these two presentations; paradoxical interventions assume that the client is not acutely ill and a danger to self or others.
Paradoxical interventions can be used with the other client types listed.
Reference:
Which of the following would be most characteristic of milieu therapy?
Controlling noise and stimulation
Discussing past relationships
Addressing eating and sleeping habits
Group assessment of shared pathology
Correct answer: Controlling noise and stimulation
Milieu therapy is a modality based on the idea that environmental change can benefit an individual’s functioning. As it can involve fundamental changes to a person’s environment as a route to better functioning, it is more characteristic of inpatient treatment. One example would be controlling the level of noise and stimulation experienced by an individual.
Discussing past relationships, addressing sleeping and eating habits, and doing group assessments of shared pathology are not milieu interventions.
Deep down, Carl feels as though he is not masculine. If Carl engages in the defense mechanism of reaction formation, which of the following is most likely?
Carl will act in an extremely masculine way
Carl will not act in a masculine way
Carl will accuse others of a lack of masculinity
Carl will avoid the topic of masculinity altogether
Correct answer: Carl will act in an extremely masculine way
Defense mechanisms exist to protect the conscious mind from undesirable unconscious thoughts or stimuli. One of these is reaction formation, in which the opposite of the inner feeling is outwardly expressed. In this case, since Carl is insecure about his masculinity, he will act it out to the extreme to protect himself.
If Carl were to accuse others of his insecurity, he would be projecting; if he were to avoid the topic, he would be either in repression or denial.
Which result is likely in a group with high group cohesion that comes under attack?
The group will abruptly disintegrate
The group will have higher group cohesion
The group will have weaker group cohesion
The group will generate more activity
Correct answer: The group will have higher group cohesion
In forming treatment groups, phenomena can be observed that will either contribute to or subtract from the group’s therapeutic process. High group cohesion is considered desirable, as this will enable greater dialogue and cooperation among members. In fact, when a group with high group cohesion comes under attack, the group will likely develop even higher group cohesion.
Relabeling, therapeutic double binds, and prescribing the symptom are concepts used in:
group therapy
structural family therapy
Bowenian family therapy
strategic family therapy
Correct answer: strategic family therapy
Strategic family therapy focuses on the power and control expressed through family communication patterns, and techniques are frequently direct suggestions or assignments. Relabeling is used by counselors who can reframe the meaning of a situation. Some strategic family counselors will prescribe a symptom or put clients in a therapeutic double bind as a way of forcing them to either give up the problematic behavior or acknowledge control over it.
Resistance is a common behavior that occurs during the group process. What is one major function of resistance?
It allows for extensive processing outside of group sessions
It serves as a way for the counselor to insert himself into the group process
It psychologically protects the group member from painful feelings
It helps group members connect with each other on an emotional level
Correct answer: It psychologically protects the group member from painful feelings
Counselors who are leading groups must frequently handle resistance, which is any behavior that impedes progress. There is a wide variety of resistant behavior, such as being disrespectful toward the group counselor, coming late to sessions or leaving early, refraining from talking during the session, changing the subject, denying that one has problems, and many other behaviors. The one thing that resistant behaviors have in common, however, is that they all protect the group member from painful or uncomfortable feelings. The task of the group counselor is to address the resistance in a way that will draw the group member back into the group process in a helpful, therapeutic way.
In order to be effective, group counselors should have certain skills that allow them to work well with group members. All of the following are important core skills counselors should have except which one?
Managing the group within time constraints
Knowing the best ways to work with cultures of all types
Preventing members from blocking productive discussion
Helping the group to set appropriate goals
Correct answer: Knowing the best ways to work with cultures of all types
Group counselors should have a group of core skills that allow them to work effectively with group members. Among other skills, they should be able to manage and direct the group within certain time constraints, prevent members from blocking discussion, and help the group set goals. While group counselors should understand that cultural differences are a factor that affects how individuals relate to each other, no counselor is expected to know everything about every culture. It is more important for counselors to have an attitude of openness to learning about each individual’s values and beliefs.
A group counselor tends to act more like a member than a leader and offers suggestions to group members, but is overall non-directive. What type of group is this counselor most likely a part of?
Adlerian
Transactional analysis
Psychoanalytic
Person-centered
Correct answer: Person-centered
Person-centered group work is based on the work of Carl Rogers and the principles of unconditional positive regard, empathy, and genuineness. Counselors leading groups based on person-centered theory are often non-directive and tend to act more like members than leaders. Because these groups are less structured, there is considerable focus on listening and reflection.
In terms of transactional analysis, which of the following describes the purpose of a game?
To prevent intimacy
To preserve the self
To falsify interaction
To win a contest
Correct answer: To prevent intimacy
Eric Berne’s transactional analysis (TA) rests on a theory of human interaction that assesses the communicative roles in which people communicate and act with each other. Not all interactions are transparent or geared for mutual benefit; a game is a mechanism one party uses in a transaction to prevent intimacy.
The point of a game in this context is not to falsify interaction, preserve the self, or promote success in a contest.
What is the role of the group leader in cognitive behavior groups?
To serve as a catalyst for change
To formulate and implement plans
To convey acceptance and facilitate discussion
To teach coping skills and ways of modifying behavio
Correct answer: To teach coping skills and ways of modifying behavior
Cognitive behavior groups, which help group members find ways of identifying and changing behaviors, aim to eliminate problems and teach self-management skills. Leaders of cognitive behavior groups teach coping skills and methods of modifying behavior. Techniques used include contracts, reinforcement, and modeling.
Which of the following helps to maintain homeostasis within a family system?
Interdependence
Positive feedback loops
Equifinality
Negative feedback loops
Correct answer: Negative feedback loops
Cybernetics is the study of methods of feedback control, both negative and positive. Negative feedback loops are patterns of interaction that maintain stability and homeostasis within the family system.
Positive feedback loops are patterns of interaction that can facilitate change. Equifinality refers to different individuals reaching the same goal through different methods or routes. Interdependence simply refers to the fact that family members rely on and are influenced by each other.
In general, how skilled are people at forecasting their emotional reactions to life circumstances?
People are relatively poor at forecasting their reactions to life circumstances but good at forecasting those of others
People are generally skilled at forecasting their emotional reactions to life circumstances
People are generally poor at forecasting their emotional reactions to life circumstances
People are relatively good at forecasting their reactions to life circumstances but poor at forecasting those of others
Correct answer: People are generally poor at forecasting their emotional reactions to life circumstances
In general, people are poor at forecasting their emotional reactions to life circumstances. People tend to overestimate the impact of events on their overall emotional life. For example, rather than a lifelong adjustment to happiness in a positive direction, the emotional boost from getting married lasts about two years.
What type of leadership function emphasizes the leader’s duty to manage the group as a social system?
Executive leadership
Caring
Meaning attribution
Emotional stimulation
Correct answer: Executive leadership
Irvin Yalom, a well-known figure in the field of group counseling, believed that certain leadership functions were present in the field of group counseling. These leader functions include emotional stimulation, in which counselors encourage healthy expression of emotions; caring, which is characterized by warmth, acceptance, genuineness, and concern; meaning attribution, in which the group leader provides a cognitive perspective to group members’ experiences; and executive leadership, which is characterized by the group leader structuring the group and ensures that the group is moving in a specific direction. During the executive leadership stage, the emphasis is placed on managing the group as a social system.
What type of group is most dedicated to exploring basic life assumptions, recognizing strengths and accepting responsibility, and developing social interests?
T-group
Cognitive behavioral
Adlerian
Self-help
Correct answer: Adlerian
Adlerian groups aim to help people explore basic life assumptions, recognize strengths, encourage the acceptance of responsibility, and develop social interests.
Cognitive behavioral groups are a type of task group that aims to teach members how their thoughts impact their behaviors and feelings. Self-help groups are informal groups without a designated leader and usually serve as a support group. A T-group is an experiential group meant to help members change various aspects of their lives.
Which of the following is a topic commonly addressed in group couples counseling?
De-escalating crisis situations
Addressing the effects of childhood trauma on relationships
Learning effective parenting skills
Reducing the amount of physical violence in the home
Correct answer: Learning effective parenting skills
Group couples counseling is frequently more content-oriented than process-oriented. The goals of many couples counseling groups are to improve communication between parents and their children, resolve conflicts, and learn new parenting skills. Sometimes parents of children with mental health problems attend psychoeducational groups to learn more about that specific diagnosis and how it can affect an individual’s life.
The remaining answer options are incorrect because they are not topics addressed in group couples’ counseling. Childhood trauma is best addressed in individual counseling due to the strong affective component of this type of work. Counseling is typically contraindicated when physical violence is occurring in the home; the best approach is for the aggressor to seek his or her own individual counseling (or perhaps participate in a group specifically for individuals who are violent to their partners). Group couples’ counseling is contraindicated for crisis situations, as crisis intervention is counselor-led rather than a process that integrates feedback from group members.
All of the following are true regarding Aaron Beck’s theory of depression except:
Internal communication of depressed people is negatively focused
Depression usually stems from early childhood trauma
The cause of depression can be a combination of genetic and environmental factors
Cognitive therapy helps more to alleviate depression than antidepressant medication
Correct answer: Depression usually stems from early childhood trauma
Aaron Beck is the main contributor to the field of cognitive therapy. He identified the concept of automatic thoughts in clients and their contribution to negative cognitive shifts. Beck believed that depression was caused by biological, genetic, personality, and stress factors. While Beck might agree that early childhood trauma could contribute to a current depressive state, this was not something articulated in his theories.
A Gestalt therapist would most likely concentrate on which of the following?
Internal conflict
The here and now
Cognitive processing
Relational competence
Correct answer: The here and now
Gestalt therapy is known for its focus on the psychological and physical “here and now.” Generally, Gestalt therapy is more concerned with the confrontational present rather than one’s internal conflict, cognitive processing, or relational competence.
Gestalt believed that by increasing one’s awareness of self and surroundings, as well as an understanding of these factors, greater psychological freedom can be achieved.
Which of the following would be consistent with an eclectic style of counseling?
Focusing on the relationships between thoughts and emotions
Taking elements from various schools
Training skills to enhance psychosocial success
Concentrating on the end result of the counseling process
Correct answer: Taking elements from various schools
Eclectic counseling draws from various schools and integrates them into a personal style unique to that practitioner.
Concentrating on the end result of the process, focusing on the relationships between thoughts and emotions, and skill training are all examples of techniques that might belong to specific schools of counseling or psychotherapy.
Which of the following is the point of catharsis?
To address relational needs
To purge emotions
To block negative thoughts
To express unconscious desires
Correct answer: To purge emotions
Catharsis is a term first used by Freud and Breuer to describe the highly emotional reactions of patients in psychoanalysis. It is still used to describe the purging of emotions that sometimes occurs as a result of the therapeutic process. The result is a feeling of relief.
The point of catharsis is not to express unconscious desires, address relational needs, or block negative thoughts.
A group has been meeting for four weeks. The counselor leading the group notes that group members often self-disclose, seem to be making good emotional connections with each other, and group members tend to come back week after week. This group is relatively:
autocratic
content-oriented
cohesive
dysfunctional
Correct answer: cohesive
When a group is cohesive, group members enjoy coming to the group, feel as if they belong, and feel included. Cohesion occurs in groups made up of members who make self-disclosures, are vulnerable with each other rather than putting up defenses, and make commitments to each other. Cohesive groups are also usually good working groups, and any attacks on the group lead to greater cohesion.
Which of the following would be the best example of psychodrama?
A client narrates a dream about being rejected by their family
A therapist describes what the client has said about being rejected by their family
A client acts out being rejected by their family
A client describes feeling rejected by their family
Correct answer: A client acts out being rejected by their family
The technique of psychodrama is associated with various schools of therapy, most notably Gestalt. It involves a client acting something out in the therapeutic environment for the purpose of exploring the feelings involved and creating an understanding of the client’s perspective.
If a therapist is practicing mimesis in a family therapy context, which of the following is likely?
The therapist is joining the family and adopting their style
The therapist is adopting the style of individual family members
The therapist is having family members copy each others’ style
The therapist is having the family enact a different style
Correct answer: The therapist is joining the family and adopting their style
Within structural family therapy, a therapist is often called upon to “join” or adopt the style of the family in order to better understand it, diagnose its issues, and participate more meaningfully in addressing those issues. This process is sometimes called mimesis.
Mimesis does not refer to family members copying each others’ style or having the family enact a completely different style.
Which of the following would be characteristic of case integration?
A patient being treated with a group of similar presentation
Two psychologists providing collaborative services
A dietitian and a psychologist addressing a patient’s needs
Two patients being treated at the same time
Correct answer: A dietitian and a psychologist addressing a patient’s needs
Case integration refers to treatment involving different, non-overlapping services to a single client, (e.g., a dietitian employed to address nutrition and a psychologist employed to address potential psychopathology).
Case integration involves a single client and does not involve professionals providing overlapping services.
Which type of group counseling approach typically requires the group leader to be the most active?
Rational emotive behavior
Person-centered
Gestalt
Existential
Correct answer: Rational emotive behavior
Rationale emotive behavior groups require a highly active and directive group leader, which may be too forceful for some clients. In these groups, the leader confronts illogical thinking and aims to make constructive changes, leading to a greater acceptance of self. The group leader often assigns homework and encourages role-playing and exercises in self-discipline.
All of the following are true regarding co-leadership of a group except which one?
If possible, one co-leader should be male and the other female
Co-leaders can serve as models and recreate situations for the group
Co-leaders should engage in power struggles from time to time to demonstrate conflict resolution skills
Co-leaders should give each other feedback
Correct answer: Co-leaders should engage in power struggles from time to time to demonstrate conflict resolution skills
Co-leadership is often a helpful technique for both group members and leaders. Group members can benefit from feedback from two leaders instead of one, co-leaders can act out role plays and model behaviors, and co-leaders can give each other feedback about their involvement with the group. When possible (and appropriate), it is helpful for one co-leader to be male and the other female, particularly if there is a combination of genders in the group. However, co-leaders should refrain from having power struggles. This could fragment the group, and it models unhelpful ways of working out differences.
According to Corey, what activities are included in the first stage of a group?
Establishing cohesion and trust
Recruiting and screening
Preparing for the outside world and deciding what courses of action to take
Challenging the leader and experiencing conflict
Correct answer: Recruiting and screening
Corey identified six stages of a group. These include formation, when the group counselor screens and selects group members; orientation and exploration, which focus on cohesion and trust between group members; transition, which deals with handling resistance and conflict; working, when the group becomes more productive and less dependent on the leader; consolidation and termination, when group members prepare for the outside world; and postgroup activities, which include evaluation and follow-up referrals for other services.
Joining or blending with a family is a feature of which kind of family therapy?
Brief strategic therapy
Solution-focused therapy
Strategic family counseling
Structural family therapy
Correct answer: Structural family therapy
Salvador Minuchin’s structural family therapy involves the therapist “joining” or blending with a family in order to discover its patterns. When the therapist has this intimate knowledge of the systems within a family, changes can be responsibly recommended.
This kind of intervention is not a feature of strategic family counseling, brief strategic therapy, or solution-focused therapy.
In solution-focused brief therapy (SBFT), what is a formula first session task (FFST)?
A small goal that must be achieved in the first session
A specific interaction between therapist and client within the first session
A homework assignment assigned after the first session
The set of five critical pieces of information that a client must offer within the first session
Correct answer: A homework assignment assigned after the first session
Solution-focused brief therapy (SBFT) uses here-and-now techniques and active client involvement to achieve measurable gains in client success within a brief and limited timeframe. One technique within SBFT is a formula first session task (FFST), which involves a homework assignment given to the client after the first session.
An FFST is not achieved within the session and is something for the client to do.
A member of an anger management group describes a recent interaction he had with his boss that led to his getting angry and leaving work. The group counselor directs various members of the group to act out the interaction that was just described to them. Which of the following is this an example of?
Homogeneity
Psychodrama
Altruism
Preaffiliation
Correct answer: Psychodrama
Psychodrama is a technique developed by Jacob Moreno that is used by group counselors to work through conflicts by reorganizing individuals’ perceptions and increasing insight. Psychodrama usually includes a director, a protagonist, an auxiliary ego, and an audience.
Which of the following would be the best example of a psychoeducation group?
A group that instructs walk-in clients about local resources
A group training executives how to be better speakers
A group teaching people with schizophrenia about medication
A group helping substance abuse clients address their trauma
Correct answer: A group teaching people with schizophrenia about medication
A psychoeducation group is designed to help a specific population with information they can use (in this case, people with schizophrenia who can benefit from an understanding of medication).
A group helping substance abuse clients address their trauma is more clinical, like group therapy. A group training executives to be better speakers is more like a t-group (or training group). A group that instructs walk-in clients about local resources sounds like a structured group, which is issue-focused rather than client-focused.
Which of the following is the purpose of a Johari window?
To call attention to maladaptive patterns
To help clients design their own goals
To help clients understand relationships
To negate transference and countertransference
Correct answer: To help clients understand relationships
A Johari window is a four-quadrant diagram separated by areas of knowledge that are known/not known to self/others. Its purpose is to help clients understand relationships by improving communication and the flow of information.
A Johari Window is not a tool for goal-setting, calling attention to maladaptive patterns, or negating transference or countertransference.
Which of the following is characteristic of cognitive restructuring?
A client adapting to a new environment
A client exploring childhood trauma
A client learning to challenge their irrational thoughts
A client renewing a past relationship
Correct answer: A client learning to challenge their irrational thoughts
In many types of cognitive therapy, cognitive restructuring is a primary activity. This involves learning about one’s irrational thoughts, learning to challenge those irrational thoughts, and then going on to replace them with rational thoughts.
This technique centers on a client’s thoughts and character and is not about relationships, adaptation, or trauma.
What is the difference between brief therapy and crisis intervention?
Brief therapy is for those experiencing normal reactions
Crisis intervention more clearly addresses pathology
Brief therapy more clearly addresses pathology
Crisis intervention is meant to be used after brief therapy fails
Correct answer: Brief therapy more clearly addresses pathology
Although they are often seen as similar, crisis intervention and brief therapy are designed to accomplish different things for different clinical groups. For the most part, brief therapy (like actual therapy of any kind) is more addressed to pathology and symptoms, using clinical tools and modalities to reduce both.
Crisis intervention is mainly addressed to those experiencing normal reactions to a crisis, with the objective of helping them manage a natural progression from stress to efficacy. There is no explicit relationship between crisis intervention and brief therapy in terms of timing.
An existential therapist would likely address which of the following?
A client’s disturbed thought process
A client’s subjective experience of the world
A client’s variable mood
A client’s sense of responsibility for their life
Correct answer: A client’s sense of responsibility for their life
The school of existential therapy focuses on the client’s sense of responsibility for their life and the anxiety that emerges as one moves through the process of life. Its interventions hand responsibility to the client, who must consciously own their choices, beliefs, and direction in life.
Existential therapy does not deal as much with subjective experience (except where it implicates present responsibility), thought disturbance, or mood.
A counselor at an inpatient psychiatric facility runs a biweekly skills group for recovering alcoholic patients. Which of the following might the counselor need to keep in mind?
Meaning attribution should be consistently implemented at a level that is slightly above the average cognitive ability of group members
The executive function of the group should be de-emphasized
Emotional stimulation should be carefully monitored to ensure group members are capable of dealing with strong feelings in ways that are not harmful
The caring function should be applied in the same way no matter what group members’ diagnoses are
Correct answer: Emotional stimulation should be carefully monitored to ensure group members are capable of dealing with strong feelings in ways that are not harmful
In terms of group leadership, emotional stimulation refers to the extent to which feelings, values, and/or beliefs are expressed by group members. In certain situations that include individuals who are at risk of harming themselves or others, such as inpatient psychiatric groups, leaders should pay close attention to the amount of emotional stimulation that is present, in order to ensure that group members are not overwhelmed by strong feelings.
Which of the following is the best example of a miracle question?
“If you could go back and change something in your life, what would it be?”
“If things could be different overnight, how could you tell the difference?”
“If you could fix one person in your life, who would it be and how?”
“What powers would you like to have over others?”
Correct answer: “If things could be different overnight, how could you tell the difference?”
In solution-focused brief therapy (SBFT), the miracle question is sometimes employed as a therapeutic tool. The client is asked this question related to the current circumstances they want to change, with the purpose of creating space for a solution in that client’s imagination. For example, the question “If things could be different overnight, how could you tell the difference?” encourages the client to visualize what not having the current problem would be like.
The other questions listed focus too much on the past or other people. SBFT deals with one’s possibility of immediate and productive change.
Which of the following is often most appealing to multicultural individuals in Transactional Analysis (TA) groups?
TA gives a broad understanding of human nature
TA groups are action-oriented
All TA concepts are easy for multicultural clients to understand
The structure of TA groups, and contracts that can be adjusted for different cultural values
Correct answer: The structure of TA groups, and contracts that can be adjusted for different cultural values
Transactional Analysis (TA) groups focus on a combination of action and affect, and the leader is regarded as the diagnostician and teacher. This role of the leader as the instructor creates a structure that many multicultural group members like. One technique commonly used in transactional analysis groups is the contract, which can be adjusted for all types of beliefs and values. Transactional analysis gives a narrow (rather than broad) understanding of human nature, is both action- and affect-oriented, and does contain some concepts that may be difficult for multicultural clients to understand.
Which of the following accurately defines Wolpe’s theory of reciprocal inhibition?
One cannot be both elevated and depressed at the same time
One cannot be manic and depressed at the same time
One cannot be psychotic and non-psychotic at the same time
One cannot be both anxious and relaxed at the same time
Correct answer: One cannot be both anxious and relaxed at the same time
Joseph Wolpe contributed the theory of reciprocal inhibition, which states that a person cannot be both anxious and relaxed at the same time. This suggests that if a person with anxiety practices relaxation, they become less anxious. This theory is the foundation of systematic desensitization, part of which is the reduction of anxiety through positive pairing with anxiety-provoking stimuli.
The other statements, though generally true, do not define Wolpe’s theory of reciprocal inhibition.
Which of the following do brief therapy and narrative therapy have in common?
They both demand a rigorous examination of the past
They are both highly limited in scope
They both involve the study of cognitive patterns
They are based on constructivist theory
Correct answer: They are based on constructivist theory
Brief therapy and narrative therapy have in common a basis in constructivist theory, which is the idea that, to some degree, reality is constructed socially. The practice implication is that by addressing this social construction or personal narrative, positive change can be enacted.
Narrative theory may not be highly limited in scope. The two therapies do not necessarily involve a rigorous examination of the past. They may or may not involve the study of cognitive patterns.
Which of the following is the best example of a self-help group?
A group for individuals with a history of alcohol abuse, led by a psychotherapist
A group for parents who have lost a child, led by a professional counselor
A group led by a school counselor for parents of children in special education settings
A group for survivors of sexual abuse, led by a survivor
Correct answer: A group for survivors of sexual abuse, led by a survivor
Self-help groups are support systems to help with psychological stress of some sort and are typically not led by a professional. A self-help group that addresses issues faced by those with a history of sexual abuse could foster invaluable support for survivors by offering a safe space for group members to share with others who have had similar experiences. Alcoholics Anonymous is one of the most well-known self-help groups.
Neuroplasticity refers to which of the following?
The brain’s ability to recover from injury
The brain’s ability to reorganize itself
The brain’s ability to recognize others
The brain’s ability to change in response to others
Correct answer: The brain’s ability to reorganize itself
Neuroplasticity refers to the ability of the brain to reorganize itself. This can take place in many ways, from the construction of new neural pathways to the production of neurotransmitters.
In this context, neuroplasticity does not refer to the ability of the brain to recover from physical injury, recognize others, or change in response to others.
Which of the following would be a good example of a primary prevention group?
A problem-solving group for people with alcohol problems
A counseling group for people with alcohol problems
An educational group about the risks of alcohol
A therapy group for people with advanced liver disease due to alcoholism
Correct answer: An educational group about alcoholism
Groups can sometimes be arranged to help those with a certain issue. If a well-known problem is present, prevention groups can be used as a strategy for either avoiding or mitigating harm. A primary prevention group would be something like an educational group about the risks of alcohol. Primary in this case means that the harm or condition has not yet taken hold, and there is an opportunity to avoid it altogether.
The other options deal with people who already have issues related to alcoholism.
Which of the following was not one of the ego states described by Eric Berne?
The Adult
The Parent
The Father
The Child
Correct answer: The Father
Eric Berne described three ego states in his work on transactional analysis (TA). These are the Parent (who has internalized all of society’s rules and expectations), the Adult (who is rationally operating in the world), and the Child (who contains spontaneity and desire). The interaction of these ego states is TA’s primary focus.
The Father is not one of the ego states described by Berne.
A child, age 17, recently dropped out of school and is living at home. He does not have a job, though he sometimes goes with his mother to the animal shelter to volunteer. When a family counselor asks the boy what his career and educational goals are, he shrugs his shoulders while his mother jumps in to explain that he wants to be a police officer but is now “just taking a break.” When asked about the boy’s responsibilities around the house, the boy’s father rolls his eyes and tells the counselor that his wife does everything for their child, including making his meals. The mother tells the counselor that she and her son have a “special” relationship and seems pleased when she says that her husband is not a part of it.
This mother and son are most likely:
differentiated
disengaged
resilient
enmeshed
Correct answer: enmeshed
Enmeshment occurs in families that have diffuse boundaries and the separation between family members is unclear. In this example, the mother and son have difficulty distinguishing themselves from one another, which seems to be a significant barrier to the marital relationship and the father-son relationship. The counselor can urge the mother to encourage her son to be more independent and to express his own feelings, opinions, and beliefs without fear of judgment
Which of the following would likely be considered a positive defense mechanism?
Sublimation
Denial
Reaction formation
Projection
Correct answer: Sublimation
Defense mechanisms are means by which the mind protects itself from inner conflict resulting from unwanted desires, motives, or emotions. Sublimation means that the person takes unwanted energy and channels it into more productive or prosocial activity, such as someone taking their work anxiety and working out in a gym.
Projection is the assignment of one’s own undesirable issues to others, denial is the rejection of facts that cause stress, and reaction formation is taking unwanted feelings and acting out the opposite. None of these would be considered positive in the same way as sublimation would be.
Which of the following would be a likely question from a therapist using motivational interviewing (MI)?
“Why do you want to change?”
“Tell me about your family of origin.”
“What has worked in the past?”
“What systems do you have to fix?”
Correct answer: “Why do you want to change?”
Motivational interviewing is a technique whose purpose is to actuate client change by finding within the client their real reason for the desire to change. An essential part of the process is to identify and deal with sources of ambivalence, as part of the function of ambivalence is to prevent the discomfort of change.
The other statements do not put the burden of identifying motivation on the client, which is the core of MI.
What is typically regarded as the optimum size for an adult group with no co-leader?
Eight
Four
Six
Ten
Correct answer: Eight
When forming groups, counselors should be careful to consider the number of group members to invite. For adult groups with only one leader (rather than co-leaders), the optimum size is eight. This gives group members the opportunity to build relationships with all other group members without feeling overwhelmed by the number of people.
Object relations theory is the belief that early relationships shape people’s current interactions with others. Of the four stages of development defined by object relations theory, which of these occurs in the first month of life?
Separation/individuation
Fusion with mother
Symbiosis
Constancy of self and object
Correct answer: Fusion with mother
Object relations theory is based on psychoanalytic concepts, as it asserts that relationships that we form early in life affect our interpersonal interactions with others in the present. There are four stages of development that should be navigated in the first three years of life: fusion with mother (first three to four weeks), symbiosis (third to eighth month), separation/individuation (begins the fourth or fifth month), and constancy of self and object (occurs by the 36th month).
Don Dinkmeyer’s Systematic Training for Effective Parenting (STEP) program integrates concepts used by which group approach?
Rational emotive behavior
Adlerian
Gestalt
Existential
Correct answer: Adlerian
Adlerian group counselors aim to help group members explore life assumptions, recognize their own strengths and accept responsibility, and increase self-esteem. The Adlerian group approach has been shown to be successful when used in parent-education models in schools. The Systematic Training for Effective Parenting (STEP) program, developed by Don Dinkmeyer, is one such program.
Denise, who has just entered middle age, has begun to spend her money in what her close associates see as excessive ways. She has begun to gamble every weekend, spends heavily on jewelry, and has just bought a sportscar.
If Denise engages in rationalization, how might she respond to the concerns of her friends?
“You only live once.”
“Mind your own business.”
“You’re the one spending all your money.”
“I don’t spend that much money.”
Correct answer: “You only live once.”
Defense mechanisms are ways in which the psyche protects itself from unwanted thoughts or inner conflict. These take many forms; in this case, rationalization would most likely cause Denise to respond with “You only live once.” Rationalization creates an acceptable reason for behavior that the mind can fall back on when questioned by itself or others.
“You’re the one spending all your money” sounds like projection, which is ascribing one’s motives to others. “I don’t spend that much money” could signal denial.
A counselor has been providing play therapy to young children for many years. She has recently noticed that many of the parents of the children she works with have had questions about the therapeutic orientation of play therapy, why play therapy is helpful, and how it works. What type of group might this counselor find to be most helpful for the parents of these children?
A counseling group for parents to work through resentment and anger related to having a child in counseling
A self-help group to alleviate the stress felt due to parenting children with emotional problems
A psychoeducational group providing information about play therapy
A psychotherapy group for parents to begin to see their own contributions to their children’s illnesses
Correct answer: A psychoeducational group providing information about play therapy
Psychoeducational groups focus on providing education and information to group members and building skills. These groups can be preventative, remedial, or simply there to provide information to interested parties. For parents curious about the purpose of play therapy, this group may be an excellent way to gain information, get answers to questions, and connect with other parents.
James has been working out at a gym for about three months. Before starting, he carefully researched local gyms and consulted with his physician. He hopes to keep up his new habits, as for a long time he did not know whether he wanted to start a physical fitness program. In fact, he did not consider joining a gym at all until a family member expressed concern about his health.
In which of Prochaska’s stages of change is James?
Action
Maintenance
Contemplation
Preparation
Correct answer: Action
Prochaska suggested a model of change that is widely used in treatment contexts. It consists of five stages.
In the first stage, precontemplation, a person does not know or understand their need to change, as when James was cued by his family member. In the second stage, contemplation, a person is ambivalent about changing, just as James was ambivalent about starting his program. In the next stage, preparation, resources and knowledge are gathered to help institute change. In the fourth stage, action, concrete action is begun toward change. In the last stage, maintenance, those changes are maintained.
The “performing” stage of group development refers to which of the following?
A stage when conflict is inevitable as members work out personality differences
A stage when group members establish goals for the group but continue to focus on themselves
A stage when members trust each other and often achieve success
A stage when the group assesses the work they have accomplished
Correct answer: A stage when members trust each other and often achieve success
Group development takes place in five stages: forming, storming, norming, performing, and adjourning. During the forming stage, members establish goals for the group but continue to focus on themselves. The storming stage is typically marked by conflict as members work out personality differences. During the norming stage, members accept differences between each other and begin to work together. The performing stage is when members trust each other and often achieve success. The final stage, adjourning, is when group members celebrate their successes and assess their work.
Which of the following would be characteristic of stress inoculation?
Practicing positive statements under stress
Taking charge of one’s own medication
Roleplaying successful interactions with peers
Connecting with others who have similar issues
Correct answer: Practicing positive statements
Donald Meichenbaum contributed the idea of cognitive behavior modification, which involves thought replacement of negative thoughts with positive ones. In keeping with this idea, stress inoculation is practiced by an individual practicing positive statements under stress with the aim of reducing negative thoughts and controlling responses to stress.
Taking charge of one’s own medication, connecting with others who have similar issues, and roleplaying successful interactions with peers may all be helpful but are not characteristic of stress inoculation.
All of the following are advantages to receiving counseling in a group setting, except which one?
There is a lack of norms among group members
The group setting is a good replication of the participants’ everyday world
Group members can experience social support
Groups are safe places to practice new skills
Correct answer: There is a lack of norms among group members
There are many advantages to group counseling, including the opportunity to experience social support, peer confrontation, and new behaviors; having a safe place to practice new skills; and getting exposure to an experience that more nearly replicates the participants’ everyday world. In addition, group norms develop over time, providing members with a chance to practice their skills in a subset of the “real” world.
Reference:
Which of the following would be the most likely use of a genogram?
To understand the structure of a family’s systems
To visualize the communication patterns in the family
To address genetic patterns in a family
To diagnose pathology at the family level
Correct answer: To understand the structure of a family’s systems
A genogram is a structural diagram of a family, with various symbols used to denote gender, status of being alive or dead, divorce, and many others. This most often goes back at least three generations. The point of this is to illustrate and understand the structure of a family’s systems, which might otherwise not be apparent.
Genograms do not address genetic patterns, nor are they simply meant to deal with communication. They are not diagnostic but informational.
R. K. Coyne developed four levels of group intervention. What are these levels?
Individual, Interpersonal, Organization, Community
Initial, Transition, Working, Termination
Assessment, Planning, Treatment, Evaluation
Forming, Norming, Storming, Performing
Correct answer: Individual, Interpersonal, Organization, Community
The Group Work Grid refers to R. K. Coyne’s four levels of intervention: Individual, Interpersonal, Organization, and Community populations.
Individual: To prevent, correct, or enhance individual personal or task functions; the focus being helping an individual.
Interpersonal: To prevent, correct, or enhance interpersonal or task functions; the focus being on interpersonal interactions.
Organization: To prevent, correct, or enhance organizational or task functions; the focus being on organizational behavior.
Community: To prevent, correct, or enhance task functions at the community level; the focus being on the larger interactions within communities
These are different from the various models of group development, such as Gerald Corey’s stages (initial, transition, working, and termination) or Bruce Tuckman’s
Which of the following is the correct description of gender differences with respect to suicide?
There is no meaningful gender difference in suicidal ideation
There is no meaningful gender difference in suicidal behavior
Men complete suicide more, and women attempt suicide more
Men attempt suicide more, and women complete suicide more
Correct answer: Men complete suicide more, and women attempt suicide more
The phenomenon of suicide appears differently in women and men. It appears that men complete suicide more (generally because of the use of more lethal means), but women seem to attempt suicide more often than men.
After having a group discussion, group members agree on a less conservative course of action than they would have taken individually. This is known as:
blocking
triangulation
linking
risky shift phenomenon
Correct answer: risky shift phenomenon
Risky shift phenomenon occurs when a group makes decisions that are riskier and less conservative due to group discussions. This is a common occurrence in groups, as shared risk makes the individual risk less. Studies also show that extensive discussion about a particularly risky course of action tends to lessen perceived risk.
Which of the following is false about the phenomenon of group cohesion?
Group members are more likely to identify with members that are perceived as powerful
Attacks on a cohesive group result in less cohesion
Attacks on a cohesive group do not necessarily result in a change in group cohesion
Attacks on a cohesive group result in greater cohesion
Which of the following is false about the phenomenon of group cohesion?
Group members are more likely to identify with members that are perceived as powerful
Attacks on a cohesive group result in less cohesion
Attacks on a cohesive group do not necessarily result in a change in group cohesion
Attacks on a cohesive group result in greater cohesion
Which statement about countertransference is correct?
Countertransference is the extra feelings brought into the therapeutic relationship by the therapist
Countertransference is an outdated notion that has been disproven by research
Countertransference is the extra feelings brought into the therapeutic relationship by anyone
Countertransference is the extra feelings brought into the therapeutic relationship by the patient
Correct answer: Countertransference is the extra feelings brought into the therapeutic relationship by the therapist
Sigmund Freud identified the notion of transference, which is the way in which patients tend to bring extra feelings into the therapeutic relationship, usually transferring these from another relationship such as a parent. Countertransference is the extra feelings a therapist brings into the therapeutic relationship.
These notions are current and have not been disproven by research.
According to the work of Alfred Adler, which of the following would be characteristic of an oldest child?
Feels left out, sees life as unfair
Pampered, tends to go their own way
Deals with adults well, wants to be center stage
Receives a lot of attention, is dependable and responsible
Correct answer: Receives a lot of attention, is dependable and responsible
Alfred Adler postulated a range of attributes according to the birth order in a family. Oldest children, according to this view, get a lot of attention, tend to be dependable and responsible, and are achievement-oriented.
Youngest children tend to be pampered and go their own way, only children tend to deal with adults well and want center stage, and middle children can feel left out and see life as unfair.
A counselor operating from a reality therapy perspective is recruiting clients for a group for recovering alcoholics who continue to have interpersonal difficulties. Which of the following should group members be prepared to do?
Restructure cognitions in preparation for change
Explore childhood experiences and family constellations
Take responsibility for their behaviors and formulate a plan for change
Learn how to modify behaviors through modeling
Correct answer: Take responsibility for their behaviors and formulate a plan for change
Reality group counseling focuses on group members taking responsibility for their behaviors and increasing control over their lives. Techniques used in reality group counseling include honest self-examination, evaluating behavior, formulating a plan for change, and following through with this plan.
What is the point of the reframing technique in psychotherapy?
To address psychopathology by treating it as normal
To rearrange family structure around a traumatic event
To see a problem or situation from another person’s point of view
To put a different perspective on an existing problem or situation
Correct answer: To put a different perspective on an existing problem or situation
It is often helpful in psychotherapy to challenge a client about a given problem or situation. One way to do this is reframing (i.e., to put a different perspective on an existing problem or situation). One example might be taking a client’s belief that others dislike him and offering the perspective that perhaps others do not know how to engage with him.
The technique is not explicitly meant to shift to another’s perspective, nor does it deal with family structure or deny psychopathology.
Which of the following would be the best example of protective systems in family therapy?
Systems designed to insulate family members from conflict
A child who maintains high-stakes relationships with peers
Systems designed to protect the family from perceived threats
An adult who maintains the high stakes of childhood relationships in adult relationships
Correct answer: An adult who maintains the high stakes of childhood relationships in adult relationships
Protective systems as a concept in family therapy deal with the failure of child role models. As the child ages, the high stakes of childhood relationships are preserved in adult relationships with undue anxiety about failure and danger.
The concept does not refer to age-peer relationships among children or protecting the family system.
For which of the following would biofeedback be least useful?
Phobias
Thought disorder
Migraine headaches
Anxiety
Correct answer: Thought disorder
The technique of biofeedback, which helps a person rewire neural networks related to autonomic response, is useful to help with migraine headaches, anxiety, and phobias, among others.
It is less useful for cases of actual brain disease or psychosis, such as those present in thought disorders.
Which of the following is the source of change in motivational interviewing (MI)?
The therapist
The environment
Reward and punishment
The client
Correct answer: The client
Motivational interviewing is a technique aimed at helping a client discover and utilize their reasons for change. The client is the source of change within MI. The aims are to identify, describe, and deal with ambivalence in a person who is in some stage of a change process.
In MI, the source of change is not the therapist, the environment, or a reward/punishment strategy.
Which of the following would be the least likely candidate to benefit from group therapy?
A client who is incarcerated
A client with severe anxiety
A client in crisis
A client with profound thought disorder
Correct answer: A client in crisis
Group therapy is a highly versatile modality that can be used effectively for a wide variety of populations. Some benefits of group therapy go beyond specific treatment for a given mental illness or condition, such as affiliation and non-expert feedback. However, clients in a state of crisis would be the least likely of those listed to benefit from a group process. Clients in crisis are generally highly concerned about their own issues of crisis, which will need to be resolved before the client can be an effective member of a therapeutic group.
The other groups listed would be normal candidates for group work, depending on the treatment context.
According to object relations theory, normal progression through four broad stages during the first three years of life is necessary for healthy functioning. All of the following disorders except which one may occur if this normal progression does not take place?
Narcissistic personality disorder
Schizophrenia
Reactive attachment disorder
Borderline personality disorder
Correct answer: Schizophrenia
According to object relations theory, which is based on psychoanalytic concepts, a child must pass through four broad stages of development in order to function normally. If normal progression through these stages does not occur, the individual is at increased risk for attachment disorders and personality disorders such as borderline and narcissism.
The concepts of unconditional positive regard and empathic understanding are central tenets of which therapy approach?
Psychoanalysis
Individual psychology
Person-centered
Gestalt
Correct answer: Person-centered
The person-centered approach focuses on the importance of the counselor showing unconditional positive regard, genuineness, and empathic understanding toward the client. The focus is on the client’s current feelings and the client’s process of becoming and moving toward self-actualization. Carl Rogers is the primary founder of this approach.
Some mental health clinicians, called Neo-Freudians, continue to practice psychoanalysis but have made some modifications to Freud’s original theories. Which of the following is true of Neo-Freudians?
They discount psychodynamic and sociodynamic forces
They place more emphasis on the ego than the id
They believe that childhood experiences are not as important as present interactions
They eliminate the concept of unconscious drives
Correct answer: They place more emphasis on the ego than the id
Neo-Freudians are psychoanalysts who have moved away from Freud’s emphasis on the id as the main psychological force. More emphasis is placed on the ego, which is controlled by the reality principle. Like Freud, Neo-Freudians still believe in the power of unconscious desires and drives, focus on childhood experiences, and emphasize both psychodynamic and sociodynamic forces.
In which module of dialectical behavior therapy (DBT) would a person learn to experience their emotions fully?
Mindfulness
Interpersonal effectiveness
Emotional regulation
Distress tolerance
Correct answer: Mindfulness
Linehan’s DBT helps individuals with a variety of presentations deal with unacceptable feelings and impulse control. It is divided into four modules:
Mindfulness, with the hope of helping a client experience their own emotions fully
Distress tolerance, accepting and tolerating the moment non-judgmentally
Interpersonal effectiveness, helping a client deal with conflict and relationships
Emotional regulation, helping a client increase positive emotions
Which of the following is the function of a positive-feedback loop in family therapy?
To prevent change in the family system
To let family members engage in positive interactions
To induce change to the family system
To encourage family members to criticize each other
Correct answer: To induce change to the family system
Feedback loops, in the language of family therapy, are the product of interlocking systems within the larger family system. There are two kinds of feedback loops: a positive-feedback loop, which induces change in the family system, and a negative-feedback loop, which is the family system in its natural (likely pathological) state attempting to preserve homeostasis and prevent change.
The function of positive feedback loops is not to facilitate certain family interactions.
What is the best example of compassion fatigue?
Hyper-engaged focus on clients
Loss of empathy and interest in clients
Having inappropriate feelings toward clients
Greater countertransference with clients
Correct answer: Loss of empathy and interest in clients
Compassion fatigue is a phenomenon common to counselors who see difficult client issues and a lack of progress. It is most commonly evidenced by a loss of empathy and interest in clients.
Compassion fatigue is not marked by inappropriate feelings toward clients, being hyper-engaged with clients, or having greater countertransference with clients.
According to Adler, what is true about birth order?
It results in psychological distress for younger siblings
It results in psychological differences between siblings
It is responsible for sibling rivalry
It has no meaningful effect on sibling psychology
Correct answer: It results in psychological differences between siblings
Alfred Adler was one of the first thinkers to identify and detail the importance of birth order among siblings in the same household. Generally, according to Adler, birth order results in a different psychological environment for each child and different psychological attributes among siblings to meet the needs of a changing family over time.
Birth order is not seen, in this perspective, as being responsible for sibling rivalry, and the phenomenon may or may not result in distress for younger siblings.
Mindfulness is a concept that many counselors integrate into their work with clients. What is the main purpose of mindfulness?
To provide the client a narrative for his or her experiences
To rid the client of unhealthy thought patterns
To provide the client with coping skills in order to avoid self-harm
To change the client’s relationship with their negative thoughts
Correct answer: To change the client’s relationship with their negative thoughts
Mindfulness is gaining popularity in many counseling approaches; it consists of two parts. One part of mindfulness is to focus and pay close attention to one’s own current emotions, thoughts, sensations, and experiences. The second part is for the therapist to take a nonjudgmental attitude toward what the client is experiencing both internally and externally. The purpose of these two parts of mindfulness is to change the client’s understanding of and relationship with their negative thoughts.
What is the best definition of attribution theory?
The belief that the future is determined more by chance than by being contingent on certain events
The expectations that people have for themselves are often higher than what they are able to accomplish
The belief that rewards are contingent on our own actions
The explanations people offer for events influence future expectations for success and failure
Correct answer: The explanations people offer for events influence future expectations for success and failure
There are many theories regarding individuals’ motivation and understanding of their own behaviors. Attribution theory refers to the way that explanations individuals offer for their outcomes influence their expectations of future success and failure. This also influences how motivated individuals may be to succeed.
The belief that rewards are contingent on our own actions refers to an internal locus of control, while the belief that the future is determined more by chance than by being contingent on certain events refers to an external locus of control. The fact that the expectations people have for themselves are often higher than what they are able to accomplish does not describe attribution theory.
Which of the following is the point of a “duty to warn”?
To advise patients about the limits of confidentiality
To notify the possible target of violence
To observe professional courtesy between partner agencies
To inform decisions about inpatient treatment
Correct answer: To notify the possible target of violence
A “duty to warn” is when a professional becomes aware that a person in their care has made a credible threat to harm someone else. Although state requirements vary along with organizational procedures, the point is to notify the possible target of violence that this violence might occur.
This warning is not about confidentiality for patients and does not have anything to do with inter-agency relationships or treatment decisions.
Which of the following describes the proper use of silence in a therapeutic session?
It can only be used with clients who present with mood difficulties
It is helpful to elicit client responses
It is threatening to clients and should be avoided
It should only be used with certain types of clients
Correct answer: It is helpful to elicit client responses
Though it can be uncomfortable for clients and therapists and should be carefully applied, the use of silence in therapy sessions is a widely known and useful counseling practice. There are several benefits to silence, including allowing for greater control of the session’s emotional level, giving control to the client, and forming a space in which a client has time to find the best response to a therapeutic direction or idea.
Silence can be mildly uncomfortable but should not be threatening if properly used. There is no directive as to which clients are more or less able to benefit: it is a tool to be carefully applied like any other with a variety of clinical presentations.
In which of the following group stages is conflict most likely to occur?
Orientation
Working
Termination
Transition
Correct answer: Transition
Group work is generally conceptualized to follow a four-stage process. In the first stage, orientation, the group is formed and acquainted. The next stage, transition, is when interpersonal dynamics are worked out and conflict is most likely to occur. When this is resolved, the working phase can begin. When the work is complete, it is appropriate to measure progress in the termination stage.
Which of the following was the initial focus of dialectical behavioral therapy (DBT)?
Patients with schizophrenia and obsessive-compulsive personality disorder
Aggressive patients and those with borderline personality disorder
Patients with schizophrenia and paranoid personality disorder
Suicidal patients and those with borderline personality disorder
Correct answer: Suicidal patients and those with borderline personality disorder
Dialectical behavioral therapy (DBT) is a treatment modality first used to address suicidal patients and those with borderline personality disorder. It has a substantial evidence base and is now used to treat a variety of other issues.
DBT involves skills training, individual treatment, and a high degree of contact with the therapist. It is considered a cognitive behavioral method.
Which of the following statements would be characteristic of choice theory?
“Let’s discuss where this pain started for you.”
“What are you going to do to address this problem?”
“If you could change everything overnight, what would it look like tomorrow?”
“How does your family feel about this?”
Correct answer: “What are you going to do to address this problem?”
Choice theory asserts that the most important driver of patient wellness is the patient’s behavioral choices in the here and now. Like other therapeutic orientations that focus on the responsibility taken and used by the client, choice theory is mainly concerned with the present and not with the past exploration of causal elements of present issues.
The other statements do not suggest a present orientation focused on patient choices in reality.
Which of the following would be the most likely use of the empty chair technique?
To address trauma by reliving past events
To overcome fear through exposure
To help a person explore their feelings about another
To allow the therapist and the client to switch roles
Correct answer: To help a person explore their feelings about another
The empty chair technique is used often in various models of therapy. It involves an empty chair in which the client imagines another person to be. That person will be someone that the client will benefit from “talking to” in this manner and can aid in clarifying and exploring feelings about another.
The technique does not involve switching roles and is more geared toward the exploration of a relationship than overcoming fear or addressing trauma.
Which of the following would be an example of implosive therapy?
A client bringing their partner to therapy to explore their conflict
A client being forced to examine their life choices critically
A client being asked to relive their crisis in the therapist’s office
A client with a fear of flying imagining a plane crash in the therapist’s office
Correct answer: A client with a fear of flying imagining a plane crash in the therapist’s office
Implosive therapy is a behaviorist technique meant to desensitize a client to a feared stimulus. One example would be a client with a fear of flying imagining a plane crash in the safe environment of a therapist’s office. This would likely be followed by more iterations with the goal of reducing experienced distress.
Implosive therapy generally does not involve others, nor would it usually ask a client to critically examine their life choices. It would most likely not ask a client to relive a crisis unless that crisis was in some way a current source of fear or distress.
In what type of situation is autocratic leadership the best option?
A closed group that does not allow changes to membership
A group that only meets for four sessions
A group made up of motivated and self-directed members
A group whose members have many differing ideas
Correct answer: A group that only meets for four sessions
Group counselors can choose from one of three main styles of leading groups: autocratic, democratic, and laissez-faire. Autocratic leaders are typically direct and set clear goals and boundaries for groups. This type of leadership works best when time restraints are an issue, when membership frequently changes, or when the group needs to coordinate with other groups. Democratic leaders allow members to express their ideas and aim to encourage discussion and participation. Laissez-faire leaders allow group members to be in charge of all decision-making and it works best when group members are very motivated.
Which of the following accurately states the stages of Meichenbaum’s stress inoculation technique?
Precontemplation, rehearsal, action
Education, rehearsal, action
Education, rehearsal, application
Education, action, maintenance
Correct answer: Education, rehearsal, application
Meichenbaum developed a three-stage stress inoculation technique that is meant to help one know and reduce one’s own stress.
The first stage, education, helps the client understand how they respond to stress through inner dialogue. The second, rehearsal, is when new strategies of self-talk are used. The third, application, is when the new self-talk is used in practice.
What is a goal that group members of a person-centered group may have?
Become free of scripts and games
Increase self-acceptance and move past self-defeating behaviors
Take responsibility for one’s life
Increase self-understanding and explore a full range of feelings
Correct answer: Increase self-understanding and explore a full range of feelings
Person-centered groups typically encourage openness and an exploration of a full range of feelings. Techniques include active listening and reflection rather than structured techniques found in other types of groups. The focus of person-centered groups is on increasing self-understanding and personal insight.
Joe has been struggling with fear of the dark since he was a child. He is engaging in a systematic desensitization strategy. He has learned to control his physical responses to the dark and, with the help of his therapist, has found a way to intellectualize the various levels of his fear of the dark.
Which of the following would happen next?
Learning how to control responses to a dark room
Going into a dark room
Thinking about what is most fearful about a dark room
Imagining being in a dark room
Correct answer: Imagining being in a dark room
Systematic desensitization deals with a person’s systematically reduced anxiety when exposed to a certain stimulus. It is generally seen as proceeding through four stages.
Relaxation training to gain control of one’s responses
Construction of anxiety hierarchy to gain intellectual knowledge of one’s fear
Imaginative desensitization to explore one’s fear in safe circumstances
In vivo sensitization to gain control over the feared stimulus
The progression is necessarily stepwise and iterative. In this case, the first two steps have been done, so the next step would be the imaginative exercise of imagining being in a dark room.
Going into a dark room would be the last stage. Learning how to control responses and thinking of what is most fearful about a dark room would have been accomplished earlier in the process.
Which of the following would be characteristic of the preparation stage of change?
Trying to figure out whether one wants to change
Being unaware that change is necessary
Taking the beginning steps of change
Coming up with a list of options
Correct answer: Coming up with a list of options
Prochaska postulated a structured, stepwise model of change that is widely used in therapeutic contexts. It contains five stages. The first, precontemplation, is one in which a person may or may not know they need to change. The second, contemplation, is when a person is most ambivalent about whether to change.
Preparation, as seen in this example, is when a person is gathering resources and information for change. Action is the stage in which change begins, and maintenance is the habitual realization of the changes that have begun.
Which of the following is false about crisis intervention?
It follows a stepwise intervention model
It is meant to address psychopathology
It is limited in time
It is meant to address the normal process of crisis
Correct answer: It is meant to address psychopathology
Crisis intervention is a specific modality meant to address the normal process of crisis, which can be stressful and debilitating. This process goes through various stages from establishing the safety of the client to the use of new skills and is limited in scope to the crisis itself.
Crisis intervention is not meant to address psychopathology but to enhance function during a challenging but normal time.
What distinguishes flooding from other types of desensitization strategies?
Flooding can only be used in cases of severe trauma
Flooding does not involve exposure to a feared stimulus
Flooding is mostly used for mood-disordered clients
Flooding involves actual exposure to a feared stimulus
Correct answer: Flooding involves actual exposure to a feared stimulus
Desensitization strategies are designed to reduce the anxiety that occurs when a person is exposed to a feared stimulus, as in the case of a phobia. The technique of flooding differs from other, more gradual applications of this strategy by making the exposure to the feared stimulus total and immediate.
Flooding is not necessarily indicated or contraindicated for persons with severe trauma and mood disorder. Its suitability depends on how the counselor evaluates their possible success with this technique in response to a feared stimulus.
Some counselors use the process of circular questioning, which is when different family members are asked the same questions about the same relationships. This approach is used most often in conjunction with which family therapy approach?
Milan systemic family therapy
Narrative family therapy
Strategic family therapy
Structural family therapy
Correct answer: Milan systemic family therapy
Milan systemic family therapy refers to an approach that views the family as a system that aims to maintain balance. Systemic family therapists often use a variety of techniques, including circular questioning, which is the process of asking different family members the same questions about relationships. The family counselor can then use the ways that members differ in how they interpret events and interactions to suggest new ways of thinking about things, thereby hopefully changing family rules and relationships.
In successful groups, what are the three distinct sections of each group counseling session?
Confinement, sharing, and closure
Basic, advanced, and termination
Self, others, and group
Warm-up, action, and closure
Correct answer: Warm-up, action, and closure
There are many group dynamic issues for counselors to remember in terms of group content and process. The content and process are often organized into three distinct group sections: warm-up, action, and closure. In well-functioning groups, there is a smooth transition from one section to the next, and there is a balance between content and process in each section.
A group member talks about a recent interaction he had that led him to wonder about how he is perceived by others. Later in the session, another member says, “No one knows what it’s like to be me.” The group counselor comments that this is similar to the first group member’s thoughts earlier in the session. The technique used by this counselor is known as:
blocking
triangulating
linking
diffusing
Correct answer: linking
In group counseling, linking is the process of relating group members’ thoughts, comments, and feelings to each other to increase cohesion and (at times) interaction. Linking is one of many techniques group counselors can use to enhance group members’ experiences and to effect change.
In his book The Seasons of a Man’s Life, Daniel Levinson presents his Stage-Crisis View theory, which examines the typical periods in a man’s life. What does Levinson say about midlife crises?
They are part of normal, healthy development
They are often the main cause of divorce and other relationship disruptions
They are social constructs that must be avoided
They are experienced by every man and woman
Correct answer: They are part of normal, healthy development
Daniel Levinson was a 20th-century American psychologist whose studies focused on typical stages in his adult subjects’ lives. Levinson’s Stage-Crisis View theory posits that there are predictable, stable, and transitional periods in life and that the social conflicts that arise during these periods must be resolved. He proposed that midlife crises are not only common but are part of normal, healthy development.
Which of the following is humans’ essential problem, according to Rational emotive behavior therapy (REBT)?
Our dysfunctional personalities
Our traumatized childhood
Our inner conflict
Our interpretation of events
Correct answer: Our interpretation of events
According to the beliefs of rational emotive behavior therapy (REBT), our essential problem is not our experience of events but our interpretation of events. We abandon rational thinking in favor of our own irrational interpretation of events.
The problem, according to REBT, is not our traumatized childhood, inner conflict, or dysfunctional personalities.
Which of the following would be the most likely use of biofeedback in behavior therapy?
Enhance a client’s control of their unconscious
Enhance a client’s control of their circumstances
Enhance a client’s control of their body
Enhance a client’s control of their behavior
Correct answer: Enhance a client’s control of their body
One well-known behaviorist technique is biofeedback, which involves the client enhancing their control of their body in some way. This generally refers to a client being able to more productively interact with their autonomic nervous system, (e.g., to control their heart rate in response to stress).
Biofeedback does not have to do with control of behavior per se, nor does it address a client’s unconscious or their circumstances.
According to rational emotive behavior therapy (REBT), when do we learn irrational beliefs?
In childhood
In adolescence
As a result of abnormal brain development
As a result of trauma
Correct answer: In childhood
REBT focuses on the identification and correction of false interpretive beliefs about reality. These false beliefs emerge, according to REBT, in childhood. They are reinforced throughout subsequent life and become concretized in the personality.
REBT does not suggest that irrational beliefs are a result of trauma, emerge in adolescence, or result from abnormal brain development.
The belief that factors such as altruism, universality, interpersonal functioning, imitative behavior, group cohesiveness, catharsis, and corrective recapitulation of the primary family groups contribute to successful group functioning was posited by whom?
Tuckman
Yalom
Corey
Satir
Correct answer: Yalom
Irvin Yalom is well-known for his contributions to the field of group counseling. He developed a list of eleven curative factors that he believes exist in successful group work. These include altruism, universality, interpersonal learning, imparting information, developing socialization techniques, imitative behavior, group cohesiveness, catharsis, corrective recapitulation of the primary family group, instillation of hope, and existential factors. Yalom believes that if these factors are present in a group, group members will grow and develop.
Which of the following would be consistent with Gestalt therapy?
“What is the most important relationship in your life?”
“What are you feeling right now?”
“What is your most painful memory?”
“Tell me about your family of origin.”
Correct answer: “What are you feeling right now?”
Fritz Perls’ Gestalt therapy is a here-and-now focused, experiential school of therapy that attempts to focus the client on present circumstances and their own responsibility. One of its techniques is to use here-and-now questions to enhance a focus on the present.
The other questions deal too much with the past and abstraction to be characteristic of Gestalt.
Which of the following statements is most accurate regarding defense mechanisms?
They are unconscious processes that protect the conscious
They are conscious processes that expand emotional expression
They are conscious processes that protect the unconscious
They are unconscious processes that expand emotional expression
Correct answer: They are unconscious processes that protect the conscious
Defense mechanisms are unconscious processes that protect the conscious. This is done by resolving, deflecting, dismissing, or otherwise short-circuiting the problematic stimuli or thought processes in the unconscious mind. In this way, the mind is protected from conflict and threats to its equilibrium.
Defense mechanisms do not expand emotional expression per se.
In the language of group therapy, which of the following would be considered a vertical intervention?
Having a group member be the focus of a session
Having the group itself be the focus of a session
Having two group members focus on each other in a session
Having a specific diagnosis be the focus of a session
Correct answer: Having a group member be the focus of a session
Group therapy involves a wide variety of specific skills and interventions. Some of these more specifically address an individual, making them the focus of a session or given intervention; these are called vertical interventions. Horizontal interventions would involve all the members of the group.
A group can deal with itself, target a specific diagnosis, and split into subgroups without practicing vertical intervention.
During a group counseling session about sexuality issues, group members discuss the differences between male and female stereotypes. One group member comments that she disagrees with some of these stereotypes. Several of the other members quickly begin to criticize her statements and make rude comments about her appearance and intelligence, requiring the counselor to intervene. These group members were:
blocking
linking
scapegoating
intellectualizing
Correct answer: scapegoating
Scapegoating occurs when several group members target an individual member of the group and criticize that person. This is a normal group process, but one that should not be tolerated due to its potential for damaging relationships.
Intellectualizing is the process of keeping group content on a cognitive, rather than emotional, level. Blocking and linking are responsibilities of the group leader that are meant to encourage group cohesion and constructive discussion.
According to the Global Scale for Rating Helper Responses, which of the following would be considered the worst score?
1.0
2.0
3.0
4.0
Correct answer: 1.0
The Global Scale for Rating Helper Responses was designed to assess counselor skills and point out directions in which they could be built. This scale is scored from 1.0 to 5.0, with 1 indicating that a counselor is non-empathic, scolding, and otherwise not attending to a client’s needs, and 5.0 indicating a full understanding of all levels of client needs and an ability to facilitate growth.
Which of the following is the goal of systematic desensitization techniques?
To substitute a troublesome stimulus with a desirable one
To train resistance to negative assessments of others
To increase receptivity to appropriate stimuli
To reduce or extinguish the effect of a troublesome stimulus
Correct answer: To reduce or extinguish the effect of a troublesome stimulus
Systematic desensitization is a technique designed to reduce or extinguish the effect of a troublesome stimulus by some form of mitigated exposure to increasingly tolerable levels of the troublesome stimulus. For example, a person who is afraid of spiders might first have a conversation about spiders, then see pictures, and at some later stage be exposed to a live spider.
The goal of systematic desensitization is not to increase receptivity to any stimuli or substitute one stimulus for another. It is not meant to train resistance to interpersonal
Which of the following would not be characteristic of a Transactional Analysis Group?
Content including dynamic ego states
Leader-centered
A focus on A-B-C theory
A focus on being free of scripts and games
Correct answer: A focus on A-B-C theory
Transactional Analysis Groups focus on the study and repair of the pattern of one’s interpersonal interactions, with a focus on being free of scripts and games. Transactional Analysis includes content based on dynamic ego states (parent, adult, and child), and is leader-centered in its character.
The A-B-C theory is used in Rational Emotive Behavior therapy.
Which of the following is the proper focus of person-centered counseling?
The person’s essential moral character
The person’s phenomenological world
The person’s inner conflict
The person’s honesty in relationships
Correct answer: The person’s phenomenological world
The school of person-centered counseling as popularized by Carl Rogers focuses on the phenomenological world of the person in counseling. The emphasis is on helping the person reach a self-actualized, personally meaningful existence.
Person-centered counseling would not focus on inner conflict, honesty in relationships, or the person’s essential moral character.
Alan is preparing to treat Amanda, his client who has a phobia of insects. He is weighing the option of in vivo systematic desensitization versus the same modality conducted in a virtual environment.
Which statement is true about the difference in effectiveness between the two types of systematic desensitization?
Physiological reactions are the same in both versions of systematic desensitization
Virtual systematic desensitization has not been shown to be effective
Physiological reactions are higher during virtual systematic desensitization
Physiological reactions are higher during in vivo systematic desensitization
Correct answer: Physiological reactions are the same in both versions of systematic desensitization
The modality of systematic desensitization can be used to describe a graduated form of regulated exposure to a feared stimulus. Research has shown no major difference in physiological reactions between in vivo and virtual versions of this modality.
Virtual systematic desensitization has been shown to be effective.
Which of the following clients would be a good choice for the intervention of rational emotive imagery?
A client who has been deeply depressed for years
A client who is struggling to control their thoughts
A client who has extreme highs and lows of mood
A client who is nervous in interpersonal interactions
Correct answer: A client who is nervous in interpersonal interactions
Rational emotive imagery is a technique often used in rational-emotive behavior therapy (REBT). It involves having the client imagine a threatening circumstance, and then approaching that circumstance with logical thought instead of an emotional response.
Clients who have thought disorders or struggle with mood/depression would be poor choices, unless the focus would be on an individual, threatening life circumstance that would benefit from analysis.
Which of the following describes the interconnectedness of family members’ influences on one another?
Triangulation
Cybernetics
Paradigm shift
Circular causality
Correct answer: Circular causality
Reciprocal determinism is a concept universally understood by family therapists and is the belief that every family member influences every other family member in a continuous process. Circular causality is the belief that forces are moving in many different directions simultaneously, resulting in a complex variety of outcomes. Counselors who focus on circular causality during family sessions focus on the process, not the content. Linear causality refers to the belief that one event or interaction directly causes another, so content and language help explain what is occurring within the family.
Which of the following would be characteristic of a vertical therapeutic relationship?
The therapist is an expert, and the client is receptive
Neither the client nor the therapist assumes a posture of expertise
The therapist and the client share therapeutic expertise
The client is the expert, and the therapist is receptive
Correct answer: The therapist is an expert, and the client is receptive
The status of a therapist and a client is important to consider as part of a therapeutic process. Most models favor some form of a vertical therapeutic relationship, in which the therapist is seen as the expert, and the client is seen as receptive to that expertise. Many models, however, favor a horizontal therapeutic relationship in which neither party is seen as the expert.
A vertical therapeutic relationship does not involve shared expertise or the absence of expertise.
Alan is plagued by intrusive thoughts about his ailing father, about whom Alan feels guilt for various reasons. If Alan engages in the defense mechanism of repression, which of the following is most likely?
Alan will forget about his father
Alan will become hostile toward his father
Alan will contact his father
Alan will speak with others about his father
Correct answer: Alan will forget about his father
Defense mechanisms serve the purpose of alleviating anxiety and protecting the psyche from troublesome or vivid emotions. Repression would most likely make Alan forget about his father, as thoughts about the troublesome stimulus (his father) would be repressed.
Repression would result in an unconscious forgetting or denial of the stimulus or thought, not the urge to contact, discuss, or become hostile toward the stimulus.
In group counseling, what is the primary purpose of linking?
To develop insight into principles of paraverbal communication
To encourage group members to think critically about their own role in the problem
To stop unproductive behaviors in the group
To facilitate members helping each other with their problems
Correct answer: To facilitate members helping each other with their problems
Group counselors have many responsibilities when leading groups and must have some general knowledge about how to encourage and mediate group dynamics. Linking is the process of looking for common themes in the group content or process and connecting them. This approach can help members work on each other’s problems.
Which of the following characterizes the techniques of structural family therapy?
Directive and focused on past contributors to dysfunction
Non-directive and focused on pathology
Abstract and discussion-based
Directive and enacted in the here and now
Correct answer: Directive and enacted in the here and now
Structural family therapy is directive and enacted in the here and now. It explicitly diagnoses and addresses maladaptive family systems through direct participatory observation and changes in the present.
Structural family therapy is not abstract, discussion-based, or focused on the past, nor is it explicitly focused on pathology.
Which of the following refers to a person’s tendency to be aware of one’s own cognition?
Supercognition
Supracognition
Self-cognition
Metacognition
Correct answer: Metacognition
Metacognition refers to a person’s tendency to be aware of their thoughts. It is a key concept in cognitive therapy, in which the monitoring of one’s thoughts and examination for patterns is central.
Supercognition, supracognition, and self-cognition are all fabricated terms.
Effective group leaders typically use what level of emotional stimulation?
Very low amounts
Moderately low amounts
Moderate amounts
High amounts
Correct answer: Moderate amounts
Irvin Yalom is well-known for his contributions to the field of group leadership and the various functions that contribute to successful groups. According to Yalom, effective leaders use moderate amounts of emotional stimulation, moderate amounts of executive direction, frequent use of caring functions, and consistent use of meaning attribution.
In terms of counseling, what is the difference between sympathy and empathy?
Sympathy places distance between individuals, while empathy encourages engagement
In current counseling practice, the terms are equivalent
Sympathy implies deep understanding, while empathy implies shallow pity
Empathy places distance between individuals, while sympathy encourages engagement
Correction: Sympathy places distance between individuals, while empathy encourages engagement
In the practice of counseling, it is important to draw a distinction between sympathy and empathy. Sympathy tends to be an expression that places a distance between individuals and is mainly a way to avoid engagement; in most cases, it expresses pity and seeks to end dealing with the presented circumstance. Empathy is an actual engagement with the feelings of the individual and is seen as far more desirable in a therapeutic context.
The terms are not equivalent.
Which of the following is the difference between first- and second-order change?
First-order change refers to change by individuals, while second-order change refers to change in groups
First-order change is more superficial, while second-order change is deeper
Second-order change is more superficial, while first-order change is deeper
First-order change addresses psychopathology, while second-order change addresses normal function
Correct answer: First-order change is more superficial, while second-order change is deeper
In the language of solution-focused brief therapy (SBFT), a first-order change is superficial and does not lead to lasting change, while a second-order change does lead to more lasting and systemic change.
These terms are not specifically related to psychopathology or group/individual status.
According to Eric Berne’s transactional analysis (TA), what is a “life script”?
A life script is a narrative at the end of life about one’s life
A life script is the therapeutic product of TA, helping a client become more truly themselves
A life script is a narrative construction formed through traumatic circumstances
A life script is a plan developed at an early age that a client follows through life
Correct answer: A life script is a plan developed at an early age that a client follows through life
According to Eric Berne’s Transactional Analysis (TA), a life script is a plan developed at an early age that a client follows through life. In analyzing this script, one can arrive at useful truths about self-concept and relational patterns.
TA does not suggest that the life script is formed through trauma per se, that the life script is a therapeutic product, or that it is an end-of-life narrative activity.
Which of the following would be an example of blocking in the context of group therapy?
The group leader takes action to shape the function of the group
The group as a whole is not making progress on the issue at hand
The group leader stops an interaction that has become an argument
A group member refuses to deal with a significant issue
Correct answer: The group leader stops an interaction that has become an argument
The role of the group leader in group therapy can change from group to group and within the context of an individual group. In some cases, the role calls for intervention when the work of the group has become less productive or when harm could result from a given group process or interaction. This is called blocking, and an example would be stopping a non-therapeutic interaction when it has gone too far.
The other examples address processes by the group or its members or deal with a group leader’s primary role, which is to shape the function of the group. These are not examples of blocking.
A counselor has a poor relationship with her own father, who tended to be emotionally unavailable and sometimes abusive during the counselor’s childhood. The counselor realizes that she has been particularly irritable during sessions with an older male client who is about her father’s age, and she finds herself getting frustrated with the client when he cannot put his feelings into words.
What is likely taking place in these sessions?
Reaction formation
Countertransference
Regression
Transference
Correct answer: Countertransference
Countertransference, a common occurrence in psychoanalytic counseling, is the projection of the counselor’s feelings and perceptions onto the client. In this situation, the counselor is feeling irritated and frustrated with the client because of characteristics that remind her of her father. The counselor should continue to pay attention to the emotional triggers that occur within that relationship and seek counsel from a colleague or mentor if necessary.
Taylor is a young boy who speaks in three-word sentences, such as “I want cookie.” He often refers to any day in the past as “yesterday,” even if the event occurred weeks before. He has an active imagination and has recently developed a fear of monsters in his closet. According to Piaget’s theory of development, what stage of development is Taylor in?
Formal operational
Concrete operational
Preoperational
Sensorimotor
Correct answer: Preoperational
Jean Piaget was a Swiss psychologist and developmental theorist known for his theory of cognitive development. His theory is based on the belief that children learn best through interactions with others, and it breaks down development into sensorimotor, preoperational, concrete operational, and formal operational stages.
During the preoperational stage, which typically occurs between ages two and seven, the child begins to speak in multi-word sentences, expands his or her imagination, engages in symbolic play, and begins to possess a relative sense of time.
The sensorimotor stage occurs during the first two years of life, when children experience the world through crawling and beginning to walk, as well as with their five senses.
The concrete operational stage occurs from age seven to eleven and is marked by an increased ability to think logically and about others’ perspectives.
The formal operational stage is the fourth and final stage and occurs from age eleven through adulthood. During this stage, children develop abstract thought and complex problem-solving skills.
Which of the following would be the best example of paraphrasing?
Calling the client’s attention to a discrepancy
Putting the client’s feelings in the counselor’s words
Going over what happened at the last session
Bringing in the client’s family to assist with communication
Correct answer: Putting the client’s feelings in the counselor’s words
Several unique communicative skills are valuable in a therapeutic context. One of the main ones is paraphrasing, which amounts to taking input from the client, such as their feelings, and relating it back to the client in the counselor’s words. This is a helpful technique to clarify the client’s feelings and enable more full communication.
Paraphrasing does not apply to calling the client’s attention to a discrepancy, going over what happened in the last session, or bringing others to the session.
Which statement is most consistent with unconditional positive regard?
“I like you no matter what.”
“I support all of your choices.”
“I am here to help you choose.”
“I accept you in all of your complexity.”
Correct answer: “I accept you in all of your complexity.”
In Rogerian therapy, the concept of unconditional positive regard refers to the therapist being accepting of the client as a human being in all of their complexity. This is not the same as liking the client or supporting all of their choices but rather being a nonjudgmental, safe other.
Unconditional positive regard does not involve assisting clients with choices per se.
Which of the following would be characteristic of a person in the contemplation stage of change?
Talking themselves in and out of going to the gym
Not believing fitness is important
Attending a gym three times a week
Generating a list of gyms to try
Correct answer: Talking themselves in and out of going to the gym
The stages of change model described in the work of Prochaska is a standard way of evaluating where a client is in a change process. The first stage, precontemplation, would be someone who does not believe change is necessary, such as a person who does not believe fitness is important. The next stage of contemplation is characterized by ambivalence, such as a person talking themselves into and out of going to a gym.
The next stage, preparation, would be most like generating a list of gyms to attend or ideas about change. Action would be attending a gym three times a week, and maintenance would be keeping this practice consistent.
What is the difference between wilderness therapy and adventure-based counseling?
Wilderness therapy is specifically meant to address trauma
Adventure-based counseling is more clinical in nature
Wilderness therapy is more clinical in nature
Adventure-based counseling is specifically meant to address trauma
Correct answer: Wilderness therapy is more clinical in nature
There are two modalities that tend to use outdoor settings and challenges as their main treatment setting. Adventure-based counseling is a less clinical mode in which participants share a challenge or experience that is mostly meant to build camaraderie and enhance communication. A more clinical option is wilderness therapy, which is specifically meant to treat particular populations such as at-risk adolescents.
Both modalities can deal with trauma, but neither is expressly designed to do so.
Carl Jung is known for his belief in the collective unconscious. His theory serves as a way of understanding humans’ emotional responses to issues of self and purpose. Which of the following is based on Jung’s theory?
Beck Depression Inventory
Rorschach Inkblot Test
Myers-Briggs Type Indicator
WISC-IV
Correct answer: Myers-Briggs Type Indicator
Carl Jung was a strong proponent of the collective unconscious, which has developed in the human species over time and contains archetypes for humans’ intense emotional responses. Goals of Jungian therapy include getting to know oneself, integration of self, and transformation of self. Jung introduced the concepts of introversion and extraversion, both of which are measured on the Myers-Briggs Type Indicator.
If a person is undergoing aversive treatment, what does this mean?
The person is experiencing immersive inpatient treatment
The person is experiencing occasional outpatient treatment
The person is experiencing punishment as an aspect of treatment
The person is experiencing rewards as an aspect of treatment
Correct answer: The person is experiencing punishment as an aspect of treatment
Aversive treatment is aimed at reducing a behavior, generally by adding a punishment. An example would be the treatment of alcoholism with Antabuse, which produces great discomfort when alcohol is ingested.
Aversive treatment does not involve the frequency or setting of treatment, and it would not involve rewards.
A counselor at an elementary school would like to start a social skills group for kindergartners, who are typically five and six years old. What is the maximum number of group members the counselor should have in each group?
Eight
Four
Six
Two
Correct answer: Four
When forming groups of young children, counselors should be careful to consider the participants’ developmental ages, abilities, and attention spans. Typically, no more than four children should be included in a group for children who are five or six years old. Older children may be able to tolerate a larger group setting.
To create a hierarchy of fear when engaging in systematic desensitization, which of the following is the optimal number of items?
10-20
1-5
5-10
10-15
Correct answer: 10-15
The technique of systematic desensitization relies on a stepwise, iterative process of controlling nervous system responses, creating a hierarchy of fear with respect to the feared stimulus, imaginative exercises with respect to the feared stimulus, and finally in vivo exposure to a feared stimulus.
According to behaviorists, one should construct a list of 10-15 items to create an effective hierarchy of fear with respect to the feared stimulus, which is graded from low to high at approximately equal intervals.
According to Murray Bowen, what is the basic building block of the family emotional system?
The mother and father
The individual
Childhood experiences
The triangle
Correct answer: The triangle
Murray Bowen is well-known for his comprehensive contributions to the field of systems family counseling. Bowen’s approach is transgenerational, meaning that he believes communication patterns and dynamics are passed down from one generation to the next. He believes that triangles within family systems represent the most basic building blocks of a family’s emotional system. In a triangle, emotional discomfort that exists between two family members may be somewhat alleviated by bringing in a third family member to resolve the stress. Bowen also stresses the importance of self-differentiation, projection onto children in families, birth order and sibling position, and societal regression.
Can psychotherapy restructure neural networks in the brain?
No, unless medication is involved
No, under no circumstances
Yes, in many circumstances
Yes, in those suffering from trauma
Correct answer: Yes, in many circumstances
The concept of neuroplasticity essentially means that the brain is not static and can adapt and positively change in response to circumstances. By training new skills and engaging in new relational and behavioral patterns, the brain’s neural network can be restructured by psychotherapy.
This is true for those suffering from trauma in addition to other presentations.
Which of the following would be the best example of a differentiated person in Bowen’s intergenerational family therapy?
A person who does not consider themselves part of their family
A person who does not react automatically to the emotions of others
A person who has found an identity outside the family
A person who has firm boundaries between themselves and their family
Correct answer: A person who does not react automatically to the emotions of others
According to Bowen’s intergenerational family therapy, a person can be considered differentiated when they are in control of the engagement of their intellectual self as opposed to their emotional self. One example might be a person who does not react automatically to the emotions of others.
Differentiation in this context does not refer to family boundaries or individual identity.
Why might meaning attribution be an important function of group leaders?
It can help group members feel validated and accepted
It may create an environment in which group members feel more comfortable expressing deep emotions and personal values and beliefs
It helps group members have a common understanding of what is being expressed, and can increase familiarity with emotions and feelings
It provides a structure and framework for each group session, implementing predictability and consistency
Correct answer: It helps group members have a common understanding of what is being expressed, and can increase familiarity with emotions and feelings
Irvin Yalom originally suggested that certain leadership functions—emotional stimulation, caring, meaning attribution, and executive leadership—are present in group counseling, no matter the style or theoretical orientation of the leader. Meaning attribution refers to the cognitive understanding that is made of the events in the group, which can enhance collective experiences and increase familiarity with emotions and feelings.
Howard is beginning a group designed to help its members become more assertive in business contexts. Training exercises and modeling activities are enacted. Which of the following types does this group resemble?
T-group
Psychoeducation group
Counseling group
Group therapy
Correct answer: T-group
A T-group (training group) is designed to help its members acquire specific skills and is often enacted in business or professional contexts.
A counseling group is designed to address issues of personal growth and development, while group therapy is a deeper and more clinical modality that addresses pathology. A psychoeducation group teaches its members about a specific issue they are facing.
A patient comes in with feelings of intense fear about life in general and concern that they may not find a mate. If the therapist were to engage in the paradoxical intervention of positioning, which of the following would be the most likely response?
“What would the world be like if you didn’t fear being alone?”
“You definitely won’t find a mate and will spend every minute alone for the rest of your life.”
“Can you paint a picture of your ideal mate for me?”
“You should evaluate your previous successes and see what they tell you.”
Correct answer: “You definitely won’t find a mate and will spend every minute alone for the rest of your life.”
Paradoxical interventions in therapy are used to violate the expectations of the client in a therapeutic manner. Perhaps by doing so, various therapeutic benefits are realized. One of these would be an internal challenge to the catastrophizing of the client; in this case, by exaggerating the client’s fear to a point where the client can take a new perspective and begin to deal with reality rather than emotional reality construction. This is called positioning.
The other statements are not paradoxical but are more traditional therapeutic questions.
What is the difference between open and closed groups?
Open groups allow members to contribute topics, while closed groups do not
Open groups allow members to join after the initial selection, while closed groups do not
Open groups are not clinical in nature, while closed groups are
Open groups allow for rotating group leadership, while closed groups do not
Correct answer: Open groups allow members to join after the initial selection, while closed groups do not
The main difference between open and closed groups is that open groups allow members to join after the initial selection, while closed groups do not.
The distinction is not based on whether group members can contribute topics, leadership changes, or clinical focus.
Reference:
A counselor is conducting diagnostic sessions with a family and wants to learn more about the family’s dynamics, unspoken rules, and communication patterns. Which of the following would be the best tool for the counselor to use?
Open system
Ecomap
Genogram
Strategic approach
Correct answer: Genogram
A genogram is a tool counselors can use to assess family dynamics. Genograms, used particularly by Bowen and his followers, are representations of a family tree that are used to explore relationships between family members. Families can complete a genogram together either during or between sessions.
Which of the following is most characteristic of Thorne’s psychotherapy integration?
To use more than one theoretical school of psychotherapy
To attempt the unification of the various parts of the psyche
To form one’s own school of psychotherapy from different parts
To use techniques from various schools of psychotherapy
Correct answer: To use more than one theoretical school of psychotherapy
FrederickThorne’s psychotherapy integration, as opposed to eclecticism, does not simply take techniques of various schools of psychotherapy; rather, it fully integrates more than one theoretical school of psychotherapy.
Psychotherapy integration does not refer to forming one’s own theoretical school, nor does it directly address psychological unification.
What type of family counseling is most likely to include introjects and the concept of psychological heritage?
Behavioral
Reality
Psychoanalytic
Gestalt
Correct answer: Psychoanalytic
Psychoanalytic family counseling, developed by Nathan Ackerman, builds on concepts from classical psychoanalysis. Key concepts include addressing introjects (imprints or memories) from other relationships of significance, as well as psychological heritage (the psychodynamic history of one’s family of origin).
Gestalt family counseling, behavioral counseling that takes place within the context of family counseling, and reality family therapy do not address these concepts explicitly.
Which of the following would be the most accurate statement about group treatment?
They are supported by research but are not more effective than single-patient modalities
They are not supported by research and are not as effective as single patient modalities
They are supported by research and are more effective than single-patient modalities
They are not supported by research but can be more effective than single-patient modalities
Correct answer: They are supported by research but are not more effective than single-patient modalities
Hundreds of studies attest to the efficacy of group work; the modality of group therapy in its various forms is well-supported by research. However, it is not accurate to say that group treatment is more effective than single-patient modalities. Shy clients or those preoccupied with interpersonal dynamics may not benefit from group work, but group work can provide advantages that single-patient modalities cannot, such as affiliation, social accountability, and non-expert engagement.
Which of the following is considered the last in Prochaska’s five-stage model of change?
Maintenance
Contemplation
Precontemplation
Action
Correct answer: Maintenance
Prochaska’s five-stage model of change is widely used in treatment contexts. It consists of five stages:
Precontemplation, in which a person likely does not see the need to change
Contemplation, in which a person is ambivalent about change
Preparation, in which a person gathers resources and information to change
Action, in which the first steps of change are enacted
Maintenance, in which desired behaviors are repeated
Reference:
Which of the following would be a good example of a secondary prevention group?
A group educating people about the risk of methamphetamine
A group educating people about treatment options for their methamphetamine problem
A group helping people with early methamphetamine problems
A group helping people with profound health issues related to methamphetamine
Correct answer: A group helping people with early methamphetamine problems
Groups are sometimes formed around a particular well-known issue for those suffering from that particular problem. In prevention groups, the focus is on avoiding harm altogether or mitigating harm from a disease process that already exists. A secondary prevention group seeks to deal with an early stage problem where significant harm can still be avoided, as in the case of a group helping people with early methamphetamine problems.
The other groups either deal with a problem that is not yet manifest or already severe.
Frederick has just lost his grandfather, with whom he was very close. If Frederick engages in introjection, which of the following is a likely behavior?
He will insist that his grandfather is still around in some way
He will become hostile at the mention of his grandfather
He will take on aspects of his grandfather’s personality
He will forget about his grandfather
Correct answer: He will take on aspects of his grandfather’s personality
Defense mechanisms are ways in which the psyche protects itself from unwanted disruptions to its equilibrium. If Frederick engages in introjection, he is most likely to take on aspects of his grandfather’s personality in an attempt to ward off grief.
Forgetting about his grandfather might signal repression. Becoming hostile at the mention of his grandfather would not necessarily be a defense mechanism. Insisting that his grandfather is still around in some way would be classic denial.
Which animals are most commonly used in animal-assisted therapy?
Dogs and horses
Cows and sheep
Mice and hamsters
Chickens and ducks
Correct answer: Dogs and horses
Animal-assisted therapy has been recognized as contributing to better relationship building, as relationship building with an animal mirrors in many ways the trust and relationship building done with humans. The most commonly used animals in animal-assisted therapy are dogs and horses, with specialties available in these disciplines, but many other kinds of animals could be used.
The other animals listed are not as commonly used as dogs and horses.
Reinforcement theory and cognitive information processing are important concepts in whose theory of career counseling?
Axelrad
Gottfredson
Holland
Krumboltz
Correct answer: Krumboltz
John Krumboltz developed the Learning Theory of Career Counseling (LTCC), based on Bandura’s social learning theory. Important concepts in Krumboltz’s theory include reinforcement theory, cognitive information processing, and classical behaviorism as ways of modifying and molding career development and decision making.
Which of the following would not be a focus of assertiveness training?
Ability to express one’s rights without violating those of others
Ability to express all emotions
Ability to know the difference between aggression and assertion
Ability to describe trauma related to passivity
Correct answer: Ability to describe trauma related to passivity
Assertiveness training seeks to help an individual express all their emotions, express their own rights without violating those of others, and know the difference between assertion and aggression. It does not focus as much on the past, including assessments of how trauma may or may not have contributed to a more passive character; rather, it is a skill-building technique related to expression in present reality.
Which of the following questions would likely be practiced by a group leader using a linking technique?
“How do you think your personal narrative has changed since the last time you brought this up?”
“Is there anyone in your life who you can depend on for support in any circumstance?”
“Did you notice you described your accident the same way your colleague did?”
“Who do you think you can reach out to if you need help after the group?”
Correct answer: “Did you notice you described your accident the same way your colleague did?”
In the context of group work, linking refers to the practice of referring similar conditions or experiences within the group to each other. In other words, linking occurs when one group member finds their issue directly resonating with that of another. Directly eliciting this connection is the technique of linking.
The other statements do not consist of a group member linking their experience with another directly.
Why does experiential therapy use confrontation with clients?
To help clients stay with their feelings
To address negative personality traits
To call attention to falsehood
To heighten personal awareness
Correct answer: To help clients stay with their feelings
Experiential therapy attempts to keep the client “in the moment” with their feelings in order to relive a past experience vividly in the therapeutic environment. Confrontation may be used to help clients stay with their feelings and not drift into intellectualization or over-cognition.
Confrontation in experiential therapy would not be used to call attention to falsehood per se, nor would it be to heighten personal awareness or address negative personality traits.
In reality therapy, what would be the least likely focus of a session?
The client’s conflicts with family
The client’s unhappiness about their job
The client’s feelings about their significant other
The client’s failed relationships in the past
Correct answer: The client’s failed relationships in the past
William Glasser’s reality therapy focuses almost exclusively on the here and now, including the improvement of present circumstances like relationships and opportunities for growth. Personal responsibility is stressed as a driver of client wellness.
Reality therapy focuses far less on the past in any sense, including past relationships.
Diane has been suffering from a phobia of cats for most of her life. She is engaging in systematic desensitization to reduce this anxiety. She has learned to control her physical responses to the idea of cats and feels that she can do so going forward.
Which of the following will happen next?
Going through an exercise of visualizing cats
Learning deep-breathing exercises to deal with the fear of cats
Being directly exposed to a cat
Figuring out what level of exposure to cats is most distressing
Correct answer: Figuring out what level of exposure to cats is most distressing
Systematic desensitization deals with a person’s systematically reduced anxiety when exposed to a certain stimulus. It is generally seen as proceeding through four stages.
Relaxation training to gain control of one’s responses
Construction of anxiety hierarchy to gain intellectual knowledge of one’s fear
Imaginative desensitization to explore one’s fear in safe circumstances
In vivo sensitization to gain control over the feared stimulus
The progression is necessarily stepwise and iterative. In this case, as the physical responses to cats have already been mastered, the next step is to arrange an intellectual hierarchy of distress with respect to cats. Then would come the exercise of visualization, followed by direct exposure. Deep breathing and other response exercises have already been done.
Which level of consciousness includes everything the mind is not currently aware of but can call upon if needed?
Conscious
Unconscious
Protoconscious
Preconscious
Correct answer: Preconscious
The mind is sometimes conceptualized as having three levels, defined by what kind of information is contained and how accessible it is. The preconscious mind contains everything the mind is not currently aware of but can call upon if needed, such as a cookie recipe or a conversation one had yesterday.
The conscious mind contains all the information of which the mind is currently aware. The unconscious mind contains everything the mind has that is neither part of current awareness nor consciously accessible. Protoconscious is a fabricated term.
Which of the following is true about trauma and disaster counseling?
Its effectiveness cannot be measured using standard instruments
Its effectiveness is more a matter of conjecture than data
Beginners are often as effective as experts
Unique skills and training are required
Correct answer: Unique skills and training are required
Trauma and disaster counseling is a highly specialized and rapidly growing field. It has been proven effective as per a variety of standard and non-standard instruments, which suggest that trauma and disaster counseling are the preferred mode of treatment for certain cases. However, unique skills and training are required, and it is not a field in which beginners are as effective as experts.
In which of the following cases is a laissez-faire group leadership style most likely to be effective?
When the group is in need of psychoeducation
When the group is being taught a skill
When the group is strongly aligned toward a common goal
When the group is exploring a sensitive traumatic issue
Correct answer: When the group is strongly aligned toward a common goal
Although all groups take on an identity of their own, the leadership style of the designated group leader has a major impact on function and results. A laissez-faire style of leadership is very “hands-off” and allows the group to function largely without direction. This would be most appropriate in cases where the group is strongly aligned toward a common goal, as the group members will each be motivated to cooperate without direction.
Psychoeducation, the exploration of sensitive traumatic issues, and teaching a skill all call for the group leader to take on a more active and directive role.
Which of the following schools of therapy involves the therapist acting as the client’s friend?
Psychoanalysis
Transactional analysis
Dialectical behavioral therapy
Reality therapy
Correct answer: Reality therapy
William Glasser’s reality therapy is different from other treatment modalities and schools of therapy in various ways. One of them is the overall approach to the client. In reality therapy, the idea seems to be to act as the client’s friend, with as little pretense as possible to traditional therapeutic roles.
Dialectical behavioral therapy (DBT), transactional analysis (TA), and psychoanalysis rely on more standard roles in the therapeutic dyad.
In practice, would an open-ended question or a closed-ended question elicit more information?
A closed-ended question
Both elicit similar information
An open-ended question
Neither in this respect
Correct answer: An open-ended question
The practice of counseling rests on the ability of the client and the therapist to communicate effectively, as well as for the therapist to be able to gather as much information as possible about a client’s circumstances.
Closed-ended questions (e.g., yes/no) have their uses but do not gain as much information as open-ended questions, such as “How do you feel about your relationship with your wife?’ Open-ended questions put the client in control in terms of how much and what information to divulge.
