Exam 2

Which of the following constitutes an open-ended invitation?

"I'd like to begin by learning more about the concerns that have brought you to therapy. What has been the difficulty?"

One of the best ways to evaluate the success of an initial interview is for therapists to ask themselves:

"Was I able to create a corrective emotional experience for my client?"

Which of the below components IS NOT used to define a working alliance?

A specific theoretical orientation used to establish collaboration

One of the most common themes that makes therapy threatening for clients is:

All choices are common themes for clients.

In order to address interpersonal conflict between therapist and client, the therapist should

All choices are correct.

When clients are threatened by conflicted feelings about continuing therapy, they:

All choices are correct.

The most important component of the definition of a collaborative process is:

All of the above are correct, all are equally important.

A common reason therapists resist focusing the client inward is:

All of the answer choices are correct.

Attachment theorists believe that "joining" a client where they are:

All of the answer choices are correct.

To "resolve shame dynamics," therapists should:

All of the answer choices are correct.

When a client becomes noticeably more anxious, the therapist's aim should be to:

Both identify the issue that has just precipitated the anxiety and engage the client about the anxiety to collaboratively discern the triggering event are correct.

To provide a "holding environment" for clients to explore their distress, therapists:

Both maintain a steady presence and clarify what the therapist is thinking and feeling as clients share conflicted feelings are correct.

Therapists can develop credibility when working with diverse clients by:

Both responding in a manner that is congruent with the client's worldview and show they are trustworthy by collaborating with clients on therapeutic goal setting are correct.

Therapist's ability to respond to the unique circumstances of each client and provide the specific interpersonal experiences the client needs to change, illustrates the concept of:

Client Response Specificity

________ is one of the most common consequences of systematic invalidation.

Disempowerment

The new therapist often experiences countertransference issues when providing therapy. Which of the below is NOT likely to occur between a new therapist and their client(s)?

Experiencing the client's problems as quite different than their own

Clients are often unaware of their own resistance, and may:

externalize it to others or outside events

Honoring the client's resistance means:

reframing it as an adaptive response to a developmental conflict.

One of the most effective ways therapists can help their clients change is to:

validate and confirm their subjective experience

. Reasons clients do not like to explore difficult feelings include their:

belief that they will be ridiculed and judged

When therapists minimize, reassure, explain, or simply move away from a client's painful feelings, it is often because:

both they feel responsible for causing the client's painful expressions and they feel responsible for alleviating their pain, but don't quite know how are correct.

In order for a client to feel understood, it is sometimes important for the therapist to:

break social rules by responding to the central affective meaning in the client's message.

By identifying the enduring issues that arise for the client, the therapist will be better prepared to:

center treatment around these repeated themes.

The principal goal of interpersonally oriented therapy is the:

client experiences a different and more satisfying kind of relationship with the therapist, than he/she has had in the past.

A therapist usually knows when a client is resisting treatment when the:

client has difficulty participating.

The most common reason clients prematurely terminate therapy is:

clients are acting on rather than talking about their conflicted feelings about entering therapy

Which observation below is NOT likely to be observed in relation to how clients interact with them:

clients generally talk about their problems in an abstract manner.

Although different sequences occur for each client, the therapist can often identify a(n) of interrelated feelings that cycle repeatedly when clients are distressed.

Triad

Entering therapy for clients involves both _______ and _______ .

desire for help; fear and shame

The interpersonal process approach can be applied by therapists who choose to work within

different theoretical orientations

According to Sullivan's theory_______is the central motivating force for human behavior

anxiety

Clients develop complex interpersonal coping strategies and defense mechanisms to ward off the ________ associated with the ________.

anxiety; client's generic conflicts

The Interpersonal Process approach is designed for a treatment length of:

any period of time.

When clients risk exposing their pain, vulnerability, or shame and the therapist responds with kindness and understanding, clients .

are personally empowered

The best way for a therapist to demonstrate his/her understanding of the client's experience is:

articulating the central meaning of what the client has said.

In order to establish a collaborative relationship, the therapist may have to:

ask the client to provide more historical information.

In fostering a collaborative process, when a client has been in treatment before, it's necessary to

ask the client what was and wasn't helpful in previous therapeutic encounters

The greatest opportunity to help clients change occurs:

at the moment clients are experiencing the full emotional impact of their problems

According to Attachment Theorists, a secure attachment configuration between the client and the therapist is established when the therapist's helps contain and soothe the client's distress.

attuned responsiveness

Attachment theorists have noted that parental styles which ignore, dismiss, or reject to console a distressed child, the child is likely to develop a(n) _______ attachment style.

avoidant

In order to utilize the process dimension, therapists may employ all but the following in helping their clients gain genuine understanding of their problems:

avoiding interactional issues which don't directly address the client's issues

When the therapist helps the client to clarify the thoughts and feelings that are associated with anxiety, the client's vague discomfort will usually:

become more specific.

One way in which therapist's countertransference reactions are revealed in therapy is by the therapist:

becomes personally invested in the way the client handles a certain issue.

To keep therapy from reenacting common but dysfunctional family patterns, the therapist and client want to begin their own relationship by:

beginning their relationship as a stable dyad.

Following an initial phone contact, the chances that a client will not show up for the first appointment are far greater if the therapist:

does not acknowledge potential indecision and uncertain commitment through non-defensive dialogue.

In order to focus clients inward, a therapist should:

encourage the client to expand and elaborate their fears and concerns.

According to Object Relations Theory, the primary motivation is to:

establish and maintain emotional ties to parental care-givers.

When the dependent client acts assertively in the session, the therapist provides a corrective emotional experience by:

explaining why the client has been dependent in the past

The process of learning how to contextualize or make sense of a client's problems involves:

exploring various theoretical frameworks

Sue et al (1998) describe cultural competence in working with clients. This is important because therapists need to know:

for many clients it is culturally taboo to speak critically of parents

An effective response to a client's ambiguity in attending a first session is:

for the therapist to acknowledge the client's ambiguity and address it directly.

One reason why beginning therapists are reluctant to approach their client's resistance is because of the therapist's strong need:

for their clients to like them.

Before clients can adopt new, more effective responses to old problems, they must:

gain more understanding and control of their reactions.

Family homeostasis requires that many patterns of interaction and communication become _______ and _______.

repetitive; rule-bound

One suggestion for new therapists to resolve their initial performance anxiety includes

requesting active support from their supervisors and instructors

In the beginning stage of therapy, most clients see the source of their problems as:

residing "out there" with someone else.

What is the four-step sequence outlined by the authors to address a client's resistance to change outdated or maladaptive coping strategies?

Identify, validate, track, generalize

The Interpersonal Process Approach is based on which three theories?

Interpersonal, Cognitive, and Familial/Cultural Systems

When clients begin therapy by externalizing their problems, the therapist must first:

acknowledge the complaints as valid concerns.

It is important to consider________when engaging in therapy with clients from some cultural groups:

acknowledging differences and inviting clients to explore the concerns together.

When a therapist makes a process comment by acknowledging a discrepancy between what a client has said and the feeling or affect that accompanied the statement, the therapist is:

addressing an incongruence.

Therapists want to respond to ambivalence about making first appointments by:

addressing it directly

When the client reenacts a central conflict in therapy:

it is an opportunity to resolve the problem in the therapeutic relationship.

The best way for a therapist to manage their own reactions to evocative material that clients present is to:

learn how to recognize and anticipate their own Countertransference propensities, and know what to do when they are evoked.

An accurate empathic response by the therapist:

makes the client feel heard, seen and compassionately understood.

Clients who do not experience or express anger, avoid interpersonal conflict, and tend to respond to others' needs at the expense of their own is said to be experiencing the affective constellation.

Sadness-Anger-Guilt

Beginning a session by telling the client that, "I would like you to begin each session by bringing up what you want to talk about. I'd like to work on what is most important to you," is an example of:

Shared Control.

When a collaborative relationship has been established:

The therapist and client share an active role.

According to Harry S. Sullivan's Interpersonal Therapy, personality is

a collection of interpersonal strategies employed to avoid or minimize anxiety, ward off disapproval, and maintain self-esteem

Empathic understanding is:

a respectful attitude and non-judgmental stance that conveys warmth and concern for the client's distress.

The locus of change in the therapeutic setting must remain

a shared control or collaborative alliance between therapist and client

After inviting clients to express their concerns about the therapist or therapy, the therapist must:

accept the validity of the client's perception

A primary treatment goal for therapists with almost all clients is to:

help clients discriminate when certain defensive coping strategies are needed and when they are outdated.

One of the most important ways to help clients achieve a greater sense of adequacy and mastery in their lives is to:

help them make sense of their emotional reactions.

An "assessment function":

helps shape the treatment focus.

Beginning therapists can find an integrating focus by:

identifying recurrent themes.

According to the author, interpersonal process therapy is a highly _______ approach, in that it emphasizes the personal experience or subjective worldview of each client.

idiographic

. Supporting the client's own autonomy and initiative is found in a/an ________ rather than a(n) ________.

independence-fostering; dependence-fostering approach

To identify recurrent themes from a client, the therapist needs to find a(n)

integrating focus

Being personally affected by a client:

is a risk a therapist has to take to be effective.

In order to work in the interpersonal process approach, therapists must shift away from the _______ of what is discussed, and track _______.

overt content; relational process.

According to Prochaska et al. ________ do not "own their problems, and usually enter treatment because of pressure from others."

precontemplators

Although reasons will vary greatly for each client, client resistance and defenses are driven most frequently by:

shame

Clients often interpret their own resistance as being _______ and want to _______ the topic.

shameful; avoid

Creating a working partnership is a treatment goal that establishes a new middle ground of ________ in the therapist-client relationship.

shared control

A hierarchical helper-helpee mode of therapy:

shifts responsibility away from the client and onto the therapist.

According to Beck's "hot cognitions," it is when ________ that clients are most apt to distort or misperceive the therapist's response and slot it to fit old expectations.

strong feelings have been triggered

"Other focused" clients:

tend to feel anxious, depressed and helpless and can resolve their problems by changing their way of responding in conflicted relationships.

The factor most responsible for the fostering of dependence of a client is:

the repeated directing of the course of therapy by the therapist.

One basic reason why familial experience has such a powerful, long-term impact on the individual is:

the repetition of family transaction patterns

One reason why clients are often ambivalent about exploring their anxiety is:

the therapist is leading the client closer to the conflict that is the source of their problems.

According to R.D. Laing, people stop feeling "crazy" when:

their subjective experience is validated

To identify patterns and themes that cause problems in clients' lives, the therapist:

tracks their anxiety.