Ch. 16: Psychological Treatment

Family therapy

A treatment approach that includes all family members, not just the identified patient.

in vivo exposure

Exposure that takes place in a real-life situation as opposed to in a therapeutic or laboratory setting.

Efficacy

In a situation where treatment is tested under ideal conditions (usually in a controlled clinical trial), _______ is how well a given treatment improves clinical outcome compared to a control or comparison condition.

Token economies

Reinforcement techniques often used in hospital or institutional settings in which patients are rewarded for socially constructive behaviors with tokens that can then be exchanged for desired objects or activities.

Behavior therapy

Use of therapeutic procedures based primarily on principles of classical and operant conditioning.

c) 15 percent

What percentage of U.S. adults receives professional mental health care each year? a) 10 percent b) 30 percent c) 15 percent d) 20 percent

d) Men may be less able to recognize and label feelings of distress than women.

Which of the following can help explain why men may be more reluctant to seek help and therapy? a) Unlike women, men can effectively reduce their symptoms of mental illness on their own, without therapy. b) Unlike men, women prefer taking control of their problems by entering treatment. c) Men tend to have less severe mental illness than women. d) Men may be less able to recognize and label feelings of distress than women.

Motivational Interviewing (MI)

A brief form of therapy, often used in areas of substance abuse and addiction, that allows clients to explore their desires, reasons, ability, and need for change.

antianxiety drugs

Drugs that are used primarily for alleviating anxiety.

antidepressant drugs

Drugs that are used primarily to elevate mood and relieve depression. Often also used in the treatment of certain anxiety disorders, bulimia, and certain personality disorders.

contertransference

Psychodynamic concept that the therapist brings personal issues, based on his or her own vulnerabilities and conflicts, to the therapeutic relationship.

Psychodynamic therapy

Psychological treatment that focuses on individual personality dynamics, usually from a psychodynamic or psychodynamically derived perspective.

Which of the following is a key element of the therapeutic relationship? a) Family involvement b) A warm and loving relationship between the therapist and client c) Agreement between the client and therapist about the goals of treatment d) Client reliance on the therapist for direction and guidance

c) Agreement between the client and therapist about the goals of treatment

Hannah has been a patient of Dr. Jones for the past year. Dr. Jones often invites Hannah out for coffee or dinner and has been known to kiss Hannah on the cheek. Recently, he suggested that Hannah join him on a trip to the Caribbean. Dr. Jones's behavior is an example of __________. a) enmeshment with the client b) a paternalistic therapist c) a boundary violation d) countertransference

c) a boundary violation

Which of the following are the three mental health professionals most likely to administer psychological treatment services? a) psychiatric social workers, counseling psychologists, and pastoral counselors b) psychiatrists, psychiatric nurses, and licensed professional counselors c) clinical psychologists, psychiatrists, and psychiatric social workers d) clinical psychologists, licensed professional counselors, and human services assistants

c) clinical psychologists, psychiatrists, and psychiatric social workers

When treatments are __________, ethnic minorities are less likely to drop out of treatment and tend to do well. a) administered appropriately b) lengthened c) culturally adapted d) shortened

c) culturally adapted

A questionable therapeutic technique called __________ involved having an individual guide an autistic child's hand over a computer keyboard with the assumption that the child was "talking" through typing on the keyboard. a) assisted speech b) enhanced communication c) facilitated communication d) digital interaction

c) facilitated communication

manualized therapy

Standardization of psychosocial treatments (as in development of a manual) to fit the randomized clinical paradigm.

Traditional behavioral couple therapy (TBCT)

Widely used form of therapy that uses behavioral approaches to bring about changes in the marital relationship.

Transcranial magnetic stimulation (TMS)

A treatment in which the clinician positions a pulsed magnet over a carefully selected area of the patient's scalp and uses it to create an electrical field that increases or decreases neuronal activity in the brain.

Flooding

Anxiety-eliciting therapeutic technique involving having a client repeatedly experience the actual internal or external stimuli that had been identified as producing anxiety reactions.

Systematic desensitization

Behavior therapy technique for extinguishing maladaptive anxiety responses by teaching a person to relax or behave, while in the presence of the anxiety-producing stimulus, in some other way that is inconsistent with anxiety.

Imaginal exposure

Form of exposure therapy that does not involve a real stimulus. Instead, the patient is asked to imagine the feared stimulus or situation.

Rational emotive behavior therapy (REBT)

Form of psychotherapy focusing on changing a client's maladaptive thought processes, on which maladaptive emotional responses and thus behavior are presumed to depend.

response shaping

Positive reinforcement technique used in therapy to establish, by gradual approximation, a response not initially in a person's behavioral repertoire.

d) new treatment approaches should be developed to recognize that many men see little value in talking about their problems and may respond more positively to action-focused treatments

In order to make therapy a better fit for men, it has been suggested that __________. a) treatment should be less focused on abstract concepts, such as self-actualization, and more on concrete solutions b) contemporary treatment for men should include exposure to emotionally expressive alternative role models in order to help men "normalize" their need for treatment c) in order to benefit from therapy, male clients need to develop a "feeling language" through affective skills training before moving into problem-resolution work of therapy d) new treatment approaches should be developed to recognize that many men see little value in talking about their problems and may respond more positively to action-focused treatments

latent content

In psychoanalytic theory, repressed actual motives of a dream that are seeking expression but are so painful or unacceptable that they are disguised by the manifest content of the dream.

manifest content

In psychoanalytic theory, the apparent (or obvious) meaning of a dream; masks the latent (or hidden) content.

Transference

In psychodynamic therapy, a process whereby clients project onto the therapist attitudes and feelings that they have had for a parent or others close to them.

modeling

Learning of skills by imitating another person who performs the behavior to be acquired.

b) personal growth reasons

Maria is a successful financial analyst who has been married for 20 years and is the mother of two adolescent children. Although Maria feels loved by family and friends and is happy in work and marriage, she recently entered therapy. Maria's reason for entering therapy most likely is for __________. a) a growing fear of the impact of environmental changes b) personal growth reasons c) an awareness of her own mortality and the aging process d) a nagging desire to be helpless and taken care of by someone else

Integrative behavioral couple therapy (IBCT)

Modification of traditional behavioral couple therapy that has a focus on acceptance of the partner rather than being solely change oriented.

Tardive dyskinesia

Neurological disorder resulting from excessive use of antipsychotic drugs. Side effects can occur months to years after treatment has been initiated or has stopped. The symptoms involve involuntary movements of the tongue, lips, jaw, and extremities.

Client-centered (person-centered) therapy

Nondirective approach to psychotherapy, developed chiefly by Carl Rogers, that focuses on the natural power of the organism to heal itself; a key goal is to help clients accept and be themselves.

c) reaching an agreement about the goals and steps of the therapy

Raquel started seeing a therapist to help her with her social anxiety. When her therapist suggested that she start completing exposures to feared social situations (e.g., public speaking), Raquel was not happy. She had no desire to complete the exposures and she felt that the therapist was pushing this technique on her, when she just wanted to talk about her anxiety with a therapist. In this situation, one key factor Raquel and her therapist need to work on is __________, a component of the therapeutic alliance, to make sure Raquel stays in therapy and completes treatment. a) the transference relationship between the patient and the therapist b) Raquel's motivation c) reaching an agreement about the goals and steps of the therapy d) clear communication

Psychopharmacology

Science of determining which drugs alleviate which disorders and why they do so.

resistance

Second stage of responding to continuing trauma, involving finding some means to deal with the trauma and adjust to it. In psychodynamic treatment, the person's unwillingness or inability to talk about certain thoughts, motives, or experiences.

Gestalt therapy

Therapy designed to increase the integration of thoughts, feelings, and actions and to promote self-awareness and self-acceptance.

couple therapy

Treatment for disordered interpersonal relationships involving sessions with both members of the relationship present and emphasizing mutual need gratification, social role expectations, communication patterns, and similar interpersonal factors.

Psychotherapy

Treatment of mental disorders by psychological methods.

Electroconvulsive therapy (ECT)

Use of electricity to produce convulsions and unconsciousness; a treatment used primarily to alleviate depressive and manic episodes. Also known as electroshock therapy.

randomized clinical trials (RCTs)

a clinical trial in which participants are randomly assigned to different treatments

What instrument has become almost standard in pre- and post-therapy assessment of depression? a) Beck Depression Inventory b) Quick Inventory of Depressive Symptomatology Self-Report c) Hamilton Depression Rating Scale d) Zung Self-Rating Depression Scale

a) Beck Depression Inventory

Administering the medication __________ has been a useful adjunct to exposure therapy with patients who have social anxiety. The medication assists the therapy by __________. a) D-cycloserine; activating a receptor that is critical in facilitating extinction of anxiety b) venlafaxine; encouraging the release of GABA, which in turn reduces patient discomfort during the extinction treatment sessions c) escitalopram oxalate; activating a receptor that is critical in facilitating extinction of anxiety d) fluoxetine; encouraging the release of GABA, which in turn reduces patient discomfort during the extinction treatment sessions

a) D-cycloserine; activating a receptor that is critical in facilitating extinction of anxiety

What therapeutic practice is known to inflict great harm, and even death, on patients? a) Rebirthing b) Unfacilitated communication c) Pharmaceutical therapy d) Attachment therapy

a) Rebirthing

The use of lithium as a treatment for __________, aside from health risks and reported deaths associated with its use to treat hypertension, was delayed because __________. a) bipolar disorder; it is a naturally occurring substance that cannot be patented and therefore is not profitable to be produced by pharmaceutical companies b) depressive disorder; lawsuits related to the hypertension treatment deaths resulted in the drug receiving a Schedule I classification for many years c) depressive disorder; producing the drug is quite expensive, thus making it difficult to market d) bipolar disorder; use of the drug for treating the disorder still posed health risks when a strict diet was not adhered to

a) bipolar disorder; it is a naturally occurring substance that cannot be patented and therefore is not profitable to be produced by pharmaceutical companies

Carol is involved in a time-limited therapy where she is encouraged to look at how she uses past schemas developed from her relationships with parents and others to understand her current relationships. Carol's therapist appears to be using __________ in her work with Carol. a) interpersonal therapy b) behavioral activation therapy c) self-therapy d) Gestalt therapy

a) interpersonal therapy

Medications are often used without including psychotherapy to treat psychological disorders. A downside of focusing only on treatment with medication is that __________. a) medications may alleviate symptoms by inducing biochemical changes, but do not help the individual understand and change the personal or situational factors that may be creating or reinforcing maladaptive behaviors b) ensuring patient compliance with consistently taking medication is difficult c) insurance companies require larger client co-payments for medications than what is required for psychotherapy d) patients can become addicted to medications, thus requiring a lifetime use of the medication or a slow withdrawal from the medication

a) medications may alleviate symptoms by inducing biochemical changes, but do not help the individual understand and change the personal or situational factors that may be creating or reinforcing maladaptive behaviors

Researchers studying psychotherapy have attempted to apply methodology similar to that used in drug studies in order to evaluate effectiveness. One factor that makes using this model for evaluating therapies challenging is __________. a) the difficulty of creating a placebo condition that will appear credible to patients b) recruiting participants for psychotherapy research is more difficult than recruiting participants for drug trials c) the higher attrition rate for participants in therapy studies compared to those participating in drug studies d) the problem of assessing what content from the psychotherapy sessions should be confidential and what content can be included for research analysis

a) the difficulty of creating a placebo condition that will appear credible to patients

Weisman and colleagues are developing culturally informed treatments for the families of patients with schizophrenia that consider __________. a) the role of family cohesiveness as well as spirituality and religion in the therapy process b) nutritional and financial counseling as important stability factors in treatment success c) the importance of improving assimilation of the minority member into the dominant culture d) education about schizophrenia through clinicians and other mental health professionals from the same culture

a) the role of family cohesiveness as well as spirituality and religion in the therapy process

Research on the impact of matching the client's race and ethnicity with the therapist's indicates that __________. a) there is no solid evidence that outcomes are diminished when client and therapist are not matched b) while clients do not care whether there is a match, outcomes are influenced by a lack of matching c) racial matching is crucial to success, but that matching on the client's primary language is not d) racial matching is crucial to success; the evidence on ethnic matching is less conclusive

a) there is no solid evidence that outcomes are diminished when client and therapist are not matched

Which of the following statements is most accurate regarding psychotherapy? a) Only a few types of psychotherapy exist to treat mental illness. b) Psychotherapy is often less expensive in the long-run than other forms of treatment, like medications. c) Psychotherapy is only effective for individuals with mild mental illness. d) Psychotherapy is often more expensive in the long-run than other forms of treatment, like medications.

b) Psychotherapy is often less expensive in the long-run than other forms of treatment, like medications.

_________ uses techniques such as clarification, confrontation, and interpretation to help the patient understand and correct the distortions that occur in his or her perception of other people. a) Rational emotive behavior therapy b) Transference-focused psychotherapy c) Client-centered therapy d) Dialectical behavior therapy

b) Transference-focused psychotherapy

What do the medications used to treat mental illnesses do? a) Restore brain chemistry to normal functioning b) Treat the symptoms of the illness with biochemical changes c) Cure the illness d) Replace depleted neurotransmitters

b) Treat the symptoms of the illness with biochemical changes

During psychotherapy, client progress is not always smooth or linear. At times, however, clients have been known to make big positive changes from one session to the next. It has been suggested that these changes are the result of __________. a) increases in the volume of neural pathways between the prefrontal cortex and parietal regions of the patient's brain b) cognitive changes that the patients experience in critical sessions c) the patient experiencing an intense emotional catharsis during a session and, consequently, being able to release tension d) the patient developing trust in the therapist and being willing to talk more openly about problems

b) cognitive changes that the patients experience in critical sessions

Rhea has experienced severe and debilitating depression over the past 5 years keeping her from maintaining a job. Several treatments have been tried, but none of these treatments, including behavioral therapy and antidepressants, have been effective. Which novel treatment, although very invasive, may help reduce Rhea's symptoms and get her back to work? a) transcranial imaging stimulation b) deep brain stimulation c) prefrontal lobotomy d) bilateral electroconvulsive therapy

b) deep brain stimulation

Client-centered psychotherapy, as developed by Carl Rogers, emphasizes __________. a) assisting people in recognizing the impact early relationships have on how clients interpret current relationships in life b) helping people remove constraints and restrictions that grow out of unrealistic demands that they place on themselves c) the need to resolve unconscious conflicts that are blocking an individual's ability to have a fulfilling life d) challenging irrational beliefs that are preventing an individual from having a fulfilling life

b) helping people remove constraints and restrictions that grow out of unrealistic demands that they place on themselves

Benzodiazepines are a widely-used antianxiety drug that that helps reduce acute anxiety and agitation, and at high doses, help to treat insomnia. However, the use of benzodiazepines is associated with __________. a) tardive dyskinesia b) psychological and physiological dependence alongside high relapse rates after discontinuation of the drug c) weight gain d) increasing symptoms of anxiety in the short-term

b) psychological and physiological dependence alongside high relapse rates after discontinuation of the drug

Neuroleptics are used to treat __________. a) impulse-control disorders b) psychotic disorders c) anxiety disorders d) mood disorders

b) psychotic disorders

Chrissy and her therapist together wrote a list of ten scenes involving Chrissy's fear of flying. After teaching her a relaxation technique, Chrissy's therapist told her to imagine herself in the least frightening scene while she made herself feel relaxed. Chrissy was undergoing ________ a) rational emotive therapy. b) systematic desensitization. c) exposure in vivo. d) modeling therapy.

b) systematic desensitization.

The conventional antipsychotic drugs have a problematic side effect involving abnormal movement. This side effect is called ________ a) agranulocytosis. b) tardive dyskinesia. c) atypical neuroleptics. d) monoamine oxidase.

b) tardive dyskinesia.

Treatment with conventional antipsychotic medications such as chlorpromazine can cause patients to develop __________, which is __________. a) bradykinesia; difficulty with maintaining posture and balance b) tardive dyskinesia; a movement abnormality c) tachycardia; a faster than normal heart rate d) athetosis; difficulty swallowing or clearing the throat

b) tardive dyskinesia; a movement abnormality

Research on the impact of matching the client's race and ethnicity with the therapist's indicates that ________ a) while clients do not care whether there is a match, outcomes are influenced by a lack of matching. b) there is no solid evidence that outcomes are diminished when client and therapist are not matched. c) racial matching is crucial to success, but ethnic matching is less conclusive. d) racial matching is crucial to success, but matching on the client's primary language is not.

b) there is no solid evidence that outcomes are diminished when client and therapist are not matched.

Contemporary therapists often describe their approach to treatment as "eclectic." By this term, therapists imply that __________. a) their treatment approach may involve only one technique practiced within the school of thought that the therapists adhere to b) they combine concepts and techniques from various schools of psychological thought in order to best meet the needs of the client c) treatment may involve practices from Eastern philosophical points of view d) therapeutic interventions will follow an acceptance-based model of treatment

b) they combine concepts and techniques from various schools of psychological thought in order to best meet the needs of the client

Dasia participated in a therapy session aimed at helping her overcome her fear of spiders. The therapy session consisted of Dasia being taken by her therapist into a room teeming with non-venomous spiders. She was instructed to confront her fear and to remain in the room with the therapist and spiders until she was no longer afraid. The technique used to treat Dasia's fear of spiders is called __________. a) counterconditioning b) imaginal exposure c) flooding d) systematic desensitization

c) flooding

In recent years, psychosurgery has been used with patients who have severe obsessive-compulsive disorder (OCD). Although many of these patients obtain relief from clinical symptoms of OCD, on follow-up, a large percentage of these patients exhibit __________. a) anterograde memory problems b) high levels of anxiety and depression c) impaired executive functioning on cognitive tests, problems with apathy, and disinhibited behavior d) motor coordination problems and problems with depth perception

c) impaired executive functioning on cognitive tests, problems with apathy, and disinhibited behavior

Assessing the treatment needs and outcomes of minority groups is difficult to fully assess because __________. a) most therapy researchers are members of a minority group and therefore cannot possess unconscious cultural biases that can impact the implementation and interpretation of therapy research b) differences in culture make it difficult to determine what the actual treatment needs of minority groups are c) minority groups are disproportionately underrepresented in treatment research studies d) many minority groups do not self-identify in research protocols

c) minority groups are disproportionately underrepresented in treatment research studies

Bupropion (Wellbutrin) is an antidepressant that inhibits the reuptake of both norepinephrine and dopamine. This medication has been shown to help reduce symptoms of depression and __________. a) symptoms of spider phobia b) anxiety in people with agoraphobia c) nicotine cravings and symptoms of withdrawal in people who want to quit smoking d) episodes of binging and purging in people with bulimia

c) nicotine cravings and symptoms of withdrawal in people who want to quit smoking

The advantage of using outside independent observers or pre/post-test comparisons to evaluate a client's progress is that ________ a) they take less time and are less costly. b) they provide a valid prediction of how the client will behave in real life. c) they increase the objectivity of ratings over those given by the people involved in treatment. d) they ensure that there is no "regression to the mean" phenomenon.

c) they increase the objectivity of ratings over those given by the people involved in treatment.

Currently, there is no empirical evidence that racial discrepancies between clients and their therapists impact the efficacy of treatment. However, this lack of evidence should be interpreted with caution because __________. a) some therapists report that they feel more effective when working with clients of a different racial group b) some people think that therapists are less effective when working with clients of different racial groups c) treatment studies tend to include relatively small numbers of minority participants, making it difficult to know if a true effect exists d) treatment studies do not provide the opportunity to self-identify as a different racial group

c) treatment studies tend to include relatively small numbers of minority participants, making it difficult to know if a true effect exists

It can be difficult for a person who identifies as a racial/ethnic minority to find a therapist who matches their racial/ethnic identity as only __________ of therapists are racial/ethnic minorities. a) 15 percent b) 12.4 percent c) 8.8 percent d) 16.4 percent

d) 16.4 percent

Research suggests that about __________ of patients show clinically significant change after 21 therapy sessions and, after 40 sessions, about __________ of patients have improved. a) 30 percent; 50 percent b) 50 percent; 55 percent c) 30 percent; 60 percent d) 50 percent; 75 percent

d) 50 percent; 75 percent

__________ was a questionable form of therapy for children with attachment problems that involved therapists wrapping children in blankets, sitting on them, and squeezing them. a) Renewal b) Attachment therapy c) Simulated birth-trauma therapy d) Rebirthing

d) Rebirthing

Which of the following factors would limit the effectiveness of imaginal exposures (but not in vivo exposures) in reducing, for example, phobic anxiety? a) The patient may not believe in the therapy as strongly, so it will not work as well. b) The therapist may not believe in the therapy as strongly, so it will not work as well. c) These decrease the anxiety produced by in vivo exposures, thus reducing their effectiveness later on in treatment. d) The patient may be unwilling or unable to vividly imagine the phobic stimulus.

d) The patient may be unwilling or unable to vividly imagine the phobic stimulus.

Which of the following pieces of evidence would most directly provide a therapist with evidence that their patient is showing reductions in symptoms of a specific phobia? a) Their patient shows greater activation of the orbitofrontal cortex when looking at pictures of insects during an fMRI test. b) Their patient tells them that they are no longer fearful of insects. c) Their patient terminates therapy. d) Their patient is now willing to hold insects of different types and sizes for extended periods

d) Their patient is now willing to hold insects of different types and sizes for extended periods

Benzodiazepines work by __________. a) blocking reuptake of norepinephrine b) blocking the reuptake of serotonin c) enhancing the activity of dopamine receptors d) enhancing the activity of GABA receptors

d) enhancing the activity of GABA receptors

The focus of integrative behavioral couple therapy (IBCT) is to __________. a) teach partners to resolve their own inner conflicts in a more constructive way through training in communication skills and adaptive problem solving b) help the couple understand past familial roles they may be playing out in their current relationship c) help the couple understand distortions that occur in their perception of each other d) help each member of the couple come to terms with and accept some of the limitations of his or her partner

d) help each member of the couple come to terms with and accept some of the limitations of his or her partner

The goal of motivational interviewing is to __________. a) assist the client in being able to assess the rationality of their beliefs and to challenge personally held irrational beliefs b) identify aspects of the client's self or world that are not being acknowledged in their awareness c) address interpersonal issues that are played out during the therapy session between the therapist and the client d) help the client resolve ambivalence about change and make a commitment to treatment

d) help the client resolve ambivalence about change and make a commitment to treatment

Pharmaceutical companies are required by the FDA to conduct studies measuring drug efficacy by using informed human subjects that are randomly assigned to either a group that receives the drug being investigated or a group receiving a placebo. These studies are referred to as __________. a) government-endorsed clinical trials (GECTs) b) calibrated clinical trials (CCTs) c) randomized treatment efficacy trials (RTETs) d) randomized clinical trials (RCTs)

d) randomized clinical trials (RCTs)

Clinicians may not be the best judge of client success because __________. a) they may fall prey to a patient's attempt to flatter or please the clinician with false life details b) they may overpathologize client difficulties c) they are limited by their own cultural definitions of successful adaptation d) they may be biased in favor of seeing themselves as competent and successful

d) they may be biased in favor of seeing themselves as competent and successful

Today, neurosurgery for psychological disorders is __________. a) still used regularly on patients who have not responded to any other treatment b) no longer practiced—it has been completely replaced by medication c) done frequently for certain types of psychological illnesses, such as obsessive-compulsive disorder d) used as a last resort and involves the destruction of only tiny areas of the brain

d) used as a last resort and involves the destruction of only tiny areas of the brain

Traditional behavioral couples therapy __________. a) tries to involve spouses in the treatment of people with severe mental disorders to prevent relapse after they are released from the hospital b) treats the couple together for any problems that one of them has, because the couple is seen as a "system" in which each person influences the other c) uses training in relaxation skills and imagery to reduce anxiety in couples d) uses training in communication skills and adaptive problem-solving to increase caring behaviors in couples

d) uses training in communication skills and adaptive problem-solving to increase caring behaviors in couples

neurosurgery

surgery on the nervous system, especially the brain

structural family therapy

treatment of an entire family by analysis of interaction among family members