The Big Six 2 Clinical Psychology

Question 1

Acculturation
(Berry)

Answer 1

According to Berry, a person’s level of acculturation can be described in terms of four categories that reflect the person’s adoption of his/her own culture and the culture of the dominant group – i.e., integration, assimilation, separation, or marginalization.

Question 2

Adler’s Individual Psychology

Answer 2

Adler’s personality theory and approach to therapy stress the unity of the individual and the belief that behavior is purposeful and goal–directed. Key concepts are inferiority feelings, striving for superiority, and style of life (which unifies the various aspects of an individual’s personality). Maladaptive behavior represents a mistaken style of life that reflects inadequate social interest. Adler’s teleological approach regards behavior as being largely motivated by a person’s future goals rather than determined by past events.

Question 3

Alloplastic vs Autoplastic Interventions

Answer 3

In the context of psychotherapy, alloplastic and autoplastic refer to the focus of an intervention with regard to the environment. The goal of an alloplastic intervention is to make changes in the environment so it better accommodates the individual, while the goal of an autoplastic intervention is to change the individual so that he/she is better able to function effectively in his/her environment.

Question 4

Black Racial (Nigrescence) Identity Developmental Model

Answer 4

Cross’s Black Racial Identity Development Model consists of four stages: During the pre-encounter stage, race and racial identity have low salience. In the encounter stage, the person has greater racial/cultural awareness and is interested in developing a Black identity. In the immersion/emersion stage, race and racial identity have high salience and the person moves from intense Black involvement (immersion) to strong anti-White attitudes (emersion). Finally, during the internalization stage, race continues to have high salience and the person adopts an Afrocentric, biculturist, or multiculturist orientation.

Question 5

Consultation (Client-Centered Case Consultation)

Answer 5

Client-centered case consultation involves working with the consultee (e.g., teacher or therapist) to develop a plan that will enable the consultee to work more effectively with a particular client (e.g., student or patient). The consultant acts as an expert and provides the consultee with relevant information.

Question 6

Consultation (Consultee-Centered Administrative Consultation)

Answer 6

The goal of Consultee-Centered Administrative consultation is to help administrative-level personnel improve their professional functioning so they can be more effective in the future with regard to program development, implementation, and evaluation.

Question 7

Consultation (Consultee-Centered Case Consultation)

Answer 7

The goal of this form of consultation is to enhance the consultee’s performance in delivering services to a particular population or group of clients. The focus is on the consultee’s skills, knowledge, abilities, and/or objectivity. A lack of objectivity can stem from several factors including theme interference, a type of transference that occurs when a past unresolved conflict related to a particular type of client or circumstance is evoked by and interferes with the consultee’s current situation.

Question 8

Consultation (Program-Centered Administrative Consultation)

Answer 8

Program-Centered Administrative Consultation. This form of mental health consultation involves working with one or more administrators (the consultees) to resolve problems related to an existing program.

Question 9

Cultural Encapsulation (Wrenn)

Answer 9

Culturally encapsulated counselors interpret everyone’s reality through their own cultural assumptions and stereotypes and disregard cultural differences and their own cultural biases.

Question 10

Cultural Vs. Functional Paranoia
(Ridley)

Answer 10

Ridley described nondisclosure by African American therapy clients as being due to two types of paranoia: A client is exhibiting cultural paranoia (which is a healthy reaction to racism) when he/she does not disclose to a white therapist due to a fear of being hurt or misunderstood. A client is exhibiting functional paranoia (which is due to pathology) when he/she is unwilling to disclose to any therapist, regardless of race or ethnicity, as a result of mistrust and suspicion.

Question 11

Cybernetics
(Positive And Negative Feedback Loops)

Answer 11

Cybernetics is concerned with communication processes and distinguishes between negative and positive feedback loops. A negative feedback loop reduces deviation and helps a system maintain the status quo, while a positive feedback loop amplifies deviation or change and thereby disrupts the system.

Question 12

Diagnostic Overshadowing

Answer 12

Diagnostic overshadowing was originally used to describe the tendency of health professionals to attribute all of a person’s psychiatric symptoms to his or her intellectual disabilities. Subsequent research found that diagnostic overshadowing applies to other conditions and diagnoses.

Question 13

Double–Bind Communication

Answer 13

As originally defined by Bateson, Jackson, Haley, and Weakland (1956), double–bind communication is an etiological factor for schizophrenia and involves conflicting negative injunctions – e.g., do that and you’ll be punished” and “don’t do that and you’ll be punished” – with one injunction often being expressed verbally and the other nonverbally. In addition

Question 14

Efficacy Vs. Effectiveness Research

Answer 14

An ongoing debate on psychotherapy outcome research is over the best way to evaluate the effects of psychotherapy. On one side of the argument are experts who support efficacy studies (clinical trials); on the other are those who prefer effectiveness studies, which are correlational or quasi–experimental in nature.

Question 15

Emic Vs. Etic Orientation

Answer 15

Emit and etic refer to different orientations to understanding and describing cultures. An emic orientation is culture–specific and involves understanding the culture from the perspective of members of that culture. An etic orientation is culture–general and assumes that universal principles can be applied to all cultures.

Question 16

Existential Therapy

Answer 16

The existential therapies are derived from existential philosophy and share an emphasis on personal choice and responsibility for developing a meaningful life. They describe maladaptive behavior as the result of an inability to cope authentically with the ultimate concerns of existence – i.e., death, freedom, existential isolation, and meaninglessness.

Question 17

Extended Family Systems Therapy
(Differentiation, Emotional Triangle, Genogram)

Answer 17

Bowen’s approach to family therapy extends general systems theory beyond the nuclear family. Key terms include differentiation of self and emotional triangles: Differentiation refers to a person’s ability to separate his/her intellectual and emotional functioning, which helps keep the person from becoming fused” with the emotions that dominate the family. An emotional triangle develops when a two–person system attempts to reduce instability or stress by recruiting a third person into the system. Therapy often begins with the construction of a genogram

Question 18

Eysenck

Answer 18

Eysenck was a British psychologist known for his factor analysis of personality traits, contributions to behavior therapy, and 1952 review of psychotherapy outcome studies in which he found that 72% of untreated neurotic individuals improved without therapy, while 66% of patients receiving eclectic psychotherapy and 44% receiving psychoanalytic psychotherapy showed a substantial decrease in symptoms. Based on these findings, Eysenck concluded that any apparent benefit of therapy is due to spontaneous remission.

Question 19

Feminist Therapy
(Nonsexist Therapy,
Self–In–Relation Theory)

Answer 19

Feminist therapy is based on the premise that the personal is political.” It focuses on empowerment and social change and acknowledges and minimizes the power differential inherent in the client–therapist relationship. Self–in–relation theory applies feminism to object relations theory and proposes that many gender differences can be traced to differences in the early mother–daughter and mother–son relationship. Feminist therapy must be distinguished from nonsexist therapy

Question 20

Freud: Defense Mechanisms (General Concept)

Answer 20

While the defense mechanisms can be considered adaptive because they serve to reduce anxiety, they may lead to dysfunctional behavior when they become the ego’s habitual way of dealing with danger.

Question 21

Freud: Defense Mechanisms:
REACTION FORMATION

Answer 21

Reaction formation, which involves avoiding an anxiety-evoking impulse by expressing its opposite.

Another sometimes painfully obvious defense mechanism is reaction formation. A person may not want to come across as feeling some type of way, so they form a reaction that appears to make them feel completely different. They may feel upset on the inside, but claim that they are super excited and happy to avoid confrontation or admitting their true feelings.

Example of Projection as a Reaction Formation

Let’s say a man has feelings for another man, but he doesn’t know how to handle the possible humiliation of coming out of the closet. To compensate for these feelings, he goes out and tries to charm every woman he can find. He puts on behaviors to prove how super “straight” he is so no person could ever think he had opposing feelings.

Question 22

Freud: Defense Mechanisms: COMPENSATION

Answer 22

People use compensation as a way to cover up for perceived shortcomings. They take actions or display traits to come across as the thing that they are insecure about. For example, an employee may flaunt all of their awards or recognition because they feel that they are not adequate enough. The list goes on and on. It is similar to sublimation, but rather than growing and building themselves to become the thing they are not, compensation usually involves pretending that they already are that thing they are insecure about.

Example of Compensation as a Defense Mechanism

Remember in Shrek, when Shrek sees Lord Farquad’s tall, phallic-shaped tower and says to Donkey, “maybe he’s compensating for something?” We all have encountered compensating for a specific type of insecurity, but compensation covers more ground than just the size of…you know. If you find that you deploy these tactics regularly, it’s time for some self-reflection. What can you do to confront negativity and learn from mistakes?

Question 23

Freud: Defense Mechanisms: DENIAL

Answer 23

We have all seen denial play out as a defense mechanism. Denial is the process of refusing to receive information or a bad situation. If you can convince yourself that the bad situation is not present, then you won’t have a need to deal with the situation.

Examples of Denial as a Defense Mechanism

Someone may be in denial that a family member died or that their boyfriend broke up with them. They go about life as if the person was still alive or that they are still in the relationship. In another example, Reddit users discuss how men in power may deny pressing issues like climate change as a defense mechanism.

Question 24

Freud: Defense Mechanisms: DISPLACEMENT

Answer 24

Displacement is the process of targeting an unrelated subject during a bad situation. Often, it would be impossible or a bad idea to target the true cause of the bad situation (i.e. the weather, everyone who bought a certain item before it was sold out, etc.,) so the person chooses an “easier” target (i.e. the person working at the cashier, the front desk, etc.)

Example of Displacement As a Defense Mechanism

Let’s say you work at the gift shop of an amusement park. In the middle of the day, it starts to pour. None of the guests can enjoy the rides or be outside in the park, so they come into the gift shop and start to unleash their frustration on you. They start to yell and scream, even though you had nothing to do with the rain. This is an example of displacement, and anyone who has worked retail during the holidays knows the ineffectiveness and frustration of this defense mechanism.

Question 25

Freud: Defense Mechanisms: RATIONALIZATION

Answer 25

If you want to “appear” that your behaviors are justified, you might use rationalization. This process involves using false reasoning to get what you want or explain away your behavior. The classic “dog ate my homework” lie is an example of rationalization.

Example of Rationalization

Let’s say you double-book yourself and stand up someone that you’re supposed to go on a first date with. Your friends remind you of that date and ask why you stood them up. You begin to rationalize. “People stand me up all the time.” “He didn’t confirm the time and date soon enough.” “We didn’t communicate today, so maybe they didn’t show up, either.” All of these rebuttals are a way to rationalize your behavior instead of owning up to what you did.

Question 26

Freud: Defense Mechanisms: REGRESSION

Answer 26

Adults cannot be blamed for envying children; it appears that children don’t have a care in the world, without insecurities or responsibilities. They cry, pout, and whine to get their way and solve a “bad” situation. Adults are expected to “be more mature” and not use these methods to get what they want. Regression is the process of “regressing” back to these childhood methods of expressing emotion. You might cry, whine, pout, stomp…you name it. Regression doesn’t always work, but it’s a way of pushing your responsibilities away and reverting to a childlike state where you could more easily express feelings in an “immature” way.

Question 27

Freud: Defense Mechanisms: REPRESSION

Answer 27

The most “basic” defense mechanism is repression, which underlies all other defense mechanisms and occurs when the id’s drives and needs are excluded from conscious awareness by maintaining them in the unconscious.

Maybe the person has internalized the negative situation and is aware of its presence. But rather than completely denying its existence, the person just refuses to consciously think about it. This is repression. It is similar to denial, but it is simply pushing the negative situation away rather than completely refusing to acknowledge the situation in the first place.

Example of Repression as a Defense Mechanism

Your friend just lost their grandparent. When this happened to you, you experienced a hard time. Out of concern for your friend, you ask them how they are doing. They brush off your concern. Every time you want to bring up their grief, they try to change the subject or let you know tersely that it’s tough, but everything is just fine. They may not be denying their grief or the death of their grandparent, but they are not allowing themselves to experience their full emotions about the situation.

Question 28

Freud: Defense Mechanisms: SUBLIMATION

Answer 28

Not all defense mechanisms are unhealthy. Sublimation is considered to be one of the more productive defense mechanisms. When a person confronts a desire that they have not achieved or expectations that they feel they cannot fulfill, they put their energy into constructive activities. These activities may or may not be related to the thing they are insecure about. When these activities aren’t as constructive as the person thinks, they could fall into an obsession, addiction, or just plain unhealthy habits.

Examples of Sublimation

For example, a woman may work out excessively to cover up insecurities about her weight. A man may study hours and hours a day to cover up for insecurities of being intelligent or unsuccessful.

Question 29

Freud: Defense Mechanism: PROJECTION

Answer 29

Projection, which occurs when a threatening impulse is attributed to another person or other external source.

A person may take feelings that they are uncomfortable with and project them onto another person. While this is commonly viewed as a “subtle” defense mechanism, it can be painfully obvious when an angry person is just dealing with insecurities or questions that they don’t want to answer about themselves.

Example of Projection as a Defense Mechanism

Have you ever watched a movie where the ruthless school bully ends up being insecure? Maybe you can name a few of these ruthless bullies in real life. They tell someone that they are fat or ugly – but only because they feel those things about themselves. This is a prime example of projection.

Question 30

Freud: Freudian Psychoanalysis
(Defense Mechanisms, Analysis)

Answer 30

According to Freud, when the ego is unable to ward off danger (anxiety) through rational, realistic means, it may resort to one of its defense mechanisms (e.g., repression, reaction formation) which share two characteristics: They operate on an unconscious level and they serve to deny or distort reality. In psychoanalysis, the analysis of free associations, dreams, resistances, and transferences consists of a combination of confrontation, clarification, interpretation, and working through.

Question 31

General Systems Theory

Answer 31

General systems theory defines a system as an entity that is maintained by the mutual interactions of its components and assumes that the actions of interacting components are best understood by studying them in their context. Consistent with general systems theory, family therapists view the family as primarily an open system that continuously receives input from and discharges output to the environment and is adaptable to change. The influence of general systems theory on family therapy is evident in the concept of homeostasis, which is the tendency for a family to act in ways that maintain the family’s equilibrium or status quo.

Question 32

Gestalt Therapy
(Boundary Disturbance, Transference, Awareness)

Answer 32

Gestalt therapy views awareness” (a full understanding of one’s thoughts, feelings, and actions in the here-and-now) as the primary curative factor and defines neurosis as a “growth disorder” that is often attributable to a boundary disturbance (e.g., introjection) that leads to an abandonment of the self for the self image. Gestaltians regard a client’s transference to be counterproductive and respond to it by helping the client recognize the difference between his/her “transference fantasy” and reality.

Question 33

Group Therapy
(Formative Stages, Cohesiveness,
Premature Termination)

Answer 33

According to Yalom, therapy groups typically pass through three formative stages – (1) orientation, participation, search for meaning, and dependency; (2) conflict, dominance, and rebellion; and (3) development of cohesiveness. Yalom describes cohesiveness as the most important curative factor provided by group therapy and the group therapy analog for the therapist–client relationship in individual therapy. He proposes that prescreening of potential group members and post–selection preparation can reduce premature termination from group therapy and enhance therapy outcomes.

Question 34

Health Belief Model

Answer 34

The health belief model proposes that health behaviors are influenced by (1) the person’s readiness to take a particular action, which is related to his/her perceived susceptibility to the illness and perceived severity of its consequences; (2) the person’s evaluation of the benefits and costs of making a particular response; and (3) the internal and external cues to action” that trigger the response.”

Question 35

High– Vs. Low–Context Communication

Answer 35

Members of many culturally diverse groups in America exhibit high–context communication, which relies on shared cultural understanding and nonverbal cues. It helps unify a culture and is slow to change. In contrast, Anglos are more likely to exhibit low–context communication, which relies primarily on the verbal message, is less unifying than high–context communication, and can change rapidly and easily. Differences in communication style can lead to misunderstandings in cross–cultural therapy.

Question 36

Homosexual (Gay/Lesbian) Identity Development Model

Answer 36

Troiden’s (1988) model of homosexual identity development distinguishes between four stages – sensitization/feeling different, self–recognition/identity confusion, identity assumption, and commitment/identity commitment.

Question 37

Howard and Colleagues
(Dose Dependent Effect;
Phase Model)

Answer 37

Howard et al. (1996) identified a dose dependent effect of psychotherapy – i.e., about 75% of patients show measurable improvement at 26 sessions and that this number increases to only about 85% at 52 sessions. They also identified a phase model, which predicts that the effects of psychotherapy are related to the number of sessions and distinguishes between three phases: remoralization, remediation, and rehabilitation.

Question 38

Hypnosis
(Repressed Memories)

Answer 38

Orne and Dinges propose that hypnosis involves experiencing alterations of memory, perception, and mood in response to suggestions and characterize its essential feature as a “subjective experiential change” (1989, p. 1503). Although hypnosis has been used to help people recover repressed memories, the research suggests that it does not seem to enhance the accuracy of memories, may produce more pseudomemories (inaccurate or confabulated memories) than accurate memories, and may exaggerate a person’s confidence in the validity of uncertain memories, especially for those that are inaccurate.

Question 39

Interpersonal Therapy
(Primary Problem Areas)

Answer 39

Interpersonal therapy (IPT) is a brief manual–based therapy that was originally developed as a treatment for depression, but it has since been applied to a number of other conditions. IPT focuses on symptom reduction and resolving one or more primary areas of interpersonal functioning – unresolved grief, interpersonal role disputes, role transitions, and interpersonal deficits.

Question 40

Jung’s Analytical Psychotherapy

Answer 40

Analytical psychotherapy views behavior as being determined by both conscious and unconscious factors, including the collective unconscious which is the repository of latent memory traces that have been passed down from one generation to the next. Included in the collective unconscious are archetypes (primordial images) that cause people to experience certain phenomena in universal ways. Therapeutic strategies include the interpretation of dreams and transferences (which reflects projections of both the personal and collective unconscious). A key concept in Jung’s personality theory is individuation, which refers to an integration of the conscious and unconscious aspects of the psyche that occurs in the later years and leads to a unique identity and the development of wisdom.

Question 41

Mental Health Consultation (Caplan)

Answer 41

Caplan distinguished between four types of mental health consultation: (1) Client–centered case consultation focuses on helping the consultee work more effectively with a particular client. (2) Consultee–centered case consultation focuses on enhancing the consultee’s ability to deliver services to a particular group or population of clients. (3) Program–centered administrative consultation involves working with one or more administrators (consultees) to resolve problems related to a particular program. (4) Consultee–centered administrative consultation involves enhancing the ability of administrators to develop, implement, and evaluate programs.

Question 42

Motivational Interviewing (Oars)

Answer 42

Motivational interviewing was developed specifically for clients who are ambivalent about changing their behavior and combines the transtheoretical (stages of change) model with client–centered therapy and the concept of self–efficacy. The specific techniques of motivational interviewing are open–ended questions, affirmations, reflective listening, and summaries (OARS).

Question 43

Multisystems Model
(Boyd–Franklin)

Answer 43

Boyd–Franklin’s multisystems model is an ecostructural approach for African American families that addresses multiple systems, intervenes at multiple levels, and empowers the family by utilizing its strengths. Systems that may be incorporated into treatment include the extended family and nonblood kin, the church and other community resources, and social service agencies.

Question 44

Network Therapy

Answer 44

Network therapy has been identified as an effective intervention for American Indian clients and is often used as a treatment for alcohol and drug abuse. It is a multimodal treatment that incorporates family and community members into the treatment process and situates an individual’s problems within the context of his/her family, workplace, community, and other social systems.

Question 45

Object–Relations Family Therapy
(Projective Identification, Multiple Transferences)

Answer 45

For object relations family therapists, maladaptive behavior is the result of both intrapsychic and interpersonal factors. A primary source of dysfunction is projective identification, which occurs when a family member projects old introjects onto another family member and then reacts to that person as though he/she actually has the projected characteristics or provokes the person to act in ways consistent with those characteristics. The primary goal of therapy is to resolve each family member’s attachment to family introjects and involves addressing multiple transferences (i.e., transferences of one family member to another, transferences of each member to the therapist, and transferences of the family as a whole to the therapist).

Question 46

Parallel Process

Answer 46

Parallel process occurs in clinical supervision when the therapist (supervisee) behaves toward his/her supervisor in ways that mirror how the client is behaving toward the therapist.

Question 47

Personal Construct Therapy

Answer 47

George Kelly’s personal construct therapy focuses on how the client experiences the world. It assumes that a person’s psychological processes are determined by the way he or she “construes” (perceives, interprets, and predicts) events, with construing involving the use of personal constructs, which are bipolar dimensions of meaning (e.g., happy/sad, competent/incompetent) that begin to develop in infancy and may operate on an unconscious or conscious level.
The goal of therapy is to help the client identify and revise
or replace maladaptive personal constructs so that the client is better able to “make sense” of his/her experiences.

Question 48

Person–Centered Therapy
(Facilitative Conditions)

Answer 48

Rogers’ person–centered therapy is based on the assumptions that people possess an inherent ability for growth and self–actualization and that maladaptive behavior occurs when incongruence between self and experience” disrupts this natural tendency. The therapist’s role is to provide the client with three facilitative conditions (empathy

Question 49

Prevention
(Primary, Secondary, Tertiary)

Answer 49

Methods of prevention are classified as primary, secondary, or tertiary: Primary preventions make an intervention available to all members of a target group or population in order to keep them from developing a disorder. Secondary preventions identify at–risk individuals who are showing early signs of a disorder and offer them appropriate interventions. Tertiary preventions are designed to reduce the duration and consequences of an illness that has already occurred.

Question 50

Psychiatric Inpatients
(Demographic Characteristics)

Answer 50

Research on the utilization rates of mental health services has provided the following information about the demographic characteristics of psychiatric inpatients: (1) For both men and women, admission rates into psychiatric hospitals are lowest among the widowed, intermediate for those who are married or divorced/separated, and highest for the never married. (2) Although Whites represent the largest number of psychiatric inpatients, when population proportions are taken into account, patients from other races are overrepresented. (3) For both men and women, the largest proportion of admissions is in the 25 to 44 age range.

Question 51

Racial/Cultural Identity Development Model

Answer 51

The Racial/Cultural Identity Development Model (Atkinson, Morten, & Sue, 1993) distinguishes between five stages that people experience as they attempt to understand themselves in terms of their own minority culture, the dominant culture, and the oppressive relationship between the two cultures. The five stages are: conformity (positive attitudes for the dominant group), dissonance (confusion and conflict over contradictory attitudes), resistance and immersion (active rejection of the dominant group), introspection (uncertainty about the rigidity of Stage 3 beliefs), and integrative awareness (adoption of a multicultural perspective).

Question 52

Reality Therapy

Answer 52

Glasser’s reality therapy is based on choice theory, which assumes that people are responsible for the choices they make and focuses on how people make choices that affect the course of their lives. It proposes that people have five basic innate needs (survival, love and belonging, power, freedom, and fun) that that a person adopts a success (versus failure) identity when he/she fulfills these needs in a responsible way.

Question 53

Separation–Individuation (Mahler)

Answer 53

Mahler’s version of object relations theory focuses on the processes by which an infant assumes his/her own physical and psychological identity, and her model of early development involves several phases. The development of object relations occurs during the separation–individuation phase, which begins at four to five months of age. According to Mahler, adult psychopathology can be traced to problems that occurred during separation–individuation.

Question 54

Sexual Minorities
(Internalized homophobia, Coming Out)

Answer 54

Issues faced by lesbian, gay, bisexual, and transsexual (LGBT) individuals include internalized homophobia and coming out: Internalized homophobia occurs when LGBT individuals accept negative stereotypes about sexual minorities and incorporate them into their self–concept. Consequences include low self–esteem, self–doubt, and self–destructive behavior. Coming out (disclosing one’s sexual orientation) to family members, friends, and others is associated with rejection and other negative consequences as well as with higher levels of self–esteem and positive affectivity, lower levels of anxiety, and other positive consequences. Research suggests that the age of coming out is about the same for gay males and lesbians.

Question 55

Sexual Stigma, Heterosexism, And Sexual Prejudice (Herek)

Answer 55

Herek (2004) argues that the term homophobia is ambiguous and imprecise and proposes that it be replaced with sexual stigma, heterosexism, and sexual prejudice.

Sexual stigma refers to the shared knowledge of society’s negative regard for any nonheterosexual behavior, identity, relationship, or community” (p. 15).

Heterosexism refers to cultural ideologies, which are “systems that provide the rationale and operating instructions” (p. 15) that promote and perpetrate antipathy, hostility, and violence against homosexuals.

Sexual prejudice refers to negative attitudes that are based on sexual orientation, whether the target is homosexual, bisexual, or heterosexual. Herek found higher levels of sexual prejudice among heterosexual men (versus heterosexual women) and among individuals who are older, have lower levels of education, live in Southern or Midwestern states or in rural areas, or have limited personal contact with homosexuals.

Question 56

Smith, Glass, And Miller
(Meta–Analysis/Effect Size)

Answer 56

Smith et al. used meta–analysis to combine the results of the psychotherapy outcome studies and found, contrary to Eysenck, that psychotherapy does have substantial benefits. In one study, they obtained an average effect size of .85, which indicates that the typical therapy client is better off than 80% of individuals who need therapy but are untreated.

Question 57

Solution–Focused Therapy (Questions)

Answer 57

Solution–focused therapists focus on solutions to problems rather than on the problems themselves. In therapy, the client is viewed as the expert” while the therapist acts as a consultant/collaborator who poses questions designed to assist the client in recognizing and using his/her strengths and resources to achieve specific goals (e.g., the miracle question, exception questions, scaling questions).

Question 58

Strategic Family Therapy
(Paradoxical Interventions)

Answer 58

Haley’s strategic family therapy focuses on transactional patterns and views symptoms as interpersonal events that serve to control relationships. Therapy focuses on symptom relief (rather than insight); and involves the use of specific strategies, especially paradoxical interventions (e.g., ordeals, prescribing the symptom, reframing) that are designed to alter the behavior of family members by helping them see a symptom in an alternative way or recognize they have control over their behaviors or by using their resistance in a constructive way.

Question 59

Structural Family Therapy
(Boundaries, Rigid Triads, Joining)

Answer 59

Minuchin’s structural family therapy emphasizes altering the family’s structure in order to change the behavior patterns of family members. Boundaries (rules that determine the amount of contact that is allowed between family members) are one element of the family structure: When boundaries are overly rigid, family members are disengaged and when they are too diffuse or permeable, family members are enmeshed. Minuchin distinguished between three chronic boundary problems, or rigid triads: detouring, stable coalition, and triangulation.

Question 60

Telepsychology

Answer 60

The use of the telephone, text, e-mail, chats, interactive tele-video conferencing technologies, or virtual reality for mental health assessment and treatment.

Question 61

Therapist–Client Matching

Answer 61

Research on therapist–client matching in terms of race, ethnicity, or culture has produced inconsistent results. However, matching may reduce premature termination for members of some groups (e.g., Asian and Hispanic/Latino). Some research suggests that other factors (e.g., similarity in values and worldview) are more important than similarity in terms of race, ethnicity, or culture.

Question 62

Transtheoretical Model
(Stages Of Change)

Answer 62

Prochaska and DiClemente’s (1992) transtheoretical model of behavior change proposes that the change process involves six stages (precontemplation, contemplation, preparation, action, maintenance, termination) and that interventions are most effective when they match the person’s stage of change – e.g., consciousness raising, dramatic relief, and environmental reevaluation are useful for helping clients transition from the precontemplation to the contemplation stage.

Question 63

Treatment Manuals

Answer 63

Treatment manuals were originally developed to standardize psychotherapeutic treatments so their effects could be empirically evaluated and to provide guidelines for training therapists. They specify the theoretical underpinnings of the treatment along with treatment goals and specific therapeutic guidelines and strategies. A potential limitation of treatment manuals is that they may oversimplify the therapeutic process.

Question 64

Triangular Model

Answer 64

A form of supervision that emphasizes providing service to clients that includes organizational policies, professional knowledge, and the supervisory relationship.

Question 65

White Racial Identity Development Model

Answer 65

According to Helms (1990), White racial identity development involves two phases: abandoning racism (statuses 1–3) and developing a nonracist white identity (statuses 4–6). Her White Racial Identity Development Model involves six statuses (stages): contact (little awareness of racism), disintegration (increasing awareness of race and racism which leads to confusion and conflict), reintegration (idealization of White society and denigration of members of minority groups), pseudo–independence (questioning of racist views), immersion–emersion (confrontation of own biases), and autonomy (internalization of a nonracist White identity).

Question 66

Worldview (Sue)

Answer 66

As defined by Sue (1978), a person’s worldview is affected by his/her cultural background and is determined by two factors – locus of control and locus of responsibility. Differences in worldview can affect the therapeutic process. For example, White middle–class therapists typically have an internal locus of control and internal locus of responsibility (IC–IR) and are likely to have problems working with an African American client with an internal locus of control and external locus of responsibility (IC–ER) who may challenge the therapist’s authority and trustworthiness and be reluctant to self–disclose.