Prevention, Consultation, and Psychotherapy Research Flashcards
Shim et al.’s (2017) review of randomized control studies on digital mental health interventions for depression and anxiety found that the reported effects of adding professional guidance to the interventions were:
A. consistently insignificant for symptom reduction, client satisfaction, and dropout attrition.
B. consistently positive for symptom reduction, client satisfaction, and dropout attrition.
C. consistently positive for symptom reduction but inconsistent for client satisfaction and dropout attrition.
D. inconsistent for symptom reduction, client satisfaction, and dropout attrition.
Answer D is correct. Shim et al.’s review found that, for anxiety and depressive disorders, study results varied for symptom reduction, client satisfaction, and dropout attrition: Some studies found no significant positive effects of guidance for these outcomes; others found small to large effects.
Norcross and Lambert (2011) concluded that which of the following accounts for the greatest amount of variability in psychotherapy outcomes?
A. therapist characteristics
B. patient contributions
C. therapeutic relationship
D. treatment method
Answer B is correct. Based on their review of the research, Norcross and Lambert (2011) attributed 40% of variability in psychotherapy outcomes to unexplained variance, 30% to patient contributions, 12% to the therapeutic relationship, 8% to the treatment method, 7% to therapist characteristics, and 3% to other factors.
Transdiagnostic treatments are aimed at disorders that are:
A. included in the same DSM-5 diagnostic category.
B. known to respond best to a combination of psychosocial and pharmacological treatments.
C. caused and maintained by similar core mechanisms.
D. caused by similar cognitive schemas and maintained by similar cognitive distortions.
Answer C is correct. The use of transdiagnostic treatments is based on the assumptions that some diagnoses share certain core biological, psychological, and environmental mechanisms that contribute to and maintain them and that treatment should focus on those common mechanisms. Answer A is not the best answer because transdiagnostic treatments can address disorders in the same or different diagnostic categories (e.g., anxiety disorders only or anxiety disorders and depressive disorders). Answer D is not the best answer because similar cognitive schemas and distortions can be a core mechanism for some disorders, but core mechanisms are not limited to these factors.
Prescribing maintenance antidepressants to prevent relapse in individuals who have received a diagnosis of major depressive disorder and participated in cognitive-behavior therapy is an example of:
A. primary prevention.
B. secondary prevention.
C. tertiary prevention.
D. quaternary prevention.
Answer C is correct. Tertiary preventions target people who have a mental or physical disorder and include relapse prevention and rehabilitation programs. Quaternary preventions (answer D) identify patients who are at risk for over-medicalization in order to reduce their exposure to unnecessary and potentially harmful interventions. It’s not one of the types of prevention described by Caplan or a type of prevention that you’re likely to be asked about on the EPPP.
According to Howard et al.’s phase model (1996), symptomatic relief occurs during which of the following phases of psychotherapy?
A. rehabilitation
B. reintegrative
C. remediation
D. remoralization
Answer C is correct. Howard et al.’s model distinguishes between three phases of psychotherapy: remoralization, remediation, and rehabilitation. According to this model, symptomatic relief occurs during the remediation phase.
Measures of treatment fidelity typically focus on which of the following?
A. reliability and validity
B. efficacy and effectiveness
C. therapist adherence and competence
D. therapist experience and consistency
Answer C is correct. Treatment fidelity refers to the degree to which a treatment is delivered as intended and is affected by the therapist’s adherence to the treatment protocol and competence in delivering the treatment. Consequently, therapist adherence and competence are commonly assessed by measures of treatment fidelity.
Research evaluating the effects of routine outcome monitoring (ROM) suggests that it:
A. decreases premature termination and client deterioration during therapy.
B. decreases premature termination but has little or no effect on client deterioration during therapy.
C. decreases client deterioration during therapy but has little or no effect on premature termination.
D. is no more effective than less frequent feedback for reducing premature termination and client deterioration during therapy.
Answer A is correct. Studies have found that ROM is associated with several benefits including a significant reduction in premature termination and client deterioration.
Based on the results of their meta-analysis of 475 psychotherapy outcome studies, Smith, Glass, and Miller (1980) concluded that the average psychotherapy patient is better off than ____% of patients who do not receive psychotherapy.
A. 90
B. 80
C. 72
D. 44
Answer B is correct. Smith, Glass, and Miller’s (1980) meta-analysis of 475 outcome studies produced a mean effect size of .85, which means that the average psychotherapy patient who received psychotherapy was “better off” than 80% of patients who did not receive psychotherapy.
Hans Eysenck (1952) found that symptom improvements due to psychotherapy were less than improvements due to of which of the following?
A. positive expectations
B. “common effects”
C. the therapeutic alliance
D. spontaneous remission
Answer D is correct. Eysenck proposed that his results not only showed that psychotherapy is ineffective but that it may actually have detrimental effects since the average recovery rates for two groups of psychotherapy patients were lower than the average spontaneous remission rate for patients who did not receive psychotherapy.
A consultant is providing consultee-centered case consultation and determines that theme interference is responsible for the consultee’s inability to work effectively with clients who have received a diagnosis of borderline personality disorder. Consequently, the consultant will focus primarily the consultee’s lack of:
A. confidence.
B. objectivity.
C. competence.
D. experience.
Answer B is correct. Caplan described four obstacles to providing effective mental health services: lack of knowledge, skills, confidence, objectivity. He also identified theme interference as one of the causes of a lack of objectivity.
Which of the following is true about efficacy and effectiveness research?
A. Efficacy research has better internal validity but poorer external validity than effectiveness research does.
B. Efficacy research has better external validity but poorer internal validity than effectiveness research does.
C. Efficacy research has better internal and external validity than effectiveness research does.
D. Efficacy research has poorer internal and external validity than effectiveness research does.
Answer A is correct. Efficacy research is conducted in well-controlled circumstances and, as a result, has good internal validity but limited external validity, while effectiveness research is conducted in naturalistic clinical settings and has limited internal validity but good external validity.
