Clinical Psychology EPPP Test Questions

The term "incongruence" as defined by Carl Rogers refers to a chasm between Select one: A. the real self and the ideal self. B. self-as-object and self-as-process. C. the perceived self-concept and the real self. D. the person's current maturity level and the person's potential.

Correct Answer is: A According to Carl Rogers' theory, which underlies his person-centered approach to psychotherapy, the healthy person is one striving toward self-actualization, which means that he is open to experience, creative, trusting of his feelings, flexible in his self-concept, and striving to meet his full potential as a human being. He contrasted the self-actualizing tendency with incongruence, which refers to a conflict between the real (or perceived) self and the ideal self. Incongruence results from conditions of worth being placed on the person, by oneself and/or others, which means that the person is only positively regarded under certain conditions. By contrast, unconditional positive regard fosters the self-actualizing tendency, and Rogers identified unconditional positive regard--along with genuineness and empathy--as one of three therapist attitudes crucial to the success of person-centered therapy.

According to Janet Helms' (1995) White Racial Identity Development Model, the final stage of racial identity development is: Select one: A. autonomy B. disintegration C. reintegration D. immersion-emersion

Correct Answer is: A According to Helms, autonomy is the final stage of racial identity development. Autonomy is characterized by a nonracist White identity based on a realistic understanding of the strengths and weaknesses of White culture. At this stage, Whites value and seek out cross-racial interactions.

An anxious client has a churning stomach, which BASIC I.D. area would be primarily addressed by biofeedback? Select one: A. sensation B. affect C. behavior D. imagery

Correct Answer is: A According to Lazarus multimodal therapy (MMT), the acronym BASIC ID represents the seven areas of the client's life or categories of interrelated aspects of personality which need to be addressed for effective treatment: behavior, affect or affective response, sensation, imagery, cognition, interpersonal relationships, and the need for drugs or other biological functioning. Multimodal clinicians tailor treatment to meet the individual client's needs (i.e., different relationship styles, individual, couples or group therapy) holding that "the correct method delivered within and geared to the context of the client's interpersonal expectancies, will augment treatment adherence and enhance therapeutic outcomes." In this question, the first-order anxiety response is in the sensory modality (churning stomach), so sensory techniques such as biofeedback or relaxation exercises would be used as initial treatments.

When patients bring medical information they have accessed on the Internet to a doctor's visit, the doctor-patient relationship is most likely to suffer if Select one: A. the physician feels that the patient is challenging the authority of the physician. B. the patient brings inaccurate information. C. the patient makes a clinically inappropriate request for medication based on the information. D. the physician is not very "tech-savvy."

Correct Answer is: A According to a survey of physicians in the United States, a large percentage of patients bring medical information they have accessed on the Internet to doctor's visits. The survey found that the doctor-patient relationship could be harmed if this information is inaccurate, or if the physician feels his or her authority is being challenged. However, the latter factor, physicians' perceptions of a challenge to their authority, was a stronger predictor of harm to the relationship than any other factor. This factor was also the strongest predictor of deterioration in health outcomes and the quality of care received.According to psychoanalytic theory, defense mechanisms are derived: Select one: A. by the unconscious part of the ego transforming the warded-off impulse into a symptom which allows for both gratification of the wish and adherence to the prohibition against its expression. B. to satisfy the id's wish for unbridled gratification without threatening the needs of the ego or the superego. C. as a means of keeping unconscious libidinal or aggressive impulses from reaching consciousness. D. as a result of conflict between the ego's attempt to follow reality and the superego's demands for adherence to social norms.

A student seeks counseling at the university counseling center due to feelings of failure as a student. When asked about his grades, he states that his grade point average is 3.9 but thinks that he should be doing better. He is most likely using which of the following cognitive distortions? Select one: A. arbitrary inference B. overgeneralization C. personalization D. dichotomous thinking

Correct Answer is: A Arbitrary inference occurs when one draws a specific conclusion without supporting evidence, or even in the face of contradictory evidence. This best applies to the student in this question. Despite having a nearly perfect GPA, the student believes he's a failure and should be doing better. Overgeneralization is the application of a general rule based on a few isolated incidents. Personalization is attributing external events to oneself without evidence of a causal connection. And dichotomous thinking is categorizing experiences into one of two extremes.

George Kelly emphasized that: Select one: A. people view the world through cognitive schemas B. individuals progress from infantile dependency to mature interdependency C. psychopathology is caused by past traumatic events D. psychopathology is caused by a maladaptive "style of life"

Correct Answer is: A George Kelly was perhaps the first cognitive theorist and introduced his "psychology of personal constructs" in 1955. A construct, which is synonymous with a schema, is a cognitive template through which the world is interpreted. individuals progress from infantile dependency to mature interdependency This choice represents a major tenet of Self-in-Relation Theory. psychopathology is caused by past traumatic events This is contrary to what Kelly believed. He believed that individuals' interpretations of events are more important than the events themselves. psychopathology is caused by a maladaptive "style of life" This uses the language of Adler.

A person's negative attitudes toward an individual because of his or her sexual orientation is referred to by Gregory Herek (2000) as: Select one: A. sexual prejudice B. homophobia C. homosexism D. gay inequality

Correct Answer is: A Gregory Herek, an authority on prejudice against lesbians and gay men, suggests the use of the term "sexual prejudice" to refer to all negative attitudes based on sexual orientation, whether the target is homosexual, bisexual, or heterosexual. Herek suggests that "sexual prejudice" is a more appropriate term than "homophobia" - which refers to heterosexuals' dread of being in close quarters with homosexuals and homosexuals' self-loathing.

Psychodrama seeks to examine and resolve difficult situations through guided dramatization and the release of creative forces inherent in the individual. The issue or problem to be explored in the psychodrama is chosen by the: Select one: A. protagonist B. antagonist C. director D. audience

Correct Answer is: A Most associated with Jacob L. Moreno, psychodrama employs experiential methods, role theory, sociometry and group dynamics to facilitate insight, personal growth, and integration on cognitive, behavioral and affective levels. Psychodrama provides participants a safe, supportive environment in which to practice new and more effective roles and behaviors. There are three distinct components of group interaction in a classically structured psychodrama session: the warm-up, the action and the sharing phases. In the warm-up phase, the group theme is identified and a protagonist (which is the the correct option), individual(s) who represents the theme in the drama, is selected. In the action phase the problem is dramatized and the protagonist explores new methods of resolving it. Then in the sharing phase, group members or the audience may express or share their associations, experience or connection with the protagonist's work. The other components of psychodrama include: auxiliary egos, or group members who assume the roles of significant others in the drama; the director, a trained psychodramatist who guides participants through each phase of the session; and the stage, the physical space in which the drama is conducted.

A therapist using Beck's cognitive approach to therapy would rely primarily on which of the following to induce desirable changes in a depressed client? Select one: A. Socratic questioning B. interpretation C. reflecting D. clarification and explanation

Correct Answer is: A Questioning is a very important strategy in Beck's cognitive therapy and, in fact, the majority of communications by the therapist take the form of questions designed to help the client consider particular issues, options, and so on.

Premature termination would be most likely to occur when Select one: A. an African-American client has a Caucasian therapist. B. an African-American client has an African-American therapist. C. a Caucasian client has an African-American therapist. D. a Caucasian client has a Caucasian therapist.

Correct Answer is: A Research with African-American clients on the relationship between therapist-client racial similarity and therapy effectiveness has yielded contradictory results and suggests that this relationship is mitigated by a variety of factors. A clearer relationship exists between similarity and premature termination, with the probability of premature dropout increasing when an African-American client works with a racially dissimilar therapist.

Solution-focused brief therapists in group work: Select one: A. utilize questioning B. focus on identifying an individual's problem C. use a directive, expert stance. D. emphasize insight as the main mechanism of change.

Correct Answer is: A Solution-focused brief therapy, also referred to as solution focused or brief therapy, is a form of psychotherapy based on social constructionist philosophy that focuses on solutions rather than problems or their causes. Underlying this approach is the assumption that clients possess the resources needed to achieve their goals. The solution-focused therapist works with people to generate solutions to their problem using direct and indirect compliments and future-oriented questions such as the miracle question.

The term "best practices" refers to: Select one: A. empirical evidence to support effectiveness of counseling approaches B. counselor characteristics that contribute to increased effectiveness. C. matching certain client problems with specific counseling models D. clinical decision making accountability and concerns for service costs

Correct Answer is: A The term "best practices" is defined as approaches to counseling practice that have empirical evidence to support their effectiveness. It is one way managed care companies and practitioners strive to maintain accountability for costs of services and clinical decision making, as well as ascertain the most effective practices available to individuals.

Although a therapy group started out with spontaneous, frequent interactions between group members, it has taken on a restrictive interaction pattern in which members speak in rotation so that only two or three members get to talk during each session. This is an example of: Select one: A. procedural norms. B. power maintenance. C. task orientation. D. family re-enactment.

Correct Answer is: A This situation is discussed by Yalom in his book titled The Theory and Practice of Group Psychotherapy. The question describes the procedure the group follows, and it apparently reflects a change in group norms. Therefore, the situation is an example of procedural norms.

Traditional Western approaches to individual psychotherapy can best be described as: Select one: A. linear and reductionist B. non-linear and holistic C. relativistic and abstract D. elitist and futile

Correct Answer is: A Traditional Western approaches to individual psychotherapy emphasize linear causal relationships and are reductionistic, that is, they tend to explain complex phenomena in terms of relatively simple principles. Non-linear, holistic, and relativistic are terms used to describe non-western and systems approaches.

Doug comes to see you because he is having problems with his supervisors at work, feeling undervalued and finding it difficult to maintain the new friendships he has made since moving to the area a year ago. You decide a "client-centered" approach with Doug would be most effective. The primary goal of such therapy is: Select one: A. development of "awareness" B. congruence between self and experience C. giving up irrational beliefs and ideas D. understanding of underlying intrapsychic conflicts

Correct Answer is: B A primary goal of the client-centered approach to therapy is achieving congruence between self and experience. Eliminating incongruence allows clients to reclaim their "self-actualizing" urges, or tendency to act, develop, and experience life in a manner that is consistent with their self-concept. Key to Rogers's theory is his concept of self, which includes the individual's perceptions of who he or she is, can do, etc. and of his or her relationships with other people, things, and so forth. Individuals are also thought to possess an image of the ideal self, or of the person they want to be. development of "awareness" This choice is associated with Gestalt therapy. giving up irrational beliefs and ideas This is associated with Rational Emotive therapy. understanding of underlying intrapsychic conflicts This is associated with psychoanalysis.

The acronym BASIC I.D is associated with: Select one: A. Frankl B. Lazarus C. Prochaska and DiClemente D. Beutler

Correct Answer is: B According to Lazarus' MMT, the acronym BASIC ID represents the categories of interrelated aspects of personality which need to be addressed for effective treatment: behavior, affect, sensation, imagery, cognition, interpersonal relationships, and the need for drugs or other biological functioning. Technically eclectic and theoretically drawing mainly from a broad-based social and cognitive learning theory, multimodal therapy is essentially psychoeducational, contends that many problems arise from misinformation and missing information and focuses on results or outcomes. In addition to use of a range of techniques, multimodal clinicians tailor treatment to meet the individual client's needs (i.e., different relationship styles, individual, couples or group therapy) holding that "the correct method delivered within and geared to the context of the client's interpersonal expectancies, will augment treatment adherence and enhance therapeutic outcomes."

A child feels confident in reaching out to others because as a baby they had a secure bond with their mother. This information would be important to a psychologist with the theoretical approach of: Select one: A. cognitive- behavioral B. object-relations C. Family systems D. Psychotherapeutic

Correct Answer is: B According to object relations theory, an object introject is the mental representation of a person, either the self or the mother. In a healthy environment the child comes to develop representations of itself based on the early interactions with the mother. When normal and age-appropriate development is delayed or skewed by having a distrubed parent, the person could easily fail to develop object introjects.

Albert Ellis' Rational Emotive Behavior Therapy focuses on Select one: A. uncovering childhood causes of current dysfunction. B. present problems and practical ways to solve them. C. reward and punishment for appropriate and inappropriate affective responses. D. self-monitoring and thought stopping.

Correct Answer is: B Albert Ellis' Rational Emotive Behavior Therapy (REBT, sometimes referred to as Rational Emotive Therapy, or RET) is based on the notion that irrational thinking, feeling, and behavior is behind most problems encountered in therapy. It relies on Ellis' A-B-C model of disturbance: An activating event (A) triggers irrational beliefs about that event (B), and those beliefs have consequences (C) such as negative emotions and self-defeating behavior. REBT adds D and E to this chain of events: The therapist disputes (D) the irrational beliefs, leading to their replacement with rational beliefs and an effective outlook (E). REBT focuses mostly on the present--currently-held maladaptive attitudes, emotions and behaviors. It does recognize that events in early life may play a role in people's problems, but it views the past as affecting people by contributing to beliefs that we hold in the present.

When working with ethnically, linguistically, and racially diverse populations, a therapist should emphasize: Select one: A. acculturation B. client's individual goals C. the political, social, and economic affects on mental health D. which stage of identity development the client is in

Correct Answer is: B Although all of the choices offered are important to consider when working with diverse populations, a therapist should not "emphasize" any of the choices other than the client's individual goals.

Asian-American students often outperform their non-Asian peers on various measures of academic achievement. Research suggests that the best predictor of higher achievement in Asian-Americans is: Select one: A. estimate of ability. B. fear of academic failure. C. self-efficacy beliefs. D. effort beliefs.

Correct Answer is: B Asian-American and non-Asian students not only differ in terms of achievement but also in their attributions for academic success. Asian-Americans are more likely to cite fear of failure as the main contributor to academic success, while non-Asians are more likely to attribute successful performance to effort.

Biofeedback is often part of treatments aimed at lowering tension and arousal and increasing relaxation. For this purpose, biofeedback is being used to control the: Select one: A. sympathetic nervous system. Incorrect B. parasympathetic nervous system. C. somatic nervous system. D. endocrine system.

Correct Answer is: B Biofeedback and other stress/anxiety reducing techniques are designed to induce a positive parasympathetic state since it is the parasympathetic nervous system that is responsible for rest, relaxation, and recuperation. On the other hand, if you wanted to increase blood flow to change body temperature, biofeedback would affect the sympathetic nervous system

Johnny, age 10, teaches his brother Justin, age 5, how to ride a skateboard. This interaction can best be described as: Select one: A. Parallel process B. Complementary communication C. Elaborative rehearsal D. Symmetrical communication

Correct Answer is: B Communication patterns can be characterized as either symmetrical or complementary. In symmetrical communication there is equality between the partners. In complementary communication there is inequality, with one member taking a dominant role and the other a subordinate role. In this example, Johnny, the older brother, took on the dominant teacher role and his younger brother was in the subordinate role of student. Although completely unrelated to this model, you should also be familiar with the other two terms -- parallel process and elaborative rehearsal. Parallel process is a phenomenon in clinical supervision where the therapist in training behaves toward the supervising therapist in ways that mirror how the client is behaving toward the therapist in training. Elaborative rehearsal involves thinking about how new information relates to existing memory.

Cultural differences and factors have an influence on the manifestation of client symptoms. If a psychologist assumes an Asian client's somatic complaints are really reflective of a mental disorder it is an example of: Select one: A. demand characteristics B. diagnostic overshadowing C. the fundamental attribution bias D. self-perception bias

Correct Answer is: B Diagnostic overshadowing is a term to describe when a therapist's ability to recognize or consider other symptoms or conditions is "overshadowed" by one aspect of a client's symptoms or condition. Demand characteristics* are unintentional cues in the experimental environment or manipulation that allow participants to guess the hypothesis and, as a result, participants may behave differently than they would under normal conditions. The fundamental attribution bias* refers to the tendency to overestimate dispositional (personality) factors and underestimate situational factors in explaining the behavior of others. Self-perception bias* refers to an individual inferring what their internal state is by perceiving how they are acting in a given situation (* incorrect options).

From the Freudian perspective, phobias are a means of reducing anxiety stemming from an unresolved conflict. Freud explained Little Hans's fear of horses, for instance, as due to an unresolved conflict that had its origins in the: Select one: A. genital stage. B. phallic stage. C. anal stage. D. oral stage.

Correct Answer is: B Freud described Little Hans's fear of horses as displacement of anxiety stemming from an unresolved Oedipus conflict.

In Gestalt therapy, introjection, projection, deflection, confluence and retroflection are examples of: Select one: A. layers of neurosis B. resistances to contact C. natural anxiety D. neurotic anxiety

Correct Answer is: B Gestalt therapy focuses on the "here and now" which encourages clients to gain awareness and full experiencing in the present. The term contact refers to interacting with nature and others without losing one's individuality. Resistances to contact are the defenses that one develops as a self-protective attempt to avoid the anxiety necessitated by change and prevents full experiencing in the present. The question lists the five defenses or types of resistance to contact. The five layers of neurosis, proposed by Perls (1969) to describe the process of working through neurosis are: phony, phobic, impasse, implosive, and explosive. Neurotic anxiety is the result of not facing normal anxiety.

Hypnosis would least likely be used in the treatment of: Select one: A. Substance Abuse. B. Obsessive-Compulsive Disorder. C. Specific Phobia. D. chronic pain.

Correct Answer is: B Hypnosis is contraindicated in individuals who have difficulty giving up control, such as obsessive-compulsive patients, or those who have difficulty with basic trust, such as paranoid patients. By contrast, hypnosis is often employed in the treatment of the other disorders. In the treatment of Substance Abuse, varying degrees of success have been reported; however, it continues to be used. It is also commonly used to help induce relaxation and/or gain access to painful memories in treating individuals with Anxiety Disorders; moreover, according to some, it is particularly effective in treating individuals with Specific Phobia because they are highly hypnotizable. Finally, hypnosis is also commonly used in the treatment of medical conditions that have a psychological component such as asthma, chronic pain, obesity, etc.

Increased awareness is the primary goal of which of the following types of therapy? Select one: A. Self Psychology B. Reality Therapy C. Gestalt Therapy D. Existential Therapy

Correct Answer is: C Although increased awareness can be considered an important goal of many types of therapy, it is perhaps most central to Gestalt Therapy. Gestalt therapy strives to increase an individual's awareness of the self, the environment, and the nature of the self-environment boundary.

Rationalist, cognitive therapy is most likely to involve Select one: A. relaxation training, systematic desensitization, and guided imagery. B. cognitive restructuring, reducing automatic thoughts, and thought stopping. C. a focus on unconscious and developmental processes. D. stress inoculation training, self-instruction, and stimulus control.

Correct Answer is: B In the literature, a distinction has been made between rationalist and constructivist cognitive therapies. Rationalist therapies are based on the assumptions that irrationality is the primary source of neurotic pathology, that explicit beliefs and logical reasoning can serve as a guide to emotion and behavior, and that the core process in effective therapy is the substitution of rational for irrational thought. The techniques described in the correct choice ("cognitive restructuring, reducing automatic thoughts, and thought stopping") are all designed to increase rational thought processes and/or decrease irrational thinking; thus, they are most in line with the assumptions of rationalist cognitive therapy. As compared to rationalist therapy, constructivist cognitive therapy is based on more complex and abstract assumptions, in which unconscious, developmental, and interactional processes are emphasized. You might have been thrown off by the word "rationalist" in the question. If so, it would have been best to answer the question as if it were about cognitive therapy in general. The best answer would still be "cognitive restructuring, reducing automatic thoughts, and thought stopping".

According to Jung, the term individuation refers to: Select one: A. differentiating between self and object. B. integrating aspects of the self to form a unique identity. C. the capacity to separate one's emotional and intellectual functioning. D. experiencing a state of anonymity.

Correct Answer is: B Individuation, as defined by Jung, involves integrating the conscious and the unconscious elements of the psyche and is the goal of psychological development. differentiating between self and object. This choice describes Mahler's separation-individuation phase of early development. the capacity to separate one's emotional and intellectual functioning. This refers to Bowen's concept of differentiation, which states the greater an individual's differentiation, the better he/she is able to resist emotionally fusing with other family members. experiencing a state of anonymity. Deindividuation, which occurs under conditions of anonymity, refers to the loss of a person's identity and a loosening of normal restraints against deviant behavior. It is used to explain why someone may be more willing to behave in uncharacteristic ways when acting as a member of a group than when acting alone.

The form of therapy based partially on the work of Harry Stack Sullivan that typically focuses on specific problem areas such as grief, role transitions, and social deficits is Select one: A. narrative therapy. B. interpersonal therapy. C. self-control therapy. D. rational-emotive therapy.

Correct Answer is: B Interpersonal Psychotherapy (IPT) is a short-term approach to the treatment of depression, and specifically for four problem areas it views as common in depressed clients: grief, role disputes, role transitions, and interpersonal deficits. The approach is based in part on the work of Harry Stack Sullivan, who is credited as one of the first pioneers of psychotherapy to focus on intrapersonal as opposed to intrapsychic problems. Treatment, which may consist of 12-20 sessions, is divided into three phases. In the initial phase, the presenting issue is identified and conceptualized as an interpersonal problem. Interventions in the intermediate phase depend on the specific problem area, but they focus directly on the problem area and interpersonal or social issues that contribute to it. Typical interventions include social skills training, role playing, and homework assignments. In the termination phase, the therapist and the client review the latter's progress, acknowledge the new skills acquired, and address feelings of loss that termination may evoke. Although originally developed as an individual therapy for adult depression, IPT has been modified and applied to treating adolescents and couples, and also to the treatment of other disorders seen as connected to interpersonal deficits, such as eating disorders.

Wolfgang Kohler, a founder of the gestalt school of learning and thought, is known for applying gestalt learning principles to the development of Select one: A. unfinished business. B. insight. C. integration of all parts of the psyche. D. awareness of psychological boundaries.

Correct Answer is: B Kohler, a founder of the gestalt school of psychology, studied insight learning. In one of his experiments, a chimpanzee had to get some food placed outside his cage. He had two sticks but they were too short to reach the food. As he was sitting with the two sticks in his hand, the chimp had what Kohler called an "a-ha experience": He quickly fit the sticks together and was able to get the food. This a-ha experience -- a sudden, novel solution to the problem -- is the basis of insight learning. According to Kohler, insight learning cannot be explained by traditional behavioral theories of learning, which are based on reinforcement and associations between stimuli.

According to Marlatt and Gordon, which of the following most increases the chance of relapse in a substance abuser? Select one: A. life changes B. negative affects C. physiological cravings D. decreased treatment durations due to the limits set by managed care companies

Correct Answer is: B Marlatt and Gordon are best known for their Relapse Prevention Therapy which views substance dependence as a collection of maladaptive over-learned habits. According to their research, nearly 75% of all relapses are due to negative affects, interpersonal conflict, and social pressure.

A child who uses the word "horse" to refer to a zebra is displaying Select one: A. overregularization. B. overextension. C. underregularization. D. underextension.

Correct Answer is: B Overextension refers to the use of a word to label a set of objects that is broader than the set the object or objects to which the word is intended to refer. In this case, the child is apparently using the word horse to refer to other four-legged animals; therefore, he is displaying overextension. Overextension is common in the speech of toddlers. Regarding the other choices, underextension is the opposite of overextension; it occurs when a child does not generalize the word's usage broadly enough. Overregularization refers to grammatical errors whereby a child uses a regular form for a word when the correct form is irregular (e.g., "holded" instead of held). Underregularization is a made up term.

High levels of stress are associated with: Select one: A. tension headaches, but not migraine headaches. B. migraine headaches, but not tension headaches. C. both tension headaches and migraine headaches. D. neither tension headaches nor migraine headaches.

Correct Answer is: C As their name suggests, tension headaches are associated with stress. The psychological correlates of migraine headaches are less clear, and more than one theory has been proposed regarding this issue; however, clinical observation has suggested that stress often plays a role in their onset.

Differences in communication style can act as a barrier in cross-cultural counseling. For example, some cultures have a high-context style, while others are more low-context. Which of the following is true about high-context communication and culture? Select one: A. The communication found in high-context cultures reflects an emphasis on rules of law and procedures. B. People belonging to high-context cultures rely heavily on nonverbal cues when communicating with others. C. People in high-context cultures make extensive use of elaborative codes in their speech. D. High-context communication changes rapidly and easily.

Correct Answer is: B The notions of high- and low-context communication were introduced by Edward T. Hall, the author of The Silent Language (1959) and The Hidden Dimension (1969). In the United States, the communication style of the Anglo majority is low-context, but many racial/ethnic minorities (e.g., Latino, Asian, African-American) make use of a high-context style. High-context communication is based on nonverbal language. Low-context communication on the other hand is based upon the verbal part of messages.

Howard et al.'s (1993) phase model of psychotherapy change does NOT include: Select one: A. remoralization B. reexamination C. remediation D. rehabilition

Correct Answer is: B The phase model of psychotherapy, an extension of the dose-response model of treatment response, was first proposed by Howard et al. in 1993 and is a client stage model that outlines a progressive, 3-stage sequence of change. The first phase, remoralization, focuses on the client's subjective well-being and occurs during the first few sessions. The second phase, remediation, focuses on symptom reduction and generally occurs between the 5th and 15th sessions. The third and final phase is rehabilitation which focuses on life functioning gains and emerges more gradually. According to this model, effective courses of treatment are initially characterized by a restored subjective sense of well-being then, as a function of this improvement, the client may benefit from interventions to provide symptom reduction or relief (e.g., decrease difficulty concentrating or sleep disruption) and finally, is able to either resume their former level of role functioning (e.g., doing well at work) or initiate new roles (e.g., obtaining a new job).

From the perspective of Beck's cognitive therapy, suicidal individuals are characterized by a high degree of hopelessness coupled with: Select one: A. maladaptive interpretations. B. poor problem-solving skills. C. the "cognitive triad." D. impulsivity.

Correct Answer is: B This is a difficult question if you are not familiar with Beck's work on suicide. Maladaptive interpretations and beliefs are, of course, an important focus in cognitive therapy regardless of the client's problem. However, since this question is asking specifically about suicide, you'd want to choose the response that fits that problem. According to Beck, suicide risk is heightened by a combination of hopelessness and poor problem-solving skills. Beck's Cognitive Triad of depression (not suicide) don't get it mixed up.

Differing locus of control and locus of responsibility combinations yield the four worldviews described by Sue and Sue (2003). Mainstream American culture would best be characterized by an: Select one: A. internal locus of control and external locus of responsibility B. internal locus of control and internal locus of responsibility C. external locus of control and internal locus of responsibility D. external locus of control and external locus of responsibility

Correct Answer is: B Worldview refers to the manner in which people perceive, evaluate and react to encountered situations. Sue and Sue describe mainstream American culture "as the epitome of the individual-centered approach that emphasizes uniqueness, independence and self-reliance" (p.277). This is characterized by an internal locus of control and locus of responsibility in Sue, D.W. & Sue, D. (2003). Counseling the culturally diverse: Theory and practice. 4th edition. New York: John Wiley.

From a family systems perspective, all of the following statements are true, except Select one: A. change in any one part of the family is associated with change in all other parts. B. the system is composed of interrelated parts. C. there is a constant dynamic toward chaos which is checked through family rituals and beliefs. D. the system maintains a balance of periods of change and periods of stability.

Correct Answer is: C A basic tenet of systems theory is that a system seeks homeostasis, or balance and stability. Consequently, the alternative description of a system as always tending toward chaos is actually opposite to what is the case. All the other alternatives are more or less true of the systems approach.

Therapists working with elderly patients should be aware that Select one: A. elderly patients have very poor memory. B. elderly patients cannot benefit much from psychotherapy. C. individual differences among elderly patients are greater than individual differences among younger patients. D. elderly people tend to drop out of therapy prematurely.

Correct Answer is: C A number of authors have noted that elderly individuals tend to vary greatly -- even more so than younger people -- in terms of physical abilities, intellectual abilities, interests, and personality characteristics. The other choices represent myths or stereotypes about the elderly that should be avoided.

According to psychoanalytic theory, defense mechanisms are derived: Select one: A. by the unconscious part of the ego transforming the warded-off impulse into a symptom which allows for both gratification of the wish and adherence to the prohibition against its expression. B. to satisfy the id's wish for unbridled gratification without threatening the needs of the ego or the superego. C. as a means of keeping unconscious libidinal or aggressive impulses from reaching consciousness. D. as a result of conflict between the ego's attempt to follow reality and the superego's demands for adherence to social norms.

Correct Answer is: C According to psychoanalytic theory, the function of defense mechanisms is to keep warded off impulses or wishes from reaching consciousness. Anxiety results when defense mechanisms break down and an impulse or wish can no longer be contained in the unconscious.

Which of the individuals listed is most associated with an emphasis on social interest? Select one: A. Berne B. Rogers C. Adler D. Perls

Correct Answer is: C Adler proposed an innate social interest primarily motivates people and acting in ways that fulfill social responsibilities is the goal of life. Humans are motivated by social urges unlike Frued's biological urges. Berne's best-known contribution to psychology is his development of transactional analysis. Rogers is best known for developing the psychotherapy method called client-centered therapy and for being one of the founders of humanistic psychology. Perls is known for founding Gestalt therapy.

The use of the technique known as self-instruction with hyperactive children involves Select one: A. programmed learning. B. having the children write down their daily goals in advance. C. having the children make self-statements. D. having the children do the their schoolwork by themselves.

Correct Answer is: C Donald Meichenbaum developed the technique of self-instruction as a means of helping impulsive and hyperactive children to perform tasks more successfully. The technique involves teaching the subject to make appropriate self-statements while performing a desired task.

Eysenck's 1952 study on psychotherapy outcome: Select one: A. concluded that individuals who receive psychotherapy are better off than 80% of controls B. concluded that psychologists and psychiatrists are more effective than master's level clinicians C. challenged the effectiveness of most psychotherapy treatments D. led to many other outcome studies, most of which have supported his findings

Correct Answer is: C Eysenck, in his 1952 study, found that 64% of patients in eclectic therapy and 44% of psychoanalytic patients improved versus a 72% improvement rate for untreated patients. His methodology and findings have been criticized for decades following his report and most studies since then have found psychotherapy to be superior to no treatment. concluded that individuals who receive psychotherapy are better off than 80% of controls This choice is one of the conclusions of Smith and Glass' (1978) meta-analysis. concluded that psychologists and psychiatrists are more effective than master's level clinicians This was not one of Eysenck's conclusions, and it is also contrary to a finding of Consumer Report's 1995 study which failed to find a relationship between therapist level of training and outcome. led to many other outcome studies, most of which have supported his findings This is partly correct, in that many other outcome studies did follow Eysenck's study; however, most of these have contradicted his findings. Indeed, even Eysenck modified his conclusion in 1985 by indicating that at least one therapy, behavior therapy, is superior to placebo or no treatment.

_________________ is a present-oriented, structured and time-limited treatment that integrates biological and psychosocial approaches. Select one: A. Motivational interviewing B. Solution-focused therapy C. Interpersonal psychotherapy D. Reality therapy

Correct Answer is: C Interpersonal psychotherapy (IPT) is a manualized psychotherapy first designed for the treatment of nonbipolar, nonpsychotic major depression with the focus on the problems of depression and interpersonal distress. IPT focuses on interpersonal aspects of depression and uses the biopsychosocial model which frames depression as a medical illness occurring in a social context. The goal of IPT is to alleviate symptoms with interpersonal relationships as a point of intervention. IPT has been found to be effective for the treatment of depression patients from adolescence to late life, for women with postpartum depression and for patients with medical comorbidity

Research on the use of mental health services by members of minority groups indicates that: Select one: A. utilization rates are lower for members of all minority groups than for whites. B. utilization rates are higher for members of all minority groups than for whites. C. utilization rates are higher for members of some minority groups and lower for members of other minority groups compared to whites. D. utilization rates for members of minority groups are about the same as the rates for whites.

Correct Answer is: C It's difficult to draw any general conclusions about utilization rates because the research findings are inconsistent. However, a 1991 study by Sue et al. (which is frequently cited in the literature) reports underutilization by Asian-and Latino-Americans and overutilization by African-Americans. The results of other studies also suggest that there are group differences in utilization rates, so this response ("utilization rates are higher for members of some minority groups and lower for members of other minority groups than for whites") is the best.

All of the following are true regarding Feminist Object Relations Theory except: Select one: A. it emphasizes the importance of the maternal relationship with the child. B. it proposes that gender differences are the result of girls being taught to remain attached to their mothers while boys are taught to separate from their mothers. C. it proposes that girls develop a healthier self-object when raised primarily by their father due to earlier separation from their mother. D. it proposes that mothering "reproduces itself" since mothers perpetuate the oppressiveness of the division of labor.

Correct Answer is: C Nancy Chodorow was one of the first to apply a feminist perspective to an Object Relations model. In The Reproduction of Mothering (Berkeley, University of California Press, 1978) she focused on the relationship between mother and child and how gender differences result from the mother being the primary caretaker. The division of labor which occurs in families (although less so in recent years), is characterized by women being more involved in affective, interpersonal relationships than men. This is inevitably passed on to both boys and girls who 'reproduce' this sexual and familial division of labor.

A therapist interested in evaluating the defenses that impact an individual's current maladaptive behavior patterns would be a practitioner of: Select one: A. personal construct therapy B. reality therapy C. object relations therapy D. solution-focused therapy

Correct Answer is: C Object relations therapy, as a psychodynamic therapy, involves an interest in defenses and transferences. Associated with Melanie Klein amongst others, object relations therapy incorporates traditional psychodynamic strategies such as the influence of unconscious processes underlying an individual's relationships, and identifying and interpreting defenses against anxiety and transferences. George Kelly's "personal construct therapy" combines cognitive, behavioral, and humanistic concepts. It emphasizes the effect of the individual's perspective on his/her experience of the world. Developed by William Glasser, "reality therapy" focuses on an individual's present issues and problems. Steve de Shazer and other strategic family therapists developed "solution-focused therapy" which focuses on the here-and-now and identifying solutions to problems.

According to Bowen, to reduce tension between them, family members often resort to: Select one: A. scapegoating. B. retribalization. C. triangulation. D. emotional divorce.

Correct Answer is: C Of the terms listed in the responses, only two are associated with Bowen (triangulation and emotional divorce). Bowen described triangles as a means of reducing tension and conflict between two family members who refocus their attention on the triangulated member.

According to Prochaska and DiClemente's Stages of Change Model, which stage best applies to a man who is aware of his drinking problem, recognizes the benefits of getting sober, and plans to quit drinking on his birthday in three months? Select one: A. Minimization B. Precontemplation C. Contemplation D. Preparation

Correct Answer is: C Prochaska and DiClemente described five Stages of Change in their model - which applies to many types of behaviors - not just substance abuse. The first stage is "Precontemplation," characterized by denial, resistance, and no plans to change. In the second stage, "Contemplation," a person begins to recognize the benefits of change and, although somewhat ambivalent, plans to change within the next 6 months. This best describes the person in this question. In the third stage, "Preparation," a person has decided to take action within the next 30 days and may have already begun to take small steps towards change. In the next stage, "Action," the person is actively engaged in making changes or acquiring new behaviors. The final stage is the "Maintenance" stage, in which the person has maintained action for at least 6 months and is actively working to prevent a relapse.

Which of the following variables is most strongly related to a preference for therapists of the same racial group in African-American psychotherapy clients? Select one: A. education B. IQ score C. racial/cultural identification D. presenting issue

Correct Answer is: C Research shows that the stronger a client's identification is with his or her racial or cultural background, the more likely he or she is to prefer a therapist from a similar background.

Researchers in the area of cognitive therapy have conducted studies regarding the predominant types and styles of cognition in different mental disorders. These studies have found all of the following to be distinguishing features of cognitions in depression and anxiety, except Select one: A. in depression, cognitions about hopelessness and failure are more common than in anxiety. B. depressed people are more likely to have absolute thoughts about negative themes; anxious people are more likely to have questioning thoughts about the future of events. C. anxious people tend to be self-absorbed; depressed people tend to be more absorbed with others. D. depressed people have enhanced recall of negative feedback; anxious people have enhanced recall of threatening situations.

Correct Answer is: C Self-absorption is characteristic of the cognitive and information processing style of both depressed and anxious individuals. The other choices about the differences between depressed and anxious individuals are true.

A father and his 19-year-old son present for therapy due a variety of conflicts in their relationship. The father is a businessman and the son is an artist. What techniques would a solution-focused family therapist use? Select one: A. Joining and restructuring. B. Paradoxical directives and reframing C. Miracle and scaling questions D. Non-directive listening and interpretation

Correct Answer is: C Solution-focused therapists use a variety of techniques designed to identify solutions to client's problems. The miracle and scaling questions are two such techniques used by solution-focused therapists. The miracle question invites the client to imagine what it would be like if his/her problem was suddenly gone. The scaling question invites each family member to rate a situation to see how the problem is perceived by others. Joining and restructuring Joining and restructuring is used by structural family therapists. Paradoxical directives and reframing Paradoxical directives and reframing is used by strategic family therapists. Non-directive listening and interpretation Non-directive listening and interpretation is used by object relations family therapists.

According to Atkinson, Sue, and Sue, the ideal outcome of racial/cultural identity development is Select one: A. full acceptance of one's own culture. B. giving individual identity priority over cultural identity. C. recognizing that all cultures have acceptable and unacceptable aspects. D. recognizing the impact of racial/cultural oppression on one's mental health.

Correct Answer is: C The final stage in Atkinson et al.'s racial/cultural identity development model is referred to as the "integrative awareness stage." Individuals in this stage recognize that all cultures have both positive and negative aspects and decide which aspects they want to accept or reject.

An elevated F score on the MMPI-2 (i.e., the F is greater than 70 and the K is very low) indicates that the: Select one: A. person is answering in a socially desirable manner. B. score should be considered in relation to the total profile. C. person is likely being careless or deliberately malingering. D. total profile can be considered valid.

Correct Answer is: C The validity scales on the MMPI-2, of which the F is one, are checks on response styles. Specifically, the F scale indicates if the person is answering in a deviant way, or is perhaps actually deviant. The higher the F, the more the answers suggest that the person is attempting to appear odd, disturbed, etc.

Traditional psychoanalytic psychotherapy and brief therapies derived from it share several characteristics but also differ in a number of ways. Which of the following is not true about brief forms of psychodynamic psychotherapy? Select one: A. In brief psychotherapy, past experiences are important to the degree that they contribute to the client's current conflicts. B. Brief therapy targets specific therapeutic goals, which are identified during the first few sessions. C. In order to solve a client's problems rapidly, brief therapy makes use of the "transference cure" rather than fostering the client's insight into his or her problems. D. Brief therapy can be described as a problem-solving process in which the therapist helps the client use his or her own resources to resolve current difficulties.

Correct Answer is: C This is the opposite of what is true. In brief forms of psychodynamic psychotherapy, client insight is desirable, although it is limited to those areas that are identified as the targets of therapy.

In group therapy, which of the following situations is most likely to increase a given member's self-disclosure? Select one: A. the group leader has made it clear that self-disclosure is expected B. a temporary and uncomfortable silence has pervaded the group C. other members of the group have freely self-disclosed D. the group consists solely of verbal and intelligent individuals

Correct Answer is: C This question is actually about social psychology as much as it is about group therapy. Research in social psychology has illustrated that we are more likely to talk openly about ourselves after someone else opens up about him or herself. This phenomenon has been termed "self-disclosure reciprocity."

Troiden's (1989) model of homosexual identity development indicates: Select one: A. females typically realize that they are homosexual at a younger age than males. B. females and males typically realize they are homosexual at about the same age. C. males typically begin to "come out" as homosexual at a younger age than females. D. males and females typically begin to "come out" as homosexual at about the same age.

Correct Answer is: C Troiden's model distinguishes between four age-related stages: sensitization, identity confusion (self-recognition), identity assumption, and identity commitment. Sensitization begins before puberty and consists of homosexual feelings or experiences without an understanding of them in terms of self-identity. Identity confusion, sometimes referred to as self-recognition, is when an individual realizes that he or she may be homosexual. This usually develops in adolescent males around 17 years and in females around 18 years of age. During identity assumption, the individual comes out as a homosexual - typically from 19-21 years for males and 21-23 for females. Identity commitment is characterized by the individual adopting a homosexual lifestyle - which usually occurs from 21-24 years for males and 22-23 for females.

An individual's symptoms of tension headaches, nausea, hyperventilation and heart palpitations would be most likely to be interpreted by a client-centered therapist as relating to: Select one: A. overwhelming environmental stress B. being unable to fulfill one's own needs C. unresolved intrapsychic conflicts D. denied threats to the self-concept

Correct Answer is: D According to client-centered therapy, when an individual's natural tendency toward growth and actualization is disrupted by incongruence between the self and experience (e.g., others' evaluations differing from one's self-concept), personality and behavioral problems arise. Denying or distorting the experience is one way of dealing with the incongruence. According to Rogers, denial and distortion leads to anxiety which may result in visceral symptoms such as those listed in the question.

An African-American client refuses to work with a non African-American therapist under any circumstances. From the perspective of Atkinson, Morten, and Sue's Minority Identity Development Model, Select one: A. the client's reaction is typical and expected due to lifelong experiences of racism. B. the client's reaction reflects a failure of racial identity development. C. the client may be in the dissonance stage of identity development. D. the client may be in the resistance and immersion phase of identity development.

Correct Answer is: D Atkinson, Morten, and Sue's Minority Identity Development Model is based on the notion that the phases of development are rooted in the struggle to form a strong sense of self- and group identity in the face of oppressive conditions. They identified five phases of cultural identity development that blend into each other, without clear boundaries: 1) conformity, in which individuals reject the values of their own racial group and strive to assimilate into the dominant culture; 2) dissonance, a transition phase where positive attitudes towards the dominant culture and negative attitudes toward one's own group are examined and questioned; 3) resistance and immersion, which involves unconditional acceptance of one's own racial group and complete rejection of the dominant culture; 4) introspection, where the person questions the monolithic viewpoints of the previous stage, is able to see positive as well as negative aspects of the dominant culture, and focuses more on individual identity issues; and 5) synergistic articulation and awareness, which is characterized by a secure balance between personal and racial identity, the desire to eliminate all forms of oppression as opposed to just oppression aimed at one's own group, and appreciation of positive aspects of the dominant culture. From the perspective of this theory, the resistance and immersion phase of development would most likely include rejecting any possibility of working with a therapist of a different racial group. It is true that such a refusal could be due to lifelong experiences of racism, as stated by the choice "the client's reaction is typical and expected due to lifelong experiences of racism." However, because you are asked to answer from the perspective of the Minority Identity Development Model, the correct answer is a better option.

Which of the following therapeutic approaches refers to changing or adapting to the environment by altering one's own behaviors or responses? Select one: A. emic B. etic C. alloplastic D. autoplastic

Correct Answer is: D Autoplastic ("self-change" ) refers to changing or adapting to the environment by altering one's own behaviors or responses. An emic perspective involves focusing on the intrinsic distinctions that are meaningful to members of a particular culture or society. An etic perspective involves focusing on extrinsic distinctions that have meaning for the observer of the culture or society. Alloplastic refers to changing or adapting to the environment by effecting changes in the environment.

Classical psychoanalytic theory and the object-relations theories both emphasize Select one: A. the interaction between the id, the ego, and the superego. B. the importance of separation and individuation in childhood. C. the need for a therapist to "re-parent" the patient. D. the role of early childhood experiences in personality development.

Correct Answer is: D Both Freudian theory and object-relations theory stress the role of early childhood experience in personality development. Freud believed that adult personality hinges to a large extent on how conflicts (e.g., the oedipal conflict) are resolved in childhood, while the object-relations theorists posit that a child's early experiences determine the development of his or her introjects (mental representations of self and others), which determine personality functioning as an adult. the interaction between the id, the ego, and the superego. This choice applies to Freudian theory. the importance of separation and individuation in childhood. This applies to object-relations theory. the need for a therapist to "re-parent" the patient. This applies to object-relations theory.

A therapist working from the perspective of Beck's cognitive therapy would approach the treatment of Panic Disorder by Select one: A. having the client identify maladaptive thoughts that precede panic attacks and then restructuring those thoughts. B. connecting the panic attacks to the client's overall attributional styles. C. teaching the client methods of self-reinforcement to use when he or she is not having a panic attack and methods of self-punishment to use when he or she is having one. D. identifying and modifying the client's interpretation of panic attacks and their associated physical symptoms.

Correct Answer is: D Cognitive therapists believe that Panic Disorder is connected to "catastrophic misinterpretations" of bodily sensations, symptoms, and mentation. The client's "overcastrophization" of early signs of the attack such as hyperventilation results in a full-blown attack. Thus, at least initially, therapy focuses on identifying and modifying the client's misinterpretations of symptoms and thoughts immediately before and during the attack.

The concept "collaborative empiricism" is affiliated with which of the following theorists? Select one: A. Perls B. Freud C. Ellis D. Beck

Correct Answer is: D Collaborative empiricism is a central technique of Beck's cognitive-behavioral therapy and refers to the therapist and client working together to gather evidence and test the logic, or hypotheses, of the client's thoughts and beliefs. Cognitive Behaviorist Ellis is behind Rational Emotive Behavior Therapy (REBT) which is not collaborative and far more direct. Perls developed Gestalt therapy which focuses on the "here and now" which encourages clients to gain awareness and full experiencing in the present.

According to Janet Helms, a White member of a city council meeting, which consists of members from different racial and cultural backgrounds, is most likely to work cooperatively if the member is in which stage of development: Select one: A. contact B. integration C. reintegration D. autonomy

Correct Answer is: D Janet Helms developed the White Racial Identity Development Model, which consists of six stages. "Contact", the first stage, is characterized by ignorance and disregard of any racial differences. The next stage is "disintegration" which involves awareness of racial inequalities which results in moral confusion and conflict. This is followed by "reintegration", in which Whites are viewed as superior to minorities. "Pseudo-Independence" is marked by dissatisfaction with reintegration. "Immersion-Emersion" follows, during which, people embrace their whiteness without rejecting minorities. "Autonomy", the last stage, is reached when a person internalizes a nonracist White identity, whereby similarities and differences are acknowledged but are not perceived as threatening. Note that "Integration" is not one of the stages in Helms' model; rather, it refers to Berry's Acculturation Model, in which a minority has a high retention for the minority culture and high maintenance of the mainstream culture.

Which of the following techniques would be least useful when working cross-culturally with a traditional Japanese family in therapy? Select one: A. when possible, framing a family member's problems in an academic or vocational context to increase comfort with the counseling process B. establishing your credibility by providing information about your education and background in the first session C. providing the family with an immediate benefit in order to prevent premature termination D. fostering empowerment of family members by adopting an egalitarian approach

Correct Answer is: D Japanese (and other Asian) clients vary. However, a common generalization is that they prefer a structured, direct approach; another is that they view the therapist as a knowledgeable expert, so adopting an egalitarian approach would not be desirable.

A family therapist who uses anecdotes from her own family to emphasize similarities with the client's family is doing which of the following? Select one: A. reframing B. triangulating C. diffusing boundaries D. joining

Correct Answer is: D Joining, a technique used by structural family therapists (Minuchin) involves taking steps to become a family insider by, among other things, assuming the same type of communication style, sharing personal stories, etc.

Lazarus cognitive appraisal theory suggests the emotional reaction to a situation follows a cognitive assessment of the situation and identifies three types of appraisal: Select one: A. central appraisal, peripheral appraisal and re-appraisal. B. conscious, unconscious and semiconscious appraisal. C. phonemic, structural and semantic appraisal. D. primary appraisal, secondary appraisal and re-appraisal.

Correct Answer is: D Lazarus cognitive appraisal theory suggests the emotional reaction to a situation follows a cognitive assessment of the situation. His theory differentiates between three types of appraisal: primary, which refers to one's perception of the situation (i.e., positive, negative, or irrelevant); Secondary, which refers the assessment of resources available to deal with the situation; and re-appraisal, referring to watching the situation and changing the other types of appraisals as necessary. Structural, phonemic, and semantic are from the levels of processing theory of memory.

If you want to keep a patient with borderline personality disorder involved with group therapy, what would be the best technique? Select one: A. You have them consult with a psychiatrist for a medication evaluation. B. You help the patient with the defense mechanism of splitting. C. You invite a client with a histrionic personality disorder to join the group. D. Offer individual therapy in addition to group therapy.

Correct Answer is: D Marsha Linehan (1993) has been achieving success with patients diagnosed with borderline PD with her use of dialectical behavioral therapy (DBT) which involves a combination of groups skills training and individual outpatient therapy. This combination has been successful at decreasing premature dropout rates in group therapy, as well as reducing suicide attempts and inpatient hospitalization rates.

In working with a triangulated family, a structural family therapist would Select one: A. work with the most differentiated family members in order to reduce their emotional reactivity. B. use a paradoxical intervention by taking steps to increase the family's initial level of triangulation. C. train the family in communication skills and techniques. D. upset the family's balance by blocking the family from its normal interactional pattern.

Correct Answer is: D Minuchin, the founder of structural family therapy, defines triangulation as a family boundary problem in which each parent demands that the child side with him or her against the other parent. According to Minuchin, the therapist's goal in this and other situations in which parents attempt to deflect conflict onto children is to restructure the parent-child and spousal subsystems so they function correctly. This involves introducing some stress into the family system to upset the family's balance and block the family from its normal way of interacting. For example, Minuchin describes strategies such as prohibiting children from talking about symptomatic behavior with their parents, rewarding parents for their capacity to nurture and support each other, and restructuring the parents in a coalition against their child.

Research on the impact of therapist experience on therapy outcome suggests that Select one: A. there is a strong positive relationship between experience and outcome. B. there is a moderate relationship between experience and outcome, with the relationship being strongest when the client's symptoms are mild to moderate. C. there is a moderate relationship between experience and outcome, with the relationship being strongest when the client's symptoms are severe. D. there is, contrary to what might be expected, no predictable relationship between experience and outcome.

Correct Answer is: D Note that in the Clinical Psychology section, we report that there is little relationship between therapist experience and outcome. In other domains they say more experience is better for more challenging patients.

Whether sex therapy results in sustained change over time appears to vary depending on the presenting problem. According to outcome research on sex therapy, which of the following is not true? Select one: A. Sex therapy for vaginismus is highly effective in the short and long-term. B. Sex therapy for erectile dysfunction is highly effective in the short and long-term. C. Low sexual desire in men shows a relatively poor treatment response in the short and long-term. D. Low sexual desire in women shows a relatively poor treatment response in the short-term but is highly effective in the long-term.

Correct Answer is: D Sex therapy for vaginismus* and erectile dysfunction* is highly effective in the short- and long-term (one to six years). Results for premature ejaculation however suggest short-term success but less permanent results. Low sexual desire in BOTH genders shows poor short and longterm treatment outcomes. Some studies suggest clients that receive an occasional "booster" session, post-treatment may maintain better improvement through preventive measures and even though some individuals had returned to pretreatment dysfunctions in sexual behavior, sex therapy yielded an improvement in the way a many felt about their sexuality

In terms of worldview, Sue and Sue (1990) propose that minority groups are increasingly more likely to exhibit an Select one: A. external locus of control and responsibility. B. internal locus of control and responsibility. C. external locus of control, internal locus of responsibility. D. internal locus of control, external locus of responsibility.

Correct Answer is: D Sue and Sue (Counseling the Culturally Different, New York, John Wiley, 1990) indicate that minority group members are becoming increasingly aware of their own ethnic identity and adopting a worldview that reflects an internal locus of control and an external locus of responsibility. external locus of control and responsibility. An external locus of control and responsibility is more characteristic of a "placater" who adopts a passive role. internal locus of control and responsibility. Internal locus of control and responsibility is characteristic of the Westernized approach to counseling and white middle-class clients. external locus of control, internal locus of responsibility. An external locus of control and internal locus of responsibility is more characteristic of "marginalized" individuals who have been oppressed by the dominant group.

The Mini Mental Status Exam (MMSE) is especially useful for: Select one: A. assessing reality testing in individuals with a Psychotic Disorder B. assessing level of consciousness in individuals with Delirium C. screening for Mental Retardation in children and adolescents D. screening for Dementia in older adults

Correct Answer is: D The Mini Mental Status Exam (MMSE) is a screening tool for cognitive functioning that assesses five areas of cognitive functioning: orientation, registration, attention and calculation, recall, and language. It is most useful for screening for Dementia in older adults.

What type of therapy is being practiced if a psychotherapist uses a method called WDEP to teach a patient new ways of coping? Select one: A. Cognitive therapy B. Family systems therapy C. Rational emotive behavioral therapy D. Reality therapy

Correct Answer is: D The WDEP system is a feature of Reality Therapy, developed by Glasser and based on Choice theory. In Reality Therapy, the emphasis is on personal responsibility and balance of five basic needs: survival (i.e., breathing, digesting, and sweating); to love and belong (i.e., need for friends and family); power (i.e., self-esteem, recognition, and competition); freedom (i.e., make choices); and fun (i.e, play, laughter, learning, recreation). Reality therapy uses questioning techniques and the WDEP system provides a questioning framework with each letter representing an identifying idea: W - exploring the client's wants and perceptions, D - direction or what client is doing (acting, thinking, feeling, physiology) to get what they want, E - evaluate whether client's behavior is getting him/her closer or further from goal, and P- planning or creating and implementing a workable plan to make positive changes. Other techniques used in this therapy include role playing, the use of humor, confronting the client, and helping the client formulate plans.

It is estimated that 60 percent of children with Tourette's syndrome also have AD/HD. In treating Tourette's and other Tic Disorders, which of the following medications requires the greatest caution when used for treatment? Select one: A. pimozide B. fluoxetine C. clonidine D. methylphenidate

Correct Answer is: D Tourette's syndrome is a chronic tic disorder that involves vocal and motor tics. Recent estimates indicate 60 percent of children with Tourette's have AD/HD, and approximately 7 percent of children with AD/HD have tics or Tourette's syndrome. The symptoms are often mild, and a significant social impact only occurs in rare severe cases. According to recent research, psychostimulant medication is not related to the development of Tourette's syndrome in children with AD/HD. However, when there is a family history of tics or Tourette's syndrome, a cautious treatment approach is recommended as some individuals will experience worsening of their tics with stimulant treatment.