NCE Practice Qs Part 2

A bipolar client who is very nervous about transitioning into the community from a sheltered environment may benefit from which of the following? a. A support group b. A 12-step program c. Antidepressants d. Peer counseling

A: A bipolar client who is very nervous about transitioning into the community from a sheltered environment may benefit from a support group comprised of people dealing with similar issues. Support groups may have a mental health professional as a leader. Support groups are usually open groups that allow clients to choose whether or not to attend, but the groups provide a safe and supportive atmosphere where people can discuss shared concerns and methods of coping.

Which of the following is an example of hypomentalism? a. A client on the autism spectrum cannot pick up clues from another person's tone of voice or eye contact b. A client with schizophrenia believes he is under surveillance by the government c. A client with psychosis believes that he is receiving messages through the television d. A client with a psychotic spectrum disorder believes the counselor is in love with her

A: A client on the autism spectrum who cannot pick up clues from another person's tone of voice or eye contact is an example of hypomentalism. Mentalism is the ability to comprehend others actions and the world about one in mental terms, such as the ability to understand intention, belief, and emotions. Those with autism spectrum disorder tend to be hypomental while those with psychotic spectrum disorders tend to be overly alert and constantly "on-guard" or hypermental.

In contrast to feeling sorry for the client, the counselor needs to demonstrate __________ toward the client. a. empathy b. sympathy c. emotionality d. stability

A: A counselor needs to be able to understand the client's predicament, not feel sorry for the client. Understanding the client's predicament is called empathy. Feeling sorry for someone's predicament is sympathy and does nothing to empower the client. Although providing stability in the session is helpful, it is not what helps the client to work through the predicament. A counselor needs to keep his/her own emotions in check when working with a client. Emotionality on the part of the counselor usually serves to confuse the client or to add additional burden onto the client.

A couple comes in to see a counselor who specializes in sex counseling. Before the counselor agrees to treat the couple for sex counseling, she refers the couple for: a. a physical examination and medical history consultation by a medical practitioner. b. a clinical assessment and interview. c. sensate focus exercises. d. an exploration of the marital relationship.

A: A counselor who sees couples for sex therapy must first rule out any physical problems one or the other partner may or may not have. Therefore, one of the first courses of action is to have the couple see their physician to verify that there are no physiological reasons for the dysfunction.

A person received a t-score of 40. This means that: a. her score fell one standard deviation below the mean. b. her score is very low. c. there is an error. d. her score is higher than average.

A: A t-score has a mean of 50 and a standard deviation of 10. In this situation, the test taker received a t-score of 40. That score is one standard deviation below the mean. It is neither a very high nor a very low score. T-scores of 70 and 30 may be considered to be high and low, respectively. A t-score of 70 is two standard deviations above the mean, while a t-score of 30 is two standard deviations below the mean.

The mother of a young adult with autism spectrum disorder and severe impairments states she is often so tired at the end of the evening that she breaks down and cries. Which of the following is the care support that is probably the most essential at this time? a. Respite care b. Support group c. Volunteer visitor d. Spiritual support

A: Caregiving can be exhausting, so if the mother of a young adult with autism spectrum disorder and severe impairment is so tired that she begins crying, then she is overwhelmed and is most in need of respite care. The caregiver needs a break of even a few days in order to rest and have time for herself. If this is not possible, then part-time respite care in the home to allow the caregiver to relinquish caregiving for a few hours may help to reduce stress.

Jenny recently lost her job and fell behind in her mortgage payments, so now she is facing foreclosure. She is seeing a counselor to help her cope with the stress in her life. She feels like a failure and wants her self-esteem to be higher, and she feels that she is not living up to her potential. Her counselor tells her that her first priorities are to fulfill her more basic needs, such as applying for food stamps so she will not go hungry and getting help with her housing situation so that she meets her needs for safety and physical security. The counselor tells her that once she has addressed these basic needs, she can then address her higher- order needs for self-esteem and fulfilling her potential as a person. Which theorist has most influenced Jenny's counselor? a. Abraham Maslow b. Edward Thorndike c. Erik Erikson d. Harry Stack Sullivan

A: Abraham Maslow's humanistic theory posits a hierarchy of needs. The more basic needs such as food/water, shelter and safety must be met before higher-order needs, such as love, belonging, and self-esteem can be addressed, according to Maslow. Edward Thorndike is known for formulating the Law of Effect, which says that a reward reinforces the connection between a stimulus and a response; this law is fundamental to behaviorism. Erik Erikson is known for his psychosocial stage theory, identifying eight (later nine) stages, each of which contains a central crisis/conflict/task, which must be resolved in order to progress. Harry Stack Sullivan was a neo- Freudian theorist who stressed the importance of social/interpersonal relationships.

According to Freudian theory, where does the conscience reside? a. Superego b. Ego c. Id d. Preconscious

A: According to Freudian psychoanalytic theory, the conscience resides in the Superego. The Id knows only what the individual wants; the Ego knows it can't always get what it wants and negotiates between the Id and the Superego. The Superego is the moral part of the mind, imposing rules and punishing inappropriate thoughts and actions. For this reason, the Superego (where the conscience is) causes the Ego to feel anxiety/guilt when the individual's behavior diverts from what is deemed morally acceptable. The Superego is an important part of the personality for obvious reasons. If the Superego is underdeveloped, the individual may not experience the necessary tension between the Ego and Superego, and thus act inappropriately in interpersonal relationships or in society in general.

Which early theorist engaged in group therapy? a. Alfred Adler b. Carl Jung c. Sigmund Freud d. Carl Rogers

A: Alfred Adler is considered by many as one of the founding fathers of psychology. Both Sigmund Freud and Carl Jung (the other two founding fathers) talked about intrapsychic dynamics, focusing on the internal processes of the individual and using individual therapy as a treatment modality. However, Alfred Adler did not. Adler looked at the individual in relation to his/her environment, and so it was natural for him to embrace a less individualized approach to therapy. As early as the 1920s, he was already involved in use of group therapy.

Which of these is NOT an issue for adults in career transition that counselors should address during career counseling? a. Not wanting to undergo job transition b. Obsolete job skills/a need for retraining c. Lack of information/job-seeking skills d. Changes in physical abilities or values

A: Although resistance to change is a common human reaction and many adults in career transition may experience it, this is not identified as an issue in counseling adults in career transition. Thus, although it may certainly be an issue for counseling, it falls into the area of "identifying issues" as opposed to being a distinct issue of its own. Some people fear or resent change simply because it is a change. Others may resist change for more pragmatic reasons such as having outdated job skills. This can be remedied by counselors who can facilitate retraining. Still other individuals need to resolve issues around the changes in their physical capacities as they age learning to accept the reality that they may need a different kind of work or a different form of work in the same or a related field. Others will find that as they have grown older and times have changed, their values have changed as well. Finally, some may fear a transition because they lack the resources to obtain needed information and the skills to look for a new job. Career counseling can help people adjust to changes in themselves and their environment, as well as providing clients with the resources they need to make a successful transition.

The difference between confidentiality and privileged communication is: a. "privileged communication" is a legal term and confidentiality is an ethical concept. b. "confidentiality" is a legal term and privileged communication is an ethical concept. c. privileged communication is enforced only when a client asks something to be privileged. d. confidentiality is enforced only when a client asks that something be kept confidential.

A: Although the two terms may seem to come up within similar contexts, "privileged communication" is a legal term and "confidentiality" is an ethical concept. Things said during sessions are kept confidential within limits. Legally, when a counselor invokes privileged communication, this means that things revealed in confidential therapy sessions cannot be disclosed in court without the client's permission. The only exceptions would be when a mental health professional who has been hired by the court conducts an evaluation or other service that relates to some legal action. In these cases, the counselor or other mental health practitioner has to inform the client of the limits of privileged communication.

Which theorist is well known for his work with prejudice? a. Allport b. Skinner c. Jung d. Freud

A: An irrational hostility toward another that is merely due to that individual's membership in a particular group is how Gordon Allport would define "prejudice." Allport believed that prejudice was a complex issue and caused by a variety of factors. He points out that the nature of prejudice is such that it can't be affected by the addition of rational facts. Situational issues such as economic factors, cultural factors, advertising, historical issues, and stereotyping are just a few of the possible influences upon the development of prejudice. Allport believed that prejudice should be regarded as a type of psychopathology, as it leads to such things as the increased use of defense mechanisms, passivity, and withdrawal.

B.F. Skinner would say that religion is: a. an example of behavioral control through conditioning. b. an exception to the behavioral rule. c. a means of mind control. d. central to human existence.

A: B.F. Skinner, as a behaviorist, attributed all behavior to external (rather than internal) causes. He would likely have viewed religious belief as a result of early parental conditioning. Skinner would have believed that religion gains control by attributing power to some supernatural force that punishes unacceptable behaviors (i.e., hell) and rewards desired behaviors (i.e., heaven). He did not believe that an individual had faith in a particular religion because of inner reasons, but rather simply because of the external reinforcements of the religion, such as parents and society.

In which is the focus on the meaning of life and the relevance of the individual experience? a. Existential counseling b. Adlerian counseling c. Gestalt therapy d. Reality therapy

A: Existentialism examines philosophical questions such as, "What is the meaning of life?" and "Is there life in the hereafter?" The focus of Adlerian counseling is on developing and maintaining social interests. The focus of Gestalt therapy is congruence and the here and now. Reality therapy is focused on becoming psychologically well by taking responsibility for oneself and formulating realistic plans.

Which of these psychologists' theories completely ignore the unconscious? a. Glasser's reality therapy, Rogerian counseling, and behaviorism b. Freudian psychoanalysis, Jungian, and Adlerian counseling c. Karen Horney, Erich Fromm, and object relations theory d. Rollo May, Victor Frankl, Abraham Maslow's existentialism

A: Glasser's reality therapy ignores the unconscious in favor of focusing on the here and now and the concrete. Rogerian or person-centered counseling emphasizes acceptance, empathy and the therapeutic relationship, and deals more with surface issues disregarding innate drives and the unconscious. Behaviorism is famous for not caring about internal states, because what is learned can be unlearned, and only observable behaviors can be changed in this theory. Freud, Adler, and Jung all did a great deal of work regarding the unconscious. Karen Horney and Erich Fromm were neo-Freudians, and object relations theory (pioneered by Ronald Fairbairn, Melanie Klein, D.W. Winnicott, and others) is based on Freudian concepts. Existential theorists focus on internal motivations such as anxiety and guilt.

A client who is an ethnic minority states that she has been passed over for promotion three times even though she is better qualified and received better reviews than those that were promoted. This is most likely an example of which of the following? a. Discrimination b. Suppression c. Oppression d. Racism

A: If a client who is an ethnic minority states that she has been passed over for promotion three times even though she is better qualified and had received better reviews that those who were promoted, this is most likely an example of discrimination, which is acting on racism (prejudice against others because of their ethnic identity) to deny opportunities to those who are different. Being a victim of discrimination can result in loss of self-esteem and depression as well as feelings of guilt and anxiety.

A client with schizophrenia has both delusions and hallucinations. Which of the following types of hallucinations pose the greatest threat to the client or others? a. Auditory command hallucinations b. Visual hallucinations c. Formication tactile hallucinations d. Gustatory hallucinations

A: If a client with schizophrenia has both delusions and hallucinations, the hallucinations that pose the greatest threat to the client and others are auditory command hallucinations during which a "voice" tells the client to carry out actions, which may involve self-injury or injury to others. Auditory hallucinations are the most common type although not all involve commands. Some clients hear clicks, music, or other noises than voices.

If utilizing exposure therapy with a client with severe phobias, which of the following approaches is likely to have the most long-lasting effect? a. In vivo spaced exposure b. In vivo massed exposure ("flooding") c. Spaced imagery exposure d. Massed virtual exposure

A: If utilizing exposure therapy with a client with severe phobias, the approach that is likely to have the most long-lasting effect is in vivo (actual) spaced exposure. Massed exposure (AKA "flooding") tend to be effective in the short-term, but the effect erodes more quickly than when exposure is spaced and progressive, allowing the client to adjust slowly to the exposure. Exposure therapy is part of a behavioral approach to treatment, and numerous different techniques are utilized.

With which type of therapist would rapport be established the quickest? a. Rogerian therapist b. Gestalt therapist c. Freudian therapist d. Rational-emotive therapist

A: It is the Rogerian therapist who is more likely to establish rapport the quickest with the client. The Rogerian therapist is warm and inviting, communicating to the client respect and the feeling of control. By contrast, the Freudian therapist is more likely to seem analytical and somewhat distant. Rational-emotive and Gestalt therapists are confrontational in their therapeutic approach, which may make the client feel less inclined toward a strong rapport at an earlier stage. Rogerian therapists don't force entry into the unconscious or confront or contradict the client. They simply mirror back what they see in the client, and guide them to an independent and self-directed state. This approach would certainly appeal to many clients, and would be more likely to encourage a swift and positive rapport between client and therapist.

Mike Brown has completed gender reassignment surgery (male-to-female) and is now legally Mikaela Brown. Mikaela states that she is still attracted to females and not males. Her sexual orientation should be most appropriately classified as which of the following? a. Lesbian b. Heterosexual c. Homosexual d. Bisexual

A: Once a person completes gender reassignment surgery and legally changes genders, that person is then considered the reassigned gender; thus, Mikaela is considered female, so her attraction to other females would result in her sexual orientation as lesbian. If she were attracted to males, she would be heterosexual. While she could also be classified as homosexual, this term is more commonly used for gay males, and she is no longer considered a male. She does not report a bisexual attraction to both genders.

A client repeatedly justifies destructive behaviors with excuses that attempt to depict them as beneficial. What Freudian defense mechanism is he making use of? a. Rationalization b. Depression c. Reaction formation d. Sublimation

A: Rationalization is a Freudian psychoanalytic defense mechanism. It occurs when the ego rejects the real motive for the individual's behavior and substitutes it with a motive that will make the behavior seem more acceptable. A client is likely to feel anxiety when acting in a manner that, for whatever reason, runs counter to what he believes is right. In order to make himself feel better for his behavior, the client will come up with reasons for his behavior (in an effort to make it seem more acceptable), and thus reduce his overall anxiety level.

Active symptoms of schizophrenia involve an ____________ of normal thinking processes; passive symptoms involve the ___________ of normal traits and abilities. a. exaggeration; exaggeration b. exaggeration; absence c. absence; exaggeration d. absence; absence

B: When diagnosing schizophrenia, there are active and passive symptoms. Active symptoms are exaggerated and passive symptoms are absent. In the daily functioning of persons with schizophrenia, they experience many distortions in their thinking processes and are usually unable or minimally able to address activities of daily living (dressing, preparing meals, etc.).

Many counselors and clients, in the therapeutic setting, would say that _______ is very difficult to deal with. a. silence b. catharsis c. role reversal d. ambivalence

A: Silence is often difficult for anyone in a social setting, but it can be particularly troublesome for a counselor and client in the therapeutic setting when not properly understood. Society in general often views silence as a sign of disinterest, rudeness, or awkwardness. In therapy, however, silence can take on another meaning. Silence is not always best used with very disturbed clients. However, it can be a valuable tool for general use. Silence not only is a means to convey empathy and understanding at particular moments, but is also a means by which to encourage deeper thought and retrospection. It can also apply subtle pressure upon the client who is resistant or otherwise holding back.

Tarasoff vs. Board of Regents of the University of California was a landmark case which brought to light the: a. duty of the counselor to warn individuals or groups about the potential of imminent danger. b. standard of practice of obtaining releases of information in order to share information with individuals or agencies. c. rights a client has as an individual with disabilities. d. potential harm an impaired professional may inflict on his clients.

A: Tarasoff is a landmark case that led to improving services for mental health by requiring mental health practitioners to warn potential victims of imminent harm. Counselors are mandatory reporters that must take reasonable steps to protect possible victims from harm. Reasonable steps are those that any person who cares about another person would take to secure that person's safety. Usually that involves informing potential victims and law enforcement agencies.

An 18-year-old client is away from home at a university and has always had a very close relationship with her mother, whom she calls every day to ask for guidance and support. The client has made four visits to the infirmary with vague complaints of headache and stomach ache and is increasingly anxious and having difficulty making decisions. Which of the following types of crises is the client likely experiencing? a. Maturational/Developmental b. Dispositional c. Life transitions d. Traumatic

A: The 18-year-old client away from home at a university is likely experiencing and maturational/developmental crisis. She has retained a dependent role with her mother and is finding it difficult to function independently and to make decisions as an adult, resulting in increasing anxiety and somatic complaints. In some cases, parents encourage this type of relationship because it makes them feel needed or because they want to exercise control over their child.

When conducting a cultural formulation interview, which of the following topics is explored first? a. Cultural definition of the problem b. Cultural factors affecting current help seeking c. Cultural perception of cause, context, and support d. Cultural factors affecting self-coping and past help seeking

A: The APA developed the cultural formulation interview as part of research and clinical evaluation to improve clinical understanding. The CFI includes a series of questions that are asked about four broad topics in the following order: -Cultural definition of the problem. -Cultural perceptions of cause, context, and support. -Cultural factors affecting self-coping and past help seeking. -Cultural factors affecting current help seeking.

What does the Likert scale measure? a. Attitudes and feelings b. Statistics c. Physical health d. Mental health

A: The Likert Scale was developed in 1932 by Renis Likert, and is a psychometric, multi-item scale used for questionnaires. Likert wanted to develop a scientific way in which to measure psychological attitudes, and the factors that influence those attitudes and feelings. The scale is commonly used in surveys and other studies in which closed-ended questions are desired (ones that don't allow the respondent to answer in their own words). A Likert Scale survey asks the respondent to choose where on a scale (ranging from "strongly disagree" to "completely agree") their attitudes lay.

A counselor gives a questionnaire to a group of respondents to measure their opinions on certain topics. Each question has seven possible choices: Strongly Agree, Agree Somewhat, Agree, Neutral, Disagree, Disagree Somewhat, and Strongly Disagree. This measurement technique is known as: a. a Likert scale. b. a scatterplot. c. a Kruskal-Wallis test. d. a Wilcoxon signed-rank test.

A: The Likert scale is the type of question where the answer choices are graduated in order of degree according to the strength of the respondent's opinion. A scatterplot is a graphic depiction of the relationship between two variables for a group of test respondents. It plots the respondent's scores on a graph. The Kruskal-Wallis test is a nonparametric test used when there are more than two mean scores on a single variable. It is a nonparametric version of an ANOVA. The Wilcoxon signed-rank test is a nonparametric measure used when there are scores for two samples that are correlated.

The Theory of Work Adjustment (TWA) focuses on work in relation to the individual's: . a. environment b. psyche. c. emotional development. d. phobias.

A: The Theory of Work Adjustment (TWA) states that career outcome depends upon satisfaction and satisfactoriness. The former refers to the worker's needs and values in relation to the job, and the latter addresses the worker's skills for the position. How well those two elements fit together impacts the ultimate outcome. Simply stated, both the work environment and the individual must meet each other's needs for the interaction to be maintained, and work adjustment is dependent upon that interaction. How well the requirements of the two factors are met is called correspondence.

Which of these tests has multiple forms for administration to differently aged subjects? a. Wechsler Intelligence Scales b. Stanford-Binet Intelligence Scales c. Miller Analogies Test (MAT) d. Scholastic Assessment Test (SAT)

A: The Wechsler Intelligence Scales include the WPPSI-IV (Wechsler Preschool and Primary Scale of Intelligence), the WISC-IV (Wechsler Intelligence Scale for Children), and the WAIS-IV (Wechsler Adult Intelligence Scale)-the Roman numerals refer to edition numbers. The Stanford- Binet IQ test has a number of subtests to assess various abilities, but does not have different versions for different age groups as Wechsler does. The MAT is a test of analytical ability given to many college students as a standard for admission to graduate school. As such, it does not have versions for different ages. The SAT is a test commonly given to high school students to measure their verbal and quantitative abilities via subtests, and thus needs no age-accommodating versions. It is used to help determine their eligibility for admission to college.

A single mother and a teenage son present for relationship problems. The son is actively defiant of instructions, argues regularly over minor requests, and can be spiteful and resentful over normal parenting efforts. School performance is marginal, but only one unexcused absence has occurred during the current school year, which is nearing its end. The most appropriate diagnosis would be: a. oppositional defiant disorder. b. conduct disorder. c. intermittent explosive disorder. d. parent-child relational problem.

A: The degree of discord is substantial, and the level of verbal conflict is high, thus oppositional defiant disorder would be the most appropriate diagnosis. A parent-child relational problem tends to be less severe in nature, while conduct disorder is much more severe (i.e., involves violations of the rights of others, physical aggression, or property damage, persistent truancy, etc.). Intermittent explosive disorder addresses impulsive acts of aggression or violence (as opposed to premeditated or planned behaviors). Persistent conduct disorder carried into adulthood may meet criteria for antisocial personality disorder.

From which perspective are the group goals to enable members to pay close attention to their here-and-now experiences so they can recognize and integrate disowned aspects of themselves? a. Gestalt b. Psychodynamic c. Reality d. Existential

A: The goal of Gestalt therapy is to enable members to pay attention to their here-and-now experiences so they can recognize and integrate disowned aspects of themselves. The goal of a psychodynamic-oriented group is to provide a climate to help members re-experience early family relationships. The goals of a reality-oriented group are to guide members toward learning realistic and responsible behavior and to develop identities that focus on success. The goals of an existential-oriented group are to provide conditions that maximize self-awareness and to remove obstacles to personal growth.

An apparent treatment success that is due to the patient's expectation or hopes rather than the treatment itself is called: a. the placebo effect. b. the nocebo effect. c. the therapeutic window. d. an empirically validated treatment.

A: The placebo effect describes when improvement occurs just by the fact that someone is expecting improvement. The opposite, the nocebo effect, occurs when an innocuous substance (a sugar pill) causes a person to get sick or to feel worse. The therapeutic window describes a range of time or dose of medication at which positive effects will be noticed. An empirically validated treatment is one in which the treatment has been systematically tested and validated through some research and found to be successful.

Which of the following statements most likely indicates suicidal ideation and risk for suicide? a. "My children would be better off without me.' b. "I can't stop crying when I think about my mother's death." c. "My brother thinks he is so much better than I am.'" d. "Sometimes, I think this therapy is totally pointless."

A: The statement by a client that is most likely to indicate suicidal ideation and risk for suicide is "My children would be better off without me." When clients make statement indicating possible suicidal ideation, the counselor should address it immediately by asking if the client has thoughts about dying and if the client has a plan. Clients who have formulated a plan (such as taking an overdose of medications) are at higher risk than those who simply think about wanting to die.

A 27-year-old male with a history of drug and alcohol abuse, stealing, and bullying behavior has been working with the counselor on educational issues related to substance abuse, self-esteem, and anger. Which of the following are the primary determinants of effectiveness of education? a. Observed behavior modification and compliance b. Self-reported behavior modification and compliance c. Positive reports from probation officer d. Drug and alcohol abstinence verified by testing

A: Two primary determinants of educational effectiveness include: -Behavior modification involves thorough observation and measurement, identifying behavior that needs to be changed and then planning and instituting interventions to modify that behavior. Techniques include demonstrations of appropriate behavior, reinforcement, and monitoring until new behavior is consistent. -Compliance rates are often determined by observation, which should be done at intervals and on multiple occasions, but in some cases, this may depend on self-reports or reports of others. If education is intended to improve individual health and reduce risk factors and that occurs, it is a good indication of compliance.

One of the goals of family therapy is to help facilitate adaptability. Adaptability from a family therapy perspective means: a. obtaining a balance between stability and change. b. reaching consensus. c. obtaining a state of enmeshment. d. reaching the status quo.

A: When a family enters into therapy, each family member must make adjustments, adjust to these changes, and maintain balance. The family wants to maintain homeostasis (balance), yet the family makes changes to which each family member must adjust and become stable again.

When conducting research, two counselors administer the same evaluation instrument to one group of clients participating in a support group, but the counselors get markedly different results. What type of problem does this suggest? a. Reliability b. Measurement c. Validity d. Comprehension

A: When the same evaluation instrument yields completely different results with different evaluators or different groups of individuals, then the problem is likely with the reliability of the instrument. Types of reliability include stability reliability (reliability over time), equivalence reliability (two different forms of the instrument should obtain the same results), and internal consistency reliability (used only if the instrument is measuring only one concept). Results should be precise and predictable to some degree. Validity refers to the degree to which the instrument actually measures that which it is intended to measure.

When working with a client with conduct disorder who has exhibited sociopathic behavior, which of the following comments by the client is the most cause for concern? a. "That pretty little daughter of yours goes to Farmin School, doesn't she?" b. "I'll bet you have no friends outside of work." c. "I know more about you than you know about me. d. "This therapy is a complete waste of time."

A: When working with a client with conduct disorder who has exhibited sociopathic behavior, the comments by the client of the most cause for concern is "That pretty little daughter of yours goes to Farmin School, doesn't she?" because this could be construed as an implied threat. The client should have no personal information about the counselor, especially about the counselor's children. This suggests that the client may be stalking the counselor.

A client who lost his job because of his inability to complete his work tasks yells at the counselor that she is "mean and stupid" and ruining his life. Which of the following ego defense mechanisms is the client using? a. Identification b. Displacement c. Sublimation d. Projection

B: Displacement: Expressing strong feelings generated by one person to another who is less threatening. In this case, yelling at the counselor instead of the boss who fired him. Identification: Modeling behavior or attitudes on those of another, such as entering the same profession as a mentor. Sublimation: Substituting behavior that is acceptable for one that is not, such as chewing gum instead of smoking. Projection: Unconsciously blaming unacceptable feelings/actions on someone else, such as by attacking gay people to deny homosexual attraction.

What is e-therapy? a. Therapy that focuses on regularly spaced client evaluations b. Online psychological treatment c. A new version of cognitive-emotive therapy d. A psychoanalytic treatment modality

B: E-therapy is also sometimes called cyber-therapy, e-counseling, tele-therapy, or just online therapy or counseling. It can involve either individual or group therapy and is accomplished in a number of ways. Videoconferencing, chat rooms, e-mail, and instant messaging are some of the more common methods of providing counseling services. As e-therapy is still a new manner of conducting therapy, it is met with skepticism by some professionals and clients. However, e- therapy is a dramatically growing field and makes therapy possible for many patients who are otherwise unwilling, or unable to, attend the traditional therapy session.

When developing an individualized Goal Attainment Scale (GAS) with a client, how would the counselor score an expected outcome? a. -1 b. 0 c. +1 d. =+2

B. When developing an individualized Goal Attainment Scale (GAS) with a client, the counselor would score an expected outcome as 0. The counselor and client develop a list of goals together and weigh the outcomes on a scale that includes both scoring and a precise description of achievement at that score so that client's progress can be quantified: -2: This is the least favorable outcome. -1: Outcomes is less than expected. 0: Outcome is that which was expected. +1: Outcome is greater than expected. +2: Outcome is the most favorable.

Of the following, which is the loosest acceptable p-value bound if a researcher needs to demonstrate that something is 98% statistically significant? a. p<0.05 b. p<0.01 c. p<0.001 d. p<0.10

B: A 98% chance of statistical significance equates to a p-value of <0.02. Of the choices listed, B and C are both less than 0.02, but the question asks for the loosest bound, so the correct answer is 0.01.

A client comes to a counselor because her house recently burned down and her husband has left her. She is depressed, and expresses suicidal ideation. Which of the following would the counselor consider? a. Referral to an inpatient program b. Individual psychotherapy c. Group therapy d. Vocational counseling

B: A client who is in the midst of a personal crisis, or is otherwise fragile, is initially best treated with individual therapy. If the individual treatment is ineffective or if the situation significantly worsens, an inpatient referral may be considered. Patients who enter a group situation before they are ready run the risk of dropping out or experiencing an exacerbation of their symptoms. They may also impede the group process for the other members. Vocational counseling may be appropriate at a later date once the client has successfully worked through the more acute issues.

Which of the following is true about the correlation coefficient? a. A perfect correlation coefficient can be a positive one but cannot be negative b. A correlation coefficient shows the relationship between two sets of numbers c. A correlation coefficient shows a cause and effect relationship between variables d. With a strong correlation, knowing one score will not help to predict another score

B: A correlation coefficient does show the relationship between two sets of numbers. A correlation coefficient ranges from -1.00, or a perfect negative correlation, to 1.00, or a perfect positive correlation. A perfect correlation can be either positive or negative. Correlation coefficients indicate the degree of relationship, but do not indicate any causal relationship between variables. When a very strong correlation exists between variables, knowing one score an individual got will enable fairly accurate prediction of another score that individual got.

For a therapy group composed of adults with a single group leader, what is generally considered to be the optimum group size? a. 3 b. 8 c. 5 d. 10

B: The optimum group size for an adult group with no co-leader is generally considered to be 8 people. With young children who are 5 or 6 years old, an optimum group size would be 3 or 4. Groups may be larger with older children. For adults, 5 may be too small and 10 too large.

In Salvador Minuchin's structural family therapy, there are ____________ between family subsystems; if these are too rigid, they lead to lead to _______________, and if they are too diffuse, they can lead to ______________. a. transactional patterns; opposition; fragmentation b. boundaries; disengagement; enmeshment c. alignments; coalitions; conflicts d. structural maps; withdrawal; disorganization

B: According to Minuchin, the family is made up of subsystems that have boundaries between them. If the boundaries are too rigid, it leads to disengagement of the subsystems. If the boundaries are too diffuse (loose or undefined), it can result in enmeshment. Insufficient boundaries can lead to unhealthy attachments and interactions. Overly strict boundaries can minimize healthy interactions. Transactional patterns are the evolved rules of the family structure, which general or individual. Alignments are the way family members join with or oppose one another. Coalitions are alliances between specific family members. Conflicts are disagreements or problems occurring within families. A structural map is a diagram or drawing showing the boundaries, alignments, coalitions, conflicts and other features or interactions within the family structure. The other terms in the answer choices are not specifically identified as terms used in structural family therapy.

Pat's therapist tells her that "self-talk" and "crooked thinking" cause emotional disturbances. He believes we all have the potential to think rationally. He uses techniques like role-playing and imagery to help Pat work through some of her issues. He also follows an A-B-C-D-E system. Pat's therapist believes that we are not influenced by the events we experience, but by our interpretation of them. Pat's therapist subscribes to which of these therapeutic approaches? a. Existential therapy (May, Frankl, Yalom) b. Rational Emotive Behavior Therapy (Ellis) c. Reality Therapy (Glasser) d. Multimodal Therapy (Lazarus)

B: Albert Ellis' rational emotive behavior therapy (REBT) has all of the characteristics summarized prior to the question. Existential therapy (Rollo May, Victor Frankl, Irvin Yalom) is based on phenomenology, or the study of our direct experiences taken at face value rather than of our interpretations of them. William Glasser's reality therapy is based on choice theory and posits that we determine our own fates. Glasser states that we all have genetically based needs of survival, love and belonging, power or achievement, freedom or independence, and fun. Taking responsibility is a key concept of reality therapy. Arnold Lazarus' multimodal therapy is a holistic and eclectic approach with considerable behavioral influences. Lazarus identified seven interactive but discrete modalities for which he used the acronym BASIC ID: behaviors, affective responses, sensations, images, cognitions, interpersonal relationships, and drugs (i.e., biology, including nutrition).

B.F. Skinner found that deprivation will ___________ the probability of an operant. a. decrease b. increase c. not affect d. sporadically alter

B: B.F. Skinner found that deprivation will increase the probability of an operant. For example, a rat deprived of food for some time is far more likely to press a bar to receive food than a rat that has not been deprived of food. B.F. Skinner would view the rat's hunger, not as an internal process, but rather as an external, measurable one (i.e., the amount of time without food). Just as deprivation will increase an operant, satiation will decrease it. For instance, a rat that has been given his fill of food and water is much less likely to manipulate a bar in order to receive food.

A patient arrives complaining of feeling restless. She describes mood swings and times of hopelessness followed by periods of high energy and creativity in which she can go for days without sleep. What is her likely diagnosis? a. Depressive disorder b. Bipolar disorder c. ADHD d. OCD

B: Bipolar disorder most often manifests itself with alternating periods of depressed and elevated mood. While both need not be present for a diagnosis of bipolar disorder, depression and mania are common to many cases. The cycles in bipolar can be of varying lengths, with differing levels of severity. The patient will have symptom-free periods where daily function is at an expected level. The cause of the symptoms must not be medication-related for the diagnosis to be bipolar disorder, and it is often treated with a combination of medication and therapy.

Who of the following is known for person-centered counseling? a. Rollo May b. Carl Rogers c. Fritz Perls d. Aaron Beck

B: Carl Rogers is known for person-centered or client-centered counseling. Rollo May is known for existential counseling. Fritz Perls is known for Gestalt therapy. Aaron Beck is known for behavioral/cognitive-behavioral counseling.

A client who is post-amputation of a lower limb and insists he needs no physical therapy or rehabilitation is probably experiencing which of the following? a. Self-confidence b. Denial c. Delusions d. Fear

B: Clients who undergo amputations often experience Kübler-Ross's five stages of grief associated with death and other losses as they try to cope with physical disability and changes in their body image. During the stage of denial, clients may believe unrealistically that they need no assistance and can return to their routine lives with no problem. Other stages include anger, bargaining, depression, and acceptance. Clients may not go through all stages or may go through the stages in no particular order.

In the steps of developing a counseling program, which of the following should come FIRST? a. Operating the program b. Conducting a pilot study c. Evaluating the program d. Development of a plan

B: Conducting a pilot study comes before developing a plan, operating the program, and evaluating the program. Critical steps identified in developing a counseling program are: 1) conceptualizing the system; 2) establishing a philosophy and assessing needs; 3) developing goals and objectives; 4) processing information; 5) conducting a pilot study; 6) developing a plan; 7) implementing the program, which includes hiring and training; operating the counseling program; 8) evaluating the program; and, 9) modifying the counseling program based on the evaluation.

What is the cause of cyclothymia? a. Prenatal drug use b. The cause is unknown c. Child abuse d. Chromosomal deficiencies

B: Cyclothymia is a mild form of bipolar disorder with a cause that is unknown. In this disorder, the mood swings from hypomanic behavior to depression symptoms. A client may be resistant to treatment because the hypomanic periods can also result in a significant increase in productivity and positive mood. However, friends and family will likely feel differently. Long-term treatment is necessary with this disorder because, like bipolar disorder, this has a recurring set of symptoms. Medication is often the primary treatment for cyclothymic disorder, but psychotherapy is also useful for support, education, and long-term management of the illness.

Which describes a violation of the "scope of practice" ethical standard? a. A counselor suggests a set of positive affirmations to her client after the counselor has discussed positive affirmations at length in session b. A counselor uses EMDR with a client who insisted on this method of treatment c. A counselor confronts her client about the negative thought patterns in which the client is engaging on a regular basis d. A counselor seeks consultation from a colleague on a difficult case

B: EMDR (eye movement desensitization and reprocessing) is a specialization that requires additional training. Unless the counselor took the specialized training and had supervision, she cannot use EMDR in her practice. In this case, the counselor is functioning out of her scope of practice. Remember, the client insisted that this treatment methodology be used. The question did not say that the counselor was a trained EMDR practitioner.

Which of the following is the best synonym for the term appraisal? a. Assessment b. Evaluation c. Measurement d. Testing

B: Evaluation is synonymous with appraisal. Both terms imply going beyond measurement to make inferences or judgments about human behavior and characteristics. Assessment refers to processes and/or procedures for gathering data or information on human behavior. Testing is a type of assessment.

What did the Milgram experiment teach us about authority? a. People usually will not obey authority b. People usually will obey authority c. Sometimes people will obey authority d. People generally disregard authority

B: Following WWII, a common excuse used to explain some of the terrible acts committed was that the individual was just following orders. Inspired by this supposition, Stanley Milgram (in the 1960s) set out to explore the issue of authority and obedience. In his famous experiment, Milgram found that the majority of people, when faced with someone of authority, will do as they are told- even to the detriment of someone else. His experiment raised ethical issues about the treatment of subjects in psychological experiments, but the study itself is still heralded today as a significant contribution to the field of social psychology.

The purpose of free association in psychoanalysis is: a. to bring conscious material into the unconscious. b. to bring unconscious material into the conscious. c. to allow for a break from the stress of analysis. d. to decipher meaning from dreams.

B: Free Association is a fundamental rule of psychoanalysis and is meant to bring unconscious material into conscious awareness. Free Association differs from usual conversation. In social conversation, an individual carefully chooses what he will say, selecting material that will fit the conversation, or that is appropriate to the circumstances. In Free Association, the patient is encouraged to say whatever comes into his mind, no matter how silly or inappropriate it may be. The therapist carefully attends to what is being said, analyzing the content and bringing the unconscious forward.

Gender bias would be LEAST aroused by which of the following? a. A man who is studying to be a nurse b. A woman who is studying to be a nurse c. A woman who drives a semi-truck d. A man who designs footwear

B: Gender bias goes both ways. Men in female-dominated careers (nursing and fashion for example) and women in male-dominated careers (truck driving) can experience discrimination. A woman studying to be a nurse, a career field highly dominated by women, would be least likely to experience gender bias.

A group has co-leaders. That is, there are two trained counselors who are facilitating the group together. All of the following are advantages of co-leadership groups EXCEPT that: a. more support and attention are provided to group participants. b. there is less time spent observing participants. c. effective modeling of appropriate behavior is provided to the participants. d. participants often view co-leaders as parents.

B: Generally, co-leaders use a team approach. Each leader observes and processes what goes on in the group and provides feedback to participants. One leader usually cannot catch everything that goes on in a group. Leaders have to be aware of content, process, flow, and progress toward goals. Co-led groups give participants opportunities to observe how conflicts are handled between or among the leaders. The participants see the effectiveness of cooperation and harmony. Oftentimes, co-leaders are viewed as parental figures, and thus participants can learn more adaptive behaviors from well-functioning "parents."

Many mental health professionals apply to HMOs and PPOs to be on their provider lists. What is the reason for their doing this? a. To enhance their professional reputations b. To allow clients to be referred to them c. To comply with national and state laws d. To gain membership in the organizations

B: HMOs (Health Maintenance Organizations) and PPOS (Preferred Provider Organizations) are managed care groups with strict policies regarding treatment including counseling. Professionals in private practice cannot receive referrals of clients whose health insurance is with one of these organizations unless the professionals have provider status with the organization. Counselors do not apply for provider status to enhance their reputations, but to increase the numbers of their potential clients. There are no national or state laws governing provider status in managed health care organizations. This is controlled by organizational policies. Counselors seeing clients insured through these organizations must obtain provider status (i.e., inclusion on the organization's list of allowed providers), not membership in the organization itself.

Which of the following Neo-Freudian theorists most strongly believed that behavior can be understood best in terms of social interactions and interpersonal relationships? a. Erich Fromm b. Harry Stack Sullivan c. Wilhelm Reich d. Karen Horney

B: Harry Stack Sullivan favored a social systems approach to understanding human behavior. He felt that human behavior is best understood in terms of social interactions and interpersonal relationships. Erich Fromm believed that individuals could develop self-fulfillment, or social character, through joining with other people and could become lonely and unproductive if they did not. He felt that society offers opportunities to experience mutual love and respect. Wilhelm Reich contributed to the body therapy manipulation movement, and he believed that repeated successful orgasms were necessary for mental health. Karen Horney believed that security motivates every individual and a lack of security causes anxiety. She felt that irrational attempts to repair disrupted relationships could turn into neurotic needs.

Which of these is NOT included in the study of kinesics and proxemics? a. Facial expressions b. Verbal expressions c. Physical body gestures d. Seating arrangements

B: Verbal expressions are NOT included. Kinesics refers to nonlinguistic or nonverbal communication such as facial expressions, physical gestures and body movements. Proxemics refers to spatial features of the environment such as seating arrangements, furniture placement, and how our personal space is affected by such arrangements.

A client reports only occasional social drinking and denies the use of illicit drugs but within 2 days of hospitalization for depression, the client becomes increasingly agitated with noticeable hand tremors and complains that she feels as though bugs are crawling under her skin. Which of the following should the counselor suspect? a. The client is exhibiting signs of bipolar disorder b. The client is undergoing alcohol withdrawal c. The client is exhibiting signs of heroin withdrawal d. The client is experiencing signs of panic disorder

B: If a client reports only occasional social drinking and denies the use of illicit drugs but within 2 days of hospitalization for depression, the client becomes increasingly agitated with noticeable hand tremors and complains that she feels as though bugs are crawling under her skin, the counselor should suspect the patient is undergoing alcohol withdrawal. Onset of withdrawal symptoms from heroin is usually within 6 to 12 hours. These symptoms are not consistent with bipolar disorder or panic disorder.

The counselor is seeing a client who has just started electroconvulsive therapy for severe depression. How many minimum ECT treatments are generally required before a client shows sustained improvement? a. 3 b. 6 c. 12 d. 15

B: If a counselor is seeing a client who has just started electroconvulsive therapy for severe depression, the counselor should be aware that a minimum of at least 6 treatments are generally required before a client shows sustained improvement. ECT is usually administered under an anesthetic three times weekly for 6 to 15 treatments. Most clients achieve the maximum benefit within 12 to 15 treatments so more are not warranted. Post-treatment effects include short-term memory impairment and mild confusion and disorientation.

A male client has been following a female client and claims that the female is "flirting" with him and using "sexual innuendos"; however, the female client complains that the male client is harassing and scaring her, and staff observations concur with the female client's complaints. The male client is most likely exhibiting which of the following? a. Introjection b. Projection c. Compensation d. Identification

B: If a male client has been following a female client and claims the female is "flirting" with him and using "sexual innuendoes" but the female client complains that the male client is harassing and scaring her, and staff observations concur with the female client's complaints, then the male client is most likely exhibiting projection, an ego defense mechanism in which the male client is projecting his own feelings of attraction onto the female client.

If a patient who has been hospitalized for treatment is resistant to discharge because of fear that she will be unable to function independently, which of the following is the most appropriate response? a. Remind the client that she has family waiting for her at home b. Review the progress the client has made c. Reinforce to the client that she no longer needs hospitalization d. Remind the client that she was also resistant to hospitalization

B: If a patient who has been hospitalized for treatment is resistant to discharge because of fear that she will be unable to function independently, the most appropriate response is to review the progress the client has made, pointing out positive changes. This can help the client gain confidence in her ability to function outside of the hospital. The counselor should also review plans the client has made for the transition to the home environment.

An adoptive parent complains to the counselor that the adoptive daughter never says, "Thank you." In which of the following situations does the complaint suggest that the problem may lie with the parent rather than the child? a. The child does not say "thank you" when the parent treats her and her friends to a movie b. The child does not say "thank you" for room and board (bedroom, food) c. The child does not say "thank you" when the parent buys her something special d. The child does not say "thank you" when the parent agrees to pay for horseback riding lessons

B: If an adoptive parent complains to the counselor that the adoptive daughter never says, "Thank you," the situation in which the complaint suggests that the problem may lie with the parent rather than the child is if the child does not say "thank you" for room and board (bedroom and food). It is a parent's understood job to provide basic care for a child and not something that a child is ordinarily expected to explicitly thank the parent. On the other hand, special treats, lessons, and treating the child and her friends to a movie are situations in which the child should show gratitude.

The counselor is assessing a victim of violent trauma. Which of the following is an essential initial step? a. Ask questions about the trauma, rapidly increasing the specificity b. Explain the procedure for screening and assessment c. Stress the importance of focusing on the future d. Stress that it's important for the client to answer every question

B: If the counselor is assessing a victim of violent trauma, and essential initial step is to explain the procedure for screening and assessment. This allows the client to have some feeling of control. Additionally, the client should be assured that he or she can choose whether or not to answer, to answer later, to avoid answering. Questions about the trauma should be asked slowly, gradually increasing the specificity. The counselor should stress the importance of focusing on the client's current recovery.

The counselor is seeing a client with a history of trichotillomania and plans to begin habit reversal training. Which of the following is the first step in HRT? a. Contingency management b. Awareness training c. Competing response training d. Relaxation training

B: If the counselor is seeing a client with a history of trichotillomania and plans to begin habit reversal training, the first step is awareness training during which the client pays close attention to hair pulling, describing in detail how and when it happens and the sensations the client feels. The next step is to develop a competing response, followed by contingency management, relaxation training to reduce stress, and generalization training. HRT may also be utilized with other disorders associated with repetitive behaviors.

During the initial interview, the client states repeatedly that his boss is to blame for all of the client's problems and that the boss "is going to pay." The counselor should respond by asking which of the following questions? a. "Why do you feel that way?" b. "What thoughts have you had about hurting your boss?" c. "Can you think of other reasons for your problems?" d. "Do you think that this anger toward your boss is productive?"

B: If, during an interview the client blames his boss for his problems and states that the boss is "going to pay," this is an implied threat. Because of the duty to warn those who might be in danger from a client with mental health issues, the counselor should ask directly, "What thoughts have you had about hurting your boss?" in order to assess whether there is a risk of violence.

Which is most accurate regarding homogeneous vs. heterogeneous therapy groups? a. Homogeneous groups are too much alike to experience effective group dynamics b. Heterogeneous groups may have more difficulty being able to relate to each other c. Heterogeneous groups are not as similar to the real world as homogeneous groups d. Homogeneous groups are more likely to simulate interactions among the members

B: In a heterogeneous group, if the members are too different from one another they may find it harder to relate. However, heterogeneous groups are more representative of the real world, so answer C is incorrect; heterogeneity is likely to stimulate interactions among members, so answer D is incorrect. Answer A is incorrect because homogeneity, or having similar members in a group, does not preclude having effective group dynamics - otherwise, homogeneous groups would never be indicated, but they are often successfully used.

Which is true of open vs. closed therapy groups? a. In an open group, anyone is allowed to join the group b. In an open group, members who leave are replaced c. In a closed group, only certain members may join d. In a closed group, members who leave are replaced

B: In an open group, if a member leaves, a new member is admitted to replace the one who left. New members can provide stimulation, new ideas, and new resources. An open group does not mean that anybody can join it; the member's needs and personality should be appropriate for the group, as determined by the leader with input from group members. A closed group does not mean that only certain people may join it; it means that new members are not admitted. This can facilitate group cohesion and maintain trust within the group. Since new members are not admitted to closed groups, it follows that members who leave are not replaced, as they are in open groups.

In order for a client with a psychiatric diagnosis to qualify for disability benefits under the Social Security Administration, the client must be unable to engage in substantial gainful activity because of the disability for what minimum period of time? a. 6 months b. 12 months c. 18 months d. 24 months

B: In order for a client with a psychiatric diagnosis to quality for disability benefits under the Social Security Administration, the client must be unable to engage in substantial gainful activity because of the disability for at least 12 months. The Office of Disability Adjudication and Review (ODAR) will review the client's medical records to determine the diagnosis, any co-occurring disabilities and their effects, treatment, and functional ability. Clients are evaluated for Social Security Disability Insurance (SSDI) and the Supplemental Security Income (SSI).

In _________ therapy, the therapist uses logical arguments to challenge a client's unrealistic beliefs or expectations. a. client-centered b. rational-emotive behavior c. existential d. aversive conditioning

B: In rational-emotive therapy, a client's irrational beliefs are challenged. In existential therapy, the focus is on the choices a client makes in order to find what is meaningful. Personal freedom and awareness are emphasized. In aversive conditioning, a person is conditioned using something aversive to stay away from or refrain from engaging in some inappropriate behavior. And client- centered therapy focuses on self-acceptance and self-exploration.

If college graduates typically earn more money than high school graduates, this would indicate that level of education and income are: a. causally related. b. positively correlated. c. negatively correlated. d. unrelated.

B: In the case presented, the more education a person has, the higher the person's salary will be. This describes a positive correlation in that as one variable increases, the other variable also increases. An example of a negative correlation would be: The hotter the temperature outside, the less hot soup people consume. In a negative correlation, one variable increases while the other variable decreases.

Compared with high school students who enter the workforce right after graduation, students who go to college can expect to: a. be hired at lower wages. b. earn about $10,000 more per year. c. work longer hours. d. be hired to fill more unskilled positions.

B: Individuals who go right into the workforce after high school graduation routinely earn substantially less than those individuals who go to college. Individuals who go to college would not be hired for unskilled positions, as they are overqualified. It would be hard to say whether or not the college-educated individuals would work longer hours than the non-college-educated individuals.

When working with individuals from different cultures, the effective counselor may not: a. use language similar to the client's. b. maintain good eye contact at all times. c. be cognizant of the context. d. honor religious beliefs.

B: It is expected in our Western culture that we maintain good eye contact at all times. In the Eastern traditions, however, eye contact is averted in some situations. It is the counselor's job to know those subtle differences and respect them. An effective counselor may not use the same language as the client, but can utilize an interpreter to assist in translation. The effective counselor must also be cognizant of context and honor religious beliefs regardless of whether they different from their own.

Elisabeth Kübler-Ross identified five stages that grieving people experience. Which of these accurately identifies these five stages? a. Shock, Panic, Sorrow, Depression, Acceptance b. Denial, Anger, Bargaining, Depression, Acceptance c. Depression, Fear, Bargaining, Stoicism, Acceptance d. Fear, Withdrawal, Bargaining, Resignation, Peace

B: Kübler-Ross identified the five stages of the grieving experience as: denial (refusal to believe one is dying); anger (resentment, feeling it is unfair to be dying/objecting to dying); bargaining (trying to make deals with God or others-e.g., "I'll give everything to charity if I can just live/I'll treat my family members better if I just don't have to die now/I'll be a better person if I can just have some more time," etc.); depression (a feeling of hopelessness and/or helplessness in the face of one's mortality; sadness over leaving bodily life and loved ones behind); and, finally, acceptance (a feeling of peace at having to come to terms with the fact of one's imminent demise). Shock, panic, sorrow, stoicism, fear, withdrawal, resignation, and peace are all emotions that a dying person could certainly experience, but they are not named as stages in Kübler-Ross' theory.

People are said to be products of five different cultures. Two are inevitable culture sources (a culture of human biology and a culture of ecology, which refers to the climates in which people live). Which is NOT one of the other three? a. Racio-ethnic b. Linguistic c. Regional d. National

B: Linguistic is NOT one of the five different cultures. Language is often a common feature in a national culture, and language may be an aspect of our ecological culture. Language is also often one part of an ethnic culture, along with practices, learning, and style of living. A specific language does not constitute one of the five distinct culture types.

What is Abraham Maslow's "Hierarchy of Needs"? a. A theory of personality b. A theory of human motivation c. A psychoanalytic theory d. A needs-based counseling concept

B: Maslow was a humanistic psychologist who developed a theory that included five basic, instinctual needs of all human beings. The strongest of the needs is "physiological," because the individual must have these met for basic survival. Once physiological needs are met, the individual can look to "safety" needs to ensure their well-being. Next on the list are needs for "love, affection, and belongingness." Once the most basic of needs are met, individuals can seek to end their loneliness by looking for love and a way to belong. The next need is "esteem" (from self and others), followed by "self-actualization" (to do what one was born to do in life).

Most counselors incorporate several therapeutic theories in their work. This would be what type of approach to counseling? a. Psychoanalytic b. Eclectic c. Integrative d. Cognitive

B: Most counselors would be considered eclectic because few choose only one theory or method through which they practice their profession. Most mental health professionals will agree that there is value and worth in all of the various theories and research that has taken place in the field of psychology, but also would concede that there are shortcomings to each as well. For that reason, most counselors will rely on several theories for their practice and will adjust their choices based upon their experience and the population they are serving. Some counselors will base their work with one population on a particular theory, and then use another theory as the base for their work with another.

Clients typically go through four phases in response to a stressor, culminating in an acute crisis. If a client has tried problem-solving techniques and found them to be unsuccessful in alleviating stress, which of the following phases is the client experiencing? a. Phase 1 b. Phase 2 c. Phase 3 d. Phase 4

B: Of clients typically go through four phases in response to a stressor, culminating in an acute crisis, and a client has tried problem-solving techniques and found them to be unsuccessful in alleviating stress, the client is experiencing phase 2. Phases in crisis development: Phase 1: Exposure to a precipitating stressor and increased anxiety. Phase 2: Usual coping strategies fail to relieve stress. Phase 3: Stress increases. New strategies may be attempted and resolution or progression to phase 4 may occur. Phase 4. Acute stress

The Education Act for All Handicapped Children (PL 94-142) requires that: a. all children who are handicapped be seen by a counselor who specializes in disabilities. b. a free and appropriate education be provided for all children with disabilities. c. children with handicaps be placed in the most restrictive environment in the schools. d. children with handicaps be sent to special schools or institutions.

B: PL 94-142 guarantees free and appropriate education for all handicapped children. Another part of this law is that handicapped children are to be placed in the least restrictive educational environment that is most appropriate for a particular child. All handicapped children are to have an individualized educational plan as well. The least restrictive environment is most often in a public- school setting.

The sensorimotor period is part of whose developmental stage theory? a. Freud b. Piaget c. Erikson d. Kohlberg

B: Piaget's theory has the following stages: sensorimotor, preoperational, concrete operational, and formal operational (and later post-formal operations). Freud, Erikson and Kohlberg also have staged theories regarding human development, but none of them includes a stage named Sensorimotor.

Giving a positive consequence every time a desired behavior is engaged in could be considered: a. negative reinforcement. b. positive reinforcement. c. aversive conditioning. d. extinction.

B: Positive reinforcement is a type of operant conditioning used in behavioral therapy. It's a way in which to strengthen a desirable behavior. An example of positive reinforcement would be if someone wanted a dog to sit upon command. Every time the dog successfully sits when given the command to do so, the dog would be rewarded with a positive consequence (such as a dog treat or pat on the head). Eventually the dog would come to identify the positive reinforcement with the behavior of sitting upon command, and therefore continue the wanted behavior on a consistent basis.

Career counseling based on Bandura's social cognitive theory emphasizes all of these concepts EXCEPT: a. personal agency. b. positive uncertainty. c. self-efficacy. d. vicarious learning.

B: Positive uncertainty is H.B. Gelatt's later model of career decision-making. According to Bandura, personal agency reflects an individual's ability to achieve objectives. Self-efficacy is Bandura's term for an individual's belief that one can succeed at something. Vicarious learning is one of several learning experiences that Bandura states can strengthen self-efficacy.

Which of these is true about professional liability insurance for counselors? a. This insurance is always required by law in every state of the U. S. b. This insurance is required by law in some states, but not in others c. This insurance is not required by law and is an unnecessary expense d. This insurance is not recommended since it invites litigation

B: Professional liability insurance is required by law in some states, but not others. It is highly recommended for counselors even in those states where it is not required, and it is not generally considered an unnecessary expense. There are several providers of this insurance. For example, the American Counseling Association (ACA) sponsors a professional liability insurance program for its members.

The standard error of measurement is NOT: a. a measure of reliability. b. a measure of validity. c. the confidence band. d. confidence limits.

B: The SEM is NOT a measure of validity but of reliability. It is also known as confidence band or confidence limits.

In career self-efficacy theory, which of these is NOT one of the three elements that will be influenced by an individual's expectations? a. Choice b. Competence c. Performance d. Persistence

B: The individual's relative competence is NOT one of the factors identified by career self- efficacy theory as likely to be affected by the individual's expectations. This theory states that the individual's expectations will influence: 1) choice or whether a behavior will be initiated; 2) performance, or how much effort will be expended; and, 3) persistence, or to what extent the individual will persevere when confronted by obstacles. Some theorists believe these explain gender differences in career choices. Higher self-efficacy seems related to choice and persistence in math and science careers.

While involved with a research study, a counselor learns that several of her students are using confidential material in an unethical manner. She had no prior knowledge of this, and all of her safeguards for professional practice were appropriate. Is she, as the principal researcher, responsible for the student's behavior? a. No, if professional safeguards were in place, the counselor is not responsible b. Yes, the counselor is ultimately responsible c. Only the students who acted unethically are to be held responsible d. The counselor would only be responsible if she had knowledge of what was occurring and did nothing to stop it

B: The principal researcher is ultimately responsible for any and all ethical breaches in the research study. All others involved in the research study are individually responsible for their unethical behavior. It is important to note that, individually, everyone involved in a research study must admit personal responsibility, but overall, the principal researcher is responsible for the entirety of the study and anything connected to it.

The severity of anorexia nervosa in adults is based on the client's BMI. If a female client has a BMI of 16 kg/m2, how would the severity be classified? a. Mild b. Moderate c. Severe d. Extreme

B: The severity of anorexia in adults is based on the client's BMI. If a female client has a BMI of 16 kg/m2, the severity would be classified as moderate. Severity classifications: Mild: ≥17 kg/m2. Moderate: 16 to 16.99 kg/m2. Severe: 15 to 15.99 kg/m2. Extreme: <15 kg/m2.

A counselor has written an article that he wants to submit to a professional journal. This article needs to be in: a. MLA format. b. APA format. c. either MLA or APA format. d. none of the above.

B: The standards for submission to most professional journals include using APA format. Most scholarly material is written in this form, at least in the mental health field. MLA format is often used in literary journals and comes from the journalism and communications fields.

The best kind of random sampling technique that would include 10% Asian, 10% Hispanic, and 15% African American, as well as individuals from the majority ethnic group, would be a: a. mixed randomized sampling technique. b. stratified sampling technique. c. cluster sampling technique. d. random chance sampling technique.

B: There is no mixed randomized sampling technique. A cluster sampling technique involves taking a smaller sample from a larger sample. In cluster sampling, the groups are randomized, not the individuals in the groups. A random chance sampling technique involves the simple randomness involved in choosing people at random regardless of any characteristics or group identities. Each person has an equal chance of being chosen. In a stratified sampling technique, different subpopulations are included in the random sample based on percentages of the subpopulations in the larger population. For example, if a researcher wants a representative sample from the general population, she would want an equal representation of males and females. Therefore, she would randomly choose half of her sample from the male subpopulation and half from the female subpopulation.

Research on gay and lesbian parents indicates: a. their children are maladjusted. b. they are as dedicated to and effective at child rearing as are heterosexual parents. c. they are less dedicated to child rearing than heterosexual parents. d. their children are parented harshly and inconsistently.

B: There is very little evidence to support that homosexual couples are poor parents. When gays and lesbians become parents, they generally are just as effective and caring as are heterosexual couples who become parents. The proportion of children who are maladjusted is just about equal for homosexual and heterosexual parents. The research shows that being gay or lesbian does not make a person a bad parent.

A behaviorist family counselor instructs the parents of a 12-year-old boy to tell their son that, when he gets his homework done, he can play his Xbox. This is an example of: a. positive reinforcement. b. the Premack principle. c. quid pro quo. d. negative reinforcement.

B: This is an example of the Premack principle, which states that using a behavior of higher probability (playing Xbox) can motivate an individual to carry out a behavior of lower probability (finishing homework). Positive reinforcement would occur when a child produces a desired behavior and is provided with positive feedback and reinforcement to increase the chances that the child will produce the same behavior again. Negative reinforcement is the taking away of an undesirable consequence to increase the likelihood that the child will engage in the behavior again (Mom stops nagging if she cleans her room). Quid pro quo is another behavioral technique that essentially means one gets something for something: "I will do something for you if you do something for me.'

A counselor who works for a county agency also has a small private practice. She screens all clients at the county agency and refers those clients with the best insurance benefits to her private practice. This counselor is: a. following standard procedure for many public agencies. b. acting unethically. c. engaging in a dual relationship. d. practicing beyond her scope of practice.

B: This is unethical. This scenario describes a situation in which the counselor profits from the referrals. If the counselor is working for a community agency, most likely she receives a salary for her work. Referring clients to her own private practice has the potential to harm the client and provides her with additional money. An ethical violation of scope of practice would be a scenario in which a counselor lacks appropriate training and supervision to perform or engage in some treatment. In a dual relationship violation, the counselor basically wears multiple hats in the relationship with the client-the therapist and a neighbor or friend.

Tiedeman's decision-making model saw career decisions as being made up of two phases. What were these? a. Anticipation or examination and execution or fulfillment b. Anticipation or preoccupation and implementation or adjustment c. Preoccupation or examination and correction or adjustment d. Examination or definition and realization or completion

B: Tiedeman said that the continuous process of career decision-making is made up of the first phase of anticipation or preoccupation, which includes the following sub-phases: exploration, crystallization, choice, and clarification. The second phase is implementation or adjustment, which includes these sub-phases: induction, reformation, and integration.

What does Title IX of the educational amendments provide? a. Remedial reading instruction b. A ban on sex discrimination c.Equal sports for both sexes d. Equal class sizes in schools

B: Title IX bans sex discrimination in academics and athletics in K-12 schools and colleges. Title IX has nothing to do with remedial reading. This law does not require that the same sports be available to both males and females, only that males and females be provided the same proportion of opportunities to participate in sports. This law has nothing to do with the sizes of classes in schools.

If a family member of a client asks the counselor what constitutes probable cause for involuntary commitment, which of the following is the best response? a. "You should ask an attorney about that." b. "The person is a threat to herself or others. c. "The person is uncooperative with the family.' d. "The person is no longer able to work and is homeless."

B: While laws may vary slightly from one state to another in relation to involuntary commitment, generally probable cause is present if a person is a threat to herself or others (and usually the threat must be imminent). A second criterion is usually that the person is too disabled to provide self-care; however, this last criterion can be interpreted in a wide variety of ways (the reason so many mentally ill individuals are homeless and living on the streets) and is rarely utilized.

Screening for intimate partner abuse should be done for which female clients? a. Age 12 or older b. Age 14 or older c. Age 16 or older d. Age 18 or older

B: While most screening for intimate partner abuse focuses on females age 18 or older, all female clients ages 14 and older should be screened as many very young females engage in sexual relationships, and this makes them vulnerable to intimate partner abuse. Additionally, some screening may also be appropriate for males, who are sometimes also the victims of abuse. Intimate partner abuse also occurs in same sex relationships, both male and female, so healthcare providers should be alert to those possibilities.

What is "group content"? a. The manner in which the group processes information b. Analysis of the group's interactions c. The material that is being discussed within the group d. The details of individuals forming the group

C: "Group content" refers to the content being discussed among the group members in the group therapy session. This is different from "group process", which refers to how the material and interactions between members are progressing in terms of the group's goals. Put simply, "group content" is what is said, and "group process" is the analysis of the content.

A 16-year-old male admitted to the mental health unit for alcohol use disorder has repeatedly failed to maintain sobriety and consistently missed support meetings while partying with his friends. Which of the following is the most likely reason that the client is not compliant with treatment? a. Disturbance of body image b. Embarrassment c. Fear of being different from peers d. Guilt about illness

C: A 16-year-old client who has repeatedly failed to maintain sobriety and consistently missed support meetings while partying with his friends has most likely done so out of fear of being different from his peers. Peer relationships are especially important to adolescents who are still developing a sense of self, so if an adolescent is involved in drinking with his friends, he may be reluctant to change the dynamic by remaining sober and may feel he will be abandoned or ridiculed if his behavior changes.

What should the counselor do if a client requests to see his confidential file? a. Immediately give the client access to the file b. Explain to the client that such information is confidential and for the counselor's eyes only c. Accept or decline depending upon the circumstances d. Ignore the request

C: A client's file should always be viewed as confidential and kept in a secure manner and location. There are few exceptions to this requirement that the client's file be kept private, but one would be the request of the client to see his/her own file. In some cases, however, it may be deemed counter to a positive counseling relationship for the client to see the file. In such cases, it is permissible to omit the parts of the file that would prove detrimental. Also, in cases where the client is considered to be incompetent, it would often be best to limit or deny access.

The social-learning perspective is to the psychodynamic perspective as _____________ are to __________. a. bodily events; social and cultural forces b. social and cultural forces; bodily events c. environmental conditions; unconscious dynamics d. unconscious dynamics; environmental conditions

C: A hallmark of the psychodynamic perspective is the unconscious process, while the social- learning perspective deals with social aspects, specifically within environmental conditions. Bodily events or bodily functions would be more aligned with a biological approach of some sort.

A test is considered "standardized" if it includes all of the following EXCEPT: a. clearly specified procedures for administration. b. clearly specified procedures for scoring. c. questions have multiple correct answers. d. normative data.

C: A standardized test must have standard procedures for administering, scoring, and interpreting the test. There must also be a set of norms to which a particular score is compared. Not all tests are standardized. For example, unless it is a test like the NCE or GRE, it is probably a test that was developed by a teacher or company. Tests may be administered the same way to everyone and scored the same, but if there are no norms to which to compare an examinee, it is not considered a standardized test. If a test has questions with multiple correct answers it cannot be standardized because there is no clear way to grade these questions in an objective manner.

A 16-year-old girl is being treated with fluoxetine and cognitive behavioral therapy for severe anxiety and depression 6 months after the death of her mother. For which of the following must the girl be regularly monitored and assessed? a. Substance abuse b. Polypharmacy c. Suicidal ideation d. Noncompliance

C: Adolescents respond well to a combination of SSRI and CBT for the treatment of depression, but SSRI use in adolescents has been associated with increased suicidal ideation, so the girl must be carefully monitored and assessed for suicidal ideation. She and her family should be educated about this possible effect and warning signs. In some cases, adolescents may be asked to sign a no-suicide contract that clearly outlines the steps to take in the event they feel suicidal.

As founder of many child development centers, ____________ could be attributed with being one of the first family counselors. a. Satir b. Ackerman c. Adler d. Rogers

C: Alfred Adler founded many child guidance clinics and thus is attributed with being one of the first family counselors. Ackerman and Satir would be considered psychoanalytic family therapists, and Rogers would be a family-centered therapist.

Which of these is NOT correct regarding standard scores? a. A standard score is obtained by converting raw score distributions b. A z-score is a type of standardized score which is commonly used c. An n-score is a type of standardized score that is commonly used d. A t-score is a type of standardized score which is commonly used

C: An "n-score" is NOT a type of standardized score. Standard scores are obtained by converting raw score distributions into an accepted standardized format. The two most commonly used standardized scores are the z-score and the t-score.

A client feels his coworker's recent promotion was not because of the coworker's own merit, but simply because of company restructuring. He feels his own promotion, however, is a reflection of his own professional abilities. In social psychology/cognition, this might becalled: a. sour grapes. b. transference. c. attribution. d. latent hostility.

C: An area of study in social cognition is attribution. Attribution refers to the explanations people make for the behaviors that people engage in. Internal attributions deal with factors within the individual. External attributions assign the cause of behavior to outside factors. Generally, people tend to assign external causes for their failures in life, and internal causes to the failures of others. The success of others is often also seen as the result of external elements, while one's own success may more likely be attributed to internal causes.

Which is correct regarding the notion of world views? a. An emic worldview is the belief in a global view of all of humanity b. An etic worldview is the belief in taking each group's perspective c. An etic worldview is the belief we are more similar than different d. An emic worldview is the belief in transcending all our differences

C: An etic worldview puts more emphasis on our similarities than on our differences. An emic worldview puts more emphasis on differences that we must understand in order to help different cultural groups from their specific perspectives. Thus, it is a specific rather than a global view. Therefore, the belief in taking each group's perspective is emic, not etic. The emic worldview does not state that we need to transcend our differences, but rather to focus on them by taking each group's perspective in order to understand and help them.

All of the following are characteristics of an open group EXCEPT that: a. members can join and leave at any time. b. the number of sessions is undetermined. c. there is good cohesion. d. group meetings are usually held in a hospital setting.

C: Because group members can come and go at will, there is a chance that at each session there are different people. This characteristic of an open group lessens the cohesion of a group. At every session, someone new may join, and group participants have to get to know someone new. In order for a group to be cohesive, a greater amount of familiarity among group members is needed, as then they are more willing to open up and share with others. In an open group, it is also harder to nurture members and to sustain continuity compared with a closed group. A closed group has greater cohesiveness, stability, and predictability.

160. Which of the following does NOT correctly pair a model of consultation with the person who developed it? a. Caplan - mental health consultation model b. Bandura - social learning consultation model c. Bergan - process consultation model d. Schein - purchase consultation model

C: Bergan's consultation model is behavioral, not process oriented. The process model was developed by Schein, who was also responsible for identifying the purchase model and the doctor- patient model. Caplan developed the mental health consultation model, and Bandura is known for the social learning model. Therefore, these other answers all correctly pair each consultation model with the person who developed it.

The counselor says a word to his client and he answers back with the first thing that comes to mind. What theorist developed the method the counselor is using? a. Jean Piaget b. Alfred Adler c. Carl Jung d. Sigmund Freud

C: Carl Jung, a student of Sigmund Freud, developed the Word Association Test (WAT). In the WAT, a single word is read to the client, who then responds as quickly as possible with whatever word comes to mind. The word the client responds with is recorded, but other factors are also noted such as speed of response and client behavior. The test was used to clarify issues of psychopathology, but also as a means of generally gleaning information about the client's personality. The WAT has also been used in the study of memory. The test was based on earlier ideas of mental associations.

In order to facilitate growth in a client, the counselor uses all of the following strategies EXCEPT: a. confrontation. b. reflection. c. abandonment. d. interpretation.

C: Confrontation is often used by counselors to point out discrepancies between a client's thoughts/beliefs and the behavior. Making the client aware of these discrepancies is a necessary skill for a counselor. When a counselor uses interpretation, she is pointing out the real meaning of a client's behavior. Reflection is another skill that a counselor uses to help clients. When a counselor reflects something back to a client, he is paraphrasing what the client said in order to emphasize the importance of the feelings associated with the statement and to project empathy. It is considered unethical to abandon a client.

How does consultation differ from counseling? a. It uses different skills than counseling does b. It is for resolving, not preventing, problems c. It is a voluntary, work-related process d. It is process-oriented, not content-oriented

C: Consultation is a voluntary problem-solving process, and it is also work-related. It uses the same skills as counseling does, but in a different context, role, and function than in counseling. It is for resolving existing problems and also for preventing future problems. It may be content-oriented or process-oriented, or both.

Presenting stimuli in different sequences to reduce "order of presentation" influences in an experiment is called: a. countertransference. b. counterculture. c. counterbalancing. d. countercounseling.

C: Counterbalancing is presenting stimuli in differing sequences to avoid influencing an experiment by the order of presentation. Countertransference is a process that can occur during therapy when an unresolved personal issue prevents a therapist from being objective. Counterculture is an alternative culture arising in opposition to the dominant values and behaviors of a society. "Countercounseling" is a made-up term.

In dual-career families, the woman typically: a. starts her family before entering the workforce. b. decides not to have children. c. has an established career before having children. d. work a part-time or flexible job.

C: Dual-career families generally are those in which both the man and the woman have some sort of professional career. Both members of the relationship usually are established in their careers before they start a family. Generally, these couples marry later than those who go directly into the workforce after high school. The key vocabulary to look at here is "career," rather than a "job," which often is part-time or flexible.

____________ is a humanist approach that emphasizes the tragic aspects of life, the burden of responsibility, and the need to face the inevitability of death. a. Social interest b. Psychoanalysis c. Existentialism d. Self-actualization

C: Existential therapy looks at the human condition in its totality from birth to death and everything in-between. "Social interest" is a term synonymous with Adlerian counseling, while self- actualization is a term used by Maslow when he talked about his hierarchy of needs. Psychoanalysis looks at bringing what is unconscious to the conscious level.

Which of the following adult attachment styles best describes clients who feel uncomfortable with close attachments because of fear of getting hurt and who have difficulty expressing feelings and few close relationships? a. Anxious-preoccupied b. Dismissive-avoidant c. Fearful-avoidant d. Secure

C: Fearful-avoidant. Adult attachment styles: Anxious-preoccupied: Seek intimacy but may become overly dependent on others, sometimes causing others to back away, resulting in loneliness and questioning of self- worth. Dismissive-avoidant: Feel a strong need for independence and may avoid intimacy with others, stating they have no need of attachments and suppressing feelings, resulting in few close friends. Fearful-avoidant: Feel uncomfortable with close attachments because of fear of getting hurt and who have difficulty expressing feelings and few close relationships. Secure: Feel positively about themselves and others and able to establish close relationships with others while maintaining a sense of independence.

Which of the following is NOT a central concept in existential therapy? a. Guilt b. Anxiety c. Free association d. Search for meaning

C: Free association is a technique commonly used in Freudian psychoanalysis. Guilt is a central concept of existential therapy; it occurs when we fail to reach our potential. Anxiety is also a central concept in existential therapy, and is considered to be the threat of non-being. Existentialists also believe that we search for meaning in life. They feel that we have freedom of choice and are responsible for our own fates. Thus, we struggle with being alone/not connected to others, and we search for the meaning of our existence.

The process of saying freely whatever comes to mind in connection with dreams, memories, fantasies, or conflicts, in the course of a psychodynamic therapy session, is referred to as: a. systematic desensitization. b. flooding. c. free association. d. exposure treatment.

C: Free association is the technique of allowing the client to speak freely about whatever comes to mind. Free association is a technique used by psychoanalysts and psychodynamic therapists to summon unconscious thoughts and motivations. The other techniques are all used exclusively by behaviorists.

Popular techniques of what approach are role playing, "empty chair," and "making the rounds"? a. Client-centered b. Psychoanalysis c. Gestalt d. Adlerian

C: Gestalt therapy utilizes the empty-chair technique and making rounds, as well as psychodrama. Free association and dream analysis are popular techniques used by psychoanalysis. Adlerian counseling utilizes examination of clients' memories, catching oneself, and spitting in the client's soup. Client-centered counselors utilize active/passive listening, open-ended questions, positive regard, and reflection of feelings.

Roger Gould believed that there were different "protective devices" people have. Which of these is the most accurate definition of protective devices according to Gould? a. Coping strategies b. Defense mechanisms c. False assumptions d.Absolute truths

C: Gould believed that what he called "protective devices" are false assumptions and are triggered at different ages. They may certainly be used as coping strategies or defense mechanisms by individuals, but these are not the most accurate definitions. The important point about these devices is that Gould thought they were false assumptions; therefore, misleading and not productive. Being false, they are in no way absolute truths.

During a staff meeting, one counselor folds his arms across his chest and rolls his eyes while another counselor speaks about a problem she has encountered with a client. This is an example of which of the following? a. Sexual harassment b. Normal response to disagreement c. Horizontal violence d. Workplace discrimination

C: Horizontal violence can include physical contact (such as hitting and shoving) but most often it involves verbal or nonverbal expressions of hostility and conflict, including defensive postures (folded arms) and gestures meant to show contempt (rolling the eyes). Horizontal violence is a form of workplace bullying and may include name-calling, sarcastic statement, blaming, ignoring other's concerns, making inappropriate jokes, and interfering with others rights as well as punishing others inappropriately. Horizontal violence may cause the victim to lose self-esteem, emotional control, and motivation.

If a 30-year-old client with paranoia and schizophrenia states he does not want his parents (who are paying for his care) to visit because he believes they are "possessed by devils," the counselor should do which of the following? a. Ask the physician to intervene b. Allow the parents to visit c. Respect the client's request d. Suggest the parents get a court order to allow visits

C: If a 30-year-old client with paranoia and schizophrenia states he does not want his parents (who are paying for his care) to visit because he believes they are "possessed by devils," the counselor should respect the client's request. Clients' rights are not determined by who is paying for care but remain with the person. Unless the client has been declared incompetent in a court proceeding and his parents granted conservatorship, the client can deny them visitation.

A client has met the criteria for binge-eating disorder and averages 8 or 9 binge-eating episodes per week. How would the severity of the disorder be classified? a. Mild b. Moderate c. Severe d. Extreme

C: If a client has met the criteria for binge-eating disorder and averages 8 or 9 binge-eating episodes per week, the severity of the disorder would be classified as severe. Severity classification: -Mild: 1 to 3 binge-eating episodes per week. -Moderate: 4 to 7 binge-eating episodes per week. -Severe: 8 to 13 binge-eating episodes per week. -Extreme: 14 or more binge-eating episodes per week.

Which of the following is the most effective method of confronting a client who routinely misses group support meetings, making various excuses, but claims that the support group is very helpful? a. "You keep making excuses as to why you don't attend." b. "Your behavior suggests that you don't really want to attend the group." c. "You don't come to group but you say it's helpful. How do you feel about this contradiction?" d. "Why do you keep missing the group if it's helpful?"

C: If a client routinely misses group support meetings, making various excuses, but claims that the support group is very helpful, the most effective method of confronting the client is: "You don't come to group but you say it's helpful. How do you feel about this contradiction?" This approach keeps the focus on the client and the client's conflict but avoids judgmental statements that may cause the client to feel it necessary to defend the failure to attend group.

A client who was the victim of sexual assault tells the counselor that she will never feel safe again. In response, the counselor asks the client if she feels safe at the moment and what she will need to do to feel safe when she goes home. This is an example of which of the following techniques? a. Thought stopping b. Cognitive restructuring c. Reframing d. Labeling distortions

C: If a client who was the victim of sexual assault tells the counselor that she will never feel safe again and the counselor asks the client if she feels safe at the moment and what she will need to do to feel safe when she goes home, this is an example of reframing. Reframing aims to stop the negative thoughts and to change the way of looking at something. Instead of focusing on a lack of safety, the counselor is reframing the issue to focus on proactive steps to feeling safe.

The counselor is working with an 8-year-old child who has been suspended from school because of anger issues. The counselor notes that the child has many bruises in various stages of healing, including on the left side of the face, and the child seems anxious when the parent is in the room. However, the child denies any abuse. Which of the following should the counselor do? a. Ask the child's parents about abuse b. Monitor the child carefully in the future c. Report possible child abuse to the appropriate authorities d. Advise the parents to take the child to a pediatrician to determine the cause of bruising

C: If a counselor working with an 8-year-old child who has been suspended from school because of anger issues notes that the child has many bruises in various stages of healing, including on the left side of the face, and the child seems anxious when the parent is in the room, but the child denies any abuse, the counselor should report possible child abuse to the appropriate authorities. Most children deny being abused even when the abuse is egregious, but there are numerous red flags (anger issues, bruising, anxiety) that point to abuse, and the counselor is a mandatory reporter.

Which of these is true of qualitative research? a. This kind of research assumes social elements have a single objective reality b. This kind of research tends to study groups, such as samples or populations c. This kind of research assumes that different realities are socially constructed d. This kind of research tries to avoid influencing its data collection instruments

C: In contrast to quantitative research, which assumes that social factors belong to a single objective reality, qualitative research assumes that individuals and groups construct a multiplicity of realities. Answers A, B, and D all describe characteristics of quantitative research.

In what therapeutic approach is the counselor's emphasis on being authentic while concentrating on verbal and nonverbal messages? a. Existential counseling b. Behavioral counseling c. Gestalt therapy d. Rational-emotive therapy

C: In existential counseling, the role of the counselor is to be authentic and understanding of the client while stressing the personal relationship and sharing experiences. The role of the behavioral counselor is to assist the client in clarifying goals and modifying behaviors while teaching, directing, and advising. The rational-emotive therapist teaches, confronts, and corrects the client's irrational beliefs and ineffective self-talk. The role of the Gestalt therapist is to be in the present while helping the client resolve unfinished business and be congruent in verbal and nonverbal messages.

In the Milgram studies, Milgram and his colleagues found that volunteers were more likely to disobey orders to continue administering electric shocks to the subject under all of the following circumstances EXCEPT when: a. the experimenter wearing a lab coat was replaced by a man dressed in street clothes. b. the order to give an electric shock was delivered by telephone. c. the volunteer's role was to instruct someone else to administer the electric shock. d. the location of the experiment was moved from Yale's campus to an office building.

C: In the baseline study, in which an experimenter wearing a lab coat instructed the volunteer to administer progressively more powerful electric shocks to a subject, Milgram's team found that the obedience rate (i.e., the percentage of participants who administered all planned shocks) was around 65%. Replacing the authority figure by someone who appeared to be an ordinary member of the public reduced the obedience rate to around 20%. When the orders were delivered by telephone, obedience rate also dropped to around 20%, though in this case, many volunteers pretended to obey the orders while not following through. When the experiment venue was moved off of Yale's campus, the obedience rate dropped below 50%. However, when the volunteers were not the ones directly initiating the electric shocks (i.e., they were instructing someone else to do so),the obedience rate climbed to well over 90%.

An infant first sucks on a nipple to nurse. Then the infant sucks on other things-a toy, Daddy's finger, etc. Later, this infant discovers other things to do with objects beyond sucking on them such as grasping them, shaking them, and otherwise manipulating them. These two behaviors were labeled by Jean Piaget with what terms, in order of their Occurrence? a. Adaptation and assimilation b. Adaptation and organization c. Assimilation and accommodation d. Accommodation and assimilation

C: Incorporating additional objects or events into the infant's existing schema or structure such as sucking on things other than a nipple is assimilation. When the infant later modifies its organization by forming new schemas in response to the environment this is accommodation. Adaptation is Piaget's term for adjustment to the environment. Assimilation and accommodation are two processes that are parts of adaptation. Organization is how we organize our knowledge and mental processes. Piaget said that we inherit two tendencies, which are organization and adaptation.

Clients with bipolar disorder are often treated with interpersonal and social rhythm therapy. This therapy helps clients do which of the following? a. Recognize triggers to mood changes b. Manage stress c. Establish consistent sleep and physical activity schedules d. Cope with bipolar disorder

C: Interpersonal and social rhythm therapy helps clients with bipolar disorder establish consistent sleep and physical activity schedules. The clients utilize a self-monitoring instrument to monitor their daily activities, including their sleep patterns. Maintaining consistent patterns of activities and sleeping at the same time and for the same duration each night help to reduce manic and depressive episodes. Clients may also engage in cognitive behavioral therapy, family therapy, and group therapy. If symptoms are severe and the client does not respond to other treatments, electroconvulsive therapy (ECT) may be considered.

Which demographic is projected about the U.S. population by the year 2050? a. The numbers of Hispanic Americans will exceed the numbers of White Americans b. The largest numbers of Americans in the U.S. population will be Non-Hispanic Whites c. All of the minority groups combined will outnumber the Non-Hispanic White population d. Non-Hispanic Whites will outnumber all the minority groups combined in the population

C: It is projected that by 2050, all of the minority groups combined will total a larger number than all of the Non-Hispanic White people in the country. It is not projected that the Hispanic population alone will outnumber the White population. Since it is projected that all minority groups combined will outnumber Whites, it is incorrect that Whites will be the largest number in the population.

169. Which theorist conducted experiments regarding imprinting? a. Jean Piaget b. Albert Bandura c. Konrad Lorenz d. Sigmund Freud

C: Konrad Lorenz is one of Austria's most famous scientists, but he is known in the field of psychology for his work on imprinting. He observed that newly hatched goslings and ducklings would imprint upon whatever they first saw after hatching. The baby birds would later follow and even try to mate with whatever they had imprinted on. Lorenz even tried inanimate objects, which the babies also imprinted on. He felt therefore that the baby birds didn't recognize their species or require reinforcement, so he saw this as innate behavior.

What are Lawrence Kohlberg's three levels of morality? a. Instinctual, Intellectual, and Physical b. Oral, Latency, and Genital c. Pre-conventional, Conventional, and Post-conventional d. Optional, Formulaic, and Oppositional

C: Lawrence Kohlberg was interested in moral development, and theorized stages by which this development occurs in the individual. There are several stages that fall under three "levels." Children begin the Pre-conventional level by doing whatever they can get away with, and end by beginning to see the needs of others (although still judging everything in terms of their own needs). In the Conventional level, the child acknowledges both others and the rules of society, feeling a duty to obey the rules. In the final level, Post-conventional, the individual understands society's role in making decisions, and answers to an inner conscience.

Irvin Yalom specified that the functions of a therapy group leader should include: emotional stimulation, caring, meaning attribution, and executive leadership. Zander Ponzo found support for these same factors, and he also identified other factors found in successful groups. The factors Ponzo identified include all EXCEPT: a. participation. b. risk-taking. c. neutrality. d. conflict-confrontation.

C: Neutrality was NOT a factor identified by Ponzo or by Yalom as being present in leaders of successful groups. Ponzo identified caring support, and Yalom identified caring as characterized by warmth and concern. Yalom identified executive leadership, which includes giving direction, and Ponzo identified participation. All of these would tend to contradict neutrality in a group leader. The additional factors Ponzo cited were: openness, participation, risk-taking, conflict-confrontation, and caring support.

What does "reliability" in testing refer to? a. How sure the researcher can be, before the test is taken, of what the outcome will be b. How accurate the test is c. How consistent the test results are d. How many samples were used in evaluation of the test

C: Reliability tells one if the test is able to give consistent results each time it is administered. A problem with determining this comes into play with the "memory factor" (as the same group may remember some of the answers during subsequent administrations), which can affect the validity of the test. There are also other types of reliability. For instance, "test-retest reliability" refers to the administration of the test, and "internal-consistency reliability" is about how the items of the test relate to each other.

One of the more common techniques used by marriage and family therapists is reframing. Which of the following is an example of reframing? a. A counselor listens intently to the family's discussion of an event and points out what happened at point A, point B, and point C b. A counselor has the members of a family each take turns talking about how they felt about a specific incident c. A counselor suggests that a mother's constant questioning of the daughter regarding a recent party the daughter attended could be interpreted by the daughter as mistrust rather than love and concern d. A counselor outlines exactly how individuals in the family are to argue by setting up fair-fighting rules

C: Response A describes the technique called tracking (keeping track of what is going on). Response B involves communication skill building techniques, as does response D. The best example of reframing is C as the therapist tries to present another perspective or reframes the situation to show a different interpretation than the one that is being held by one or another person.

Cases of _____________ lead to the most malpractice lawsuits for any mental health provider, including counselors and psychologists. a. dual relationships b. failure of duty to warn c. sexual misconduct d. breach of confidentiality

C: Sexual misconduct yields the highest number of malpractice cases for all mental health professionals. The other malpractice cases usually focus on breaches of confidentiality.

The Id, Ego, and Superego are attributed to which psychoanalyst? a. Erik Erikson b. William Perry c. Sigmund Freud d. Alfred Binet

C: Sigmund Freud's theory of how the human personality is formed consists of five parts, one of which includes the Id, Ego, and Superego. The Id is all about the "pleasure principle" and animalistic instincts. It's the part of the personality that wants what it wants regardless of the circumstances. The Ego is referred to as the "reality principle" and needs to balance the needs of the Id with the reality of the situation. The Superego is the moral part of the personality and is concerned with issues of right and wrong.

Which of the following is true regarding payment for counseling? a. Payment to master's degree-level counselors is only automatic if they are licensed b. Master's degree-level counselors do not receive payment even if they are licensed c. Some counselors are reimbursed by insurance through a supervising psychologist d. Counselors in private practice may not require direct payments from their clients

C: Some counselors work under the supervision of a psychologist or psychiatrist (particularly those with Master's degrees rather than Ph.D. or M.D. degrees), and insurance companies reimburse the supervising psychologist or psychiatrist who then remits payment to the supervising counselor. Payment to master's degree-level counselors is NOT automatic even if they are licensed. However, it is also NOT true that counselors with Master's degrees must remain unpaid unless they are licensed. Their payment would depend on whether they have a supervising psychologist or psychiatrist and upon applicable state laws. Some counselors can practice without a license in certain states as long as they do not use the title of a licensed professional counselor and do not advertise that they are licensed. Some counselors in private practice will not see clients unless they pay them directly.

Dual-career families engage in leisure time: a. more often than families with one wage earner. b. that is costlier than that of families with one wage earner. c. less often than families with one wage earner. d. as often as families with one wage earner.

C: Suffice to say, dual-career families tend to have less free time due to work and family responsibilities. They may or may not be involved in expensive leisure activities, which are similar to those of other families. Because no one is at home to take care of household duties during the day, these activities must be done after work, thus, dual-career families have less time to spend on leisure activities.

The DSM system of diagnosis is based on: a. a model set up by insurance companies. b. an educational model. c. the medical model. d. an integrated model of doctors and lawyers.

C: The DSM system is based on the medical model that looks at client's disease states or mental conditions. None of the other options are appropriate.

What is the Rorschach also called? a. The random sample test b. The personality evaluation c. The inkblot test d. All of the above

C: The Rorschach test was introduced in 1921 by Herman Rorschach. It came to be known as the "inkblot test" because the test consists of ten cards, each with the picture of an inkblot on them. Most are shades of black and grey, but a few have some color on them. The client tells the clinician what he sees in each inkblot, and the test is used to determine information about the client's personality. It is a very popular test in psychology, but is considered by some to be unreliable. Other tests similar to it have also been developed in recent years.

The Yerkes-Dodson law states that people perform better: a. under high levels of arousal. b. under low levels of arousal. c. under moderate levels of arousal. d. without notable arousal.

C: The Yerkes-Dodson law says that people tend to perform best under moderate levels of arousal. If arousal is too high for an individual, it may be difficult to maintain focus on a particular duty or activity. Too low an arousal level, and the individual may not feel motivated enough to complete a job, or lack the necessary energy to perform a given task. Of course, the optimal level of arousal for maximum productivity differs from person-to-person. For example, one person's high like moderate arousal to another. However, overall, moderate levels of arousal arousal may seem tend to be best for optimal performance.

All of the following are physical characteristics of Down Syndrome EXCEPT: a. short, stocky build. b. almond-shaped eyes. c. large hands and feet. d. flattened face.

C: The chromosomal abnormality, Down syndrome, is the most common chromosomal disorder, occurring in 1 out of every 800 births. Individuals with Down syndrome suffer from intellectual disabilities, memory and speech problems, and slow motor development. They usually have some heart deformities, as well as being of short and stocky build. They have almond-shaped eyes, a flattened face, a protruding tongue, and an unusual crease running across the palm of the hand. Large hands and feet are not common characteristics of Down Syndrome.

Which is NOT an aspect of a "closed group" therapy session? a. Stronger cohesiveness within the group b. Less cost-effective for the counselor c. Greater diversity among members d. Members that leave are not replaced

C: The closed group promotes greater cohesiveness within the group because of the stability of the membership. With the same members interacting with each other during each session, the group members can form closer relationships, and will have fewer inhibitions as time goes by. There is a lack of diversity/change, but that can be a good thing depending upon the dynamics and goals of the group setting. The closed group is less cost-effective because as members may drop out or miss sessions, the counselor will not be able to replace them with new paying members.

Which of the following types of psychotherapists would be most likely to use free association and transference? a. Rational-emotive behavior therapists b. Behavior therapists c. Psychodynamic therapists d. Client-centered therapists

C: The focus of psychodynamic therapy is bringing to the surface that which is unconscious. To achieve this goal, the therapist uses free association and transference. Psychodynamic therapy has roots in Freudian theory. Freud spent much of his time discussing early childhood experiences and defense mechanisms. Rational-emotive behavior therapy examines irrational thoughts and beliefs. Behavioral therapy examines observable behavior, and client-centered therapy focuses on making clients feel good about themselves.

A married couple presents for counseling. Evaluation reveals that the wife comes from a dysfunctional, neglectful, alcoholic home and has little trust or tolerance for relationships. Consequently, their marriage is marred by constant arguing and distrust, frequent demands that he leave, episodes of impulsive violence, alternating with brief periods of excessive over-valuation (stating that he is the "best thing that ever happened" to her, "too good" for her, etc.). Which is the most likely diagnosis for the wife? a. Anti-social personality disorder b. Histrionic personality disorder c. Borderline personality disorder d. Narcissistic personality disorder

C: The key features of borderline personality disorder (BPD) involve instability in relationships and affect, poor self-image, and high impulsivity. Violations of personal rights and apathy common to antisocial personality disorder are insufficiently pronounced. While evidence of histrionic behavior exists, the devaluation/over-valuation pattern common to BPD is not accounted for via histrionic personality disorder. Nor is the need for admiration, pervasive with narcissism, not otherwise addressed.

The client is having difficulty deciding what career she would like to pursue. The counselor gives her a test that will help her make an informed choice. What type of test did the counselor give her? a. An achievement test b. A psychoanalytic test c. An aptitude test d. A personality test

C: The terms "aptitude test" and "achievement test" are often used interchangeably, but they are quite different from each other. Achievement is what one can do, while aptitude is what one has the ability to do. In the achievement test, the test measures what the subject currently knows. It is the type of test commonly used in the school setting. In the norm-referenced achievement test, the subject is measured against others who also took the test. In a criterion-referenced achievement test, the subject is measured against a previously set criterion. Aptitude tests differ from achievement tests in that they measure the subject's ability or interests in particular areas. Career testing would be a common example of an aptitude test that helps subjects choose a career based upon their interests.

There are long silences, several members of the group are acting out, and it seems like all the group members are expressing frustrations with both the structure of the group and the way the group leader is functioning. Most likely this group is in the____________ state of the group process. a. working b. initial c. transition d. closing

C: There are five stages in the group process: forming, initial, transition, working, and closing. In the forming stage, the group leader recruits, screens, and orients potential group members. The initial stage involves tasks such as setting the ground rules, introducing members, and discussing confidentiality. The transition stage includes storming (a time of anxiety and conflict as the members test the leadership) and norming (when the group falls into a rhythm with expected routines and roles established). During the working stage, members work on specific issues while sharing personal information. At the closing stage, the leader begins the termination process.

The emphasis for which type of group is on prevention and development of healthy behaviors? a. Secondary b. Tertiary c. Primary d. Homogeneous

C: There are three levels of groups-primary, secondary, and tertiary. Each level has a different focus or emphasis. The emphasis of a primary group is on preventing problems from occurring and developing healthy behaviors. The emphasis of a secondary group is preventative and remedial- its focus may be on the reduction of symptoms, lessening the severity of problems, and/or helping with overall adjustment to life stressors. The tertiary group can be thought of more as a "therapy" group in that its focus is on getting members of the group back to a more functional level of living. Tertiary groups may involve aspects of personality change and/or rehabilitation. One way to think about the three levels is in terms of severity-primary usually is very mild; secondary is mild to moderate; and tertiary is moderate to severe.

What kind of tests are the Rotter Incomplete Sentences Blank and the Draw-A-Person Test? a. Specialized personality tests b. Specialized achievement tests c. Projective personality tests d. Inventory personality tests

C: These tests are projective in nature. The Rotter's Incomplete Sentences Blank prompts the subject to complete partial sentences in the testing process. The Draw-A-Person Test prompts the subject to make a drawing of a person. The results are evaluated and interpreted by the counselor. Both tasks are unstructured or open-ended allowing the subject to project individual feelings, ideas, states, needs, etc., onto it. From this, the tester may gain insights to the subject's internal consciousness. Specialized personality tests include the Tennessee Self-Concept Scale, the Bender® Visual-Motor Gestalt Test, and the Luria-Nebraska Neuropsychological Battery. Specialized achievement tests include the GED test, the College Board's AP Program test, and the College-Level Examination Program (CLEP) test. Inventory personality tests include the MMPI, the California Psychological Inventory (CPI), the NEO Personality Inventory (revised), the Beck Depression Inventory, and the Myers-Briggs Type Indicator.

During the past several sessions, a heated discussion has occurred between the father and the mother. The gist of the argument stems from the mother's constant attention being focused on the daughter. This is an example of: a. negative attention seeking. b. disequilibrium. c. enmeshment. d. triangulation.

C: This is an example of enmeshment, the diffusion of boundaries. Here the mother is trying to dominate or live her life through her daughter. An example of negative attention seeking would be if the daughter constantly misbehaved to get her mother or father to pay attention to her. Disequilibrium refers more to family structure than behaviors. Triangulation is described above.

In career development and counseling, what is meant by the compensatory vs. spillover theory of leisure? a. Individuals who are dissatisfied with their jobs compensate by engaging in excessive leisure activities b. Individuals whose leisure interests tend to spill over into the workplace are not as productive c. Individuals may compensate for work with different leisure activities or their work may spill over into their leisure activities d. Individuals may compensate for leisure by working harder or leisure activities may spill over to work

C: This theory states that some people compensate for things they cannot do in their jobs by engaging in leisure activities which are markedly different from what they do at work, while other people use the same skills and do similar activities in their leisure time as they have at work, so that their jobs are said to "spillover" into their leisure activity. This theory does not state that unhappy workers compensate with excessive leisure pursuits, nor does it state that people's preferences in leisure time reduce their job productivity. It also does not state that people try to make up for having leisure activities by working harder, nor that leisure interests spill over into their work lives.

What do "title and practice-control" laws mean? a. These are laws stating that one cannot practice counseling without using the title of LPC b. These are laws stating that one can practice counseling without a license, but cannot use the title c. These are laws stating that one cannot practice counseling without a professional counselor license d. These are laws stating one may not get a professional counseling license without using the title

C: Title and practice-control laws state that one cannot practice counseling without a professional counselor license. Some states have laws saying that one may practice counseling without a license, but if doing so one may not legally use the licensed professional counselor (LPC) title. These are called "title-control" laws rather than "title and practice-control" laws. There is no law specifying that one cannot practice counseling without using the LPC title. Using the LPC title is not a requirement for obtaining a license.

Everyone says that Jack and Samantha are alike in every way, and it isn't long before they marry. What might explain their relationship? a. Biological processes b. Attribution theory c. Consensual validation d. Conformity

C: When the thoughts and behaviors of two people are similar, they validate each other. In other words, each feels good in the presence of the other because of their similarities. Consensual validity is the term for this interpersonal dynamic, which helps to explain why people are attracted to those who are like them. Being similar also has the advantage of allowing for the enjoyment of common activities, and the increased ability to control the relationship (because of the increased understanding of how the other person thinks and feels), which also lends to the attraction.

A 62-year-old homeless man hospitalized for schizophrenia is to be discharged but has no place to go and no income. Which of the following is of primary importance in preparing for discharge? a. Specific directions for medication or treatments, including side effects b. Information sheets outlining signs for all risk factors c. List of safe shelters and assistance in applying for welfare assistance or Social Security d. Follow-up appointment dates, with physicians, labs, or other healthcare providers

C: While all of these are important, clients who are homeless require further assistance with discharge, as compliance with treatment and follow-up appointments is poor in the homeless population. Interventions that are most important include: -Lists of safe shelters and places they can go to bathe, eat, and get mail. -Assistance in applying for welfare assistance or Social Security.

In a group therapy setting, what is a "blocker"? a. Someone who blocks the others from taking up previous discussions b. A counselor who severely restricts group discussion c. A member who blocks others from veering off topic d. A group member who blocks new ideas

D: A "Blocker" is one of several "self-oriented roles" that involve the group member's concern about their own place in the group dynamics rather than the progress of the group as a whole. The Blocker tends to waste the group's time with old issues, and is almost always negative, as well as resistant to new ideas. Other self-oriented roles would be those who are aggressive or seek attention. Some members also avoid issues or remain passive in the group setting, and there are others who may tend to dominate the group discussion, turning discussions back toward themselves and their own issues.

A client with symptoms consistent with narcolepsy-cataplexy should be referred to a physician for which of the following types of testing? a. Thyroid function b. Liver function c. Blood glucose d. Hypocretin

D: A client with symptoms consistent with narcolepsy-cataplexy should be referred to a physician for testing for hypocretin, which is measured in the cerebrospinal fluid. Narcolepsy is an irrepressible and recurrent need to sleep, and cataplexy is a sudden loss of muscle tone triggered by laughing/joking. The narcolepsy-cataplexy condition typically is a sign of loss of cells in the hypothalamus that produce hypocretin. This loss is associated with an autoimmune reaction. In young people with narcolepsy without cataplexy but with a low level of hypocretin, cataplexy usually develops at a later time.

A correlation coefficient shows: a. how strong the relationship between two variables is. b. the direction of two variables' relationship. c. the degree of relationship between two variables. d. all of the above.

D: A correlation coefficient is a number that shows the degree of relationship between the two variables studied in an experiment. The numeric value of the correlation coefficient falls between +1.00 and -1.00, and there are two parts to each. The number of the correlation coefficient reveals how strong the relationship between two factors is the closer the number is to 1.00, the stronger the correlation is (regardless of the sign). The closer the number of the correlation coefficient is to 0.00, the weaker the relationship. The sign (plus or minus) shows the direction of the two variables' relationship. A negative correlation's variables vary in opposite directions. A positive correlation's variables vary in the same direction.

Which of these is NOT commonly cited as a reason for counseling program evaluation? a. The emphasis on accountability in the human services field b. A strong need to show the efficacy of counseling in general c. A need to show efficacy of specific theories and techniques d. A need to show the effectiveness of a particular counselor

D: A need to show a particular counselor's effectiveness is NOT generally cited as a reason for counseling program evaluation. Evaluation goals are to demonstrate how well a technique, process, or program of treatment works rather than how well an individual therapist works. Program evaluation has been stimulated by the increasing emphasis on accountability in the field of human services, which arose in the 1970s and currently continues. Evaluation speaks to a crucial need to demonstrate the effectiveness of counseling in general and the effectiveness of specific theories, approaches, and therapeutic techniques as well.

A child who throws food at the dinner table is removed from the dining area and told to sit on the stairs for five minutes. This discipline technique is known as: a. coercion. b. the Premack principle. c. shaping. d. time-out.

D: A time-out is the removal of the child from the situation so that all attention is withdrawn from the child. Coercion, by definition, is forcible manipulation of a person to do what you want the person to do. The Premack principle states that more-probable behaviors will reinforce less- probable behaviors. Shaping is another behavioral technique that involves successive approximations of a desired behavior being reinforced as a means to teach a desired response.

Super describes four stages of career development, beginning in adolescence with the ____________ stage, in which a person fantasizes and role-plays in order to clarify the emerging self-concept. In the __________ stage the self-concept adjusts to fit the stabilized career choice and the person tries out various options. a. maintenance; establishment b. establishment; maintenance c. establishment; exploratory d. exploratory; establishment

D: According to Super, adolescents explore career options, fantasize about various careers, and role-play as a means to narrow down their choices. Thus, they explore. In the establishment stage, individuals try out options and establish their careers. The maintenance stage is where the career path has already been established and now is being maintained.

Which of these is a limitation to confidentiality in the ethical practice of counseling? a. Clerical staff in the counseling office will see client information b. A health insurance company or HMO will see client information c. A counselor gets helpful advice about a client from a colleague d. All of these situations represent valid confidentiality limitations

D: All of the situations listed are limitations to confidentiality. These limitations include: 1) danger to the client or to others (requiring certain reporting); 2) discussing a case with other professionals who can help; 3) discussing a case with superiors or teachers if the counselor is still a student; 4) client requests for release of records; 5) a lawsuit is filed against a counselor; 6) court orders for release of information; 7) clerical office staff working with client records; 8) managed care providers and health insurance companies' requests for client information.

Dr. Stanwyck has found a significant difference in the mean test scores of his two student groups. He has also found a significant interaction between their scores. He subsequently tested for significance on a second dependent variable as well. Now he wants to make one more analysis based on the information he has obtained related to the first dependent variable he tested-that of self-efficacy. In pretesting, he noticed that the college seniors in each group had higher average scores in self-efficacy than the college juniors in each group. Therefore, he now adjusts the groups' scores statistically to control for these initial differences before he compares his two test groups. What kind of test is he using? a. Factorial ANOVA b. MANOVA c. One-way ANOVAC. d. ANCOVA

D: Analysis of covariance (ANCOVA) is used when the influence of an independent variable or variables upon a dependent variable is statistically controlled. Since the seniors initially scored higher in self-efficacy than the juniors before the counseling, the researcher evens out the differences in their scores to control the effect of grade level on the dependent variable of self- efficacy. An ANOVA does not control the influence of an independent variable or variables on a dependent variable. It also cannot be used when there is more than one dependent variable, as is the case here. A MANOVA would work for this researcher's analysis of two dependent variables (self-efficacy and optimism), but would not control for the effect of grade level on self-efficacy the way the ANCOVA does.

Binge eating coupled with inappropriate methods of controlling one's weight may be a symptom of what disorder? a. Pica b. Anorexia nervosa c. Rumination disorder d. Bulimia nervosa

D: Bulimia is an eating disorder, characterized by periods of binge eating followed by inappropriate methods of avoiding weight gain. The bulimic patient will often lose control of efforts to avoid eating, only to binge uncontrollably. Following the bingeing behavior, the patient will induce diarrhea, vomit, exercise excessively, or any other number of extreme methods. There are many possible causes of bulimia, including body image issues, biological factors, and control issues. Major life changes and stress can also be a factor in bulimic behavior. Cognitive-behavioral therapy is often chosen as a method of treatment, but psychotherapy is also often used.

Disadvantages of closed-ended questions include all of the following EXCEPT: a. the client fails to disclose personal information. b. the client fails to come up with an answer to the questions. c. the client fails to continue to dialogue with the counselor. d. the client fails to provide important information.

D: Closed-ended questions are those that can be answered with one- or two-word responses (e.g., yes or no). A client who is asked a closed-ended question generally does not add any other information other than answering the question asked directly, therefore personal information may not be disclosed, full answers to questions may not be communicated, and dialogue may not occur. While these are disadvantages of closed-ended questions, there is still purpose to closed-ended questions, including collecting important information in the patient's history that can be successfully and efficiently communicated by clients answer direct closed-ended questions.

A client with schizophrenia and a history of violent behavior in response to "voices" has been pacing about his room and suddenly begins shouting at the counselor "Get away from me! Let me out of here!" Considering the 5-phase aggression cycle, the client is most likely in which of the following phases? a. Crisis b. Recovery c. Triggering d. Escalation

D: Considering the 5-phase aggression cycle, the client is most likely in the phase of escalation. The 5-phase aggression cycle includes: Triggering: Client appears restless, irritable, pacing, tense, and exhibits increased perspiration, loud voice, and angry demeanor. Escalation: Client may begin yelling and swearing and making threatening gestures, exhibiting hostility and loss of self-control. Crisis: Client loses complete control and may begin hitting, spitting, throwing items, kicking, and screaming. Recovery: Client begins to relax physically and emotionally, lowering voice and acting more rationally. Post-crisis: Client experiences remorse and may cry or become withdrawn.

Donald Super identified four theaters of life in which we play roles. The home is one of them. Which of these is NOT one of the other three? a. Community b. School c. Workplace d. Church

D: Donald Super did NOT identify the church as one of the theaters in which we play out our roles. Home, community, school, and workplace are the four theaters he identified.

A focus on confronting clients and pushing them to choose the present instead of allowing the past to affect them is: a. person-centered therapy. b. classical conditioning. c. self-efficacy. d. Gestalt therapy.

D: Frederick and Laura Perls developed Gestalt therapy. Its focus is on challenging clients to become more self-aware and face their problems. Frederick Perls was a student of psychoanalysis and was trained as a Freudian psychoanalyst. As such, he believed that many problems resulted from early conflicts. However, he also believed that those conflicts should be forced into the here and now for clients to deal with. He believed that counselors should confront clients with questions that would lead them to face their thoughts and feelings, and force them to choose if they will allow the past to control the present.

A counselor has been involved in a counseling relationship with a client for six months, when he is presented with a small gift from the client. What should the counselor do? a. Accept the gift and thank the client b. Decline the gift with an explanation of why it's inappropriate to accept it c. Request that the gift be given only once therapy is complete d. Accept or decline depending upon the circumstances

D: Giving a gift is sometimes, and in some cultures, a means of showing respect and gratitude in a way that monetarily compensating the counselor does not. In certain circumstances, accepting a gift may be an acceptable thing for a counselor to do. However, in deciding whether or not to accept a gift, a counselor must consider the client's motivation, the counselor's motivation (in wanting to accept or decline), the monetary value of the item, and of course the point at which the therapeutic relationship has reached. For instance, in some cases declining a gift may be detrimental to therapy. However, for the most part, it is generally best if the counselor does not encourage or accept gifts from those with whom they are in a therapeutic relationship.

Haley's strategic family therapy assumes that: a. the client's symptoms are serving a protective function. b. the power hierarchy of the family is confused. c. the real problem is the family communication pattern. d. All of the above.

D: Haley's strategic family therapy focuses on how families use or abuse power, how they fail to communicate effectively and clearly, and how a symptom serves as a protection against something that is painful.

A client has experienced complicated grief after the death of her father, with whom she had a "love-hate" relationship as he tended to be overbearing and judgmental. However, the client's level of enmeshment was high because the father discussed his marital problems with his ex-wife (the client's mother) with the client and used her to carry messages. Which of the following is likely the cause of the client's complicated grief? a. Chronic depression b. Anger c. Introjection d. Unresolved conflicts

D: If a client has experienced complicated grief after the death of her father with whom she was highly enmeshed because of her inappropriate role as go-between for her parents but had a "love-hate" relationship because he was overbearing and judgmental, the likely cause of the client's complicated grief is unresolved conflicts. The client may suppress grief for a time after the death but over time the conflicted feelings that the client has may intrude more and more, affecting functioning.

A client in the depressive stage of bipolar disease experiences "all or nothing" negative automatic thoughts and states, "I'm a complete failure at everything I try to do." The counselor is using cognitive behavioral therapy to alter dysfunctional thinking. Which of the following is the most appropriate intervention? a. Assist the client to develop a list of positive achievements b. Reassure the client that the feelings are the result of the depression and not real c. Remind the client how the client felt during the manic stage of the disorder d. Ask the client to describe supporting and disputing evidence for this statement

D: If a client in the depressive stage of bipolar disease experiences "all or nothing" negative automatic thoughts and states, "I'm a complete failure at everything I try to do," and the counselor is using CBT to alter dysfunctional thinking, the most appropriate intervention is to ask the client to describe supporting and disputing evidence for this statement. Then, the counselor and the client discuss the underlying logic for the evidence that the client presents.

What is the MOST concerning sign to look for in assessing the risk of suicide in a client? a. A lifting of depression due to the relief of having made a decision b. An unnatural sense of gaiety as all responsibilities are discarded c. Frequent explosions of hostility or rage directed at other people d. Establishment of a definite plan and having the means available

D: If a suicidal person has made a definite plan to commit suicide and also has means such as sleeping pills or a gun available, this is a sign of serious risk that the individual will attempt suicide. Another sign of suicide risk is depression and a sense of hopelessness, so a lifting or relief of depression is not necessarily correct, although it has been seen that some patients demonstrate a lift of depression before suicide because they are at peace with the decision. An unnatural sense of gaiety at giving up responsibilities is not a common sign of serious suicide risk, but the giving away of valuables is another sign to be wary of. Frequent explosions of hostility or rage directed at others is a sign of disturbance, but this is more likely a sign of risk for murder or otherwise harming others than for suicide. Depression is anger turned inward at the self, and suicide is aggression against the self. A person who lashes out at others is less likely to commit suicide.

What are the four levels of data measurement used to determine the statistics used? a. Nominal, random, stratified, cluster b. Ordinal, purposeful, cluster, nominal c. Ratio, random, cluster, interval d. Nominal, ordinal, interval, ratio

D: In nominal measurement, the numbers represent categories such as male and female. In ordinal measurement, the numbers show differences in magnitude such as from high to low or vice versa. In interval measurement, the numbers have equal quantities throughout so that the interval between them is always the same; the interval between 10 and 11 being the same as the interval between 2 and 3. In ratio measurement the numbers are on a scale with a true zero and can be compared by ratios such as 400 being twice as much as 200. Random, stratified, cluster, and purposeful are types of sampling not types of measurement.

What is the fourth stage of Jean Piaget's four stages of cognitive development? a. Sensory Motor Stage b. Preoperational c. Concrete Operations d. Formal Operations

D: Jean Piaget's last stage of development, formal operations, is when the individual's thinking becomes less tied to reality, and they are more able to use abstract reasoning and formal logic. When faced with a problem during this stage, the child is able to systematically solve problems in a more methodical manner. Jean Piaget theorized that cognitive development is tied to one's ability to process new information. Piaget's stages, in order, are sensory motor (involving motor skill and sensory input), preoperational (increased verbalizations and crudely formed concepts), concrete operations (organized thought and logic), and formal operations.

One method of assessing a client's ability to concentrate is to ask the client to do which of the following? a. Give the name of the previous president b. State the client's social security number c. State the client's current location d. Count backward from 100 in serial 7s

D: One method of assessing a client's ability to concentrate is to ask the client to count backward from 100 by serial 7s (100, 93, 86...). Other tests of concentration include asking the client to spell the word world backward, state the days of the week backward, or carry out a simple three-part task (pick up the card, fold it in half, and place it on the desk). Requests that require the production of facts, such as "give the name of the previous president," are used to assess memory rather than concentration.

A formal mental status examination covers all BUT which of the following areas? a. Appearance and behavior b. Thought processes, mood and affect c. Intellectual functioning, sensorium d. Personality, brain dysfunctions

D: Personality characteristics are typically tested using psychological instruments such as the Minnesota Multiphasic Personality Inventory (MMPI) or the California Psychological Inventory, which are personality tests. Brain dysfunctions are typically measured using neuropsychological assessments such as the Luria-Nebraska Neuropsychological Battery which measures organic damage and its location(s); the Bender® Visual-Motor Gestalt Test, which is often used with children to measure brain dysfunction. The five areas covered by a formal mental status examination are: appearance and behavior; thought processes; mood and affect; intellectual functioning; and, sensorium. Sensorium refers to orientation to self, place, time and environment.

All of these are characteristics of test reliability EXCEPT: a. stability. b. equivalence. c. internal consistency. d. predictive.

D: Predictive is a type of validity, not of reliability. It means that predictions made by a test are confirmed by later behavior. Stability refers to test-retest reliability using the same testing instrument with the same group at different times. Equivalence is a type of reliability using alternate forms of the same test with the same group and correlating the results. Internal consistency refers to the degree of correlation between different aspects of a test intended to address the same characteristic. This measure of reliability is often measured via a split-half method - where items addressing a shared characteristic are divided into two test "halves" and then administered to involved subjects. The degree of correlation between the two halves measures the instrument's internal consistency.

11. Which of these is true of quantitative research? a. This kind of research tends to use naturalistic observation of individual behaviors b. This kind of research tends to use impressions, feelings or judgments of researchers c. This kind of research has as its primary goal the description of the nature of reality d. This kind of research tends to investigate with a goal of finding causal relationships

D: Quantitative research is more focused on finding relationships, often cause and effect relationships if they can be statistically proven. Answers A, B, and C all describe characteristics of qualitative research.

What is meant by the term "regression toward the mean?" a. It means that most individuals are more likely to score near the mean on most standardized tests b. It means that most individuals' standardized test scores will go down from a pretest to a posttest c. It means that those individuals scoring near the mean on a pretest will score lower on a posttest d. It means that most scoring very high or low on a pretest will score nearer the mean on a posttest

D: Regression toward the mean, or reversion to the mean, expresses the fact that if an individual scores very high (85% or higher) or very low (15% or lower) on a pretest, that individual is likely to earn a score closer to the mean (average) on the posttest. The unusual pretest score is usually an error due to chance, personal and environmental factors, which are reliably likely to be different on the posttest. This term does not express that most individuals will score near the mean on standardized tests. It does not mean that posttest scores will be lower than pretest scores, since they could also be higher depending on the pretest score. It does not mean that individuals scoring close to the average on a posttest will score lower on the pretest.

Which of the following is NOT true about standardized scores? a. Standardized score scales allow comparison of different test scores for the same individual b. Standardized scores enable comparisons of scores between or among different individuals c. Standardized scores indicate the individual's distance from the mean in standard deviations d. Standardized scores may be discontinuous and may employ units which are not equivalent

D: Standardized scores are continuous and the units they use are equal. Standardized scores do enable us to compare several different test scores for the same person. They allow normative or relative meaning, which enables comparisons between or among individuals. They do express the distance of an individual's score from the mean in terms of the particular standard score distribution's standard deviation.

In the landmark 1976 Tarasoff case, the California court ruled that failure to warn an intended victim is professionally irresponsible. Out of what event did this ruling come? a. A university psychologist by the name of Tarasoff was murdered by one of his clients b. A client named Tarasoff, under the care of a university psychologist, was murdered c. A university psychologist murdered his client, Tatiana Tarasoff, and her family sued d. A client of a university psychologist murdered Tatiana Tarasoff and her family sued

D: Tatiana Tarasoff was murdered by Prosenjit Poddar, who was a client of a university psychologist, and her family subsequently sued the Board of Regents of the University of California. The court ruled that if a therapist has reason to believe that a client may pose a serious danger of violence to one or more third parties, that therapist must either confine the client under state laws of psychiatric involuntary hospitalization, or else break confidentiality to notify the police and warn the intended victim(s). This is known as the Duty to Warn. Since this case, decisions in other court cases in other states have reaffirmed this legal precedent.

The Wisconsin card sorting test is used with clients with traumatic brain injury to assess which of the following? a. Fine motor skills b. Language skills c. Memory d. Cognitive reasoning

D: The Wisconsin card sorting test is used with clients with traumatic brain injury to assess cognitive reasoning. This test requires the client to classify cards by color, shape, or number, and the rules keep changing, so the client must pay close attention to feedback. The test is generally done on the computer, which automatically calculates the number of errors, including perseveration errors (where the client continues to classify to the same category after a rule change) and non-perseveration errors.

Which of the following behaviors would differentiate aggression from anger? a. Passive-aggressive behavior b. Holding clenched fists c. Yelling and shouting d. Verbal threats

D: The behavior that would differentiate aggression from anger is making verbal threats, as this often means that the client's anger is escalating, and the person's response may be disproportionate to the situation. Other indications of aggression include restless behavior and pacing back and forth, shouting in a loud voice, and using obscenities. The person may be very suspicious and exhibit disturbed thought processes and increased agitation and overreaction to stimuli. Aggressive individuals almost always have intent to hurt someone or something.

When instituting suicide precautions, which client is likely at highest risk? a. A 15-year-old girl who overdosed on aspirin and then told her best friend b. A 50-year-old woman who overdosed on pills and alcohol while her family was present c. A 26-year-old man who threatened to jump out of a second story window d. A 38-year-old man who shot himself in the chest while alone at home

D: The client most likely at risk is the man who shot himself in the chest while alone. A suicide risk assessment should evaluate some of the following criteria: Would the individual sign a contract for safety? Is there a suicide plan? How lethal is the plan? What is the elopement risk? How often are the suicidal thoughts, and has the person attempted suicide before? High-risk findings include:

The counselor should be aware that which of the following common drugs may be associated with depression? a. Isotretinoin (Accutane®) b. Beta blockers c. Calcium channel blockers d. Digoxin (Lanoxin®)

D: The counselor should be aware that digoxin (Lanoxin®) is a common drug that may be associated with depression, affecting about 5% of clients taking the drug. Depression may occur at therapeutic doses as well as toxic doses. Other drugs that may cause depression include carbonic anhydrase inhibitors, interferon-alpha, carmustine, busulfan, L-asparaginase, clonidine, and amiodarone, phenytoin, metronidazole, metoclopramide, H-2 blockers, steroids, and thiazide diuretics. Beta blockers, calcium channel blockers, and isotretinoin (Accutane®) are not associated with depression.

There is a distinction between group content and group process. An example of process would be: a. Sarah monopolizes the group by continuously talking and doesn't allow other participants to contribute to the discussion. b. Joe says, "I think today's topic should be what to do on a first date." c. Randy rolls his eyes every time Karen says something. d. both A and C.

D: The distinction between group content and group process hinges on behavior. Group content involves the topics of discussion or the skills to be addressed. Group process involves looking beyond someone's words and instead observing the person's behavior. It's not what is said; it's how it is said. In the examples, Joe brought up a topic to be discussed (content). Randy reacted not so much to what Karen said, but rather to Karen herself. The act of rolling his eyes is a process (behavior pattern that he perpetuates). Sarah's constant monopolizing is her pattern of responding. It wasn't that she spoke often, it was that she dominated the discussion and didn't allow others to join in.

A 28-year-old client has a dual diagnosis of bipolar disorder and substance abuse (cocaine, alcohol). Which of the following is the first outcome goal for the client? a. Interact appropriately with others b. Become active in drug and alcohol-free activities c. Develop a plan for activities during free time d. Take only medications that have been prescribed

D: The most immediate goal is to manage the client's symptoms with appropriate medications and for the client to take only prescribed medications rather than self-medicating with cocaine and alcohol. Clients with dual diagnoses can present challenges because they cannot abstain from all medications if their symptoms are to be controlled. Once they are properly medicated, they can begin to interact with others, express feeling, and develop plans for activities. When stabilized, they can begin to work on social skills and participate in alcohol/drug-free activities.

Which of the following is not a behavioral therapy? a. Flooding b. Skills training c. Exposure d. Unconditional positive regard

D: The only technique that is not behavioral is unconditional positive regard, which is client centered, or Rogerian. A Rogerian-oriented therapist reflects back whatever a client says as a way to show empathy or unconditional regard. Behaviorists do not address feelings at all, so unconditional positive regard would not be something a behaviorist would consider offering to a client directly.

An experienced counselor is the supervisor for a new counselor and is asked to attend her wedding. Would it be ethical to do so? a. It would not be ethical to attend her wedding b. It would depend on the counselor's role in the festivities c. Yes, but only if the counselor doesn't bring a gift d. Yes, the counselor should be able to attend her wedding without a breach of ethics

D: There is a significant power differential between supervisors and supervisees. As a supervisor, the counselor must be diligently aware of any and all possible circumstances that might negatively affect his ability to competently conduct his role as a supervisor. Some activities can be beneficial to the professional relationship. Activities such as visits to the hospital or attendance at weddings and other significant events may enhance the relationship. However, other activities such as romantic involvements or business investments could prove detrimental and could be considered unethical.

Which of the following is NOT true of the FERPA? a. The acronym stands for the Family Educational Rights and Privacy Act of 1974 b. This law is also referred to as the Buckley Amendment c. The intention of this act was to protect individuals' privacy d. It gives students' parents access to their counseling records

D: This act does NOT give students' parents access to their counseling records. Rather, it gives them access to their educational records. It also gives the students themselves this access providing they are 18 years of age or older. Answers A, B, and C are all correct.

Which of the following terms is associated with transactional analysis? a. Free association b. Unconditional positive regard c. Irrational beliefs d. Complementary transactions

D: Transactional analysis examines the interactions or complementary transactions that occur within an individual (parent, adult, child). Free association is paired with the psychoanalytic or psychodynamic approach. Unconditional positive regard is affiliated with the client-centered counseling of Carl Rogers. Irrational beliefs are associated with rational-emotive behavior therapy.

Which is most accurate statement regarding the duration of a therapy group? a. When a therapy group is first formed, nobody knows exactly how long the group will exist or run b. When a therapy group is first formed, it is generally accepted that it will run for about six months c. When a therapy group is first formed, the group members decide on how long they want it to run d. When a therapy group is first formed, the leader should set its duration and advise the members

D: When a therapy group is formed, the leader(s) should decide in advance how long it will run and should advise the members of this. The group's duration should not be unknown or indefinite. There is no generalization that therapy groups should run for six months. The group members should not decide on its length, as they do not have the leader's knowledge or expertise.

When publishing research, it is LEAST appropriate to: a. give credit to other contributors or sources. b. not plagiarize. c. submit material to only one journal at a time. d. submit material to several journals at a time.

D: When reporting research, it is important to always give credit to any other source or individual who has contributed to the work, or from whom the researcher has drawn significant information. Work must also be original (unless indicated otherwise), and one should never plagiarize. Editorial must also be made aware of previous publication of the material, and only one journal should be submitted to at a time. If material is substantially based on the work of students, they should certainly be listed as principal authors.

The counselor is carrying out a spiritual assessment using the FICA tool (Faith, Importance, Community, Address). Which of the following is the first question that the counselor should ask? a. "What importance does your faith have in your daily life?" b. "Do you have a faith or belief system that gives your life meaning?" c. "What faith issues would you like me to address in your care?" d. "Do you participate and gain support from your faith community?"

If the counselor is carrying out a spiritual assessment using the FICA (Faith, Importance, Community, Address) tool, the first question that the counselor should ask is, "Do you have a faith or belief system that gives your life meaning?" The questions go from the general to the specific. FICA is an abbreviated spiritual assessment: F - Faith - Do you have a faith or belief system that gives your life meaning? I - Importance - What importance does your faith have in your daily life? C - Community - Do you participate and gain support from a faith community? A - Address - What faith issues would you like me to address in your care?