STUDY-MODE - Practice Exam 1 Flashcards
As described in the DSM-5, _______________ is the likely diagnosis for an adult client who has experienced a depressed mood, a poor appetite, and impaired concentration for most of the day on most days for over two years.
Select one:
A. Dysthymic Disorder
B. Mood Disorder NOS
C. Persistent Depressive Disorder
D. Unspecified Depressive Disorder
Answer C is correct: The client’s symptoms are consistent with a diagnosis of Persistent Depressive Disorder.
Answer A: Dysthymic Disorder is not a DSM-5 diagnosis.
Answer B: Mood Disorder NOS is not a DSM-5 diagnostic category.
Answer D: Unspecified Depressive Disorder applies when a clinician does not want to indicate the reason why a client’s symptoms do not meet the criteria for a specific depressive disorder.
The correct answer is: Persistent Depressive Disorder
Your new client, a college freshman, says she sometimes has an "out of body" experience in which she is watching what she is doing from outside herself. She describes a recent experience in which she was in her dorm room writing a paper when she realized she couldn't feel her fingers on the computer keyboard or her feet on the floor and then suddenly felt like she was watching herself from the ceiling. The client says that these episodes make her feel like she's "going crazy" and are interfering with her ability to attend class and complete course assignments. The client's symptoms are most suggestive of a DSM-5 diagnosis of: Select one:
A. Delusional Disorder
B. Dissociative Fugue
C. Depersonalization/Derealization Disorder
D. Depersonalization Disorder
Answer C is correct: Depersonalization/Derealization Disorder is characterized by recurrent episodes of depersonalization (a sense of unreality, detachment, or being an outside observer of one’s thoughts, feelings, etc.) and/or derealization (a sense of unreality or detachment involving one’s surroundings) that cause clinically significant distress or impaired functioning.
Answer A: Delusional Disorder involves one or more delusions that last at least one month. As defined in the DSM-5, a delusion is “a false belief based on incorrect inference about external reality that is firmly held despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary” (p. 819).
Answer B: A dissociative fugue is characterized by apparently purposeful travel with an inability to recall some or all of one’s past and is included in the DSM-5 as a specifier for Dissociative Amnesia.
Answer D: Depersonalization Disorder is not a DSM-5 diagnosis.
The correct answer is: Depersonalization/Derealization Disorder
The most likely DSM-5 diagnosis for a person who experiences genital pain during sexual intercourse that causes significant distress and cannot be better explained by a non-sexual mental disorder, relationship distress, or a medical condition is which of the following?
Select one:
A. Dyspareunia
B. Vaginismus
C. Genito-Pelvic Pain/Penetration Disorder
D. Other Specified Sexual Dysfunction
Answer C is correct: The symptoms listed in this questions are consistent with the DSM-5 diagnosis of Genito-Pelvic Pain/Penetration Disorder.
The correct answer is: Genito-Pelvic Pain/Penetration Disorder
Older adults are at a particularly high risk for ________, with the risk being increased by medical illness and surgery.
Select one: A. depersonalization B. derealization C. dementia D. delirium
Advancing age is one of the factors that increases the risk for delirium.
a. Incorrect See explanation for Answer D.
b. Incorrect See explanation for Answer D.
c. Incorrect See explanation for Answer D.
d. CORRECT Several factors place people at higher risk for delirium. People over 60 are usually cited as the group at highest risk in general. Moreover, the risk for this population increases as the result of a medical illness or surgery. Other high risk factors include cardiotomy, burns, and rapid withdrawal from alcohol or a sedative, hypnotic, or anxiolytic.
The correct answer is: delirium
A person with seasonal affective disorder (SAD) is most likely to exhibit which of the following symptoms?
Select one:
a. overeating and weight gain
b. loss of appetite without weight loss
c. insomnia
d. a craving for salty foods
Your answer is incorrect.
Common symptoms of SAD are listed in the Abnormal Psychology chapter of the written study materials.
a. CORRECT - People with SAD usually experience hypersomnia, increased appetite and weight gain, and a craving for carbohydrates.
b. Incorrect - This is not characteristic of SAD.
c. Incorrect - Hypersomnia (not insomnia) is characteristic of SAD.
d. Incorrect - People with SAD often experience a craving for carbohydrates.
The correct answer is: overeating and weight gain
Restlessness, psychomotor agitation, flushed face, diuresis, rambling speech, and muscle twitching are most suggestive of which of the following?
Select one:
A. Alcohol Withdrawal
B. Caffeine Intoxication
C. Cocaine Intoxication
D. Hyperthyroidism
It is sometimes difficult to distinguish between substance-induced disorders and medical conditions.
a. Incorrect Alcohol Withdrawal is characterized by tremor, nausea and vomiting, autonomic hyperactivity, depressed mood and irritability, transient illusions and hallucinations, and insomnia.
b. CORRECT The symptoms listed in the question are characteristic of Caffeine Intoxication.
c. Incorrect Cocaine Intoxication is marked by euphoria, grandiosity, hypervigilance, impaired judgment, rambling and incoherent speech, perspiration, chills, and visual or tactile hallucinations.
d. Incorrect Hyperthyroidism, an endocrine disorder, produces weight loss, increased appetite, intolerance to heat, tremors, and rapid heart rate.
The correct answer is: Caffeine Intoxication
Research investigating high-risk situations associated with relapse for a variety of addictive and other problem behaviors has shown that which of the following accounts for nearly three-fourths of relapse incidents?
Select one:
A. urges and temptations
B. negative and positive emotional states and negative physical states
C. social pressure, interpersonal conflicts, and negative physical states
D. negative emotional states, interpersonal conflicts, and social pressure
Of the various precipitants of relapse, negative emotional states have been found to be the most frequent cause.
a. Incorrect According to Marlatt and Gordon (1985), urges and temptations account for about 11% of relapses among alcoholics (and for similar rates for other types of addictions).
b. Incorrect Although negative emotional states are important determinants of relapse, positive emotional states and negative physical states are less predictive than interpersonal conflicts and social pressure (response d).
c. Incorrect This response can be eliminated because it doesn’t include negative emotional states.
d. CORRECT Marlatt and Gordon report that, for alcoholics, 38% of incidents of relapse are related to negative emotional states; 18% to interpersonal conflicts; and 18% to social pressure. Together, these three account for nearly three-fourths of relapse incidents.
The correct answer is: negative emotional states, interpersonal conflicts, and social pressure
John Conger (1956) offered the tension-reduction model of alcohol consumption as an explanation for: Select one:
A. satiation.
B. habituation.
C. addiction.
D. tolerance.
J. Conger’s model provides an explanation for alcohol addiction (Reinforcement theory and the dynamics of alcoholism, Quarterly Journal of Studies on Alcohol, 17, 296-305, 1956).
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Conger’s theory proposes that drinking is reinforced by its tension reduction properties (i.e., drinking recurs because it removes anxiety and stress) and that this effect eventually leads to addiction.
d. Incorrect See explanation for response c.
The correct answer is: addiction.
A woman and her husband, who have been married for two years, come for marital therapy. The woman complains about her husband’s lack of interest in family activities and in their 9-month-old child, his lack of affection toward her, and his lack of interest in sex. The husband, who says he did not want to come to therapy at all, states that he is a “loner,” that he has always had few friends, and that he has never really been interested in his family. He seems quite aloof and emotionally unresponsive. Your tentative diagnosis is:
Select one:
a. Avoidant Personality Disorder.
b. Schizoid Personality Disorder.
c. Schizoaffective Disorder.
d. Schizotypal Personality Disorder.
Your answer is correct.
The husband’s symptoms appear to be long-term and experienced by him as ego-syntonic, thereby suggesting a personality disorder.
a. Incorrect - An individual with Avoidant Personality Disorder desires close interpersonal relationships but avoids them in order to avoid being hurt.
b. CORRECT - The husband’s symptoms are most suggestive of Schizoid Personality Disorder which is characterized by detachment from social relationships and a restricted range of emotional expression.
c. Incorrect - Schizoaffective Disorder involves a combination of schizophrenic and affective symptoms. This man does not exhibit the psychotic symptoms (hallucinations and delusions) that must be present for this diagnosis.
d. Incorrect - The husband does not seem to have the cognitive or perceptual distortions and eccentricities that are characteristic of Schizotypal Personality Disorder.
The correct answer is: Schizoid Personality Disorder.
A young woman has just received a diagnosis of Schizophrenia. Which of the following family members is most likely to receive the same diagnosis?
Select one:
a. her father
b. her grandmother
c. her identical twin
d. her biological brother
Your answer is correct.
The research has consistently confirmed a genetic contribution to Schizophrenia.
a. Incorrect - See explanation for response c.
b. Incorrect - See explanation for response c.
c. CORRECT - The closer the genetic similarity, the higher the concordance rate for Schizophrenia. The woman’s identical twin is most similar to her in terms of genetic make-up and, therefore, most likely to also receive the diagnosis.
d. Incorrect - See explanation for response c.
The correct answer is: her identical twin
__________ is a cause of delirium and may result from kidney or liver failure or from diabetes mellitus, hypo- or hyperthyroidism, vitamin deficiency, electrolyte imbalance, severe dehydration, or a number of other conditions.
Select one:
a. Gerstmann’s syndrome
b. Cushing’s syndrome
c. Wernicke’s encephalopathy
d. Metabolic encephalopathy
Your answer is incorrect.
If you are unfamiliar with the disorder being asked about by this question, you may have been able to identify the correct answer through the process of elimination.
a. Incorrect - Gerstmann’s syndrome is caused by damage to certain areas of the parietal lobe and involves a combination of finger agnosia, right-left confusion, agraphia, and acalculia.
b. Incorrect - Cushing’s syndrome is caused by excessively high levels of cortisol resulting from the use of glucocorticoids or an abnormality in the pituitary or adrenal gland.
c. Incorrect - Wernicke’s encephalopathy is caused by lesions in certain areas of the brain~ especially the thalamus and mammillary bodies~ often as the result of a thiamine deficiency.
d. CORRECT Metabolic encephalopathy is a state of global brain dysfunction. Its symptoms range from impairments in executive functioning to agitated delirium to coma.
The correct answer is: Metabolic encephalopathy
The symptoms of Oppositional Defiant Disorder are categorized in three groups in the DSM-5. These groups are:
Select one:
A. destruction of property, deceitfulness or theft, and serious violations of rules.
B. negativistic, defiant, and hostile behavior.
C. deceitfulness/dishonesty, irritability/aggressiveness, and failure to conform to social norms.
D. angry/irritable mood, argumentative/defiant behavior, and vindictiveness.
Answer D is correct: Angry/irritable mood, argumentative/defiant behavior, and vindictiveness are the three categories of symptoms included in the DSM-5 for Oppositional Defiant Disorder.
Answer A: These are three of the four categories of symptoms included in the DSM-5 for Conduct Disorder (the fourth is aggression to people and animals).
Answers B and C: See explanation for answer D.
The correct answer is: angry/irritable mood, argumentative/defiant behavior, and vindictiveness.
Alcohol Withdrawal is characterized by:
Select one:
a. dysphoric mood, vivid dreams, insomnia or hypersomnia, and increased appetite.
b. hand tremor, insomnia, hallucinations, and seizures.
c. incoordination, nystagmus, impaired memory, and mood lability.
d. dysphoric mood, pupillary dilation, insomnia, and fever.
Your answer is incorrect.
Answer B is correct: Alcohol Withdrawal is diagnosed in the presence of at least two characteristic symptoms within several hours to a few days following cessation or reduction of alcohol consumption, e.g., hand tremor; insomnia; transient illusions or hallucinations; and generalized tonic-clonic seizures.
Answer A: These symptoms are characteristic of Stimulant Withdrawal.
Answer C: These are symptoms of Alcohol Intoxication.
Answer D: These symptoms are associated with Opioid Withdrawal.
The correct answer is: hand tremor, insomnia, hallucinations, and seizures.
Which of the following suggests that a DSM-5 diagnosis of Anorexia Nervosa is more appropriate than a diagnosis of Bulimia Nervosa?
Select one:
A. the presence of episodes of binging and purging
B. a disturbance in body image
C. menstrual irregularities
D. persistent restriction of energy intake
Answer D is correct: This question is asking which symptom is characteristic of Anorexia but not Bulimia. One of the DSM-5 diagnostic criteria for Anorexia (but not Bulimia) is a “restriction of energy intake relative to requirements, leading to a significantly low body weight” (p. 338).
Answer A: While binging and purging are classic signs of Bulimia Nervosa, some individuals with Anorexia engage in binging and purging, and the DSM-5 includes binge-eating/purging type as a specifier for Anorexia.
Answer B: Anorexia Nervosa and Bulimia Nervosa both involve a disturbance in the perception of one’s body weight or shape.
Answer C: Menstrual irregularity is an associated feature of both disorders.
The correct answer is: persistent restriction of energy intake
The majority of older adults who complete suicide have a psychiatric disorder at the time of their death, with __________ being the most common diagnosis.
Select one:
A. Major Depressive Disorder
B. Substance Use Disorder
C. Major Neurocognitive Disorder
D. Generalized Anxiety Disorder
Answer A is correct. The research has been fairly consistent in identifying Major Depressive Disorder as a significant risk factor for suicide among older adults. In their review of psychological autopsy studies of older adults who completed suicide, Y. Conwell, P. R. Duberstein, and E. D. Caine report that Major Depressive Disorder was identified as the most common psychiatric diagnosis [Risk factors for suicide in later life, Biological Psychiatry, 52, 193-204, 2002]. While Substance Use Disorders, Major Neurocognitive Disorder, and Anxiety Disorders were also linked to suicide in these studies, they were present in a smaller number of cases.
The correct answer is: Major Depressive Disorder
During the postpartum period, approximately _____ of women experience postpartum depression.
Select one:
A. 1 to 2%
B. 10 to 15%
C. 25 to 30%
D. 45 to 50%
Postpartum depression is a mood disorder that begins within several weeks following delivery.
a. Incorrect See explanation for response b.
b. CORRECT Ten to 15% is the rate most often reported in the literature for postpartum depression in the United States. Factors associated with an increased risk for postpartum depression include having difficulty getting pregnant, having twins or triplets, having premature labor and delivery, experiencing pregnancy and birth complications, and having a baby during adolescence. See, e.g., CDC, Prevalence of self-reported postpartum depression - 17 states, 2004-2005, Morbidity and Mortality Weekly Report, 57(14), 361-366, 2008.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: 10 to 15%
Maxine M. states she believes that messages on a particular radio station are being broadcast especially to her. Maxine is displaying which of the following?
Select one:
A. illusion
B. hallucination
C. delusion
D. blocking
All of the phenomena listed in the answers are characteristic of Schizophrenia and other disorders, but only one describes the woman’s symptom.
a. Incorrect An illusion is a distorted perception or memory.
b. Incorrect An hallucination is a false perception. A person is hallucinating, for example, if she hears voices that are not really there.
c. CORRECT A delusion is a false belief that persists despite evidence to the contrary. The woman’s delusion (her interpretation of an external event as though it has special significance for her) is a “delusion of reference.”
d. Incorrect Blocking is an abrupt, involuntary interruption in the flow of speech or thought.
The correct answer is: delusion
A 35-year old client has a history of relationship problems. Although he usually makes a good first impression, his friendships don’t last very long. He attributes this problem to the fact that other people are jealous of what he has accomplished. The client has a great idea that will “revolutionize the field of telemarketing,” but, so far, no one has recognized the potential importance of his contribution. He left his wife six months ago and spends very little time with his two-year old son. He has been busy “doing what he wants to do,” which has included moving into an expensive condominium, buying a new sports car, and dating as many attractive women as possible. These characteristics are most suggestive of:
Select one:
a. Histrionic Personality Disorder.
b. Narcissistic Personality Disorder.
c. Schizotypal Personality Disorder.
d. Delusional Disorder, grandiose type.
Your answer is correct.
The man’s primary symptoms are grandiosity and lack of empathy.
a. Incorrect - A diagnosis of Histrionic Personality Disorder requires a pattern of excessive emotionality and attention-seeking.
b. CORRECT - These are core features of Narcissistic Personality Disorder.
c. Incorrect - A diagnosis of Schizotypal Personality Disorder requires the presence of pervasive social and interpersonal deficits and eccentricities in cognition, perception, and behavior.
d. Incorrect - A diagnosis of Delusional Disorder is made in the presence of one or more non bizarre delusions with unimpaired functioning apart from the impact of the delusions.
The correct answer is: Narcissistic Personality Disorder.
Linehan’s (1993) dialectical behavior therapy (DBT) for borderline personality disorder is based on the assumption that this disorder is due to:
Select one:
A. a boundary disturbance.
B. learned helplessness.
C. emotion dysregulation.
D. pathologic internalized object relations.
A key assumption underlying DBT is that the central problem in borderline personality disorder (BPD) is a dysfunctional emotion regulation system, which may be the result of genetic factors, events that occurred during prenatal development, and/or early trauma that adversely affected the brain.
a. Incorrect Boundary disturbances are viewed as the cause of neurotic behavior by Gestalt therapists.
b. Incorrect Learned helplessness has been linked to depression.
c. CORRECT Linehan has described BPD as resulting from emotion dysregulation, which is viewed as due to a combination of a biological predisposition to react to even low levels of stress and other forms of provocation with intense and long-lasting emotions and an emotion-invalidating environment. According to Linehan, most of the behaviors associated with BPD are attempts to regulate intense emotions or the undesirable outcomes of emotion dysregulation.
d. Incorrect Kernberg identified pathologic internalized object relations as the etiological factor in BPD.
The correct answer is: emotion dysregulation.
Cataplexy is often triggered by which of the following?
Select one:
A. smells associated with a traumatic event
B. physical fatigue
C. strong emotions
D. stimuli associated with a feared object or event
Cataplexy is a brief episode of a sudden loss of muscle tone that is associated with narcolepsy. a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Cataplexy occurs in the majority of individuals who have narcolepsy and is triggered by strong emotions (most often positive emotions such as joking and laughing but also by anger).
d. Incorrect See explanation for response b.
The correct answer is: strong emotions
Meta-analyses of research on the treatment of pediatric acute lymphoblastic leukemia with cranial radiation or chemotherapy have found that:
Select one:
A. either treatment alone is associated with decreased intellectual functioning and lower academic achievement.
B. only cranial radiation is associated with decreased intellectual functioning and lower academic achievement.
C. only chemotherapy is associated with decreased intellectual functioning and lower academic achievement.
D. they are associated with decreased intellectual functioning and lower academic achievement only when used in combination.
A number of studies have confirmed that radiation and chemotherapy improve survival rates but are associated with a number of negative consequences.
a. CORRECT Either treatment alone has substantial negative effects on intellectual functioning and academic achievement, although the effects vary from individual to individual and may be less severe for chemotherapy. In addition, the negative effects are largely irreversible and may worsen over time. See, e.g., C. C. Peterson et al., A meta-analysis of the neuropsychological sequelae of chemotherapy-only treatment for pediatric acute lymphoblastic leukemia, Pediatric Blood Cancer, 51, 99-104, 2008.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: either treatment alone is associated with decreased intellectual functioning and lower academic achievement.
Which of the following has been found to be the strongest predictor of Intellectual Disability with an unknown etiology?
Select one:
A. paternal health
B. female gender
C. large family size
D. low birth weight
Answer D is correct: Croen et al. (2001) investigated individual and family characteristics of children with a mild or severe Intellectual Disability with an unknown etiology and found low birth weight to be the strongest predictor of both levels of disability.
Answers A, B, and C: See explanation for answer D.
The correct answer is: low birth weight
Based on the initial evaluation of a 15-year-old boy, a clinician believes the nature and number of his symptoms suggest a DSM-5 diagnosis of Attention-Deficit/Hyperactivity Disorder, predominantly inattentive presentation. Before assigning the diagnosis, the clinician will want to confirm that some symptoms were present before the boy was _____ years of age and that he exhibits them in at least _____ settings.
Select one:
A. 7; 2
B. 12; 2
C. 6; 3
D. 10; 3
Answer B is correct: For a diagnosis of ADHD, the DSM-5 requires that “several inattentive or hyperactive-impulsive symptoms were present prior to age 12” (p. 60) and that symptoms are present in at least two settings.
The correct answer is: 12; 2
A dimensional approach to diagnosis is based on a(n) ________ of attributes.
Select one:
a. quantification
b. categorization
c. exclusion
d. dichotomization
There are two basic approaches to diagnosis - categorical classification and dimensional classification. The DSM utilizes a categorical approach, which involves determining whether or not a person meets the criteria for a given diagnosis.
a. CORRECT - When using a dimensional approach~ the individual is ranked on a quantitative dimension (e.g., on a scale from 1 to 10) on each symptom or other characteristic.
b. Incorrect - See explanation for response a.
c. Incorrect - See explanation for response a.
d. Incorrect - See explanation for response a.
The correct answer is: quantification
As described in the DSM-5, which of the following are symptoms of Stimulant Intoxication?
Select one:
A. nystagmus, numbness, and muscle rigidity
B. blurred vision, tremor, and depressed reflexes
C. pupillary dilation, nausea, and muscular weakness
D. fatigue, increased appetite, and vivid dreams
Answer C is correct: Symptoms of Stimulant Intoxication include tachycardia or bradycardia, pupillary dilation, elevated or lowered blood pressure, perspiration or chills, nausea or vomiting, weight loss, psychomotor agitation or retardation, muscular weakness, respiratory depression or cardiac arrhythmias, confusion, seizures, and coma.
Answer A: These symptoms are characteristic of Phencyclidine Intoxication.
Answer B: These symptoms are characteristic of Inhalant Intoxication.
Answer D: These are symptoms of Stimulant Withdrawal, not Stimulant Intoxication.
The correct answer is: pupillary dilation, nausea, and muscular weakness
Use of which of the following substances is NOT likely to produce a Substance-Induced Psychotic Disorder?
Select one:
A. alcohol
B. cannabis
C. cocaine
D. opioids
Answer D is correct: The DSM-5 identifies 10 classes of drugs that are associated with Substance-Induced Disorders but only eight are associated with Substance-Induced Psychotic Disorder: alcohol; cannabis; phencyclidine; other hallucinogen; inhalant; sedative, hypnotic, or anxiolytic; amphetamine or other stimulant; and cocaine.
Answers A, B, and C: See explanation for answer D.
The correct answer is: opioids
A 16-year-old suddenly exhibits a change in behavior that includes irritability, concentration problems at school, a decreased need for sleep, and sexual promiscuity. Her mother says that the girl has had behavioral problems at school for the past few years but that her current symptoms are new and developed about ten days ago. Based on this information, the most likely diagnosis is:
Select one:
a. ADHD.
b. Conduct Disorder.
c. Bipolar I Disorder.
d. Bipolar II Disorder.
The girl’s symptoms and their sudden onset are most suggestive of Bipolar Disorder.
a. Incorrect - For a diagnosis of ADHD, there would have to be some evidence of hyperactivity-impulsivity and/or inattention in at least two settings.
b. Incorrect - A diagnosis of Conduct Disorder requires a persistent pattern of antisocial behavior. Although the question mentions that the girl has had “behavioral problems,” there is not sufficient evidence to conclude that they meet the criteria for this diagnosis.
c. CORRECT - The girl’s symptoms are suggestive of mania which, in adolescents, is sometimes preceded by a history of behavioral problems.
d. Incorrect - A diagnosis of Bipolar II disorder requires a history of both major depressive and hypomanic episodes.
The correct answer is: Bipolar I Disorder.
A 12-year-old boy’s mother says her son is very argumentative, doesn’t do what he is asked to do, and frequently bullies and threatens his sister and classmates at school. Also, in the past year, the boy has skipped school at least a half dozen times, ran away from home for two days on three different occasions, and was expelled from school for throwing a rock through a school window. The mother has been divorced for four years, and she says that these problems started several months after she remarried two years ago. Based on these symptoms, the most likely diagnosis for the boy is:
Select one:
a. Child or Adolescent Antisocial Behavior.
b. Adjustment Disorder with disturbance of conduct.
c. Oppositional Defiant Disorder.
d. Conduct Disorder.
Answer D is correct: The diagnosis of Conduct Disorder requires a persistent pattern of behavior that violates the basic rights of others and/or age-appropriate social norms or rules with three or more characteristic symptoms, e.g. bullying, threatening, or intimidating others; being frequently truant from school; running away from home at least twice; and vandalizing school property.
Answer A: Child or Adolescent Antisocial Behavior is included in the DSM-5 with Other Conditions That May Be a Focus of Clinical Attention and may apply when the individual’s symptoms do not meet the criteria for a mental disorder.
Answer B: A diagnosis of Adjustment Disorder is assigned when the individual does not meet the diagnostic criteria for another mental disorder.
Answer C: Oppositional Defiant Disorder involves a recurrent pattern of an angry/irritable mood, argumentative/defiant behavior, or vindictiveness. The boy’s symptoms are more severe than those associated with Oppositional Defiant Disorder.
The correct answer is: Conduct Disorder.
The DSM-5 requires which of the following for a diagnosis of Autism Spectrum Disorder?
Select one:
A. an onset of symptoms prior to three years of age
B. an onset of symptoms during the early developmental period
C. apparent normal development for at least six months followed by a loss of previously acquired skills
D. apparent normal development for at least two years followed by a loss of previously acquired skills
Answer B is correct: For the diagnosis of Autism Spectrum Disorder, the DSM-5 requires that “symptoms must be present in the early developmental period” (p. 50).
Answers A, C, and D: See explanation above.
The correct answer is: an onset of symptoms during the early developmental period
Renaldo, age 20, is afraid he’s going to be fired from his job as an inventory stocker at a large warehouse because he frequently “loses track” of inventory and does not follow-through on his boss’s instructions. He says he’s always been forgetful and never did well in school because he had a hard time focusing on his schoolwork. Based on this information, the best DSM-5 diagnosis for Renaldo is which of the following?
Select one:
A. Attention-Deficit/Hyperactivity Disorder, combined presentation
B. Attention-Deficit/Hyperactivity Disorder, in partial remission
C. Other Specified Attention-Deficit/Hyperactivity Disorder, with insufficient inattention symptoms
D. Attention-Deficit/Hyperactivity Disorder, predominantly hyperactive/impulsive presentation
Answer C is correct: Of the diagnoses listed in the answers, Other Specified Attention-Deficit/Hyperactivity Disorder is the best since Renaldo’s symptoms involve problems related to attention but it’s unclear if he has the minimum number of symptoms (at least six for children and five for individuals ages 17 and older) required for a diagnosis of Attention-Deficit/Hyperactivity Disorder, predominantly inattentive presentation.
Answer A: The information provided in the question does not indicate that Renaldo has symptoms of hyperactivity or impulsivity, so Attention-Deficit/Hyperactivity Disorder, combined presentation can be eliminated as the correct answer.
Answer B: There is no information provided in the question to suggest that Renaldo met the full diagnostic criteria for ADHD in the past and it’s not clear how many symptoms he has now, so it is not possible to conclude that he is currently in remission.
Answer D: See explanation for answers A and C.
The correct answer is: Other Specified Attention-Deficit/Hyperactivity Disorder, with insufficient inattention symptoms
In their study of outpatient mental health services in Los Angeles County, Sue et al. (1991) found that, while clients from all groups showed improvement at the end of therapy, __________ had the best outcomes.
Select one:
A. African Americans
B. Anglo Americans
C. Asian Americans
D. Hispanic Americans
Answer D is correct. Sue et al. (1991) and others have found a few consistent differences in outcomes for members of different racial/ethnic groups. Sue et al. found that Hispanic Americans had the best outcomes, followed by Anglos, Asian Americans, and, lastly, African Americans.
The correct answer is: Hispanic Americans
- Hispanic
- Anglos
- Asian
- African American
Jung’s theory differs from Freud’s in all of the following ways except:
Select one:
A. Jung’s perspective reflects a more optimistic view of human nature.
B. Jung promoted a more active interchange between analyst and patient.
C. Jung conceptualized the psyche as continuing to evolve throughout the lifespan.
D. Jung replaced the concept of the ego with the concepts of the self and the ideal-self.
Jung’s analytic psychology differs from Freud’s psychotherapy in a number of important ways. For Jung, for example, the basic elements of the psyche are the conscious (which includes the ego) and the unconscious (which includes a personal and collective component).
a. Incorrect This is true about Jung’s perspective. He described people as being more creative and goal-directed than Freud.
b. Incorrect This also describes Jung’s approach.
c. Incorrect Jung placed a great deal of emphasis on changes that occur during adulthood, especially in midlife.
d. CORRECT The ego is an important part of Jung’s theory, and, although he did make use of the notion of the “self,” he considered the self to be the archetype for the ego.
The correct answer is: Jung replaced the concept of the ego with the concepts of the self and the ideal-self.
According to Atkinson, Morten, and Sue’s (1993) Racial/Cultural Identity Development Model, the final stage of identity development is characterized by:
Select one:
A. assimilating into the dominant culture.
B. developing a self-identity that is consistent with one’s racial/cultural background.
C. adopting an identity that is independent of the minority and majority cultures.
D. adopting a multicultural perspective.
Atkinson et al.’s (1993) model distinguishes between five stages:
CONFORMITY DISSONANCE RESISTANCE-IMMERSION INTROSPECTION INTEGRATIVE AWARENESS
a. Incorrect Atkinson et al. do not view assimilation as the outcome of successful identity development.
b. Incorrect Although successful identity development does involve developing an ethnic identity, that identity is not necessarily reflective of the individual’s cultural/racial background in all ways. Instead, the individual chooses which elements he/she wants to incorporate into his/her identity.
c. Incorrect Atkinson’s model does not propose that being “culture-free” is an optimal state.
d. CORRECT Like most cultural/racial identity development models, the Atkinson et al. model describes the final stage as one of integration - i.e., of accepting one’s own minority culture while also recognizing and incorporating the positive contributions of the majority culture. They refer to this as adopting a multicultural perspective.
The correct answer is: adopting a multicultural perspective.
A husband and wife avoid conflicts with one another by focusing their attention on helping their child overcome his difficulties at school. As described by Minuchin, this is an example of:
Select one:
A. reframing.
B. detouring.
C. stable coalition.
D. triangulation.
Minuchin distinguished between three types of rigid triads that help alleviate tension between two family members -
DETOURING
STABLE COALITION
TRIANGULATION
a. Incorrect Reframing is a paradoxical technique that involves providing an alternative meaning for a behavior so that it can be seen from a new perspective.
b. CORRECT Detouring occurs when parents avoid the tension between them by either blaming or overprotecting a child.
c. Incorrect A stable coalition occurs when a parent and child consistently “gang up” against the other parent.
d. Incorrect Triangulation occurs when both parents attempt to get the child to side with him or her.
The correct answer is: detouring.
Caplan (1970) distinguished between four types of mental health consultation. Which of the following is an example of the type he labeled “consultee-centered case consultation”?
Select one:
A. A consultant is hired by a colleague to resolve a diagnostic dilemma she is having with a current client.
B. A consultant is hired by a school to help school administrators evaluate the effectiveness of an existing remedial program for at-risk students.
C. A consultant monitors a support group for administrators to help them develop better interpersonal skills.
D. A consultant helps a teacher acquire the behavior modification skills she needs to reduce disruptions in her classroom.
As its name implies, “consultee-centered case consultation” targets the consultee.
a. Incorrect This is an example of client-centered case consultation.
b. Incorrect This is an example of program-centered administrative consultation.
c. Incorrect This is an example of consultee-centered administrative consultation.
d. CORRECT In this situation, the consultant is helping the consultee improve her skills so that she is better able to deal with future problems in the classroom. The focus of the consultation is on the consultee rather than on particular individuals who the consultee will be in contact with.
The correct answer is: A consultant helps a teacher acquire the behavior modification skills she needs to reduce disruptions in her classroom.
Which of the following is likely to be least effective when working with American Indian or Alaskan Native therapy clients?
Select one:
A. promoting a value free environment in therapy
B. adopting a holistic perspective that regards illness as a result of multiple factors
C. incorporating traditional healers and practices into the treatment process
D. adopting a client-centered approach that avoids highly directive techniques
Although psychologists must be careful not to stereotype members of specific cultural groups, it is always important to take a client’s cultural background into consideration as part of the treatment planning process.
a. CORRECT Promoting a “value-free” environment is similar to adopting a “color-blind” perspective and is inappropriate when working with members of American Indian and Alaskan Native communities. A more effective approach is to establish credibility and trust by demonstrating familiarity with and respect for the client’s culture.
b. Incorrect This would be an appropriate approach when working with American Indians and Alaskan Natives who tend to view illness holistically - i.e., as being the result of multiple factors, including disharmony with nature.
c. Incorrect Incorporating elders, medicine people, and other traditional healers as well as traditional healing practices and ceremonies into the treatment process is considered an essential component of successful treatments for members of American Indian and Alaskan Native communities.
d. Incorrect A collaborative, problem-solving, client-centered approach is appropriate for members of these communities.
The correct answer is: promoting a value free environment in therapy
African-American adolescents who exhibit a “blended bicultural” behavioral pattern:
Select one:
A. are situated midway between ethnic and American culture and consider themselves part of neither
B. acknowledge their American heritage but are more strongly influenced by their ethnic background
C. do not distinguish between ethnic and American cultures
D. view themselves as having integrated American and ethnic identities
Biculturalism among African-American and Mexican-American adolescents was examined by J. S. Phinney and M. Devich-Navarro (Variations in bicultural identification among African-American and Mexican-American adolescents, Journal of Research in Adolescence, 7(1), 3-32, 1997). These investigators found that the adolescents in their sample exhibited one of three patterns: blended biculturalism, alternating biculturalism, or separated.
a. Incorrect This describes MARGINALISATION. None of the adolescents in Phinney and Devich-Navarro’s sample fit this pattern.
b. Incorrect Phinney and Devich-Navarro refer to this as ALTERNATING BICULTURALISM.
c. Incorrect This is referred to as a FUSED IDENTITY. Phinney and Navarro found no evidence of this pattern in their sample.
d. CORRECT As defined by these authors, this pattern represents blended BICULTURALISM.
The correct answer is: view themselves as having integrated American and ethnic identities.
Which of the following is a challenge that may arise from mandating Evidence Based Therapies?
Select one:
A. The financial cost of training all of the individuals needed.
B. The limited number of trainers with which to prepare those that are gaining skills in Evidence Based Therapies.
C. The limited number of Evidence Based Trainings.
D. The varied type and intensity of training that differs across regions.
The correct answer is D. Many community-based training initiatives in evidence-based psychosocial treatments have acquired significant support due to the evidence that some EBTs can be conveyed effectively into non-research and community-based settings. Although many large health organizations such as the National Health Service in the United Kingdom, the United States Department of Veterans Affairs and state mental health systems have mandated the implementation of EBTs, the intensity and type of training varies considerably across these fields.
Answers A, B and C are incorrect as the main difficulty is the lack of consistency across the field, not the expense, number of trainers or lack of evidenced based therapies.
The correct answer is: The varied type and intensity of training that differs across regions.
Manuel is a 21-year old college student who moved to the United States from Mexico with his family when he was four years old. Manuel has many Anglo friends at school and usually dates Anglo women, but, at home, he speaks Spanish and participates in the cultural traditions practiced by his family. When asked about his ethnic identity, Manuel says, “I’m American and Hispanic, but I guess I consider myself mostly Hispanic.” Manuel is best described as:
Select one:
A. fused.
B. separated.
C. assimilated.
D. bicultural.
Different experts have labeled the different levels or categories of acculturation somewhat differently, but most distinguish between at least four levels -
ASSIMILATED
INTEGRATED (bicultural)
SEPARATED
MARGINAL
a. Incorrect The term “fused” refers to the melting pot position in which the two separate cultures cannot be distinguished.
b. Incorrect Separation occurs when the individual is immersed in his/her own ethnic culture and is not part of the larger (dominant) culture.
c. Incorrect An assimilated individual has given up his/her own ethnic culture and identifies with the larger (dominant) culture.
d. CORRECT The bicultural individual has adopted both cultures. Biculturalism can be alternating (as in Manuel’s case) or blended.
The correct answer is: bicultural.
For Yalom (1985), in group therapy,\_\_\_\_\_\_\_\_\_\_ is the analogue of the client-psychotherapist relationship in individual therapy and is a key factor in therapy outcome. Select one:
A. cohesiveness
B. family re-enactment
C. universality
D. identification
Answer A is correct. If you think about Yalom’s initial stages in group therapy, you might recall that it is the development of cohesiveness that moves the group forward into the working stage. Although Yalom believes that group therapy provides a number of curative factors, he emphasizes the importance of group cohesiveness and describes it as the analogue to the therapist-client relationship in individual therapy.
The correct answer is: cohesiveness
You are beginning a therapy group for individuals dealing with mid-life issues. From your experiences with new groups, you know that, during the beginning stages of group therapy:
Select one:
A. group members will talk through the therapist and seemingly ignore one another.
B. group members will interact with one another and more or less ignore the therapist.
C. group members will act quite hostile toward the therapist and resist his/her suggestions.
D. cliques will begin to develop within the group.
In the beginning of group therapy, clients rely more on the therapist. Later, as the group members become closer, group cohesion develops and members interact more with one another.
a. CORRECT Initially, group members ignore each other and direct all of their comments and questions to the therapist.
b. Incorrect As response A suggests, interactions between group members will be sparse at the onset of therapy.
c. Incorrect Although this may be true in some cases, most group members perceive the therapist as their ally.
d. Incorrect Cliques begin to develop, if at all, after the beginning stages of group therapy.
The correct answer is: group members will talk through the therapist and seemingly ignore one another.
Bateson, Jackson, Haley, and Weakland (1956) identified double-bind communication as an etiological factor for which of the following disorders?
Select one:
A. Anorexia
B. Schizophrenia
C. Antisocial Personality Disorder
D. Narcissistic Personality Disorder
As described by Bateson et al. (1956), double-bind communication occurs when a family member receives contradictory injunctions (messages) from another family member and is unable to comment on those injunctions or escape from them.
a. Incorrect See explanation for response b.
b. CORRECT The title of Bateson et al.’s 1956 paper was Toward a Theory of Schizophrenia. Their double-bind hypothesis provided an alternative to psychodynamic theory regarding the development of this disorder and proposed that the recipient of double-bind communication learns to escape the discomfort it creates by responding with similarly distorted and contradictory messages. Eventually, the individual becomes unable to understand the true meaning of his/her own messages and those of others.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: Schizophrenia
When treating a couple in which the husband has physically abused his wife and it has been clearly determined that the abuse can be classified as instrumental (vs. expressive), the best initial approach is:
Select one:
A. to ensure that the husband and wife are physically separated and to provide them with separate therapy.
B. to have the husband and wife sign a “no-violence contract” and to provide them with separate therapy.
C. to have the husband and wife sign a “no-violence contract” and to provide them with conjoint therapy.
D. to provide combined individual and group therapy for both the husband and wife.
The key to this question is noting that the abuse is instrumental rather then expressive and knowing that therapists often recommend conjoint treatment only in the latter case (see, e.g., R. N. Mack, Spouse Abuse: A Dyadic Approach, in G. R. Weeks, Treating couples, New York: Bruner/Mazel, 1989).
a. CORRECT In cases of instrumental abuse (which is brutal, dangerous, and committed with little provocation), the woman’s physical safety is the priority. Therefore, the best course of action is to make sure the husband and wife are physically separated and provided with separate therapy.
b. Incorrect See explanations for responses a and c.
c. Incorrect This is usually the treatment-of-choice in cases of expressive abuse, in which the abuse is related to the emotional life of the couple and occurs within the context of escalating conflict.
d. Incorrect See explanations for responses a and c.
The correct answer is: to ensure that the husband and wife are physically separated and to provide them with separate therapy.
In Freudian psychoanalysis, clarification:
Select one:
A. reduces the clients resistance.
B. links current behavior to unconscious processes.
C. brings a confusing or unclear issue into focus.
D. helps the client gain control over his/her inner conflicts.
The process of Freudian psychoanalysis is described as involving a combination of:
CONFRONTATION
CLARIFICATION
INTERPRETATION
WORKING THROUGH
a. Incorrect This does not accurately describe the function of clarification.
b. Incorrect This is a better description of interpretation than of clarification.
c. CORRECT Clarification is used to clarify an issue by, for example, separating a key issue from less important ones.
d. Incorrect This is part of the working through process.
The correct answer is: brings a confusing or unclear issue into focus.
Family therapy is probably contraindicated in which of the following situations?
Select one:
A. The presenting problem involves long-term marital conflict.
B. Family members attribute their problems to one of the members.
C. One of the family members has severe depression.
D. One of the family members has anorexia or bulimia.
Family therapy is generally contraindicated when one family member’s disturbance, while affecting the family, is basically unrelated to family processes or structure or is so disruptive that it would interfere with the success of therapy.
a. Incorrect Family therapy would be appropriate in this situation.
b. Incorrect Family therapy would be appropriate in this situation.
c. CORRECT Depression has been linked to a variety of factors including heredity, biochemical abnormalities, learned helplessness, hostility or aggression turned inward, and illogical schemata. It has not, however, been consistently linked with any particular family factor; and family therapy, therefore, would not be particularly useful as a treatment for this disorder.
d. Incorrect Family therapy would be appropriate in this situation since eating disorders (especially anorexia and bulimia) have been linked to family factors.
The correct answer is: One of the family members has severe depression.
In their meta-analysis of research evaluating psychotherapy outcomes for children and adolescents, Weisz and his colleagues (1995) obtained the largest effect size for:
Select one:
A. female children.
B. male children.
C. female adolescents.
D. male adolescents.
The Weisz et al. meta-analysis examined the effects of type of disorder, type of therapy, therapist experience, and child age and gender on psychotherapy outcomes [J. R. Weisz et al., Effects of psychotherapy with children and adolescents revisited: A meta-analysis of treatment outcome studies, Psychological Bulletin, 117(3), 450-468, 1995].
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Weisz et al. report an effect size of .86 for female adolescents. In contrast, they report an effect size of .37 for male adolescents, .44 for female children, and .48 for male children.
d. Incorrect See explanation for response c.
The correct answer is: female adolescents.
A strategic family therapist is working with a family in which the husband and wife have avoided their own conflicts by focusing their attention on the problems of their 9-year old son. The therapist in this situation is most likely to:
Select one:
A. educate the parents about “triangulation.”
B. obtain a detailed family history from the husband and wife to identify the pattern of interactions in their families of origin.
C. give the husband and wife a homework assignment designed to foster recognition of the conflicts that exist between them.
D. use “circular questions” to help family members gain insight into each other’s perspectives.
As its name implies, strategic family therapy involves the use of “strategies.”
a. Incorrect This is not characteristic of strategic family therapy.
b. Incorrect This is not characteristic of strategic family therapy.
c. CORRECT Of the responses given, this one is the best example of the techniques used by a strategic family therapist. The therapist is assigning the couple a task that will help them face their own conflicts.
d. Incorrect This is also not typical of strategic family therapy.
The correct answer is: give the husband and wife a homework assignment designed to foster recognition of the conflicts that exist between them.
Based on her review of the existing models of gay and lesbian identity development, Sophie (1985/86) developed a general stage theory of lesbian identity development, which she tested on several women who were currently experiencing changes with regard to their sexual orientation. Which of the following accurately presents Sophie’s four stages?
Select one:
A. identity confusion, identity comparison, identity acceptance, and identity pride
B. sensitization, identify confusion, identity assumption, and identity integration
C. first awareness, testing and exploration, identity acceptance, and identity integration
D. pre-encounter, encounter, immersion-emersion, and internalization
Sophie reviewed several of the prominent stage theories to derive her own general model [A critical examination of stage theories of lesbian identity development, Journal of Homosexuality, 12(2), 39-51, 1985/86].
a. Incorrect These are four of the six stages of Cass’s (1984) stage model of gay and lesbian identity development. In order, the six stages are identity confusion, identity comparison, identity tolerance, identity acceptance, identity pride, and identity synthesis.
b. Incorrect These are the four stages of Troiden’s (1988) gay/lesbian identity development model.
c. CORRECT These are the four stages described by Sophie.
d. Incorrect These are the four stages of Cross’s (1991) Black racial identity development model.
The correct answer is: first awareness, testing and exploration, identity acceptance, and identity integration
Although it is necessary to avoid stereotypes when providing services to members of ethnic and racial minority groups, some generalizations are often made. For example, when working with Hispanic and Hispanic American clients, it is important to keep in mind all of the following except:
Select one:
A. different levels of acculturation among Hispanics can influence their perceptions of and responses to therapy.
B. family therapy is often contraindicated because of the hierarchical nature of the Hispanic family.
C. behavioral and other active, problem-oriented therapies are usually more acceptable than insight-oriented therapies.
D. sex-roles tend to be demarcated clearly and are fairly rigid.
Some generalizations about the treatment of Hispanic and Hispanic American clients have been made in the literature, and you should be familiar with them for the licensing exam.
a. Incorrect This is true. There are different levels of acculturation not only between families but also within families (i.e., younger members of the family tend to be more acculturated to the white middle-class way of life).
b. CORRECT Although Hispanic families do tend to be hierarchical, this does not preclude them from family therapy. In fact, family therapy is often the treatment-of-choice because of the close relationships between family members.
c. Incorrect This is true not only for Hispanics but also members of other minority groups.
d. Incorrect This is also generally true.
The correct answer is: family therapy is often contraindicated because of the hierarchical nature of the Hispanic family.
Don Jackson, Murray Bowen, and a number of pioneers in the field of family therapy had a psychodynamic background, which they incorporated, to some degree, in their approach to family therapy. However, it is the psychoanalyst _______________ who is generally identified as the first to formally adapt and apply psychoanalytic principles to the understanding of the family.
Select one:
A. Nathan Ackerman
B. Carl Whitaker
C. Richard Stuart
D. Robert Liberman
Nathan Ackerman, a psychoanalyst and child psychiatrist, began investigating the role of family dynamics in the 1930s; and, in the 1940s, he started developing clinical techniques that applied psychoanalytic principles to the treatment of preschool children and their families.
a. CORRECT Ackerman is considered a pioneer in the assessment and treatment of families and the first to integrate the psychoanalytic approach with a systems approach in assessing and treating families.
b. Incorrect Whitaker applied experiential (humanistic) principles to family therapy.
c. Incorrect Stuart was an early contributor to behavioral family therapy.
d. Incorrect Liberman is a major figure in behavioral family therapy.
The correct answer is: Nathan Ackerman
__________ described “personal constructs” as bipolar dimensions of meaning that determine how a person perceives, interprets, and predicts events.
Select one:
A. William Glasser
B. George Kelly
C. Victor Frankl
D. Fritz Perls
This question should have been easy to answer as long as you’re familiar with the individual who developed Personal Construct Therapy.
a. Incorrect William Glasser is associated with Reality Therapy.
b. CORRECT Kelly’s Personal Construct Therapy is a constructivist approach that focuses on how people “construe” events and proposes that construing involves reliance on personal constructs.
c. Incorrect Victor Frankl is associated with Existential Therapy.
d. Incorrect Fritz Perls is associated with Gestalt Therapy.
The correct answer is: George Kelly
Helms’s (1995) White Racial Identity Development Model distinguishes between six statuses, with each status being associated with a different information processing strategy. For example, the “flexibility and complexity” strategy is characteristic of the __________ status.
Select one:
A. internalization
B. integrative awareness
C. reintegration
D. autonomy
Helms’s six identity statuses are:
CONTACT DISINTEGRATION REINTEGRATION PSEUDO-INDEPENDENCE IMMERSION/EMERSION AUTONOMY
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Not surprisingly, information processing flexibility and complexity are characteristic of the final status in Helms’s model. The attributes of the autonomy status include awareness of one’s own “whiteness” and role in perpetuating racism and a commitment to abandoning a sense of White entitlement.
The correct answer is: autonomy
Data published by Hans Eysenck in 1952:
Select one:
A. confirmed the effectiveness of behavioral treatments for a variety of psychological disorders.
B. confirmed the “Dodo bird” hypothesis, which predicts that various types of therapy are equally effective for a variety of psychological disorders.
C. challenged the notion of “spontaneous remission.”
D. challenged the effectiveness of conventional psychotherapeutic interventions.
Eysenck’s 1952 publication sparked research on psychotherapy outcomes.
a. Incorrect See explanation for response d.
b. Incorrect This sounds more like the Smith, Glass, and Miller (1980) meta-analysis, which found relatively few differences between various therapeutic approaches.
c. Incorrect This is just the opposite of what Eysenck concluded.
d. CORRECT Eysenck reported that 66% of patients in eclectic therapy and 44% in psychoanalytic psychotherapy improved versus 72% of those with similar problems who did not receive therapy.
The correct answer is: challenged the effectiveness of conventional psychotherapeutic interventions.
According to Irvin Yalom (1985), in group therapy, increasing intimacy and willingness to self-disclose and greater adherence to group norms are attributable to which of the following?
Select one:
A. cohesiveness
B. universality
C. identification
D. group transferences
Yalom describes the beginning of a new therapy group as involving three formative stages.
a. CORRECT According to Yalom, the third stage of group therapy is characterized by a growing sense of group cohesiveness, which leads to greater participation in the group and increased adherence to group norms.
b. Incorrect See explanation for response a.
c. Incorrect See explanation for response a.
d. Incorrect See explanation for response a.
The correct answer is: cohesiveness
As described by Sue and Sue (1999), “playing it cool” and “Uncle Tom Syndrome” are:
Select one:
A. signs of an internal locus of control.
B. survival mechanisms.
C. characteristics of the immersion-emersion stage of racial/cultural identity development.
D. signs of functional (versus cultural) paranoia.
D. W. Sue and D. Sue describe “playing it cool” and the “Uncle Tom Syndrome” as reactions of African Americans to long-term racial oppression (Counseling the culturally different, New York, John Wiley & Sons, 1999).
a. Incorrect See explanation for response b.
b. CORRECT Playing it cool helps African Americans conceal feelings that might be unacceptable to Whites and that, if expressed, could lead to harm and exploitation. The Uncle Tom Syndrome refers to the use of passivity as a defense mechanism.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: survival mechanisms.
In the book, A Theory of Multicultural Counseling and Therapy, Sue, Ivey, and Pedersen (1996) describe three multicultural counseling competencies. These are:
Select one:
A. ability, knowledge, and sensitivity.
B. flexibility, sensitivity, and awareness.
C. awareness, knowledge, and skills.
D. self-awareness, expertise, and strategies.
The three multicultural counseling competencies described by Sue, Ivey, and Pedersen (1996) were originally identified by D. W. Sue et al. (Position paper: Cross-cultural counseling competencies, The Counseling Psychologist, 10, 45-52, 1982).
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT The first competency is AWARENESS of one’s own values, beliefs, and stereotypes regarding human behavior. The second competency is KNOWLEDGE about the worldview of minority and culturally-different clients. Finally, the third competency is possession of culturally-appropriate counseling SKILLS.
d. Incorrect See explanation for response c.
The correct answer is: awareness, knowledge, and skills.
Which of the following statements regarding sexual relationships between a therapist and a former client is most consistent with the APA’sEthics Code?
Select one:
A. A sexual relationship between a therapist and a former (but not current) client is ethical.
B. A therapist may have a sexual relationship after two years have passed since termination of the therapeutic relationship.
C. A therapist may have a sexual relationship after two years have passed since termination, the circumstances of the therapy and/or termination were not exploitative, and the client’s mental status and/or personal history does not show susceptibility to exploitation.
D. A sexual relationship between a therapist and a former client is always unethical.
Standard 10.08(a) addresses this issue. It states: “Psychologists do not engage in sexual intimacies with former clients/patients for at least two years after cessation or termination of therapy.” In addition Standard 10.08(b) states: “Psychologists do not engage in sexual intimacies with former clients/patients even after a two-year interval except in the most unusual circumstances. Psychologists who engage in such activity … bear the burden of demonstrating that there has been no exploitation, in light of all relevant factors ….”
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT This answer is most consistent with the admonitions set forth in Standard 10.08.
d. Incorrect See explanation for response c.
The correct answer is: A therapist may have a sexual relationship after two years have passed since termination, the circumstances of the therapy and/or termination were not exploitative, and the client’s mental status and/or personal history does not show susceptibility to exploitation.
Which of the following is most consistent with ethical requirements regarding publication credit for publications that are substantially based on a student’s doctoral dissertation?
Select one:
A. Authorship credit must reflect each individual’s relative contribution to the research project.
B. Authorship credit must be mutually agreed upon by all individuals who contributed to the project.
C. The student must be listed as first author except under exceptional circumstances.
D. The student must always be listed as first author.
This issue is addressed in Standard 8.12(c) of the APA’s Ethics Code. a. Incorrect This is the general rule for authorship credit. However, the standards for publications based primarily on a student’s dissertation project differ.
b. Incorrect This is not consistent with the requirements of the Ethics Code.
c. CORRECT Standard 8.12(c) states that “Except under exceptional circumstances, a student is listed as principal author on any multiple-authored article that is substantially based on the student’s doctoral dissertation.” Note that timeliness is one consideration when determining if a circumstance is “exceptional.” As an example, the University of Victoria provides the following authorship guidelines for research conducted by graduate students: “If a student does not produce the first draft of the manuscript within e.g., 12 months of defending the thesis or dissertation, unless another arrangement has been negotiated in advance, the supervisor can take over the lead and be listed as the principal author. The student, however, remains an author of the article” (web.uvic.ca/psyc/GradAdvisor/GradRegs_Sept2004.pdf).
d. Incorrect The statement “except under exceptional circumstances” in Standard 8.12(c) suggests that there are times when it would be acceptable not to list the student as the principal author.
The correct answer is: The student must be listed as first author except under exceptional circumstances.
You go out for a drink with a psychologist who is a co-worker of yours at a mental health clinic. After several beers, he accidentally lets it slip that he is currently having a sexual relationship with one of his clients. Your best course of action would be to:
Select one:
A. discuss the matter with the clinic director as soon as possible.
B. discuss the issue with the psychologist when he has not been drinking.
C. make an appointment with the client to discuss the issue with her.
D. file a formal complaint against the psychologist with the Ethics Committee.
As noted in the Ethics Code, any attempt at resolving a potential ethical violation by a psychologist must include consideration of the client’s confidentiality.
a. Incorrect Although this may be appropriate, note that this answer does not mention the issue of confidentiality. Consequently, it is not the best answer of those given.
b. CORRECT This is the best response since it is most consistent with Standard 1.04 (Informal Resolution of Ethical Violations) of the Ethics Code and does not violate the client’s confidentiality.
c. Incorrect This would not be an appropriate course of action since there is nothing in the question to imply that you already have a therapeutic relationship with the client.
d. Incorrect See explanations for responses a and b.
The correct answer is: discuss the issue with the psychologist when he has not been drinking.
Dr. Dither is hired by the court to conduct an evaluation of a family as part of a child protection matter. Based on Dr. Dither’s evaluation and other evidence, the court determines that the child can remain at home with his family who will be provided with supervision and counseling. Six months after the case is heard in court, Dr. Dither is contacted by the mother who says she would like to begin therapy with him for issues unrelated to the child protection matter. Dr. Dither should:
Select one:
A. agree to see the woman in therapy since the child protection matter has been resolved.
B. agree to see the woman in therapy only if her problem is, in fact, unrelated to the child protection matter.
C. agree to see the woman in therapy since his familiarity with her situation will be an advantage.
D. refer the woman to a colleague.
In most situations, multiple relationships are to be avoided.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT This answer is most consistent with ethical guidelines that require psychologists to avoid multiple relationships. For example, Guideline 7 of the APA’s Guidelines for Child Custody Evaluations in Family Law Proceedings identifies providing psychotherapy to prior child custody examinees as a multiple relationship that should be avoided.
The correct answer is: refer the woman to a colleague.
The participants in a research study you are conducting at a university are all students in an introductory psychology class. As part of the study, you administer a test to each student that has been found to be an excellent predictor of suicide risk. You discover that one of the student’s scores on the test indicate that he is at high risk for suicide. Your best initial course of action would be to:
Select one:
A. contact the student’s instructor immediately.
B. contact the student to suggest that he see a therapist at the counseling center.
C. discuss your concerns with the student immediately.
D. re-administer the test to the student to confirm its results.
Immediate action is the appropriate response to situations involving a high risk for suicide.
a. Incorrect See explanation for response c.
b. Incorrect Referral to a therapist might be the next step after talking with the student.
c. CORRECT Of the responses given, this is the best one. It implies an immediate action that would help determine if the student is actually at risk.
d. Incorrect There’s no information in this question suggesting that the test needs to be re-administered.
The correct answer is: discuss your concerns with the student immediately.
A 15-year old client who you have been seeing for several months says he’s been thinking about killing himself. In response to your concern, he says he’s “just kidding” and asks that you not tell his parents. Your best course of action would be to:
Select one:
A. tell the boy that you need to contact his parents and then do so.
B. tell the boy that you won’t tell his parents as long as he signs a “no suicide” contract.
C. continue to discuss the matter to determine if the boy is, in fact, at risk for suicide.
D. do nothing since he was “just kidding” but ask him about the issue during the next session.
This is pretty straightforward. The boy’s welfare is your first concern, and you’d want to make sure that he is not at risk for suicide.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Suicide threats and ideation should always be taken seriously. Before notifying his parents, however, you’d want to determine how serious his thoughts about suicide are.
d. Incorrect See explanation for response c.
The correct answer is: continue to discuss the matter to determine if the boy is, in fact, at risk for suicide.
Murphy, DeBernardo, and Shoemaker’s (1998) survey of psychologists about the effects of managed care on their professional practice found that the most frequently cited negative effect was:
Select one:
A. increased demands due to utilization review.
B. some panels being closed to psychologists.
C. income decline due to decreased volume of patients.
D. increased need for supervision.
This question is referring to a survey of APA Division 42 members [M. J. Murphy, C. R., DeBernardo, & W. E. Shoemaker, Impact of managed care on independent practice and professional ethics: A survey of independent practitioners, Professional Psychology: Research and Practice, 29(1), 43-51, 1998]. The results of that survey are described in the Ethical Manual in the written study materials.
a. CORRECT Increased demand due to utilization review was the most frequently cited negative effect, with 87% of respondents referring to the increase in paperwork and 83% referring to the increase in phone contacts with third-party payors.
b. Incorrect Thirty-eight percent of respondents cited some panels being closed to psychologists.
c. Incorrect Forty percent of respondents cited a decline in income due to a decrease in the volume of patients.
d. Incorrect Increased need for supervision was not one of the effects cited by respondents.
The correct answer is: increased demands due to utilization review.
Dr. D. Centt is conducting a study to investigate the effectiveness of a brief behavioral treatment for reducing self-mutilation in young women. The treatment involves 20 hourly sessions that will be administered once a week for 20 weeks. Dr. Centt randomly assigns 40 women with a history of self-mutilation to either the treatment group or the no-treatment control group. After women in the treatment group have completed only six sessions, he finds that the treatment has nearly eliminated their self-mutilating behaviors. In contrast, nearly all of the women in the control group report multiple incidents of self-mutilation since the study began. As an ethical psychologist, Dr. Centt’s best course of action would be to:
Select one:
A. continue the study as long as the women in the control group signed informed consents at the onset of their participation.
B. continue the study but offer the treatment to the women in the control group at the end of the study.
C. discontinue the study and offer the treatment to the women in the control group immediately.
D. try to get the results of the study published as soon as possible so that the effectiveness of the treatment is recognized.
This issue is addressed by A. J. Kimmel in Ethical issues in behavioral research, Blackwell Publishers, Cambridge, MA, 1996.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Kimmel concludes that, when the effectiveness of an intervention is unknown, it is acceptable to include a “no-treatment control group” in a research study. However, as soon as the treatment is shown to be effective (especially when it is effective for a serious disorder or problem), the treatment should be made immediately available to individuals in the control group.
d. Incorrect See explanation for response c.
The correct answer is: discontinue the study and offer the treatment to the women in the control group immediately.
The Examination for Professional Practice in Psychology (EPPP) is best described as:
Select one:
A. a measure of basic knowledge of psychology.
B. a predictor of job proficiency.
C. an aptitude test.
D. a way to protect the public from incompetent psychologists.
The licensing exam measures knowledge of several areas in the field of psychology.
a. CORRECT The EPPP is a measure of knowledge that candidates seeking licensure should have.
b. Incorrect This would be nice, but the test has not been validated as a measure of job proficiency.
c. Incorrect This is not an accurate description of the licensing exam.
d. Incorrect This describes licensure but not the licensing exam.
The correct answer is: a measure of basic knowledge of psychology.
In the context of managed health care, “gatekeeper” refers to the:
Select one:
A. peer review board.
B. HMO.
C. clinical supervisor.
D. primary care physician.
Managed care reduces health costs in several ways including the use of a “gatekeeper” who makes referrals to specialists.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The gatekeeper is the person who makes referrals to a psychotherapist or other specialist or the person who evaluates the individual to determine if additional care is needed. Very often, the gatekeeper is the individual’s primary care physician.
The correct answer is: primary care physician.
A former client leaves a voicemail message requesting that you send a copy of her clinical records to her new therapist. She leaves the new therapist’s address and phone number. You should:
Select one:
A. send the records to the therapist as requested by the client.
B. send the records to the client rather than to the therapist.
C. contact the client to clarify what information should be sent to the therapist and to obtain a verbal or written consent from the client.
D. contact the therapist to identify what information is relevant to the clients current therapy and then send that information to the therapist.
Before releasing any information to the client’s new therapist, you’d want to discuss the release with her to make sure she understands what information is being released. In addition, to be consistent with ethical obligations, you’d want to obtain a verbal or written consent before releasing the information.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT You would not want to provide another professional with confidential client information unless you had discussed this with the client and obtained a signed written consent or a verbal consent (which you would document in her file).
d. Incorrect Although contacting the therapist to determine what information is needed might be appropriate, you should not do so without first getting the client’s consent to communicate directly with the therapist. Therefore, answer b is a better response.
The correct answer is: contact the client to clarify what information should be sent to the therapist and to obtain a verbal or written consent from the client.
A colleague at the mental health clinic where you are employed tells you that one of his clients has admitted to sexually abusing his daughter. The colleague says he is not going to report the abuse since it was mild in nature and the client has expressed remorse, promised not to do it again, and is willing to continue therapy. In addition, he feels that reporting the abuse would be detrimental to the community since the client is a widely-known, well-respected person. You should:
Select one:
A. attempt to discuss the matter further with the colleague and encourage him to make a report to the appropriate child abuse reporting authority.
B. file a complaint against the colleague with APA or the state licensing board.
C. contact the appropriate child abuse reporting authority and provide them with information about the abuse and with the colleague’s name.
D. contact the appropriate child abuse reporting authority and provide them with information about the abuse but refuse to give them the colleague’s name if they request it.
This issue is addressed by Leland Swenson in Psychology and the law for the helping pofessions, Brooks/Cole, Pacific Grove, CA, 1997.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Swenson notes that “Any required reporter who knows that another required reporter has not reported must report the evidence of abuse as well as identify the nonreporter” (p. 413).
d. Incorrect See explanation for response c.
The correct answer is: contact the appropriate child abuse reporting authority and provide them with information about the abuse and with the colleague’s name.
An evaluation of a defendant’s competence in a criminal court case is conducted to determine his/her mental status:
Select one:
A. at the time of the evaluation.
B. at the time the crime was committed.
C. at the time of the arrest.
D. prior to committing the crime.
This question is apparently asking about competence to stand trial.
a. CORRECT A psychologist may be asked to evaluate a person’s current mental status to determine if he/she is competent to stand trial (i.e., is able to understand court procedures and the charge against him/her).
b. Incorrect A psychologist would determine the person’s status at the time of the crime in order to support the insanity defense.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: at the time of the evaluation.
You receive a phone call from the attorney of one of your current therapy clients. The attorney asks you to forward information from the client’s file for a court case the client is currently involved in and tells you that the client has signed a release. While reviewing the client’s file, you encounter a note that you made indicating that the client said he would never want you to release personal information about him under any circumstances. As an ethical psycholgist, you will:
Select one:
A. contact the client to discuss the matter with him before taking any further action.
B. release only information to the attorney that you believe is relevant to the client’s case.
C. release the requested information to the attorney since the client has signed a release.
D. refuse to release the records without a court order.
The situation described in this question is not directly addressed by the APA’s Ethics Code. However, one of the answers is most consistent with the “spirit” of the Code.
a. CORRECT This response is most consistent with the requirements of the Ethics Code. Specifically, Standard 3.04 states that psychologists “take reasonable steps to avoid harming their clients/patients.” Contacting the client prior to releasing the requested information to the attorney would help ensure that the client is not harmed.
b. Incorrect Releasing only relevant information is always the best action but, before making a decision about releasing the requested information, you’d want to discuss the issue with the client given that he said he would never want you to release personal information under any circumstance. Therefore, answer a is the best response.
c. Incorrect Because of the client’s statement to you about the release of personal information, you would want to check with him to make sure he understands what information will be released and how that information will be used. You would also want to see a copy of the release before providing the attorney with the requested information.
d. Incorrect There is no information given in the question suggesting that it would be necessary to obtain a court order before releasing the requested information to the attorney.
The correct answer is: contact the client to discuss the matter with him before taking any further action.
You receive a court order requesting that you provide information about a 19-year-old client who is currently the defendant in a court case. You discuss the request with the client but he refuses to sign a waiver of confidentiality. You should:
Select one:
A. refuse to provide the court with the requested information until you obtain a waiver from the client.
B. refuse to provide the court with the requested information until you obtain a waiver from the client’s attorney or legal guardian.
C. provide the court only with information that you believe will not be harmful to the client.
D. provide the court with the requested information.
The key term in this question is “court-ordered.”
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Therapist-client privilege implies that, in most circumstances, a psychologist does not reveal confidential client information in the context of a legal proceeding without the consent of the client or his/her legal representative. There are exceptions to privilege, however, and a court order is one of these exceptions. (If the information is damaging to the client, the normal procedure is to request that it be read by the judge in camera - i.e., in the privacy of the judge’s chambers.)
The correct answer is: provide the court with the requested information.
With regard to the care and use of animals in research, a psychologist who is the principal investigator:
Select one:
A. can designate which employees or assistants are responsible for the animals.
B. can designate which employees or assistants are responsible for the animals as long as the psychologist has provided them with appropriate training.
C. is ultimately responsible for the animals him/herself.
D. shares equal responsibility for the animals with the employees and assistants.
The Ethics Code is not “crystal clear” about this issue, but it does seem to imply that the psychologist maintains responsibility for the care and treatment of animal subjects.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Standard 8.09(b) states that “Psychologists trained in research methods and experienced in the care of laboratory animals supervise all procedures involving animals and are responsible for ensuring appropriate consideration of their comfort, health, and humane treatment.” In light of this statement, this response is the best one.
d. Incorrect See explanation for response c.
The correct answer is: is ultimately responsible for the animals him/herself.
Which of the following is generally considered the best defense for a psychologist in cases of litigation?
Select one:
A. licensure
B. adequate records
C. informed consent
D. liability insurance
A review of the literature on risk management reveals consensus among the experts that good record-keeping is a key defense in cases of malpractice.
a. Incorrect See explanation for response b.
b. CORRECT S. Knapp, for instance, notes that “An axiom of risk management is that if it is not documented, it did not occur” (Professional liability and risk management in an era of managed care, in D. T. Marsh and R. O. Magee [Eds.], Ethical and legal issues in professional practice with families, New York, John Wiley and Sons, 1997).
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: adequate records
A married couple’s insurance provides reimbursement for individual therapy but not for marital therapy. The psychologist has determined, however, that marital therapy is the appropriate form of treatment for the couple. The psychologist should:
Select one:
A. treat them in individual therapy since it is covered by the insurance.
B. bill for individual therapy while treating them as a couple.
C. appeal to the insurance company for coverage for marital therapy.
D. none of the above.
The psychologist should not mislead the insurance company about the appropriate form of treatment for the couple since doing so would constitute insurance fraud.
a. Incorrect This would not be appropriate because individual therapy is not indicated.
b. Incorrect Standard 6.06 of the Ethics Code states: “In their reports to payors for services or sources of research funding, psychologists take reasonable steps to ensure the accurate reporting of the nature of the service provided or research conducted, the fees, charges, or payments, and where applicable, the identity of the provider, the findings, and the diagnosis.”
c. CORRECT The psychologist should make a request to the insurance company for marital therapy.
d. Incorrect See explanation above.
The correct answer is: appeal to the insurance company for coverage for marital therapy.
A 23-year old client of yours is currently the defendant in a court case. The client’s attorney contacts you, requesting that you provide him with some information about the client from your files. The information will be helpful in preparing the client’s defense. You:
Select one:
A. release the information since, to do so, is in the “best interests of the client.”
B. release the information because privilege is waived in this situation.
C. release only the information you believe is relevant to the case.
D. discuss the release with the client before taking any additional action.
The release of confidential client information ordinarily requires a waiver from the client.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Of the responses given, this is the best one. Privilege may or may not be waived in this situation and, even if it is, you should discuss the release of confidential information (even to the client’s attorney) with the client and, in most cases, obtain a waiver.
The correct answer is: discuss the release with the client before taking any additional action.
According to the APA’s Specialty Guidelines for Forensic Psychology (APA, 2012), accepting contingent fees for professional services in a legal proceeding:
Select one:
A. is acceptable.
B. is acceptable only if the fees are “fair and equitable.”
C. should be avoided unless doing so does not interfere with the psychologist’s objectivity.
D. should ordinarily be avoided.
This issue is addressed in Paragraph 5.02 of the Specialty Guidelines.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT This answer is most consistent with the provisions of Paragraph 5.02 which states: “Forensic practitioners seek to avoid undue influence that might result from financial compensation or other gains. Because of the threat to impartiality presented by the acceptance of contingent fees and associated legal prohibitions, forensic practitioners strive to avoid providing professional services on the basis of contingent fees.”
The correct answer is: should ordinarily be avoided.
During her third therapy session, Mrs. Maitalain, age 32, reveals that her husband has “forced her” to have sex with him two or three times in the last six months. She says that she usually agrees to have sexual relations with him but sometimes doesn’t feel like it because she’s too tired; and, in those circumstances, he sometimes uses threats and physical violence to force her to do so. Her therapist should:
Select one:
A. inform Mrs. Maitalain that he is legally required to report these incidents to the appropriate authorities in order to protect her from future harm.
B. make a report to the appropriate authorities only if he believes that Mrs. Maitalain is at high risk for future harm from her husband.
C. maintain Mrs. Maitalains confidentiality but discuss her options in this situation.
D. encourage Mrs. Maitalain to bring her husband to the next therapy session.
In most situations, psychologists must maintain the confidentiality of their clients unless the client waives his/her right to confidentiality or a breach of confidentiality is mandated by law.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Psychologists ordinarily maintain the confidentiality of a client who is the victim of spousal or partner abuse, and the primary intervention in this situation would be to ensure the safety of Mrs. Maitalain, which would include discussing her options. An exception is when there is reason to suspect that children are also at risk. Also note that some jurisdictions mandate reporting of certain types of abuse for “vulnerable adults,” but there is no information given in this question that indicates that Mrs. Maitalain is a vulnerable adult.
d. Incorrect See explanation for response c.
The correct answer is: maintain Mrs. Maitalains confidentiality but discuss her options in this situation.
A psychologist has just started seeing a third grader who has been exhibiting behavioral problems at school and home. The psychologist suspects that the child has dyslexia but has had no training in the evaluation of this disorder. The child’s parents want the psychologist to conduct the evaluation because of the good rapport she has with the child. The psychologist should:
Select one:
A. conduct the evaluation only after informing the parents of their options and obtaining an informed consent.
B. conduct the evaluation only after attending a workshop on Learning Disorders.
C. conduct the evaluation only if available assessment instruments do not require extensive training to administer.
D. refer the child to a colleague who has experience in Learning Disorders for the evaluation.
This question addresses the issue of competence. The Ethics Code clearly prohibits psychologists from working outside their scope of the competence and expertise.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Although psychologists can (and should) add to their skills, doing so requires special care so that the welfare of a client is not jeopardized. Mislabeling a child as learning disabled (or not learning disabled) can have very serious and long-lasting consequences, so this response is the best of those given.
The correct answer is: refer the child to a colleague who has experience in Learning Disorders for the evaluation.
It would be acceptable to include client testimonials in an advertisement or brochure for your services as long as:
Select one:
A. the testimonials are not from current therapy clients.
B. the testimonials have not been directly solicited by you from current or past clients.
C. the testimonials are not from current clients or others who are susceptible to exploitation.
D. the testimonials have not been solicited from current clients or from others who are vulnerable to undue influence.
This question requires you to be familiar with the language of the Ethics Code. Testimonials are not entirely prohibited but should be obtained and used with caution.
a. Incorrect This is a good answer but not as complete as response d.
b. Incorrect Direct solicitation from a former client is not necessarily prohibited.
c. Incorrect This is close but, if you read carefully, it’s not a completely accurate reflection of the requirements of the Ethics Code.
d. CORRECT This is closest to the actual language of Standard 5.05 of the Ethics Code and, consequently, is the best answer.
The correct answer is: the testimonials have not been solicited from current clients or from others who are vulnerable to undue influence.
The mother of a previous client of yours asks for a copy of her daughter’s records. The daughter saw you for two years and died three months ago when she was 38. You should:
Select one:
A. send the woman a copy of the records as requested.
B. send the woman only that information you believe will not be harmful.
C. allow the woman to inspect the records in your office.
D. not release any information without appropriate authorization.
Although the laws vary from jurisdiction to jurisdiction, in general, a psychologist should not release information after a client’s death without proper authorization (e.g., from the executor of the estate or the client’s legal representative).
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT This is the best course of action. See, e.g., R. I. Simon, Clinical psychiatry and the law, American Psychiatric Press, Washington, DC, 1992.
The correct answer is: not release any information without appropriate authorization.
Dr. Nillson, a behavioral psychologist, is teaching clinical psychology at a university. She does not use, nor can she tolerate the use of, psychodynamic principles and interventions in psychotherapy. She refuses to teach psychodynamic therapy in her classes and actually makes fun of it in front of her students during informal gatherings. Her behavior is:
Select one:
A. unethical she has an obligation to provide accurate and objective information about the topic she is teaching.
B. ethical she has the freedom of choice to teach whatever she wants in her classes.
C. acceptable she would be poorly trained to teach psychodynamics and psychotherapy anyway.
D. ethical but she should not be making fun of any psychological practice in front of her students.
Dr. Nillson’s behavior violates Standard 7.03 of the Ethics Code, which calls for accuracy in teaching, as well as General Principle C (Integrity), which encourages “accuracy, honesty, and truthfulness.”
a. CORRECT Dr. Nillson’s behavior is in violation of the Ethics Code.
b. Incorrect As a psychologist, Dr. Nillson has an ethical duty to teach objectively, fully, and accurately.
c. Incorrect Dr. Nillson is ethically obligated to make sure her choice of topics is not biased by her own personal beliefs. If she is unqualified to teach certain areas, she could arrange to have someone else do so.
d. Incorrect Dr. Nillson’s behavior is biased and, therefore, is unethical.
The correct answer is: unethical she has an obligation to provide accurate and objective information about the topic she is teaching.
The review process used by managed care organizations (MCOs) to ensure that providers meet and maintain the requirements to participate in a health plan is referred to as:
Select one:
A. concurrent review.
B. credentialing.
C. quality management.
D. clinical audit.
For the exam, you want to be familiar with the managed care terms listed in the answers to this question.
a. Concurrent review is the term used for utilization reviews conducted during the course of treatment.
b. CORRECT Credentialing is a formal process for determining whether or not a provider meets and maintains qualification standards and provides some legal protection for the MCO.
c. Quality management is another name for quality assurance.
d. Clinical audit is a method of quality assurance.
The correct answer is: credentialing.
A psychologist who obtained a Ph.D. in organizational psychology wants to change her specialty to clinical psychology. To meet the requirements of APA’s guidelines regarding a change in specialty, the psychologist must:
Select one:
A. complete an internship in clinical psychology under the supervision of a licensed clinical psychologist.
B. complete appropriate doctoral-level classes and supervised post-doctoral training.
C. obtain a second Ph.D. in clinical psychology from an accredited university or professional school.
D. obtain appropriate supervision of her clinical practice.
This issue is addressed in the APA’s General Guidelines for Providers of Psychological Services and Specialty Guidelines for Clinical Psychologists.
a. Incorrect This would not be adequate.
b. CORRECT Section 1.7 of the Specialty Guidelines states that “professional psychologists who wish to qualify as clinical psychologists meet the same requirements with respect to subject matter and professional skills that apply to doctoral and postdoctoral education and training in clinical psychology.”
c. Incorrect This would not be sufficient.
d. Incorrect This would not be sufficient.
The correct answer is: complete appropriate doctoral-level classes and supervised post-doctoral training.
An insurance company is conducting a peer review and requests that you provide it with information about a current client whose fee is being paid by the company. In this situation, you are best advised to:
Select one:
A. provide the company with the requested information only if the client is willing for you to do so.
B. provide the company with only that information you believe to be pertinent to the review.
C. provide the company with relevant information after ensuring that it is aware of the need to maintain confidentiality.
D. provide the company with the requested information because the client waived confidentiality when he/she signed the insurance form.
Although this issue is not explicitly addressed in the Ethics Code, the “spirit” of the Code dictates that confidential information be treated with care.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT When a client’s therapy fee has been paid by an insurance company, it is likely that the client has already signed a waiver on his/her insurance form. In addition, therapists are expected to cooperate with peer reviews. Therefore, this is the best response. A therapist would be required to provide information to the insurance company as requested, but the therapist should release only relevant information and should take steps to ensure that confidentiality will be safeguarded.
d. Incorrect See explanation for response c.
The correct answer is: provide the company with relevant information after ensuring that it is aware of the need to maintain confidentiality.
Except under certain conditions, psychologists are ethically obligated to maintain a client’s confidentiality. Potential limitations on confidentiality should be:
Select one:
A. discussed at the onset of the professional relationship.
B. discussed at the onset of the professional relationship and when feasible thereafter as needed.
C. discussed and documented in writing as soon as feasible.
D. discussed when the psychologist deems it to be appropriate.
None of the responses given are technically “wrong,” but only one reflects the actual language of the Ethics Code and, therefore, is the best answer.
a. Incorrect See explanation for response b.
b. CORRECT This is the language of Standard 4.02: Discussing the Limits of Confidentiality. Documenting the discussion in writing (response c) may be a good idea but is not required.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: discussed at the onset of the professional relationship and when feasible thereafter as needed.
In the context of Holland’s theory of vocational choice, a high degree of differentiation:
Select one:
A. reflects an uncommon or unusual pattern of interests.
B. reflects a common pattern of interests.
C. increases the predictability of the person-environment interaction.
D. decreases the predictability of the person-environment interaction.
Holland used the term differentiation to describe the extent to which a person has clearly defined interests. A person who scores high on one of his interest scales and low on all other scales is highly differentiated.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT According to Holland, the importance of a good “fit” between a person’s interests and the characteristics of the job is most important for those who are highly differentiated.
d. Incorrect See explanation for response c.
The correct answer is: increases the predictability of the person-environment interaction.
According to Janis (1972), groupthink is most likely to occur when:
Select one:
A. a group is highly cohesive.
B. a group has a “laissez-faire” leader.
C. group members have low levels of organizational commitment.
D. group members are overly influenced by outside opinions.
Groupthink was originally described by Arthur Janis to describe several failed foreign policy decisions including the Kennedy administration’s decision to invade Cuba.
a. CORRECT Although Janis did not believe that high cohesiveness alone necessarily leads to groupthink, he considered it to be the primary condition and proposed that cohesiveness is likely to lead to poor decision making when it is combined with certain other conditions including insulation from outside opinions, the presence of external threats, and highly directive leadership.
b. Incorrect See explanation for response a.
c. Incorrect See explanation for response a.
d. Incorrect See explanation for response a.
The correct answer is: a group is highly cohesive.
In their research on terrorist groups, McCauley and Segal (1987) found that, when people come together because of a shared grievance, their views often become increasingly extreme as they continue to interact in isolation from possible moderating influences. This finding supports which of the following?
Select one:
A. deindividuation
B. social trap
C. group polarization
D. group contagion
This question is asking about a situation in which the views of group members become increasingly extreme due to their participation in the group.
a. Incorrect Individuation occurs when a person feels “anonymous” as a member of a group.
b. Incorrect A social trap is a conflict that occurs when behavior has positive short-term consequences but negative long-term consequences.
c. CORRECT Group polarization refers to the tendency of people to make more extreme decisions when acting as members of a group than they would have made as individuals.
d. Incorrect Group contagion refers to the transmission of emotion through a crowd or group.
The correct answer is: group polarization
The three components of a needs assessment are:
Select one:
A. microsystem, macrosystem, and exosystem.
B. unfreezing, changing, refreezing.
C. worker satisfaction, worker performance, and organizational effectiveness.
D. organization analysis, task analysis, and person analysis.
A needs assessment is conducted in organizations to determine training needs.
a. Incorrect These are systems in Bronfenbrenner’s ecological model.
b. Incorrect These are the stages in Lewin’s model of planned change.
c. Incorrect These are not the components of a needs assessment.
d. CORRECT The systems approach to needs assessment involves three types of analysis - organization, task/job, and person.
The correct answer is: organization analysis, task analysis, and person analysis.
Which of the following is most relevant to equity theory?
Select one:
A. Rosenthal effect
B. social comparison theory
C. drive theory
D. the buffering hypothesis
Equity theory predicts that motivation is a function of the comparisons workers make between their own input/outcome ratio and those of workers doing similar jobs.
a. Incorrect The Rosenthal effect is another name for the self-fulfilling prophecy effect, which isn’t really relevant to equity theory.
b. CORRECT According to equity theory, motivation is a result of our social comparisons. Additional information on equity theory is provided in the Industrial-Organizational Psychology chapter of the written study materials.
c. Incorrect Drive theory is also a theory of motivation but isn’t as relevant to equity theory as social comparison theory.
d. Incorrect The buffering hypothesis predicts that the perception of adequate social support buffers people against the negative effects of stress.
The correct answer is: social comparison theory
