STUDY-MODE - Practice Exam 6 Flashcards
Some research suggests that racial identity has a greater impact than race itself on the therapeutic process. For instance, studies on African American therapy clients suggest they are most likely to prefer an African American therapist when they are in which stage of identity development?
Select one:
A. pre-encounter
B. immersion
C. internalization
D. autonomy
The stages listed in responses a, b, and c are included in Cross’s Black Racial Identity Development Model.
a. Incorrect During the pre-encounter stage, race has low salience.
b. CORRECT The first half of the immersion-emersion phase is characterized by immersion in African American (ethnic) culture. Not surprisingly, people in this phase usually prefer a therapist of their own ethnicity.
c. Incorrect Internalization-commitment is the final stage of identity development. During this phase, other factors in addition to ethnicity are considered when choosing a therapist.
d. Incorrect Autonomy is not a stage in Cross’s model and, in other models, is most similar to Cross’s internalization phase.
The correct answer is: immersion
Freud argued that the “work of the mental apparatus is directed toward keeping the quantity of excitation low.” If the mental apparatus is unsuccessful in doing so, the result is likely to be which of the following?
Select one:
A. anxiety
B. ego decompensation
C. psychosis
D. object-cathexis
Excessive excitation by the id’s impulses, according to Freud, leads to anxiety.
a. CORRECT The function of the ego’s defense mechanisms, for example, is to keep the conflicts that produce anxiety out of consciousness.
b. Incorrect This is a “made up” term.
c. Incorrect While unresolved anxiety can, from a Freudian perspective, lead to psychosis, this is not necessarily the case and, therefore, is not the best answer.
d. Incorrect Although object cathexis is a psychoanalytic term, it refers to the id’s investment of energy into an object that will satisfy an instinctual need and is not the correct answer to this question.
The correct answer is: anxiety
Sue and his colleagues (2007) distinguish between three forms of racial microaggression. As described by these investigators, __________ is occurring when a White person says to an African-American individual, “When I look at you, I don’t see color” or “There’s only one race, the human race.”
Select one:
A. microassault
B. microinsult
C. microinvalidation
D. microinequity
Microassault, microinsult, and microinvalidation are the three forms of microaggression described by D. W. Sue et al. (Racial microaggressions in everyday life: Implications for clinical practice, American Psychologist, 62, 271-286, 2007).
a. Incorrect Microassaults are “explicit racial derogations characterized primarily by a violent verbal or nonverbal attack meant to hurt the intended victim through name-calling, avoidant behavior or purposeful discriminatory actions” (p. 278).
b. Incorrect Microinsults are “remarks or comments that convey rudeness, insensitivity and demean a person’s racial heritage or identity” (p. 278).
c. CORRECT Microinvalidation refers to “verbal comments or behaviors that exclude, negate, or nullify the psychological thoughts, feelings, or experiential reality of a person of color” (p. 278). “Color blindness” is a type of microinvalidation.
d. Incorrect Microinequity is not one of the three forms of microaggression described by Sue et al.
The correct answer is: microinvalidation
When conducting Seligman’s Positive Psychotherapy (PPT), a client is asked to keep a daily journal in which he/she lists:
Select one:
A. three good things that happened each day.
B. three good and three bad things that happened each day.
C. his/her thoughts about the good and bad things that happened each day.
D. at least one positive activity that he/she will engage in the following day.
Knowing that the name of the daily journal is the blessings (gratitude) journal may have helped you identify the correct answer to this question. See, e.g., M. E. P. Seligman, T. Rashid, and A. C. Parks, Positive psychotherapy, American Psychologist, 61, 774-788, 2006.
a. CORRECT Although Positive Psychotherapy does not entirely ignore negative events, as its name implies, it focuses primarily on positive events.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: three good things that happened each day.
As defined by Alfred Adler, __________ refers to a person’s goals and the ways in which he or she attempts to achieve those goals.
Select one:
A. homeostasis
B. success identity
C. self-actualization
D. style of life
When preparing for exam questions from the area of Clinical Psychology, a good strategy is to associate key concepts and terms with each of the major theories and theorists.
a. Incorrect Homeostasis refers to the tendency for a system (e.g., a family system) to maintain its current level of functioning.
b. Incorrect In reality therapy, a person has adopted a success identity when he or she fulfills his or her needs in responsible way.
c. Incorrect The term “self-actualization” is used by several theorists. As defined by Rogers, it refers to an internal biological force that serves as a major source of motivation and guides the individual toward positive, healthy growth.
d. CORRECT Adler believed that each person has a unique set of goals and ways for achieving goals, which he referred to as the person’s style of life. According to Adler, a person’s style of life is fairly well established by 4 or 5 years of age.
The correct answer is: style of life
With regard to power in the client-therapist relationship, a feminist therapist would most likely:
Select one:
A. recognize that her power stems primarily from her ability to serve as a role-model.
B. acknowledge the power differential inherent in the relationship but view it as a temporary condition.
C. initially foster her position of power so as to maximize her influence.
D. regard power a “non-issue” because feminist therapists consider the therapeutic relationship to be egalitarian.
A key feature of feminist therapy is its promotion of an egalitarian approach.
a. Incorrect Although the therapist is viewed as a role model by many feminist therapists (and their clients), feminist therapists attempt to minimize the power differential inherent in the therapeutic relationship.
b. CORRECT This issue is addressed by M. A. Douglas in her chapter entitled “The Role of Power in Feminist Therapy: A Reformulation” [in L. B. Rosewater and L. E. A. Walker (Eds.), Handbook of feminist therapy: Woman’s issues in psychotherapy, New York: Springer, 1985]. According to Douglas, the power differential inherent in the therapeutic relationship should, first of all, be acknowledged. It should also be viewed as temporary since the goal of therapy will be to terminate the relationship and/or to readjust the relationship so that it is more egalitarian. Douglas stresses the importance of minimizing the power differential inherent in the therapeutic relationship.
c. Incorrect See explanation for response b.
d. Incorrect Feminist therapists acknowledge the power differential inherent in the therapeutic relationship and view it as an issue that must be dealt with.
The correct answer is: acknowledge the power differential inherent in the relationship but view it as a temporary condition.
A therapist is most likely to say that which of the following is the most stressful type of client behavior?
Select one:
A. threats of a malpractice suit
B. demands for time and attention
C. suicidal statements
D. a lack of gratitude
Therapists experience stress and burnout for several reasons. Not surprisingly, the most difficult situation–i.e., the one requiring an immediate response–is the one that is associated with the greatest stress.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Surveys of therapists have revealed that suicidal ideation and threats are considered the most stress-producing client behaviors.
d. Incorrect See explanation for response c.
The correct answer is: suicidal statements
Which of the following approaches in family therapy encourages the therapist to develop a “therapeutic triangle” with family members?
Select one:
A. extended family systems therapy
B. communication/interaction family therapy
C. adaptive family therapy
D. strategic family therapy
In extended family systems theory, one therapeutic technique involves creating a therapeutic triangle in which the therapist actively interacts with two family members during the treatment process. The goal is to shed light on and reduce the fusion that exists between family members.
a. CORRECT Bowen’s extended family systems therapy encourages the therapist to become a member in a therapeutic triangle with two family members (usually the spouses/partners).
b. Incorrect In communication/interaction family therapy, the therapist serves as a facilitator and teacher.
c. Incorrect Adaptive family therapy is a “made up” term.
d. Incorrect Although strategic family therapy involves an active therapist, the role of the therapist is to assess the problems, not to become a member of the family’s triangles.
The correct answer is: extended family systems therapy
According to Atkinson, Morten, and Sue’s (1993) Racial/Cultural Identity Development Model, the resistance and immersion stage is characterized by:
Select one:
A. a preference for the dominant group and resistance to being considered a member of a minority group.
B. conflicting attitudes toward both the dominant group and one’s own group.
C. rejection of the dominant group and preference for one’s own group.
D. active participation in efforts to promote social change that will benefit one’s group.
The Racial/Cultural Identity Development Model distinguishes between five stages of identity development: conformity, dissonance, resistance and immersion, introspection, and integrative awareness.
a. Incorrect Preference for the dominant group is characteristic of the conformity stage.
b. Incorrect This best describes the dissonance stage.
c. CORRECT During the resistance and immersion stage, the individual actively resists the dominant cultural group and becomes immersed in his/her own culture.
d. Incorrect This describes the internalization stage of Cross’s Nigrescence model.
The correct answer is: rejection of the dominant group and preference for one’s own group.
Research on the use of cognitive-behavioral therapy with older adults has found that it is:
Select one:
A. less effective than cognitive-behavioral therapy for younger adults and, consequently, is generally contraindicated.
B. usually most effective when it is conducted at a slower pace and at higher levels of abstraction.
C. usually most effective when it is short- (versus long) term and conducted at lower levels of abstraction.
D. usually most effective when it focuses on replacing negative cognitions with positive ones and on the present rather than on the past.
The research has generally found that older adults benefit from cognitive-behavioral therapies and other forms of therapy to the same degree as do younger adults. However, the effectiveness of therapy with older adults may be enhanced when certain modifications to therapy are made. See, e.g., B. G. Knight and D. Satre, Cognitive behavioral therapy with older adults, Clinical Psychology: Science & Practice, 62(2), 188-203, 1999.
a. Incorrect Cognitive-behavioral therapy has been found to be an effective treatment for older adults for a variety of disorders including depression, anxiety, and insomnia and for coping with physical disability, chronic pain, and grief.
b. CORRECT Knight and Satre note that older adults generally benefit most from cognitive-behavior therapies when therapy is presented at a slower pace and is conducted at an abstract level (i.e., at a level that focuses on schemas and relationship scripts rather than on simple cognitions).
c. Incorrect This is the opposite of what is true. Because many of the problems faced by older adults are chronic, they are more likely to benefit from long-term interventions.
d. Incorrect This is also the opposite of what is true. The emotions of older adults are generally more complex than those of younger adults, and emotional reactions to events often consist of a mixture of positive and negative emotions. Consequently, it is usually best to focus on both the positive and negative connotations of emotions in therapy. In addition, allotting some time in therapy for older adults to reminisce about the past (rather than focusing only on the present) is beneficial.
The correct answer is: usually most effective when it is conducted at a slower pace and at higher levels of abstraction.
From the perspective of Prochaska and DiClemente’s (1984) transtheoretical model of change, the failures of treatment programs for cigarette smoking are often due to the fact that:
Select one:
A. the majority of smokers are not ready to change.
B. cigarette-smoking is self-reinforcing and difficult to extinguish.
C. nicotine addiction has a genetic component.
D. interventions do not address the environmental cues that trigger relapse.
The Prochaska and DiClemente model describes six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. Additional information about these stages is provided in the Clinical Psychology chapter of the written study materials.
a. CORRECT Research by Prochaska and colleagues has shown that a majority of individuals with addictions are in the precontemplation or contemplation stage and, therefore, are ambivalent about change. For these individuals, most interventions will be unsuccessful.
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: the majority of smokers are not ready to change.
According to Cross (2001), an African American adult in which of the following stages of identity development is likely to say that racial discrimination is not a contributor to his problems and that he prefers to see a White therapist?
Select one:
A. disintegration
B. pre-encounter
C. emersion
D. pseudo-independence
Cross’s Black Racial (Nigrescence) Identity Development Model distinguishes between four stages: pre-encounter, encounter, immersion/emersion, and internalization.
a. Incorrect See explanation for response b.
b. CORRECT According to Cross, race has low salience for individuals in the pre-encounter phase. People in this stage are likely to deny the impact of racial oppression and prefer a White therapist.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: pre-encounter
A therapist relying on a solution-focused family therapy approach would be most interested in which of the following?
Select one:
A. miracle and scaling questions
B. boundary disturbances
C. joining and mimesis
D. schism and skew
If you are unfamiliar with solution-focused therapy, you may have been able to choose the correct answer to this question through the process of elimination.
a. CORRECT Solution-focused therapists use various types of questions to identify solutions to a client’s problems. The miracle question involves asking what the individual would notice first if, as the result of a miracle, his/her problem is suddenly gone. Scaling questions are used to determine how a client currently feels.
b. Incorrect Boundary disturbances are of concern to Gestalt psychologists.
c. Incorrect Joining and mimesis are techniques used by structural family therapists.
d. Incorrect Marital schism and skew are terms used by Theodore Lidz to describe dysfunctional marital relationships.
The correct answer is: miracle and scaling questio
A man who smokes two packs a day says he has decided to stop smoking the day after his birthday, which is two weeks away. According to Prochaska and DiClemente (1992), this man is in which of the following stages of the change process?
Select one:
A. precontemplation
B. contemplation
C. preparation
D. action
Prochaska and DiClemente (1992) distinguish between six stages in the change process. These include the four listed in the responses plus maintenance and termination stages.
a. Incorrect During this stage, the individual has little insight into the need for change.
b. Incorrect In the contemplation stage, the person is aware of the need for change and is considering change but has not yet committed to it.
c. CORRECT In the preparation stage, the person has a clear intent to take action in the near future.
d. Incorrect In the action stage, the person actually takes steps to bring about change. (In the maintenance stage, he/she consolidates the change and takes steps to prevent relapse.)
The correct answer is: preparation
In discussing a depressed client, a therapist says the client’s problems are due to the fact that she did not experience normal grief following the death of her mother three years ago. He says that the focus of treatment will be on helping the client go through the grieving process and restore her interests and friendships so that she can overcome her loss. Apparently, this therapist is a practitioner of:
Select one:
A. rational-emotive therapy.
B. interpersonal therapy.
C. object-relations therapy.
D. reality therapy.
Although a client’s unresolved grief would be a focus of many forms of treatment, only one of the therapies listed explicitly defines grief as a treatment target.
a. Incorrect See explanation for response b.
b. CORRECT Interpersonal therapy (IPT) defines four key problem areas presented by depressed patients:
grief
interpersonal role disputes
role transition and
interpersonal deficits.
These areas are the primary targets of therapy.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: interpersonal therapy.
For gay and lesbian adolescents, the primary presenting problem at social service agencies is:
Select one:
A. suicidal ideation.
B. drug or alcohol abuse.
C. social and emotional isolation.
D. academic problems.
Gay and lesbian adolescents face similar problems as their heterosexual peers. However, their identity development is also complicated by stigmatization and a lack of role models.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Isolation is frequently cited as a primary problem for gay and lesbian adolescents, and one study found it to be the single-most frequent presenting problem (A. D. Martin and E. S. Hetrick, The stigmatization of the gay and lesbian adolescent, Journal of Homosexuality, 15(1-2), 163-183, 1988).
d. Incorrect See explanation for response c.
The correct answer is: social and emotional isolation.
Members of an outpatient therapy group are likely to rank which of Yalom’s therapeutic factors as most important?
Select one:
A. interpersonal input, catharsis, cohesiveness, and self-understanding
B. self-understanding, universality, identification, and instillation of hope
C. family re-enactment, catharsis, altruism, and interpersonal input
D. interpersonal input, interpersonal output, universality, and identification
In his book, The Theory and Practice of Group Therapy, Yalom (1970) distinguishes between 12 therapeutic (curative) factors and discusses the results of research examining the importance of these factors for group therapists and for group therapy members.
a. CORRECT Although the results vary somewhat from study to study, these four factors are usually the most highly rated ones by group therapy members.
b. Incorrect Identification is usually among the factors that are rated least important.
c. Incorrect Family re-enactment is also rated as less important by group members.
d. Incorrect As noted above, identification is not rated as being particularly important by group members.
The correct answer is: interpersonal input, catharsis, cohesiveness, and self-understanding
According to the Health Belief Model, health behavior is related to:
Select one:
A. a combination of information, motivation, and behavioral skills.
B. perceived severity, perceived susceptibility, and perceived benefits.
C. habit.
D. intentions and perceived norms.
Several models have been developed to predict when people will act in ways that benefit their health.
a. Incorrect These are components of the Information-Motivation-Behavioral Skills model of AIDS prevention.
b. CORRECT The Health Belief Model is based on the premise that perceived severity of consequences, perceived susceptibility to consequences, and perceived benefits of preventive behavior all contribute to health behavior.
c. Incorrect Habit is not a component of the Health Belief Model.
d. Incorrect This sounds more like the Theory of Reasoned Action.
The correct answer is: perceived severity, perceived susceptibility, and perceived benefits.
An existential therapist is most likely to describe “existential anxiety” as:
Select one:
A. the result of unresolved intrapsychic conflicts.
B. a potential stimulus for growth.
C. the result of a boundary disturbance.
D. a manifestation of incongruence between self and experience.
Existential therapists view anxiety as an inevitable condition of life and distinguish between normal and neurotic anxiety.
a. Incorrect This is more consistent with the Freudian view of anxiety.
b. CORRECT For existential therapists, neurotic anxiety is out of proportion to the situation and can be immobilizing. In contrast, normal (existential) anxiety can serve as a source of motivation to change.
c. Incorrect According to Gestalt psychologists, boundary disturbances are a source of neurotic behavior.
d. Incorrect This answer is consistent with Carl Rogers’s view of anxiety.
The correct answer is: a potential stimulus for growth.
A practitioner of Rogers’s client-centered therapy would use the Q-sort technique to:
Select one:
A. facilitate identifying a client’s diagnosis.
B. help the client identify specific therapy goals.
C. help identify solutions to a client’s presenting problems.
D. evaluate a clients progress in therapy.
The Q-sort technique involves rank-ordering descriptive statements that are printed on separate cards. It requires the sorter to distribute the cards into a fixed number of piles along a continuum (for example, a continuum ranging from “not at all characteristic of me” to “extremely characteristic of me”) and to do so in a way so that the piles create a normal distribution. In therapy, this technique is often used to evaluate a client’s self-perceptions.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Rogers used the Q-sort technique to evaluate therapy progress by evaluating a client’s degree of congruence between his/her self and ideal self. This involved having the client first sort the cards in terms of how well they describe the client’s current self and then in terms of his/her ideal self. The more similar the two sorts, the greater the congruence between the self and ideal self.
The correct answer is: evaluate a clients progress in therapy.
In treating a client, a practitioner of Reality Therapy would most likely be interested in which of the following?
Select one:
A. the client’s sense of responsibility and needs for power, freedom, and belongingness
B. the client’s cognitive distortions (e.g., selective inattention, misperceptions)
C. the nature of the client’s ego state pathology
D. the client’s level of “response-ability”
Reality Therapy emphasizes fulfilling one’s needs in a responsible way.
a. CORRECT For practitioners of Reality Therapy, behavior is motivated primary by biological and psychological needs (e.g., needs for belongingness, power, and freedom). The ability to fulfill one’s needs in a way that doesn’t deprive others of the ability to do the same (i.e., in a responsible way) is the goal of therapy.
b. Incorrect This sounds more like cognitive therapy.
c. Incorrect This sounds more like Transactional Analysis.
d. Incorrect This is a goal of Gestalt therapy. It refers to the ability to act, decide, choose, and otherwise respond.
The correct answer is: the client’s sense of responsibility and needs for power, freedom, and belongingness
Which of the following information-processing strategies is characteristic of the reintegration status of Helms’s (1995) White Racial Identity Development Model?
Select one:
A. suppression of information and ambivalence
B. obliviousness and denial
C. flexibility and complexity
D. selective perception and negative out-group distortion
Helms’s (1995) White Racial Identity Development Model distinguishes between six stages or statuses:
- contact (Obliviousness and denial are characteristic of the contact status.)
- disintegration (Suppression of information and ambivalence are characteristic of the disintegration status)
- reintegration (A combination of selective perception and negative out-group distortion is characteristic.)
- pseudo-independence
- immersion-emersion
- autonomy (Flexibility and complexity are characteristic of the autonomy status.)
Each status is characterized by a different information-processing strategy (IPS), which are the methods the individual uses to reduce discomfort related to racial issues.
a. Incorrect Suppression of information and ambivalence are characteristic of the disintegration status.
b. Incorrect Obliviousness and denial are characteristic of the contact status.
c. Incorrect Flexibility and complexity are characteristic of the autonomy status.
d. CORRECT The combination of selective perception and negative out-group distortion is characteristic of the reintegration status. A person in this stage attempts to resolve moral conflicts about racism by idealizing White society and denigrating members of minority groups.
The correct answer is: selective perception and negative out-group distortion
The traditional Hawaiian practice of ho’oponopono is best described as a:
Select one:
A. primary prevention.
B. family intervention.
C. type of individual psychotherapy.
D. method for promoting relaxation.
Being a culturally competent practitioner requires being familiar with indigenous healing practices that might be appropriate for culturally diverse clients.
a. Incorrect See explanation for response b.
b. CORRECT Ho’oponopono (“setting it right”) is a traditional Hawaiian spiritual healing ritual for restoring harmony among family members by resolving a current conflict or other interpersonal problem. It is a structured process that is led by a senior family member or other respected elder and incorporates prayer, discussions aimed at identifying and resolving the problem, and a closing ceremony.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: family intervention.
From the perspective of structural family therapy, triangulation, parent-child coalition, and detouring are:
Select one:
A. methods for establishing clearer boundaries.
B. methods for maintaining homeostasis.
C. types of positive feedback.
D. attempts to increase intimacy.
As its name implies, structural family therapy focuses on the family structure, especially its boundaries. Also, like many other forms of family therapy, it is based on systems theory.
a. Incorrect Although boundaries are important in structural family therapy, the phenomena listed in the question do not always create “clearer boundaries.”
b. CORRECT The function of these three processes is to reduce conflict or stress and thereby maintain the status quo.
c. Incorrect These phenomena are probably better conceptualized as sources of negative feedback since their function is to maintain a state of homeostasis.
d. Incorrect This is not the function of these processes as defined by Minuchin.
The correct answer is: methods for maintaining homeostasis.
Research on Helms’s White Racial Identity Development Model has shown that White therapists are most effective in cross-cultural counseling situations when they are in which stage of identity development?
Select one:
A. the stage that matches the client’s stage of identity development
B. the stage that complements the client’s stage of identity development
C. the reintegration stage
D. the autonomy stage
Helms’s (1995) model distinguishes between six stages of identity development:
Contact Disintegration Reintegration Pseudo-independence Immersion-emersion, and Autonomy.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The research on Helms’s model has found that, the more advanced the White therapist’s identity development, the greater his/her effectiveness when working with clients from culturally diverse groups.
The correct answer is: the autonomy stage
When working with a client belonging to an ethnic minority group, a White therapist interprets the client’s reluctance to disclose personal information as a sign of paranoia. According to Ridley (2005), this therapist is exhibiting which of the following?
Select one:
A. marginalization
B. overidentification
C. color blindness
D. cultural ambivalence
C. R. Ridley distinguishes between ten race-related defense mechanisms: color blindness, color consciousness, cultural transference, cultural countertransference, cultural ambivalence, pseudotransference, overidentification, identification with the oppressor, race-based misdiagnosis, and avoidance of race (Overcoming unintentional racism in counseling and therapy: A practitioner’s guide to intentional intervention, Thousand Oaks, CA, Sage Publications, 2005).
a. Incorrect Marginalization is not one of the race-related defense mechanisms identified by Ridley.
b. Incorrect Overidentification occurs when a minority therapist overidentifies with the experiences of a minority client and assumes that the client’s presenting problems are race-related.
c. CORRECT As defined by Ridley, color blindness refers to a therapist’s “illusion that minority clients are no different than non-minority clients” (p.67). He notes that “color blind” therapists tend to overlook the effects of racism and discrimination and, consequently, view deviations from White middle-class norms as pathological.
d. Incorrect According to Ridley, cultural ambivalence refers to a therapist’s ambivalent motivations for treating members of ethnic minority groups (e.g., needs for power and dominance versus needs for acceptance and approval).
The correct answer is: color blindness
The presence of which of the following symptoms would suggest a diagnosis of Conduct Disorder rather than a diagnosis of Oppositional Defiant Disorder?
Select one:
A. frequent lying and running away from home
B. low frustration tolerance and temper outbursts
C. drug use
D. onset of symptoms after age 12
Conduct Disorder involves a pattern of behavior in which the basic rights of others and major age-appropriate social norms or rules are violated.
a. CORRECT Lying and running away are characteristic of Conduct Disorder. Behaviors associated with Oppositional Defiant Disorder are less severe and include negativism, defiance, and hostility.
b. Incorrect Low tolerance for frustration and temper outbursts are characteristic of both disorders.
c. Incorrect The use of drugs does not help distinguish between the two disorder.
d. Incorrect The onset of both disorders is typically prepubertal.
The correct answer is: frequent lying and running away from home
The research has found that individual therapy, group therapy, and family therapy are effective treatments for Bulimia Nervosa. With regard to individual therapy, the research has shown that:
Select one:
A. behavior therapy is superior to either cognitive-behavior therapy or interpersonal therapy in terms of both short- and long-term effects.
B. cognitive-behavior therapy is superior to either behavior therapy or interpersonal therapy in terms of both short-term and long-term effects.
C. cognitive-behavior therapy is superior to either interpersonal therapy or behavior therapy in terms of short-term effects, but cognitive-behavior therapy and interpersonal therapy are about equally effective in terms of long-term effects.
D. behavior therapy, cognitive-behavior therapy, and interpersonal therapy are about equally effective in terms of short-term effects, but cognitive-behavior therapy is superior in terms of long-term effects.
Not surprisingly, cognitive-behavior therapy (which combines a variety of strategies and has been found effective for a number of disorders) has been found to be a beneficial treatment for Bulimia.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT C. G. Fairburn et al. (Psychotherapy and bulimia nervosa: Long-term effects in interpersonal therapy, behavior therapy, and cognitive-behavior therapy, Archives of General Psychiatry, 50, 419-428, 1993), for example, compared behavior therapy, cognitive-behavior therapy, and interpersonal therapy and found cognitive-behavior therapy to be superior in terms of short-term effects. However, a long-term follow-up revealed that cognitive-behavior therapy and interpersonal therapy had similar effects on both eating behaviors and attitudes toward weight and shape.
d. Incorrect See explanation for response c.
The correct answer is: cognitive-behavior therapy is superior to either interpersonal therapy or behavior therapy in terms of short-term effects, but cognitive-behavior therapy and interpersonal therapy are about equally effective in terms of long-term effects.
The psychoanalyst Adolph Stern provided the first organized clinical description of the borderline patient. Of the ten basic characteristics Stern delineated, which of the following did he consider to be the most primary?
Select one:
A. inhibited aggression
B. fixation
C. emotional dysregulation
D. narcissism
Stern described the borderline patient in terms of 10 basic characteristics. Only one of these is listed in the responses.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Stern considered the difficulties experienced by the borderline patient to be secondary to narcissism and viewed narcissism as arising from a serious disturbance in the early mother-child relationship. (Note that other psychoanalytically-oriented theorists have identified other factors as being primary: Kernberg, for example, emphasizes the role of excessive aggression.)
The correct answer is: narcissism
When using the DSM-5, level of severity of Intellectual Disability is based on:
Select one:
A. The individual’s score on a standardized intelligence test.
B. The individual’s adaptive functioning in conceptual, social, and practical domains.
C. The degree of discrepancy between the individual’s cognitive and adaptive functioning.
D. The degree of discrepancy between the individual’s IQ and academic achievement.
Answer B is correct: The DSM-5 distinguishes between four levels of severity for Intellectual Disability - mild, moderate, severe, and profound - and bases them on level of adaptive functioning in conceptual, social, and practical domains.
The correct answer is: The individual’s adaptive functioning in conceptual, social, and practical domains.
The clinical course of AIDS dementia complex (ADC) is described in the literature in terms of six stages. For example, a person with AIDS who has unequivocal evidence of functional, intellectual, or motor impairment but is able to perform all but the most demanding aspects of activities of daily living and can walk without assistance is in which of the following stages?
Select one:
A. Stage 0.5 (equivocal/subclinical)
B. Stage 1 (mild)
C. Stage 2 (moderate)
D. Stage 3 (severe)
AIDS dementia complex (ADC) has been estimated to affect up to one-third of adults and one-half of children with AIDS.
a. Incorrect Stage 0.5 is characterized by minimal or equivocal signs of impairment with no deficits in work or activities of daily living.
b. CORRECT The symptoms listed in the question are characteristic of Stage 1.
c. Incorrect A person in Stage 2 cannot work or perform demanding activities of daily living and may require assistance when walking.
d. Incorrect A person in Stage 3 has significant intellectual impairments and cannot walk unassisted. Additional information about the stages of ADC is provided in the Abnormal Psychology chapter of the written study materials.
The correct answer is: Stage 1 (mild)
For a diagnosis of Bulimia Nervosa, an individual has to exhibit which of the following?
Select one:
A. purging following binge eating for at least one month
B. binge eating for at least two months
C. lack of control over eating plus either purging or excessive exercise for at least two months
D. binge eating and inappropriate compensatory behavior for at least three months
The key features of Bulimia Nervosa are binge eating and recurrent inappropriate compensatory behavior (e.g., purging, diuretic use, excessive exercising) for at least three months.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT As noted above, this is consistent with the diagnostic criteria for this disorder.
The correct answer is: binge eating and inappropriate compensatory behavior for at least three months
Of the 6 to 10% of adults over 65 who have dementia, what percent have Alzheimer’s disease?
Select one:
A. 85 to 95
B. 65 to 75
C. 40 to 50
D. 20 to 35
Estimates of the prevalence rates for Alzheimer’s disease and other forms of dementia vary, with rates increasing as age increases.
a. Incorrect See explanation for response b.
b. CORRECT The studies indicate that, of adults over 65 with dementia, between two-thirds to three-fourths have Alzheimer’s disease. See, e.g., H. C. Hendrie, Epidemiology of dementia and Alzheimer’s disease, American Journal of Geriatric Psychiatry, 6(2 Suppl. 1), S3-18, 1998.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: 65 to 75
An electrolyte imbalance is a possible complication of Bulimia Nervosa. The danger of this complication lies in the fact that it can lead to:
Select one:
A. cardiac arrhythmia and arrest.
B. blood dyscracias.
C. permanent memory loss.
D. dehydration.
Of the conditions listed, only one is a consequence of an electrolyte imbalance.
a. CORRECT Electrolyte imbalances caused by vomiting and the use of laxatives and diuretics can have serious consequences, including, in extreme cases, cardiac arrhythmia and arrest.
b. Incorrect Blood dyscracias are not caused by electrolyte imbalances.
c. Incorrect Permanent memory loss has not be linked to electrolyte imbalances.
d. Incorrect Dehydration is one of the causes (not consequences) of an electrolyte imbalance.
The correct answer is: cardiac arrhythmia and arrest.
A graduate student is extremely anxious about a lecture he has to give to undergraduate students the next morning. To reduce his anxiety, he drinks two beers. According to Steele and Joseph (1990), the student’s anxiety will actually increase in this situation if he:
Select one:
A. relaxes and “does nothing.”
B. performs a simple task.
C. performs a moderately demanding task.
D. performs a very demanding task.
C. M. Steele and R. A. Joseph have developed an attention-allocation model to explain why alcohol sometimes reduces anxiety but other times has no effect or actually increases anxiety (Alcohol myopia: Its prized and dangerous effects, American Psychologist, 45(8), 921-933, 1990).
a. CORRECT According to Steele and Joseph, alcohol creates a “myopia” in that it restricts the drinker’s attention to the most salient aspect of the situation and reduces attention to other, less salient aspects. Consequently, if an intoxicated person engages in a distracting task, he/she will worry less about the anxiety-arousing stimulus (e.g., giving a lecture). Conversely, if the person does not engage in a distracting task, he/she will focus on the anxiety-arousing stimulus and actually become more anxious about it.
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: relaxes and “does nothing.”
Longitudinal studies of individuals who receive a diagnosis of Borderline Personality Disorder in adolescence or early adulthood indicate that these individuals often exhibit a reduction or remission in symptoms over time. However, recovery varies for type of symptom, with _________ symptoms showing the least amount of improvement with increasing age.
Select one:
A. impulsive
B. interpersonal
C. affective
D. cognitive
Of the Personality Disorders, Borderline Personality Disorder (BPD) has been found to have the best prognosis, with the majority of patients showing a significant improvement in or remission of symptoms over time.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Longitudinal studies have found that, by middle age or sooner, most individuals with BPD no longer meet the diagnostic criteria for the disorder. The resolution of symptoms varies, however: For example, in a six-year prospective study of 290 patients with BPD, Zanarini et al. found that impulsive symptoms resolved most quickly, affective symptoms were the most chronic, and cognitive and interpersonal symptoms were intermediate in terms of resolution (M. C. Zanarini, F. R. Frankenburg, J. Hennen, and K. R. Silk, The longitudinal course of borderline pathology: 6-year prospective follow-up of the phenomenology of borderline personality disorder, American Journal of Psychiatry, 160, 274-283, 2003).
d. Incorrect See explanation for response c.
The correct answer is: affective
During the first few sessions with a male client, you learn that he has trouble maintaining friendships and is disturbed by this since he doesn’t like being alone, has frequent mood shifts, gets very angry about even minor irritations, isn’t sure what he wants to do with his life, and has had three different jobs in the past two years. Based on this information, the best diagnosis is:
Select one:
A. Borderline Personality Disorder.
B. Narcissistic Personality Disorder.
C. Histrionic Personality Disorder.
D. Schizoid Personality Disorder.
To distinguish between different Personality Disorders, you need to be familiar with their essential features, and these are summarized in the Abnormal Psychology chapter of the written study materials.
a. CORRECT The pattern of instability in mood, relationships, and occupation is characteristic of Borderline Personality Disorder.
b. Incorrect The man isn’t exhibiting the grandiosity that characterizes Narcissistic Personality Disorder.
c. Incorrect Although shifts in mood are typical of Histrionic Personality Disorder, the man isn’t exhibiting attention-seeking behavior.
d. Incorrect Schizoid Personality Disorder is characterized by restricted emotions and detachment from interpersonal relationships.
The correct answer is: Borderline Personality Disorder.
Fairburn’s (2008) CBT-E (cognitive-behavioral therapy - enhanced) adds which of the following to traditional cognitive-behavioral therapy for individuals with Bulimia Nervosa?
Select one:
A. interventions aimed at boundary disturbances
B. interventions aimed at interpersonal relationships
C. interventions that foster insight into the cause of the disorder
D. interventions derived from Rogerian therapy
Cognitive-behavioral therapy is considered the most effective treatment for Bulimia Nervosa. However, several experts have suggested that the effectiveness of a traditional approach to CBT is improved if it includes a greater focus on other issues such as emotional responding and interpersonal relationships.
a. Incorrect See explanation for response b.
b. CORRECT C. G. Fairburn’s CBT-E incorporates interventions that target perfectionism, low self-esteem, interpersonal factors, and emotional factors (Cognitive behavior therapy and eating disorders, New York, Guilford Publ., 2008).
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: interventions aimed at interpersonal relationships
The most effective intervention for cigarette smoking combines nicotine replacement therapy with:
Select one:
A. antidepressants and bibliotherapy.
B. support from a clinician and skills training.
C. covert sensitization and relapse prevention.
D. stimulus control and habit reversal training.
Reviews of the literature conclude that combined treatments are most effective for cigarette smoking, especially in terms of long-term consequences (e.g., American Psychiatric Assoc., 1996).
a. Incorrect See explanation for response b.
b. CORRECT There is evidence that NRT is most effective in terms of long-term effects when it is combined with guidance and support from a mental health professional and skills training that focuses on ways for avoiding and dealing with relapse.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: support from a clinician and skills training.
Which of the following is true about sleep terrors and sleepwalking?
Select one:
A. Both occur during REM sleep.
B. Both are usually followed by amnesia for the event.
C. Both are associated with an impaired homeostatic sleep drive.
D. Both are accompanied by difficulty awakening in the morning with morning confusion.
Answer B is correct: In the DSM-5, sleep terrors and sleepwalking are types of Non-Rapid Eye Movement Sleep Arousal Disorder. Both types occur during non-REM sleep and are characterized by amnesia for the episode.
Answer A: This is the opposite of what is true - both occur during non-REM sleep.
Answer C: An impaired homeostatic sleep drive has been linked to Circadian Rhythm Sleep-Wake Disorder.
Answer D: Difficulty awakening and morning confusion are associated with Circadian Rhythm Sleep-Wake Disorder.
The correct answer is: Both are usually followed by amnesia for the event.
When using the DSM-5, a clinician would code which of the following to indicate that a client has symptoms that do not meet the diagnostic criteria for a specific disorder but does not want to specify the reason why?
Select one:
A. [Disorder] not otherwise specified
B. [Disorder] provisional
C. other specified disorder
D. unspecified disorder
Answer D is correct: When using the DSM-5, diagnostic uncertainty about a client’s diagnosis is indicated by coding one of the following: Other specified disorder is coded when the clinician wants to indicate the reason why the client’s symptoms do not meet the criteria for a specific diagnosis (e.g., “other specified depressive disorder, recurrent brief depression”); and unspecified disorder is coded when the clinician does not want to indicate the reason why the client’s symptoms do not meet the criteria for a specific diagnosis (e.g., unspecified depressive disorder).
Answer A: See explanation for answer D.
Answer B: When using the DSM-5, the provisional specifier applies when “there is a strong presumption that the full criteria will ultimately be met for a disorder but not enough information is available to make a firm diagnosis” (p. 23).
Answer C: See explanation for answer D.
The correct answer is: unspecified disorder
Studies investigating anxiety over the lifespan suggest that, when compared to younger adults, older adults are:
Select one:
A. more likely to be misdiagnosed as having an anxiety disorder.
B. much less likely to benefit from pharmacotherapy or cognitive-behavioral therapy.
C. less likely to have comorbid symptoms of depression.
D. more likely to believe their symptoms are due to physical health problems.
Studies indicate that anxiety is the most common psychiatric disorder in older adults, with generalized anxiety disorder being the most prevalent anxiety disorder.
a. Incorrect In fact, underdiagnosis and undertreatment of anxiety disorders are more common among older (versus younger) adults.
b. Incorrect The research has generally found that older adults with anxiety benefit to about the same degree as younger adults from pharmacotherapy and CBT.
c. Incorrect Younger and older adults with anxiety frequently have comorbid symptoms of depression, but this may actually occur more often in older adults.
d. CORRECT Older adults are more likely than younger adults to attribute their anxiety symptoms to physical health problems and, as a result, to seek help from a medical (versus mental health) professional. See, e.g., M. A. Stanley and J. G. Beck, Anxiety disorders, Clinical Psychology Review, 2000, 20, 731-754.
The correct answer is: more likely to believe their symptoms are due to physical health problems.
Electroconvulsive shock therapy (ECT) is considered an effective intervention for severe depression that has not been responsive to other treatments or is accompanied by a high suicide risk. However, ECT also often produces adverse side effects including:
Select one:
A. patchy anterograde amnesia.
B. temporary retrograde amnesia.
C. patchy anterograde amnesia and temporary retrograde amnesia.
D. permanent retrograde amnesia.
The side effects of ECT vary from patient to patient but usually include some degree of memory loss.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Memory loss most often involves patchy anterograde amnesia for three to six months post-ECT and retrograde amnesia for events that occurred within several months prior to ECT. In most cases memories of past events eventually return.
d. Incorrect Permanent retrograde amnesia is relatively uncommon, so this is not the best response.
The correct answer is: patchy anterograde amnesia and temporary retrograde amnesia.
Augustine, age 5, is in foster care and enrolled in a therapeutic nursery school. He and his older sister were removed from their home after they were found wandering in the park asking people for food and their parents were both found to have a drug problem. While observing Augustine at school, you notice that he impulsively approaches strangers, tends to be overly familiar with people he has just met, and quickly becomes attached to any adult who pays attention to him. Before assigning a DSM-5 diagnosis of ______________ to Augustine, you will want to confirm that his symptoms are attributable to ______________.
Select one:
A. Reactive Attachment Disorder, disinhibited type; developmental delays
B. Disinhibited Social Engagement Disorder; developmental delays
C. Reactive Attachment Disorder, disinhibited type; early neglect or deprivation
D. Disinhibited Social Engagement Disorder; early neglect or deprivation
Answer D is correct: Disinhibited Social Engagement Disorder involves a pattern of culturally inappropriate and overly familiar behavior with unfamiliar people with evidence that the behavior is related to the experience of extremely insufficient care.
Answer A: The presence or absence of developmental delays is not a diagnostic criterion for a diagnosis of Disinhibited Social Engagement Disorder or Reactive Attachment Disorder and, therefore, would not be useful for confirming either diagnosis, which is what this question is asking about.
Answers B and C: See explanations for answers A and D.
The correct answer is: Disinhibited Social Engagement Disorder; early neglect or deprivation
In terms of sexual orientation, most men who receive a diagnosis of Transvestic Disorder identify themselves as:
Select one:
A. solely or predominantly heterosexual.
B. solely or predominantly homosexual.
C. unequivocally bisexual.
D. unequivocally asexual.
Answer A is correct: According to the DSM-5 the majority of men with Transvestic Disorder identify themselves as heterosexual, although some have occasional sexual relations with other men, especially when cross-dressed.
Answers B, C, and D: See explanation for answer A.
The correct answer is: solely or predominantly heterosexual.
Hypnagogic hallucinations are:
Select one:
A. misperceptions of real stimuli.
B. sensations perceived in the wrong sensory modality.
C. false perceptions that occur when falling asleep.
D. false perceptions associated with hallucinogenic use.
Hypnagogic hallucinations are not necessarily indicative of a mental disorder but are associated with Narcolepsy.
a. Incorrect This sounds more like an illusion.
b. Incorrect This is referred to as synesthesia.
c. CORRECT This is the definition of hypnagogic hallucinations.
d. Incorrect These are simply hallucinations.
The correct answer is: false perceptions that occur when falling asleep.
Research on the comorbidity of the eating disorders suggests that the rates of OCD, Social Phobia, and Specific Phobia are:
Select one:
A. higher in individuals with Anorexia Nervosa and Bulimia Nervosa than in other individuals and that the onset of the anxiety disorder is most often prior to the onset of the eating disorder.
B. higher in individuals with Anorexia Nervosa or Bulimia Nervosa than in other individuals and the onset of the anxiety disorder is most often simultaneous with the onset of the eating disorder.
C. higher in individuals with Anorexia Nervosa or Bulimia Nervosa than in other individuals and the onset of the anxiety disorder is most often after the onset of the eating disorder.
D. similar in individuals with Anorexia Nervosa or Bulimia Nervosa as the rates for other individuals and the onset is most often simultaneous with the onset of the eating disorder.
The research has generally found that the rates of several anxiety disorders are higher among individuals with an eating disorder than among individuals in the general population.
a. CORRECT The majority of studies have found that the onset of the anxiety disorder precedes the onset of the eating disorder. See, e.g., W. H. Kaye et al., Comorbidity of anxiety disorders with anorexia nervosa and bulimia nervosa, American Journal of Psychiatry, 161, 2215-2221, 2004.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: higher in individuals with Anorexia Nervosa and Bulimia Nervosa than in other individuals and that the onset of the anxiety disorder is most often prior to the onset of the eating disorder.
Your new client, Elwood E., age 28, says that, for as long as he can remember, he has had trouble finishing projects because of his tendency to repeatedly check for mistakes and desire to achieve perfection in whatever he does. He says that, because of these tendencies, he received several “incompletes” when he was in college and was fired from his last job. Elwood also reports that he has constant thoughts and impulses that he knows are inappropriate, that make him very anxious, but that he cannot control. He says he’s afraid he’s going to hurt one of his family members by forgetting to turn off the stove or by accidentally leaving a door or window unlocked at night and that, for this reason, he spends a great deal of time checking and rechecking the stove, doors, and windows. Based on these symptoms, the most likely diagnosis or diagnoses for Elwood is/are:
Select one:
A. Obsessive-Compulsive Disorder and Generalized Anxiety Disorder.
B. Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder.
C. Obsessive-Compulsive Personality Disorder and Impulse Control Disorder NOS.
D. Obsessive-Compulsive Personality Disorder only.
Elwood is exhibiting symptoms characteristic of two disorders.
a. Incorrect A diagnosis of Generalized Anxiety Disorder (GAD) requires the presence of excessive anxiety and worry about a number of events. Elwood’s concerns about safety sound more like true obsessions than symptoms of GAD. In addition, Elwood’s other symptoms suggest that he has Obsessive-Compulsive Personality Disorder.
b. CORRECT Elwood’s preoccupation with perfection and orderliness and the duration of these symptoms (“for as long as he can remember”) are characteristic of Obsessive-Compulsive Personality Disorder. Elwood also has obsessions and compulsions which are not characteristic of Obsessive-Compulsive Personality Disorder but are symptoms of Obsessive-Compulsive Disorder.
c. Incorrect Elwood’s symptoms do not meet the diagnostic criteria for an impulse control disorder. Also, the behaviors associated with this disorder (unlike Elwood’s behaviors) are not performed in response to an obsession.
d. Incorrect See explanation for response b.
The correct answer is: Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder.
A meta-analysis of the research on expressed emotion and relapse by Butzlaff and Hooley (1998) found that high levels of expressed emotion by family members:
Select one:
A. are predictive of relapse for patients with schizophrenia but not for patients with a mood or eating disorder.
B. are predictive of relapse for patients with a mood disorder or schizophrenia but not for those with an eating disorder.
C. are predictive of relapse for patients with an eating disorder or a mood disorder but not for patients with schizophrenia.
D. may be somewhat more predictive of relapse for patients with a mood or eating disorder than for patients with schizophrenia.
Expressed emotion has been well-established as a predictor of relapse in patients with schizophrenia, and recent studies have linked it to negative outcomes for a number of other disorders.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT R. L. Butzlaff and J. M. Hooley looked at studies investigating the impact of expressed emotion on outcomes for schizophrenia, mood disorders, and eating disorders and found that high expressed emotion by family members was more strongly predictive of relapse for mood and eating disorders than for schizophrenia, although all effect sizes for all three were significant. Specifically, they obtained weighted mean effect sizes for mood disorders, eating disorders, and schizophrenia of, respectively, .39, .51, and .31. (Expressed emotion and psychiatric relapse: A meta-analysis, Archives of General Psychiatry 55, 547-552, 1998.)
The correct answer is: may be somewhat more predictive of relapse for patients with a mood or eating disorder than for patients with schizophrenia.
A nine-year old child with Panic Disorder:
Select one:
A. has been misdiagnosed because Panic Disorder does not occur in preadolescent children.
B. is most likely to manifest his disorder as crying, freezing, and clinging to his parents.
C. is most likely to manifest his disorder as shortness of breath, chest pain, and heart palpitations and saying that he “feels like he’s going crazy.”
D. is most likely to manifest his disorder as shortness of breath, chest pain, tachycardia, and school refusal.
There is some controversy regarding the ability of children to experience the cognitive symptoms of panic; however, cases of the disorder in children are described in the literature.
a. Incorrect See explanation for response d.
b. Incorrect These symptoms are characteristic for children aged 3 through 5.
c. Incorrect These symptoms are characteristic for adolescents.
d. CORRECT These are the symptoms listed for children aged 6 through 12 in M. L. Wolraich (ed.), The classification of child and adolescent mental diagnosis in primary care: Diagnostic and statistical manual for primary care (DSM-PC), Elk Grove Village, IL, American Academy of Pediatrics, 1996.
The correct answer is: is most likely to manifest his disorder as shortness of breath, chest pain, tachycardia, and school refusal.
A caller to a suicide helpline is most likely to be which of the following?
Select one:
A. an African-American male
B. an African-American female
C. a White male
D. a White female
The few studies that have been conducted to identify the types of callers to suicide helplines indicate that they are consistent with the groups who are at high risk for a suicide attempt. a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Young White females are the most frequent callers to suicide helplines. This is not too surprising since whites make up the largest proportion of the population, and females are at a higher risk than males for both depression and a suicide attempt.
The correct answer is: a White female
A female client says she frequently misperceives things and this has made her anxious about leaving home. For example, she often thinks she sees small animals at work when, in fact, the “animals” are actually inanimate objects such as books, coffee mugs, and office supplies. The woman’s misperceptions are best described as:
Select one:
A. illusions.
B. delusions.
C. hallucinations.
D. depersonalization.
For the exam, you want to be familiar with the definitions of the terms listed in the responses to this question.
a. CORRECT An illusion is a misperception of reality (e.g., misperceiving a coffee mug as a rodent).
b. Incorrect A delusion is a false belief about reality that is firmly held regardless of evidence to the contrary.
c. Incorrect While an illusion is elicited by an actual stimulus, an hallucination is a sensory perception in the absence of an external stimulus. Since this women is “misperceiving things,” this suggests she is experiencing illusions rather than hallucinations.
d. Incorrect Depersonalization is an alteration in the sense of self – i.e., the sense that one is detached from one’s mind or body.
The correct answer is: illusions.
Childhood-onset Obsessive-Compulsive Disorder:
Select one:
A. is about equally common in boys and girls.
B. is four times more common in girls than boys.
C. is two times more common in girls than boys.
D. is more common in boys than girls.
For the exam, you want to be familiar with the prevalence rates and gender ratios for several disorders including OCD. The rates and ratios you’re most likely to encounter on exam questions are included in the Abnormal Psychology chapter of the written study materials.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT While OCD is about equally common in male and female adults, because of its earlier onset in males, it is more common in male children than in female children.
The correct answer is: is more common in boys than girls.
Research on the impact of cultural identification on substance abuse among Native American youth has found that the risk for abuse is:
Select one:
A. lowest for those who are acculturated into the non-Native American (mainstream) culture.
B. lowest for those who can adapt to both Native American and non-Native American cultures.
C. highest for those who strongly identify with the Native American culture and reject the non-Native American culture.
D. highest for those who do not strongly identify with either the Native American or non-Native American culture.
The studies have established a link between risk for substance abuse and cultural identity for Native American youth.
a. Incorrect See explanation for response b.
b. CORRECT The studies have shown that either strong identification with one’s own Native American tribe or a bicultural identity is associated with a lower risk for substance use than a strong identification with the mainstream culture only. See, e.g., E. R. Oetting, F. Beauvais, and J. Velarde, Marijuana use by reservation Native American youth, Listening Post (Indian Health Service), 4, 25-28, 1982.
c. Incorrect Strong identification with the Native American culture is associated with a lower risk for substance abuse.
d. Incorrect The highest risk seems to be for those who reject the Native American culture and are highly acculturated into the mainstream.
The correct answer is: lowest for those who can adapt to both Native American and non-Native American cultures.
Alcohol-Induced Sleep Disorder most often involves which of the following symptoms?
Select one:
A. increased wakefulness, restless sleep, and vivid dreams
B. abnormal physiological and behavioral symptoms during sleep
C. excessively long nocturnal sleep and excessive sleepiness during the day
D. difficulty falling and staying asleep with a reduction in REM (dream) sleep
According to the DSM, Alcohol-Induced Sleep Disorder is usually of the insomnia type.
a. CORRECT Although alcohol initially produces sleepiness, this is followed by insomnia, restless sleep, and increased REM sleep, often with vivid, anxiety-laden dreams.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: increased wakefulness, restless sleep, and vivid dreams
Research by Kaye, Gendall, and Strober (1998) suggests that food restriction associated with Anorexia Nervosa reduces __________ levels.
Select one:
A. serotonin
B. acetylcholine
C. dopamine
D. glutamate
Kaye et al. found that anorexia is related to a higher-than-normal levels serotonin in the brain.
a. CORRECT Kaye proposes that high levels of serotonin cause anxiety and that starvation reduces tryptophan, which then reduces brain levels of serotonin and temporarily relieves anxiety. See, e.g., W Kay et al., Serotonin neuronal function and selective serotonin reuptake inhibitors in anorexia and bulimia, Biological Psychiatry, 44(9), 825-838, 1998.
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: serotonin
With regard to information revealed by a client in the context of the client-therapist relationship, who is the “holder of the privilege”?
Select one:
A. the client
B. the therapist
C. the court
D. both the client and the therapist
The psychotherapist-patient privilege refers to the legal right of the client to have his/her psychotherapy records and disclosure withheld in a legal proceeding. This privilege is state law in all 50 states, though the laws related to privilege (e.g., exceptions to privilege) vary somewhat from state to state.
a. CORRECT In all states, the client is ordinarily the holder of the privilege, which means that it is up to the client to decide whether to exercise or waive the privilege.
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: the client
The primary function of the psychology licensing board is best described by which of the following?
Select one:
A. establishment of minimal standards of competence
B. limitation of access to the profession
C. protection of the public through the collection of fees for licensure
D. the establishment, monitoring, and enforcement of ethical principles
Although the various state and provincial boards have different requirements for licensure, they all set the minimum requirements for licensure.
a. CORRECT Licensing boards establish and monitor entry-level qualifications required to offer services to the public for a fee under the title “psychologist”; by doing so, the boards helps ensure competence.
b. Incorrect The licensing boards do not function to limit access to the profession.
c. Incorrect Although licensing is designed to protect the public, this protection is not accomplished through the collection of fees.
d. Incorrect The APA, not the licensing boards, establishes, monitors, and enforces the ethical principles.
The correct answer is: establishment of minimal standards of competence
A psychologist is hired by an industrial development corporation to administer tests to help select key personnel. After being hired, the psychologist learns that the corporation is interested in screening potential employees for “homosexual tendencies,” and he is asked by company management to administer a projective test for the purpose of assessing sexual orientation. The psychologist should:
Select one:
A. administer the test to applicants only after obtaining signed informed consents from job applicants.
B. administer the test and make recommendations but do not give management the actual test results.
C. administer the test and give the results to management since it is not his responsibility to decide what information should be used in making employment decisions.
D. refuse to administer the test and explain to management that it is inappropriate to utilize projective tests for this purpose.
Ethical guidelines require psychologists to use tests only for purposes for which the tests have been validated. For example, Standard 9.02(a) of the APA’s Ethics Code requires psychologists to use tests only for purposes that are “appropriate in light of the research on or evidence of the usefulness and proper application of the techniques.”
a. Incorrect Consent is not the issue in this situation. Obtaining an informed consent would not resolve the unethical use of a test.
b. Incorrect Use of a projective test to make employment decisions is not considered ethical due to a lack of validity evidence, and the psychologist, therefore, should not administer the test.
c. Incorrect It is the psychologist’s responsibility to ensure that tests and test results are not misused.
d. CORRECT Use of projective tests for this purpose is unethical because (1) projective tests have not been validated as job selection tests and (2) homosexuality has not been shown to be related to job performance. Therefore, using a projective test in the selection process to identify homosexual tendencies violates ethical guidelines.
The correct answer is: refuse to administer the test and explain to management that it is inappropriate to utilize projective tests for this purpose.
A psychologist is asked to evaluate a prisoner for the purpose of making a recommendation about the prisoner’s readiness for parole. To be consistent with ethical guidelines, the psychologist should:
Select one:
A. refuse to do the evaluation since making a recommendation in this situation is prohibited.
B. conduct the evaluation but base his recommendation on the results of standardized tests only.
C. conduct the evaluation as long as the prisoner has been told the purpose of the evaluation and has been warned about the limits on confidentiality.
D. conduct the evaluation after obtaining a consent from the prisoner’s legal representative and report the results without making a recommendation.
Special precaution is required when conducting evaluations and making recommendations in forensic settings.
a. Incorrect Making a recommendation is not prohibited by APA guidelines.
b. Incorrect The techniques used by psychologists must be valid, but there is nothing that says a psychologist can only use standardized tests.
c. CORRECT This response is most consistent with the requirements of Standard 9.03(a) of the Ethics Code and Paragraph 6.03 of the Specialty Guidelines for Forensic Psychology (APA, 2012).
d. Incorrect Again, a recommendation is not prohibited, so this response is not as good as response c.
The correct answer is: conduct the evaluation as long as the prisoner has been told the purpose of the evaluation and has been warned about the limits on confidentiality.
Dr. Bill sets his clients’ fees on the basis of a “sliding scale” that is based on their current income. This practice is:
Select one:
A. acceptable but not explicitly mentioned in the Ethics Code.
B. unacceptable but not explicitly mentioned in the Ethics Code.
C. explicitly recommended in the Ethics Code.
D. explicitly prohibited in the Ethics Code.
Sliding scale fees are not explicitly addressed in the Ethics Code.
a. CORRECT Sliding scale fees are generally considered acceptable as long as they are fair and serve the best interests of the client.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: acceptable but not explicitly mentioned in the Ethics Code.
Employee X is thinking about filing a sexual harassment suit against her boss, Supervisor Y. He makes a habit of complimenting Employee X on how she looks, often with a “wolf whistle” and this makes Employee X feel very uncomfortable. Employee X decides to tell Supervisor Y that she finds his behavior offensive. Supervisor Y says he “means no harm” but that he’ll stop if that’s what she wants. This situation:
Select one:
A. represents a sexual harassment suit because Supervisor Y is in a position of authority.
B. represents a sexual harassment suit because Supervisor Y’s comments have created a hostile work environment for Employee X.
C. represents a sexual harassment suit only if it is determined that a “reasonable woman” would find Supervisor Y’s behavior offensive.
D. does not represent a sexual harassment suit as long as Supervisor Y actually stops making comments about Employee X’s appearance.
Sexual harassment laws and policies continue to be reinterpreted but, in this case, there does not seem to be grounds for a sexual harassment suit. For additional information on this issue, see the discussion of Standard 3.02 of the Ethics Code in the chapter on ethics and professional issues in the written study materials.
a. Incorrect When the harasser is in a position of power, this increases the likelihood that a claimant will win a suit. However, the harasser’s status is not all that is taken into consideration.
b. Incorrect If Supervisor Y continues with his comments after being asked to stop, then this might be the case.
c. Incorrect The “reasonable woman” standard is used to determine if a person’s actions constitute sexual harassment but, as noted above, if the supervisor stops his behavior, it is unlikely that the employee would have grounds for a suit against him.
d. CORRECT If the harassment is not severe and the person stops when asked, it is unlikely that the act would be found to constitute sexual harassment.
The correct answer is: does not represent a sexual harassment suit as long as Supervisor Y actually stops making comments about Employee X’s appearance.
Dr. Tout, a psychologist, has been asked to serve as a fact witness by the plaintiff’s attorney. The plaintiff was in a car accident three months ago and is claiming that he has suffered from persistent emotional problems as a result of the accident. He has been seeing Dr. Tout in therapy for these problems for several weeks. During her testimony in court, Dr. Tout is asked by the plaintiff’s attorney whether, in her opinion, the patient’s emotional difficulties are directly related to the accident. Dr. Tout should:
Select one:
A. comply with the request as long as she also presents any information regarding possible limitations of her opinion.
B. comply with request only if her evaluation of the defendant has provided her with sufficient information for an informed opinion.
C. comply with the request only if the defendant has waived his right to confidentiality.
D. not comply with the request unless she is ordered to do so by the court.
The distinction between a fact witness and an expert witness is an important one. As their names imply, a fact witness testifies only to the facts, while an expert witness can offer an opinion. Note that, in this question, Dr. Tout has been asked to serve as a fact witness.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT This issue is addressed by T. P. Remley in Preparing for court appearances, American Counseling Association, Alexandria, VA, 1991. Remley notes that a fact witness should not render an opinion at a hearing or trial and, if asked to give an opinion, should note that he/she is not in a position to do so because of potential bias, insufficient information on which to base an opinion, etc. (A psychologist may be required to give an opinion when ordered to do so by the court. However, even in this situation, the psychologist should qualify the opinion with a statement about its potential limitations.)
The correct answer is: not comply with the request unless she is ordered to do so by the court.
To encourage college students to participate in her research study, Dr. LaPlace offers students free admittance to a popular four-hour workshop (“Finding a Meaningful Relationship and Keeping It”) that is offered by a colleague of hers. This policy:
Select one:
A. is unacceptable since it is coercive and, therefore, violates the provisions of the Ethics Code.
B. is unacceptable since it represents a multiple relationship and, therefore, violates the provisions of the Ethics Code.
C. is unacceptable since it represents a “conflict of interest” and, therefore, violates the provisions of the Ethics Code.
D. may be acceptable as long as Dr. LaPlace is careful to clarify any risks, obligations, and so on with the students.
The Ethics Code does not prohibit the use of inducements for encouraging people to participate in a research study but does place some limitations on their use.
a. Incorrect The situation described in this question cannot really be considered coercive: It would be coercive if the research was being conducted in a prison and prisoners were led to believe that they would receive special privileges if they participate in the research study.
b. Incorrect There may be cases when this would be true, but there isn’t any information in the question to assume that a multiple (dual) relationship is relevant to this situation.
c. Incorrect A conflict of interest is not relevant to this situation.
d. CORRECT Standard 8.06(b) of the Code states that in offering professional services as an inducement to potential research participants, “psychologists clarify the nature of the services, as well as the risks, obligations, and limitations.
The correct answer is: may be acceptable as long as Dr. LaPlace is careful to clarify any risks, obligations, and so on with the students.
You are working as a school psychologist. A teacher asks you to evaluate one of her students. After talking with the teacher and the student, you begin to suspect that the teacher is the one with the problem. As an ethical psychologist, you would:
Select one:
A. file a formal report with the School Board.
B. discuss the problem with the child’s parents immediately.
C. talk to the teacher about your suspicions.
D. report the teacher to the local ethics committee.
Although this problem is not dealt with directly by the Ethics Code, it does recommend an informal resolution with other psychologists whenever appropriate. Presumably, this would apply to other professionals as well.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT This is the most “conservative” of the responses given and most consistent with the “spirit” of the Ethics Code, which requires psychologists to attempt to informally resolve problems first rather than immediately contacting the ethics committee or other authority.
d. Incorrect See explanation for response c.
The correct answer is: talk to the teacher about your suspicions.
An intern at a large mental health clinic decides to work at another agency and makes appointments to see several of her previous clients at her new place of employment. Her actions are:
Select one:
A. commendable since it makes it possible for the clients to have continuity in therapy.
B. ethical as long as adequate supervision is available at the agency.
C. unethical because she has previously worked with the clients.
D. unethical because the clients are already receiving services from the clinic.
Standard 10.04 of the APA’s Ethics Code states that, “in deciding whether to offer or provide services to those already receiving mental health services elsewhere, psychologists carefully consider the treatment issues and the potential client’s/patient’s welfare. Psychologists discuss these issues with the client/patient … in order to minimize the risk of confusion and conflict, consult with the other service providers when appropriate, and proceed with caution and sensitivity to the therapeutic issues.”
a. Incorrect As suggested by this Standard, interns should not take clients from a previous place of employment without considering the professional relationships involved, the therapeutic issues, and the welfare of the clients.
b. Incorrect Interns should not see clients without supervision. However, even if appropriate supervision is available, an intern should not offer his/her services to clients of a previous place of employment.
c. Incorrect This response really doesn’t make sense.
d. CORRECT This response is most in line with Standard 10.04. By going ahead and making the appointments, the intern is not taking steps to minimize the risk of confusion and conflict and is not consulting with the other service providers.
The correct answer is: unethical because the clients are already receiving services from the clinic.
You receive a voicemail from a well-respected licensed psychologist in your community who is currently seeing one of your former clients. She says that she has obtained the client’s consent and wants you to forward the client’s record to her. You should:
Select one:
A. forward a photocopy (not the original) of the record to her.
B. forward only information that you feel is relevant and not obsolete.
C. contact the client to obtain a release directly from him.
D. wait until you hear directly from the client before taking any action.
Even though the psychologist is licensed and well-respected, you would not want to breach confidentiality by forwarding client information to her without knowing specifically what the client has consented to (or if, in fact, his consent was actually obtained).
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT This is the best option of those given. You would want to verify that the client has signed a release and discuss the release and its potential consequences with him before providing the psychologist with the requested information.
d. Incorrect See explanation for response c.
The correct answer is: contact the client to obtain a release directly from him.
According to the APA’s General Guidelines for Providers of Psychological Services, the term “psychological services” applies to all of the following except:
Select one:
A. administration and scoring of psychological tests.
B. teaching psychology at a university.
C. supervising delivery of psychological services.
D. conducting psychotherapy in private practice.
As noted in the ethics and professional issues chapter of the written study materials, teaching psychology at a university is not listed as a psychological service in the General Guidelines for Providers of Psychological Services.
a. Incorrect This activity is defined as being a psychological service.
b. CORRECT As noted above, this activity is not defined as a psychological service.
c. Incorrect This activity is considered a psychological service.
d. Incorrect This activity is considered a psychological service.
The correct answer is: teaching psychology at a university.
Shortly after a school psychologist begins working for a small rural school district, she finds that there are a number of children in a class for students with an Intellectual Disability who are emotionally disturbed but who appear to have an average or above average level of intelligence. The county has no class for emotionally disturbed children. The psychologist should: Select one:
A. report the situation immediately to the psychology ethics committee in her state.
B. report the situation immediately to the teacher’s standards and practices commission in her state.
C. threaten to quit if the children are not placed in a regular classroom.
D. evaluate each student and recommend an appropriate action regardless of available options.
This question presents a rather complex ethical dilemma. Before responding too quickly, consider the psychologist’s responsibilities and the options that are available. For ethics questions, the most conservative course of action is often the most appropriate one.
a. Incorrect At first glance, reporting may seem appropriate. However, the psychology ethics committee does not respond to complaints about the unethical activities of teachers and schools.
b. Incorrect There is no indication that the inappropriateness of this situation is the responsibility of a particular teacher.
c. Incorrect A psychologist should always try to correct a situation before quitting. Insisting that a situation be resolved and threatening to quit is not necessarily the most ethical or useful response.
d. CORRECT The psychologist’s first intervention should be to assess each child and make appropriate recommendations. If appropriate actions are not taken by the school, the psychologist will then want to consider other interventions (e.g., talking to the school board, consulting with the ethics committee).
The correct answer is: evaluate each student and recommend an appropriate action regardless of available options.
A psychology intern administers tests to clients of a mental health clinic, but her supervisor scores the tests and interprets their results. When preparing the psychological report, the supervisor does not indicate that the intern administered the tests. This is:
Select one:
A. ethical as long as the client was informed that the examiner is a psychology intern and was given the supervisors name.
B. ethical since the supervisor is ultimately responsible for the accuracy of the psychological report.
C. unethical since the intern should not be administering psychological tests.
D. unethical since the intern should be listed as the examiner in the report.
Answer D is correct: This issue is not directly addressed in the Ethics Code or the Standards for Educational and Psychological Testing. Therefore, to answer this question, you must consider which response is most consistent with the “spirit” of these documents. This response is most consistent with the provisions of the APA guidelines. See, for example, Standard 5.01(b) of the Ethics Code, which prohibits psychologists from making misleading statements, and Standard 6.06, which requires psychologists to provide accurate information to payors and funding sources.
The correct answer is: unethical since the intern should be listed as the examiner in the report.
A licensed psychologist who is working in an isolated rural community finds that some of his clients have problems that are beyond his training and expertise. The psychologist should:
Select one:
A. continue seeing the clients only if there is no other psychologist available.
B. use only those interventions he feels competent to use in treating the clients.
C. obtain appropriate consultation by phone.
D. refuse to see the clients until he receives adequate training.
The Ethics Code requires psychologists to provide only services that are within “the boundaries of their competence.” However, it is acceptable to provide new services when certain conditions are met (Standard 2.01). Note that none of the responses to this question is optimal, so you have to pick the best one of those given.
a. Incorrect The lack of another psychologist is certainly a consideration in this situation, but, even in the absence of another psychologist, seeing the clients without getting necessary supervision or consultation would not be acceptable.
b. Incorrect This would not be acceptable if more effective treatments for the clients’ problems were available.
c. CORRECT It is perfectly acceptable for psychologists to acquire new skills during the course of their practice as long as they obtain adequate training, supervision, or consultation. Of course, consultation might not be sufficient in certain situations, but, of the responses given, this is the best choice. Note that nothing in the Code suggests that consultation must be in-person.
d. Incorrect Not providing services at all would not be the best course of action in most situations if the clients had no other professional they could see.
The correct answer is: obtain appropriate consultation by phone.
The court offers a defendant the choice of jail or an in-patient alcohol treatment program after he is found guilty of driving while intoxicated. As the clinician who will be working with the man at the treatment center, you should keep in mind that:
Select one:
A. a waiver of confidentiality is not required because treatment has been court-ordered.
B. a waiver of confidentiality is not required because the man gave up his right to confidentiality by committing the crime.
C. a waiver of confidentiality is not required because the man gave up his right to confidentiality by choosing the treatment program instead of jail.
D. a waiver of confidentiality is required and should be obtained before you release any information about the man’s treatment to the court.
Even though the treatment is court-ordered, a waiver of confidentiality is required before any information about the man’s treatment is released to the court.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The usual procedure is for the individual to sign a waiver of confidentiality when he/she chooses the treatment option. However, you would want to check to make sure this has occurred and, if not, you would want to obtain a signed waiver. See, e.g., L. C. Sobell and M. B. Sobell, Preserving client rights, New York: The Free Press, 1981.
The correct answer is: a waiver of confidentiality is required and should be obtained before you release any information about the man’s treatment to the court.
With regard to the termination of professional services, the Ethics Code requires psychologists to:
Select one:
A. offer to help the client locate alternative services.
B. take actions that protect the best interests of the client.
C. provide pretermination counseling and suggest alternative services.
D. take action that is consistent with the reason(s) for the termination.
Standard 10.10(c) of the Ethics Code applies in this situation. It advises that certain steps be taken, regardless of the reason for the termination.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT None of the responses given is wrong but this one comes closest to the actual language of the Ethics Code and, therefore, is the best answer.
d. Incorrect See explanation for response c.
The correct answer is: provide pretermination counseling and suggest alternative services.
A client you have been seeing for eight months says he wants to quit therapy. He feels that the original problems he came to therapy for have all been resolved. You disagree and feel that there is good reason for the man to continue seeing you. You should:
Select one:
A. get the client to agree to a few more sessions.
B. discuss his reasons for wanting to terminate.
C. discuss his reasons for wanting to terminate and your reasons for thinking he should continue.
D. let him terminate but let him know he can come back if he desires.
Obviously you can’t force a client to continue seeing you, but you should discuss your reservations about his termination.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT If you believe it would not be good for the client to quit at this time, you should discuss this with him. If he still wants to leave, then you’d want to assure him that he can come back and/or give him appropriate referrals.
d. Incorrect See explanation for response c.
The correct answer is: discuss his reasons for wanting to terminate and your reasons for thinking he should continue.
Dr. Bascom, a newly-licensed psychologist, has been hired by a community mental health center. Several months after beginning her job, Dr. Bascom starts treating a college student who experiences severe test anxiety. Although Dr. Bascom took a graduate course in behavior therapy and has had some clinical experience with behavioral techniques, she has never worked with anyone with test anxiety. As an ethical psychologist, Dr. Bascom should:
Select one:
A. review the literature on test anxiety before beginning treatment.
B. seek consultation from an experienced colleague and continue working with the client.
C. refer the student to another psychologist who has experience in treating test anxiety.
D. continue to see the student since she has adequate experience in behavioral techniques.
In a clinical setting, when a psychologist is faced with an unfamiliar situation, the question of whether to refer the client to another therapist or seek supervision arises. Standard 2.01(a) of the APA’s Ethics Code states that “Psychologists provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study, or professional experience.” This principle suggests that, in deciding whether to seek supervision or make a referral, psychologists must consider their training and experience.
a. Incorrect While the psychologist does need further training in treating test anxiety, a literature review undertaken on one’s own is not sufficient study or training.
b. CORRECT Seeking consultation is probably the best course of action in this situation since Dr. Bascom does have experience and training with behavioral techniques. Such a course of action is consistent with Standard 2.01(a), which states that psychologists provide services involving new techniques “based on their education, training, supervised experience, consultation, study, or professional experience.”
c. Incorrect This is not an incorrect course of action, but it is not the best choice in this situation. While acceptable, a referral is not necessary since the psychologist has the training and experience necessary to use behavioral techniques. If the psychologist did not have such training and experience, a referral would be a better course of action.
d. Incorrect Since the psychologist has not used behavioral techniques specifically to treat test anxiety before, it would be better to obtain supervision.
The correct answer is: seek consultation from an experienced colleague and continue working with the client.
During the first session with a client, you learn that he has a history of offenses that you find difficult to deal with and feel, therefore, that you would not like working with him. As an ethical psychologist you should:
Select one:
A. disregard your personal preferences and accept the young man into therapy.
B. refer the young man to another professional.
C. accept the young man into therapy but seek supervision.
D. tell the young man that you cannot accept him into therapy.
The therapeutic alliance is considered a crucial factor in therapy outcome. If a therapist believes that some characteristic of a client would interfere with the development of that alliance, it would not benefit the client to continue treatment.
a. Incorrect It is unethical for a psychologist to accept a client into therapy if the psychologist’s personal preferences may negatively affect the therapeutic process.
b. CORRECT It is not a violation of the Ethics Code to NOT accept a client into treatment when the psychologist feels that he/she would be unable to form a therapeutic relationship with the client – and, to do so, would be consistent with Ethics Code Standard 3.04 (Avoiding Harm). Therefore, the best (and most ethical) course of action in this situation is to refer the client to another professional (see Standard 2.06).
c. Incorrect Supervision may not be adequate to overcome the personal preferences of the psychologist. Therefore, answer b is a better response.
d. Incorrect Although it is acceptable to refer a client to another therapist, referrals must be handled in a professional manner. Abrupt termination is unethical.
The correct answer is: refer the young man to another professional.
If a psychology licensure candidate is believed to have cheated on the psychology licensing exam, he/she will:
Select one:
A. be allowed to re-take the exam but will be monitored during the process.
B. be barred from re-taking the exam for a period of no less than three years.
C. be given an opportunity to provide evidence to the licensing board why his/her test score should not be cancelled.
D. be required by the Ethics Committee to appear at a formal hearing on the matter within six months.
This situation is addressed in the Standards for Educational and Psychological Testing (AERA, APA, & NCME, 1999).
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Standard 8.11 of the Standards states that, in cases of misconduct by a test taker (e.g., suspected cheating), the test taker should be notified and “given a timely opportunity to provide evidence that the score should not be cancelled or withheld.” In addition, Standard 8.13 states that, in this situation, the test taker is entitled to “some form of procedural due process protection.” In other words, the test taker must be given an opportunity to respond to the charge and be provided with information about the procedures that will be followed before any action against him/her is taken.
d. Incorrect See explanation for response c.
The correct answer is: be given an opportunity to provide evidence to the licensing board why his/her test score should not be cancelled.
For a claim of malpractice:
Select one:
A. the therapist must have had malevolent intentions and there must be a causal connection between the therapist’s acts and the harm suffered by the client.
B. the therapist must have had malevolent intentions and/or there must be some harm to the client as a result of the therapist’s acts.
C. the therapist may or may not have had malevolent intentions but there must be a causal connection between the therapist’s acts and the harm suffered by the client.
D. the therapist must have violated normal “standards of practice” or must have had malevolent intentions.
A complaint of malpractice requires that (1) the psychologist had a professional relationship with the client that established a legal duty of care; (2) there must be a demonstrable standard of care that the psychologist breached; (3) the client must have suffered harm or injury; and (4) the psychologist’s breach of duty must be the proximate cause of that harm or injury.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT The psychologist’s actions do not have to be malevolent but there must be evidence that the psychologist’s actions are the cause of the harm suffered by the client.
d. Incorrect See explanation for response c.
The correct answer is: the therapist may or may not have had malevolent intentions but there must be a causal connection between the therapist’s acts and the harm suffered by the client.
You agree to see an adolescent in therapy. Before you begin therapy, the parents tell you they will want information about how their son is progressing. As an ethical psychologist, you should:
Select one:
A. tell the boy you’ll have to tell his parents everything.
B. tell the boy’s parents that you can’t tell them anything.
C. agree in advance with all parties what, if anything, will be revealed to the parents.
D. proceed with caution.
Ethically, a psychologist has the obligation to protect the confidentiality of his/her client, but legally, in most situations, parents have the right to information obtained in therapy about their minor child. This dilemma is acknowledged by the Ethics Code, which requires that psychologists consider the preferences and best interests of individuals who are legally incapable of giving informed consent.
a. Incorrect In most circumstances, this course of action will not be consistent with the adolescent’s best interest.
b. Incorrect If you do this, you will be acting in conflict with the law. Legally, in most situations, parents have the right to information obtained in therapy by a psychologist about their minor children. Ethically, however, in order to safeguard the child’s interests, psychologists should try to encourage parents to respect confidentiality.
c. CORRECT This course of action best meets the psychologist’s ethical and legal obligations. An advance agreement safeguards the interests of the adolescent, who would be made aware of the types of information which may not be kept confidential.
d. Incorrect Certainly, you should proceed with caution in this situation, as you should in any situation in which you are faced with a possible ethical dilemma. However, this is a very general response to a situation that is more specific. When answering these types of questions, you should choose responses with a level of specificity that matches the question.
The correct answer is: agree in advance with all parties what, if anything, will be revealed to the parents.
A client you have been seeing in therapy for three months tells you that her former therapist made repeated sexual advances toward her. She tells you that she does not want you to say anything about it to anyone and that she just wants to “get over it.” As an ethical psychologist, you should:
Select one:
A. inform the client that you are ethically obligated to make a report to the state licensing board.
B. convince the client that she should make a report to the appropriate authorities.
C. tell the client that you will maintain confidentiality.
D. tell the client that you must file a complaint with APA but that you will not reveal her name.
It is important to keep in mind that client confidentiality nearly always takes priority over other concerns.
a. Incorrect In this situation, you are not required to make a report since the client has not waived confidentiality.
b. Incorrect “Convincing” the client would not be the best course of action.
c. CORRECT You would not want to make a report unless you had permission from the client.
d. Incorrect Although you could file a complaint without naming the client, the Ethics Committee would be unable to take action in most cases.
The correct answer is: tell the client that you will maintain confidentiality.
A psychologist working for the criminal justice system is asked by the court to evaluate a young man accused of committing a felony. She is told by an attorney who has attempted to interview the man that he has difficulty attending to general directives and that his perceptions of time, place, and people appear to be confused. The psychologist will be required to testify in court regarding her assessment of the young man. In terms of confidentiality, the psychologist is:
Select one:
A. legally bound to maintain confidentiality unless she obtains a written release from the young mans attorney.
B. legally bound to maintain confidentiality unless she obtains a written release from the young man.
C. not legally bound to maintain confidentiality but ethically required to inform the young man of the limits of confidentiality.
D. not legally bound to maintain confidentiality or ethically required to discuss the limits of confidentiality due to the nature of the case.
Standard 4.02(a) of the Ethics Code mandates psychologists to discuss “the relevant limits of confidentiality.” Note that, in this case, the psychologist has been asked by the court to evaluate the defendant.
a. Incorrect A psychologist who is asked by the court to evaluate a defendant is not required legally or ethically to obtain the attorney’s permission to conduct the evaluation.
b. Incorrect When the court requests a psychologist to conduct an evaluation, the psychologist is not required to obtain a written release from the individual being evaluated.
c. CORRECT When working within the criminal justice system, a psychologist is serving both the offender and the criminal justice system. In such situations, a psychologist is not legally bound to maintain confidentiality; however, in accordance with Standard 4.02, the psychologist should inform the offender of the limits of confidentiality.
d. Incorrect To be consistent with the requirements of the Ethics Code, psychologists should always discuss the limits of confidentiality.
The correct answer is: not legally bound to maintain confidentiality but ethically required to inform the young man of the limits of confidentiality.
If a health care provider is faced with a conflict between state law and the HIPAA requirements:
Select one:
A. state law would preempt the HIPAA requirements.
B. the health care provider should respond based on the best interests of the client.
C. the HIPAA requirement would preempt state law when it provides the client with greater privacy protection or control over access to his/her records.
D. the health care provider has the discretion to resolve the issue in any appropriate manner.
The HIPAA Privacy Rule provides a Federal floor of privacy protections for individuals’ individually identifiable health information where that information is held by a covered entity or by a business associate of the covered entity. State laws that are contrary to the Privacy Rule are preempted by the Federal requirements, unless a specific exception applies. These exceptions include if the State law (1) relates to the privacy of individually identifiable health information and provides greater privacy protections or privacy rights with respect to such information, (2) provides for the reporting of disease or injury, child abuse, birth, or death, or for public health surveillance, investigation, or intervention, or (3) requires certain health plan reporting, such as for management or financial audits. In these circumstances, a covered entity is not required to comply with a contrary provision of the Privacy Rule [See California Office Of HIPAA Implementation’s Frequently Asked Questions at http://www.ohi.ca.gov/calohi/#].
a. Incorrect See explanation above.
b. Incorrect See explanation above.
c. CORRECT See explanation above.
d. Incorrect See explanation above.
The correct answer is: the HIPAA requirement would preempt state law when it provides the client with greater privacy protection or control over access to his/her records.
The function of the state licensing boards is probably best described as:
Select one:
A. ensuring that psychologists provide clients with effective services.
B. ensuring that only competent psychologists become and remain licensed.
C. setting entry-level qualifications for licensure and monitoring the conduct of licensed psychologists.
D. defining the services that can be legitimately provided by licensed psychologists.
As you are likely aware, the state licensing boards set the minimum requirements for licensure.
a. Incorrect Although this may be a desired outcome of the licensing requirements, it can’t be assumed that licensure will result in the provision of effective services.
b. Incorrect See explanations for responses a and c.
c. CORRECT This is the most accurate description of the function of the licensing boards.
d. Incorrect See explanation for response c.
The correct answer is: setting entry-level qualifications for licensure and monitoring the conduct of licensed psychologists.
Dr. Blue, a psychologist, is hired by a company to administer tests for the purpose of evaluating current employees to determine if they should be considered for promotion. In this situation:
Select one:
A. an informed consent from examinees should be obtained.
B. an informed consent is not required since the employer is Dr. Blue’s “client.”
C. an informed consent from examinees is not required, although they should be reminded about the limits of confidentiality.
D. it is up to Dr. Blue to decide whether any information about the test should be given to examinees.
This issue is addressed in APA’s Statement on the Disclosure of Test Data and in Standards for Educational and Psychological Testing.
a. CORRECT In most situations, psychologists obtain informed consents prior to testing from the person being evaluated or his/her legal guardian. Although there are exceptions in certain employment situations, this response is the best of those given.
b. Incorrect While it is not always necessary to get an informed consent in employment situations, this response is not as good as response a because the fact that the employer is the client does not automatically eliminate the need for an informed consent. (And, even when it isn’t necessary to obtain a consent, the individual should ordinarily be given some information about the purpose of the test, etc.)
c. Incorrect See explanation for response a.
d. Incorrect See explanation for response a.
The correct answer is: an informed consent from examinees should be obtained.
A client says she is upset because her doctor has suggested she undergo tests for a possible hyperactive thyroid. She says she believes that doctors are always looking for excuses to perform unnecessary procedures in order to make more money. You should:
Select one:
A. read up on hyperthyroidism so that you can give her an informed opinion.
B. have her sign a release of information and contact her physician.
C. refer her to an endocrinologist to discuss the purpose of the tests.
D. explore the source of her hostility toward doctors.
This woman needs to find out if tests for hyperthyroidism are necessary. A psychologist cannot ethically render a professional opinion on this matter.
a. Incorrect No matter how much you read up on hyperthyroidism, you will not, as a psychologist, be qualified to offer a professional opinion. Thus, this course of action would be a direct violation of the above-cited principle.
b. Incorrect While this is not an unethical or incorrect course of action, it does not address the woman’s needs as well as answer c. The woman needs to know if the physician’s recommendation was warranted; the physician’s own opinion on this matter is not likely to be objective.
c. CORRECT Of the choices offered, a referral to an endocrinologist most directly meets the woman’s needs and addresses the issue of the psychologist’s competence, which is the ethical issue that underlies this question. An endocrinologist is qualified to discuss the tests with the woman.
d. Incorrect There is no indication in this question that the woman has general feelings of hostility toward doctors.
The correct answer is: refer her to an endocrinologist to discuss the purpose of the tests.
Brousseau and Driver’s (1994) notion of “career concept” refers to an individual’s:
Select one:
A. work-related values.
B. career-related identity.
C. work-related personality characteristics.
D. career decisions.
Career concept is a key concept in Brousseau and Driver’s model of career development.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Career concept refers to an individual’s career decisions, which vary along three dimensions: frequency of job change; direction of change; and type of change in job content. Brousseau and Driver distinguish between four career concepts - steady state, linear, spiral, and transitory. See, e.g., K. R. Brousseau and M. J. Driver, Enhancing informed choice: A career-concepts approach to career advisement, Selections, Spring, 24-31, 1994.
The correct answer is: career decisions.
According to Donald Super, “career maturity” refers to:
Select one:
A. the final stage of career development.
B. the ability to accomplish the tasks of each stage of career development.
C. the ability to make realistic career choices.
D. the acquisition of skills needed to successfully perform one’s chosen job.
Super proposes that career development involves several stages.
a. Incorrect See explanation for response b.
b. CORRECT Career maturity refers to successful accomplishment of the tasks of each stage of career development.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: the ability to accomplish the tasks of each stage of career development.
Social loafing is most likely to occur when members of a team are less productive than individual members would have been working alone because:
Select one:
A. they believe their lack of effort will not be recognized by others.
B. they experience a diminished sense of self-awareness while in the presence of others.
C. the mere presence of others produces a level of arousal that interferes with productivity.
D. they experience an enhancement of pre-existing tendencies.
Social loafing is one of the possible negative outcomes of group participation.
a. CORRECT Social loafing is the tendency of people to exert less effort when working as a member of a group than they would exert when working alone. It has been attributed to the belief that one’s effort (or lack of effort) will not be recognized or that group outcomes do not depend on one’s effort.
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: they believe their lack of effort will not be recognized by others.
Which of the following is specifically excluded as a “disability” in the Americans with Disabilities Act?
Select one:
A. HIV/AIDS
B. learning disabilities
C. transvestism
D. diabetes
Disability is defined in the Americans with Disabilities Act (ADA) as “a physical or mental impairment that substantially limits one or more of the major life activities” of an individual.
a. Incorrect HIV/AIDS is included as a disability.
b. Incorrect Dyslexia and other learning disabilities are included in the definition of disability.
c. CORRECT The ADA lists several conditions that do NOT qualify as disabilities. These include transvestism, exhibitionism, gender identity disorder not resulting from a physical impairment, compulsive gambling, kleptomania, and use of illegal drugs.
d. Incorrect Diabetes is included as a disability.
The correct answer is: transvestism
A supervisor administers a test on the material covered in a training program to employees who have just completed the program in order to assess its effectiveness. Six months later, the same supervisor rates the employees on their job performance and correlates the two sets of scores. She obtains a correlation coefficient of .65. Most likely, the magnitude of the coefficient has been biased by which of the following?
Select one:
A. shrinkage
B. criterion contamination
C. a contrast effect
D. demand characteristics
In the situation described in this question, the same person is rating employees on the predictor and criterion.
a. Incorrect Shrinkage is associated with cross-validation.
b. CORRECT When knowledge of a person’s performance on the predictor affects how he/she is rated on the criterion, criterion contamination has occurred and is likely to inflate the criterion-related validity coefficient. A coefficient of .65 is relatively high and may reflect criterion contamination.
c. Incorrect The contrast effect occurs when the ability of previous interviewees or applicants affects how a subsequent interviewee or applicant is evaluated.
d. Incorrect Demand characteristics are cues in the environment that inform research participants what behaviors are expected from them.
The correct answer is: criterion contamination
