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Chapter 13 Treatment of Psychological Disorders Multiple Choice Questions 1. _____________ is treatment in which a trained professional—a therapist—uses psychological techniques to help someone overcome psychological difficulties and disorders, resolve problems in living, or bring about personal growth. A. Phototherapy B. Psychotherapy C. Biomedical therapy D. Physiotherapy Answer: B. Psychotherapy 2. Therapy that relies on drugs and other medical procedures to improve psychological functioning is referred to as _____________ . A. phototherapy B. psychotherapy C. biomedical therapy D. physiotherapy Answer: C. biomedical therapy 3. Dr. Andersen attempts to bring about personal growth by using psychological techniques; Dr. Bradley attempts to improve psychological functioning through the use of psychotropic medication. Dr. Andersen practices _____________; Dr. Bradley, _____________. A. psychotherapy; psychoanalysis B. psychotherapy; biomedical therapy C. psychoanalysis; biotherapy D. physiotherapy; psychotherapy Answer: B. psychotherapy; biomedical therapy 4. Today therapists use a(n) _____________ approach to therapy, which means they use a variety of methods with an individual patient. A. existential B. behavioral C. psychoanalytical D. eclectic Answer: D. eclectic 5. _____________ are professionals with a Ph.D. or Psy.D. who have also completed a postgraduate internship. They specialize in assessment and treatment of psychological difficulties, providing psychotherapy and, in some U.S. states, can prescribe drugs. A. Psychoanalysts B. Psychiatrists C. Psychiatric social workers D. Clinical psychologists Answer: D. Clinical psychologists 6. _____________ are professionals with a Ph.D. or Ed.D. who typically treat day-to-day adjustment problems, often in a university mental health clinic. A. Counseling psychologists B. Psychiatrists C. Licensed professional counselors D. Psychoanalysts Answer: A. Counseling psychologists 7. Which of the following mental health professionals is correctly matched with a brief description? A. Counseling psychologist–treats everyday adjustment problems, often in a university mental health clinic B. Psychiatrist–specializes in Freudian treatment techniques C. Psychoanalyst–prescribes medication and treats severe disorders D. Clinical social worker–holds Ph.D.; assesses and treats psychological difficulties Answer: A. Counseling psychologist–treats everyday adjustment problems, often in a university mental health clinic 8. Which of the following professionals most likely has a Ph.D.? A. Counseling psychologists B. Psychiatrists C. Licensed professional counselors D. Psychoanalysts Answer: A. Counseling psychologists 9. Professionals with a master's degree who provide therapy to individuals, couples, and families and who hold a national or state certification are called _____________. A. counseling psychologists B. psychiatrists C. licensed professional counselors D. psychoanalysts Answer: C. licensed professional counselors 10. Professionals with a master's degree and specialized training who may provide therapy, usually regarding common family and personal problems are called _____________. A. counseling psychologists B. psychiatric social workers C. licensed professional counselors D. psychoanalysts Answer: B. psychiatric social workers 11. _____________ therapy seeks to bring unresolved past conflicts and unacceptable impulses from the unconscious into the conscious, where patients may deal with the problems more effectively. A. Cognitive B. Psychodynamic C. Behavioral D. Humanistic Answer: B. Psychodynamic 12. Psychodynamic therapy involves: A. the consideration of unresolved past conflicts and unacceptable impulses. B. the use of drugs and medical procedures. C. behavior modification techniques. D. an attempt to challenge the patient's current thinking patterns. Answer: A. the consideration of unresolved past conflicts and unacceptable impulses. 13. The most common defense mechanism is _____________. A. dissociation B. projection C. reaction formation D. repression Answer: D. repression 14. Which of the following statements best expresses the relationship between psychoanalysis and psychotherapy? A. Psychoanalysis is limited to only dream analysis. B. Psychotherapy is one type of psychoanalysis. C. Psychoanalysis is one type of psychotherapy. D. The two are unrelated. Answer: C. Psychoanalysis is one type of psychotherapy. 15. _____________ was developed by Freud in which the goal is to release hidden unconscious thoughts and feelings in order to reduce their power in controlling behavior. A. Psychoanalysis B. Transactional analysis C. Meta-analysis D. Microarray analysis Answer: A. Psychoanalysis 16. The surface description of a dream is called the _____________ content. A. latent B. philological C. semiotic D. manifest Answer: D. manifest 17. The underlying meaning of a dream which is the true unconscious meaning of the dream is called _____________ content. A. latent B. philological C. semiotic D. manifest Answer: A. latent 18. Noah dreams that he suddenly becomes paralyzed as he tries to cross a busy intersection. In Freudian terms, this is the _____________ content of Noah's dream. The underlying meaning of the dream is the _____________ content. A. manifest; repressed B. manifest; latent C. repressed; manifest D. repressed; latent Answer: B. manifest; latent 19. _____________ is an inability or unwillingness to discuss or reveal particular memories, thoughts, or motivations. A. Resistance B. Transference C. Dissociation D. Projection Answer: A. Resistance 20. After telling his psychoanalyst about his relationship with his ex-wife for a few minutes, Jerome suddenly changes the subject. Jerome is exhibiting: A. resistance. B. transference. C. a latent conflict. D. projection. Answer: A. resistance. 21. _____________ is the transmission of feelings to a psychoanalyst of love or anger that had been originally directed to a patient's parents or other authority figures. A. Regression B. Transference C. Dissociation D. Projection Answer: B. Transference 22. What is transference? A. The transfer of a learned response from one task to another similar task B. The transfer of irrational cognitions to the self C. The transfer of strong feelings about parents or authority figures to a psychoanalyst D. A behavioral technique invented to facilitate the transfer of learned behaviors from the session to the outside world Answer: C. The transfer of strong feelings about parents or authority figures to a psychoanalyst 23. Which of the following is a suitable way of handling transference? A. The therapist should discourage and attempt to minimize the patient's transference. B. The therapist can take advantage of transference to help the patient "redo" difficult relationships. C. The therapist should simply ignore the patient's transference. D. The therapist should refer the patient to another professional toward whom the patient is unlikely to demonstrate transference. Answer: B. The therapist can take advantage of transference to help the patient "redo" difficult relationships. 24. How does contemporary psychodynamic therapy differ from classic psychoanalysis? A. Contemporary psychodynamic therapy generally lasts longer than classic psychoanalysis. B. Today, psychoanalysis takes a less directive role than was the case in the past. C. Classic psychoanalysts concentrated more on an individual's current relationships and specific complaints than contemporary therapists. D. Contemporary therapist puts less emphasis on a patient's past history and childhood than classic psychoanalysts. Answer: D. Contemporary therapist puts less emphasis on a patient's past history and childhood than classic psychoanalysts. 25. Despite being criticized, why has psychodynamic therapy remained a viable approach to psychological treatment? A. It facilitates the development of deep insight into one's life. B. It is brief and inexpensive. C. It is more objective than are some other forms of therapy. D. It doesn't differentiate between articulate and less verbal patients. Answer: A. It facilitates the development of deep insight into one's life. 26. _____________ treatment approaches make use of the basic processes of learning, such as reinforcement and extinction, and assume that normal and abnormal behaviors are both learned. A. Cognitive B. Psychodynamic C. Behavioral D. Humanistic Answer: C. Behavioral 27. Which of the following approaches to psychotherapy is correctly matched with its description? A. Psychodynamic approach—Treatment aims to change maladaptive thinking patterns. B. Behavioral approach—Classical and operant conditioning principles are used to change people's behavior. C. Psychoanalysis approach—Treatment aims to change a patient's dysfunctional cognitions about the world. D. Humanistic approach—Therapy aims to bring unconscious conflicts and impulses into the conscious. Answer: B. Behavioral approach—Classical and operant conditioning principles are used to change people's behavior. 28. According to a behavior therapist, how might psychological disorders be treated most effectively? A. The client should learn new behaviors to replace the faulty skills. B. Patients should say aloud whatever comes to mind. C. Unconscious conflicts should be brought to light. D. Neurotransmitter irregularities should be rectified through drugs. Answer: A. The client should learn new behaviors to replace the faulty skills. 29. _____________ is a form of therapy that reduces the frequency of undesired behavior by pairing an unpleasant stimulus with undesired behavior. A. Systematic desensitization B. Aversive conditioning C. Manifest structuring D. Exposure treatment Answer: B. Aversive conditioning 30. _____________ is a behavioral technique in which gradual exposure to an anxiety-producing stimulus is paired with relaxation to extinguish the response of anxiety. A. Systematic desensitization B. Aversive conditioning C. Manifest structuring D. Exposure treatment Answer: A. Systematic desensitization 31. Giovanni abuses cocaine; Hans has a dog phobia. Which alternative below correctly identifies the behavioral treatment most appropriate for each of these individuals? A. Giovanni—aversive conditioning; Hans—exposure treatment B. Giovanni—systematic desensitization; Hans—exposure treatment C. Giovanni—aversive conditioning; Hans—systematic desensitization D. Giovanni—exposure treatment; Hans—aversive conditioning Answer: C. Giovanni—aversive conditioning; Hans—systematic desensitization 32. A hierarchy of fears may be used in: A. aversive conditioning. B. systematic desensitization. C. transference. D. manifest structuring Answer: B. systematic desensitization. 33. _____________ is a behavioral treatment for anxiety in which people are confronted either suddenly or gradually with a stimulus that they fear. A. Aversive conditioning B. Systematic desensitization C. Transference D. Exposure Answer: D. Exposure 34. How do flooding treatments differ from systematic desensitization? A. Exposure treatments use a hierarchy of anxiety-provoking stimuli; systematic desensitization does not. B. Exposure treatment gauges neurotic symptoms; systematic desensitization does not. C. Exposure treatment does not use learned relaxation techniques; systematic desensitization does. D. Exposure treatment is a very complicated form of therapy; systematic desensitization is not. Answer: C. Exposure treatment does not use learned relaxation techniques; systematic desensitization does. 35. Which of the following operant conditioning techniques is incorrectly paired with its description? A. Token system—An individual is rewarded for desired behavior with such items as chips or play money, which he or she can exchange for desired items. B. Contingency contracting—The therapist and client create a written agreement specifying the consequences for desirable and undesirable behaviors. C. Observational learning—An individual models desired behavior for the client. D. Token system—The therapist reduces the frequency of undesired behavior by pairing an aversive, unpleasant stimulus with undesired behavior. Answer: D. Token system—The therapist reduces the frequency of undesired behavior by pairing an aversive, unpleasant stimulus with undesired behavior. 36. _____________ rewards a person for desired behavior with a poker chip or some kind of play money. A. The token system B. Contingency contracting C. Observational learning D. The appraisal technique Answer: A. The token system 37. The token system is most often used: A. in institutional settings, for individuals with relatively serious problems. B. as an appraisal technique. C. by friends in a dorm. D. as a classroom management technique. Answer: A. in institutional settings, for individuals with relatively serious problems. 38. In _____________, the therapist and client (or teacher and student or parent and child) draw up a written agreement. A. the token system B. contingency contracting C. observational learning D. the appraisal technique Answer: B. contingency contracting 39. _____________ is the process in which the behavior of other people is modeled to systematically teach people new skills and ways of handling their fears and anxieties. A. Token systematization B. Contingency contracting C. Observational learning D. Exposure therapy Answer: C. Observational learning 40. A client with social anxiety watches a film in which an individual greets strangers in a crowded room, makes small talk, and smiles pleasantly. The individual in the film appears to gain pleasure from these activities. The behavior therapy technique used in this scenario is: A. token systematization. B. contingency contracting. C. observational learning. D. aversive conditioning. Answer: C. observational learning. 41. _____________ is said to occur when therapists imparting certain basic social skills to their clients maintain eye contact and act assertively. A. Observational learning B. Contingency contracting C. Dialectical behavior therapy D. Behavioral activation Answer: A. Observational learning 42. Which of the following statements is false regarding behavior therapy? A. It is especially effective in the treatment of anxiety disorders. B. It can produce actual changes in the functioning of the brain. C. It is actually based mainly on psychoanalytic ideas. D. It has no problem other than the maladaptive behavior itself. Answer: C. It is actually based mainly on psychoanalytic ideas. 43. How might one best respond to the charge that behavior therapy produces only a superficial change in external behavior? A. Research shows that behavior therapies produce the same sorts of insights into one's life that one associates with psychoanalytic and humanistic therapies. B. Neuroscientific evidence shows that behavioral treatments produce actual changes in the functioning of the brain. C. External behavior is a result of internal functions. D. Research shows that behavior therapies and cognitive therapies are fundamentally the same. Answer: B. Neuroscientific evidence shows that behavioral treatments produce actual changes in the functioning of the brain. 44. _____________ evidence shows that behavioral treatments can produce actual changes in brain functioning, which suggests that behavioral treatments can produce changes beyond external behavior. A. Neuroscientific B. Psychodynamic C. Cognitive D. Hearsay Answer: A. Neuroscientific 45. _____________ treatment approaches teach people to think in more adaptive ways by changing their dysfunctional notions about the world and themselves. A. Cognitive B. Psychodynamic C. Behavioral D. Humanistic Answer: A. Cognitive 46. _____________ approach is a treatment approach that incorporates basic principles of learning to change the way people think. A. Psychodynamic-cognitive B. Humanistic-behavioral C. Cognitive-behavioral D. Psychodynamic-humanistic Answer: C. Cognitive-behavioral 47. _____________ is a form of therapy that attempts to restructure a person's belief system into a more realistic, rational, and logical set of views by challenging dysfunctional beliefs that maintain irrational behavior. A. Multi-modal therapy B. Rational-emotive behavior therapy C. Dialectical-behavior therapy D. Prolonged-exposure therapy Answer: B. Rational-emotive behavior therapy 48. Characteristics of cognitive treatment approaches include each of the following EXCEPT that: A. it is relatively short term. B. it focuses on concrete problems. C. it involves an active therapist. D. it is not structured. Answer: D. it is not structured. 49. Which of the following therapies emphasizes the challenging of irrational, unrealistic beliefs? A. Multi-modal therapy B. Rational-emotive behavior therapy C. Dialectical-behavior therapy D. Prolonged-exposure therapy Answer: B. Rational-emotive behavior therapy 50. Rational-emotive therapy is associated with _____________; cognitive-behavioral approach with _____________. A. Beck; Ellis B. Beck; Seligman C. Ellis; Beck D. Ellis; Seligman Answer: C. Ellis; Beck 51. Which of the following alternatives correctly illustrates a term in Ellis's A-B-C model? A. Activating condition—"I must get the top score in the class; a perfect score." B. Irrational belief—extreme anxiety C. Emotional consequence—a midterm test is scheduled for next week D. Irrational belief—"I will never get a good score in my test" Answer: D. Irrational belief—"I will never get a good score in my test" 52. In _____________ appraisal, clients are asked to evaluate situations, themselves, and others in terms of their memories, values, beliefs, thoughts, and expectations. A. cognitive B. psychodynamic C. behavioral D. humanistic Answer: A. cognitive 53. How is cognitive therapy different from rational-emotive therapy? A. It entails a more confrontational therapist. B. It entails a less confrontational therapist. C. It is relatively long-term and loosely structured. D. It aims to change people's behavior, rather than their thought pattern. Answer: B. It entails a less confrontational therapist. 54. Which of the following is NOT regarded as one of the strengths of the cognitive approach to treatment? A. It encourages deep insight into one's life. B. It has been successful in dealing with a wide range of problems. C. It is flexible and open to incorporating elements of other approaches to treatment. D. Therapy tends to be highly structured and focused on concrete problems. Answer: A. It encourages deep insight into one's life. 55. _____________ therapy is therapy in which the underlying rationale is that people have control of their behavior, can make choices about their lives, and are essentially responsible for solving their own problems. A. Cognitive B. Psychodynamic C. Behavioral D. Humanistic Answer: D. Humanistic 56. According to humanistic therapists, psychological disorders result from: A. the inability to find meaning in life and connection to others. B. unconscious conflicts and early experiences. C. irrational thought patterns. D. faulty learning. Answer: A. the inability to find meaning in life and connection to others. 57. Person-centered therapy is a specific type of _____________ therapy. A. cognitive B. psychodynamic C. behavioral D. humanistic Answer: D. humanistic 58. Person-centered therapy was developed in the _____________ by _____________. A. 1920s; Albert Ellis B. 1950s; Carl Rogers C. 1970s; Carl Rogers D. 1990s; Aaron Beck Answer: B. 1950s; Carl Rogers 59. Therapy in which the goal is to reach one's potential for self-actualization is known as _____________ therapy. A. self-help B. person-centered C. interpersonal D. group Answer: B. person-centered 60. In person-centered therapy, the therapist: A. challenges the client's irrational statements. B. teaches the client cognitive appraisal techniques. C. uses the token system to monitor behavior. D. provides unconditional positive regard. Answer: D. provides unconditional positive regard. 61. Which of the following terms most nearly captures the essence of unconditional positive regard? A. Directional B. Empathetic C. Judgmental D. Challenging Answer: B. Empathetic 62. How is contemporary person-centered therapy different than it was in Rogers's day? A. Therapists are even less directive now than in the past. B. The patient's insight is now seen as less central to the therapeutic process. C. Therapists are more likely to nudge clients towards insights rather than merely reflecting back their statements. D. Person-centered therapy is used today in its purest form. Answer: C. Therapists are more likely to nudge clients towards insights rather than merely reflecting back their statements. 63. _____________ therapy refers to short-term therapy that focuses on the context of current social relationships. A. Self-help B. Person-centered C. Interpersonal D. Group Answer: C. Interpersonal 64. Interpersonal therapy derives from _____________ approaches to therapy, but it is _____________. A. psychodynamic; shorter and more directive B. psychodynamic; longer and less directive C. humanistic; shorter and more directive D. humanistic; longer and less directive Answer: A. psychodynamic; shorter and more directive 65. Therapy in which people meet collectively with a therapist to discuss problems is specifically known as _____________ therapy. A. client-centered B. person-centered C. interpersonal D. group Answer: D. group 66. Regarding group therapy, which of the following statements is TRUE? A. Group therapy is generally more economical than individual therapy. B. In group therapy, the therapist is usually highly directive. C. Shy individuals benefit more from group therapy than do assertive people. D. Group therapies are for shorter durations than individual therapies. Answer: A. Group therapy is generally more economical than individual therapy. 67. Family therapy practitioners believe each of the following statements EXCEPT: A. individual members of a family may be treated successfully in isolation. B. the family as a single unit to which each member contributes. C. an individual member of the family cannot be treated successfully without simultaneously involving other family members. D. family members tend to take on set roles with respect to each other. Answer: A. individual members of a family may be treated successfully in isolation. 68. Alcoholics Anonymous (AA) is an example of _____________ therapy. A. client-centered B. self-help C. person-centered D. interpersonal Answer: B. self-help 69. In 1952, noted psychologist _____________ published a study challenging the effectiveness of _____________ therapy. A. Eysenck; humanistic B. Eysenck; psychodynamic C. Cattell; cognitive D. Cattell; behavioral Answer: B. Eysenck; psychodynamic 70. Today, most psychologists: A. echo Eysenck's 1952 position on the effectiveness of psychotherapy. B. dispute Eysenck's 1952 position on the effectiveness of psychotherapy. C. believe that psychotherapy is only minimally effective, especially as compared to drug therapy. D. accept that the symptoms of abnormal behavior go away by themselves if left untreated. Answer: B. dispute Eysenck's 1952 position on the effectiveness of psychotherapy. 71. A research technique in which data from a large number of studies are statistically combined is known as: A. matrix analysis. B. factor analysis. C. meta-analysis. D. correlational analysis. Answer: C. meta-analysis. 72. The effectiveness of various approaches to therapy found that although success rates vary somewhat by treatment form, most treatments show that success rates range from about _____________% greater success for treated compared with untreated individuals. A. 15-20 B. 25-30 C. 70-85 D. 90-95 Answer: C. 70-85 73. Research shows that behavioral therapy is roughly _____________% more effective than no treatment at all. A. 15 B. 25 C. 60 D. 80 Answer: D. 80 74. _____________ approaches to psychotherapy tend to be more successful than do _____________ approaches. A. psychodynamic and humanistic; behavioral cognitive B. cognitive behavioral; psychodynamic C. cognitive and humanistic; behavioral and psychodynamic D. behavioral and client-centered; cognitive and psychodynamic Answer: B. cognitive behavioral; psychodynamic 75. What proportion of people fail to benefit from psychotherapy? A. 2% B. 5% C. 10% D. 25% Answer: C. 10% 76. Which of the following statements is most TRUE? A. Different forms of therapy work best in different situations. B. People who don't attend therapy do just as well as people who do. C. The effectiveness of the different treatments is the same in all cases. D. Psychotherapy can safely be said to be beneficial for everyone. Answer: A. Different forms of therapy work best in different situations. 77. No greater change has occurred in mental hospitals than the successful introduction in the mid- _____________ of antipsychotic drugs. A. 1940s B. 1950s C. 1960s D. 1970s Answer: B. 1950s 78. The first major antipsychotic drug to be introduced was _____________; it was used to treat _____________. A. paliperidone; bipolar disorder B. paliperidone; schizophrenia C. chlorpromazine; bipolar disorder D. chlorpromazine; schizophrenia Answer: D. chlorpromazine; schizophrenia 79. The newest antipsychotics are called _____________ antipsychotics. A. depot B. atypical C. tricyclic D. typical Answer: B. atypical 80. Atypical antipsychotics affect both _____________ and _____________ levels in certain parts of the brain. A. serotonin; dopamine B. prolactin; histamine C. epinephrine; GABA D. oxytocin; glycine Answer: A. serotonin; dopamine 81. Tricyclic drugs, MAO inhibitors, and selective serotonin reuptake inhibitors are examples of which class of drugs? A. Antipsychotics B. Mood stabilizers C. Antianxiety drugs D. Antidepressants Answer: D. Antidepressants 82. Which of the following is NOT among the neurotransmitters that are influenced by the various antidepressant and antipsychotic drugs? A. Endorphins B. Norepinephrine C. Serotonin D. Dopamine Answer: A. Endorphins 83. Prozac is an example of a(n) _____________. A. antipsychotic drug B. antidepressant drug C. mood stabilizer D. antianxiety drug Answer: B. antidepressant drug 84. Which type of antidepressant is matched with the correct neurotransmitter action? A. Tricyclics–increase activity of neurotransmitter GABA B. SSRIs–prevent neurotransmitter breakdown C. MAO inhibitors–increase norepinephrine D. SSRIs–inhibit reuptake of serotonin Answer: D. SSRIs–inhibit reuptake of serotonin 85. _____________ are a class of medications used in cases of severe depression to improve a patient's mood and feeling of well-being. A. Mood stabilizers B. Antianxiety drugs C. Antipsychotic drugs D. Antidepressant drugs Answer: D. Antidepressant drugs 86. Which drug class is correctly matched with a drug that represents it? A. Antidepressants—lithium B. Antipsychotics—Chlorpromazine C. Mood stabilizers—Xanax D. Antianxiety drugs—Prozac Answer: B. Antipsychotics—Chlorpromazine 87. Which drug class is matched with the correct neurotransmitter action? A. Mood stabilizers—increase norepinephrine activity B. Antipsychotics—block dopamine receptors C. Antidepressants —increase activity of GABA D. Antianxiety drugs—inhibit serotonin reuptake Answer: B. Antipsychotics—block dopamine receptors 88. Drugs that reduce the level of worry or tension a person experiences essentially by reducing excitability and increasing feelings of well-being are known as _____________. A. mood stabilizers B. antianxiety drugs C. antipsychotic drugs D. antidepressant drugs Answer: B. antianxiety drugs 89. Approximately what percentage of U.S. families have a member who has taken an antianxiety drug? A. 10% B. 25% C. 35% D. 50% Answer: D. 50% 90. Electroconvulsive therapy (ECT) was introduced in the _____________; it is used to treat severe _____________. A. 1930s; depression B. 1930s; anxiety C. 1950s; depression D. 1950s; anxiety Answer: A. 1930s; depression 91. Which of the following is NOT one of the negative consequences of the use of electroconvulsive therapy (ECT)? A. Disorientation and confusion B. Memory loss C. Sudden death D. Potential brain damage Answer: C. Sudden death 92. Transcranial magnetic stimulation (TMS) is used to treat: A. depression. B. bipolar disorder. C. schizophrenia. D. obsessive-compulsive disorder. Answer: A. depression. 93. Which of the following is TRUE of transcranial magnetic stimulation (TMS)? A. It uses an electrical current. B. It is still experimental. C. It is not as popular as it used to be. D. It does not have any side effects. Answer: B. It is still experimental. 94. In the _____________, surgeons performed prefrontal lobotomy on thousands of patients often with little precision. A. 1920s and 1930s B. 1930s and 1940s C. 1940s and 1950s D. 1950s and 1960s Answer: B. 1930s and 1940s 95. A newer form of psychosurgery—cingulotomy—is used in cases of: A. obsessive-compulsive disorder. B. bipolar disorder. C. major depression. D. schizophrenia. Answer: A. obsessive-compulsive disorder. 96. Radiation is used to destroy specific brain areas in a type of psychosurgery called _____________; it is used to treat _____________. A. transcranial magnetic stimulation; obsessive-compulsive disorder B. transcranial magnetic stimulation; major depression C. gamma knife surgery; obsessive-compulsive disorder D. gamma knife surgery; major depression Answer: C. gamma knife surgery; obsessive-compulsive disorder 97. Community psychology came of age in the _____________; its aim was to minimize psychological disorders. A. 1960s B. 1970s C. 1980s D. 1990s Answer: A. 1960s 98. Which of the following best represents the percentage of homeless adults who have a major psychological disorder? A. 5-10% B. 15-35% C. 75-85% D. 50-60% Answer: B. 15-35% 99. College students in counseling are treated in only _____________ sessions on average. A. three B. five C. ten D. twelve Answer: B. five Worksheet Questions 100. _____________ are professionals with a master's degree and specialized training who may provide therapy, usually regarding common family and personal problems. Answer: Clinical or psychiatric social workers 101. Adrienne is describing a dream to her therapist. The events she recounts constitute the _____________ content of her dream. Answer: manifest 102. Bryan is feeling angry with his therapist; Bryan's anger reflects his feelings toward his father when he was a young boy in the throes of the Oedipal conflict. This example illustrates _____________ . Answer: transference 103. Cathy visits a behavior therapist for help with her alcohol abuse. To treat Cathy's problem, the therapist will most likely use _____________ conditioning. Answer: aversive 104. In _____________ , gradual exposure to an anxiety-producing stimulus is paired with relaxation to extinguish the response of anxiety. Answer: systematic desensitization 105. _____________ is a list in order of increasing severity of the things you associate with your fears. Answer: Hierarchy of fears 106. Contingency contracting and token economies are based on _____________ conditioning. Answer: operant 107. Declan and his mother have signed a written agreement: Each day that Declan fails to complete all his homework, he must complete an additional household chore. Declan and his mother are using a behavior modification technique known as _____________ . Answer: contingency contracting 108. Ingrid is learning to carefully examine situations so that she may learn to think more appropriately about herself and others in terms of her memories, values, beliefs, thoughts, and expectations. Ingrid is undertaking a process of _____________ . Answer: cognitive appraisal 109. Eli's client-centered therapist clarifies and reflects back Eli's remarks. The therapist is using a technique known as _____________ . Answer: nondirective counseling 110. Client-centered therapists should communicate that not only they are caring and nonjudgmental, but also _____________ ; that is, they should reflect a genuine understanding of the client's emotional experience. Answer: empathetic 111. _____________ is a statistical technique in which the results of a large number of studies are combined. Answer: Meta-analysis 112. Dr. Grimaldi consults the research literature each time he acquires a new client; he seeks to use the most effective technique available, given a client's particular disorder. Dr. Grimaldi practices _____________ psychotherapy. Answer: evidence-based 113. Many therapists integrate multiple approaches to treat an individual's problems; that is, they use a(n) _____________ approach. Answer: eclectic 114. The newest generation of antipsychotics is called _____________ antipsychotics; they influence serotonin and dopamine levels in the brain. Answer: atypical 115. Many newer antidepressants are selective _____________ reuptake inhibitors. Answer: serotonin 116. Like ECT, transcranial magnetic stimulation may be used to treat _____________ . Answer: depression 117. One form of psychosurgery used today is _____________ , performed occasionally to treat cases of obsessive-compulsive disorder. Answer: cingulotomy 118. _____________ is a branch of psychology that focuses on the prevention and minimization of psychological disorders in the community. Answer: Community psychology 119. _____________ is the transfer of former mental patients from institutions to the community. Answer: Deinstitutionalization Essay Questions 120. Discuss how (a) free association; (b) dream interpretation; (c) resistance; and (d) transference may be used as tools in psychoanalytic therapy. Answer: The answer should include the following points: Free association. When therapists use free association, they instruct the patient to say aloud whatever comes to mind, regardless of how irrelevant or nonsensical it seems. The therapist attempts to identify connections between what the patient says and his or her unconscious, and to point out and label these connections for the patient. Dream interpretation. The patient reports his or her dreams. The surface content of the dream is the manifest content, a disguised or symbolic representation of the true, underlying meaning, or latent content, which presumably reflects the contents of the unconscious mind. The therapist attempts to decode the manifest content in order to understand the dream's latent content, and thereby the patient's unconscious mind. Resistance. Resistance is the patient's inability or unwillingness to discuss or reveal particular memories, thoughts, or motivations. Resistance may be revealed in many ways: the patient may change the subject abruptly, appear to forget what he or she was saying, and so on. The therapist attempts to identify instances of resistance and use these as a clue to particularly painful or disturbing elements of the unconscious. Transference. Transference is the transfer to the analyst feelings of anger or love that the patient originally directed toward his or her parents or other authority figures. The therapist can use these feelings to reenact the patient's past relationships. Therapy sessions can be used to redo these relationships and to potentially resolve the conflicts or difficulties they entailed. In psychoanalytic therapy: (a) Free association: Clients freely express thoughts and feelings without censorship, allowing unconscious material to surface. (b) Dream interpretation: Analysts interpret dreams to uncover latent content and unconscious conflicts. (c) Resistance: Clients' reluctance to discuss certain topics reveals unconscious conflicts needing exploration. (d) Transference: Clients transfer emotions and attitudes toward significant others onto the therapist, offering insight into relational patterns and unresolved issues. These tools help uncover unconscious processes and facilitate therapeutic progress in psychoanalysis. 121. Briefly describe in one or two paragraphs what psychodynamic therapy entails as well as current perspectives and criticisms about its efficacy as a treatment. Answer: Even with its current modifications, psychodynamic therapy has its critics. In its longer versions, it can be time consuming and expensive, especially in comparison with other forms of psychotherapy, such as behavioral and cognitive approaches. Furthermore, less articulate patients may not do as well as more articulate ones. Ultimately, the most important concern about psychodynamic treatment is whether it actually works, and there is no simple answer to this question. Psychodynamic treatment techniques have been controversial since Freud introduced them. Part of the problem is the difficulty in establishing whether patients have improved after psychodynamic therapy. Determining effectiveness depends on reports from the therapist or the patients themselves—reports that are obviously open to bias and subjective interpretation. Furthermore, critics have questioned the entire theoretical basis of psychodynamic theory; they maintain that constructs such as the unconscious have not been scientifically confirmed. Despite the criticism, though, the psychodynamic treatment approach has remained viable. For some people, it provides solutions to difficult psychological issues, provides effective treatment for psychological disturbance, and also permits the potential development of an unusual degree of insight into one's life. 122. Describe using concrete examples how a behavior therapist might use systematic desensitization and flooding treatments to treat a specific phobia or source of anxiety. Answer: Students’ examples may vary. The answer should include the following components: Systematic desensitization. In systematic desensitization, exposure to an anxiety-producing stimulus is paired with relaxation to extinguish the response of anxiety. The idea is to learn to associate relaxation with a stimulus that previously produced anxiety. First, the patient is trained in relaxation techniques to learn how to relax his or her body fully. Next, the patient creates a hierarchy of fears—a list of stimuli associated with the patient's phobia, arranged in order of increasing severity. For example, a patient with a needle phobia might place seeing a discarded needle on the sidewalk near the bottom of the hierarchy; having a blood test would be near the top of the hierarchy. Then the patient is asked to imagine each scene in the hierarchy while in a fully relaxed state. When the patient can imagine a scene in the hierarchy and remain relaxed, the patient moves to the next level in the hierarchy. At the end of treatment, the patient is asked to confront the object of the phobia in real life; the hope is that the patient will not become anxious but will remain relaxed. For example, the patient may be asked to take a blood test or receive an injection. Flooding Treatments. Flooding is a behavioral treatment for anxiety in which people are suddenly confronted with a stimulus that they fear. The goal behind flooding is to allow the maladaptive response of anxiety or avoidance to become extinct. For example, a patient who has a deep fear of germs may be made to soil her hands in dirt and to keep them dirty for hours. For a person with a fear of germs, initially this is a highly anxiety-producing situation. After a few hours, however, the anxiety will decline, leading to extinction of the anxiety. In behavior therapy: Systematic desensitization involves gradually exposing a client to feared stimuli while teaching relaxation techniques. For instance, treating a fear of flying might start with imagining boarding a plane, then progressing to visiting an airport, and finally taking a short flight. Flooding directly confronts the phobia by exposing the client to the feared stimulus at full intensity. An example would be immediately placing someone with a fear of heights on a high balcony until their anxiety decreases due to exhaustion. 123. Assume you are treating two patients: Betina, who has anorexia, and Sebastian, who has anger management issues with his girlfriend. Using operant conditioning techniques, like token or contingency techniques, suggest a plan to treat them? Answer: Students’ examples may vary. One example of the systematic application of operant conditioning principles is the token system, which rewards a person for desired behavior with a token such as a poker chip or some kind of play money. Although it is most frequently employed in institutional settings for individuals with relatively serious problems and sometimes with children as a classroom management technique, the system resembles what parents do when they give children money for being well behaved—money that the children can later exchange for something they want. The desired behavior may range from simple things such as keeping one's room neat to personal grooming and interacting with other people. In institutions, patients can exchange tokens for some object or activity, such as snacks, new clothes, or, in extreme cases, sleeping in one's own bed rather than in a sleeping bag on the floor. Contingency contracting, a variant of the token system, has proved quite effective in producing behavior modification. In contingency contracting, the therapist and client (or teacher and student or parent and child) draw up a written agreement. The contract states a series of behavioral goals the client hopes to achieve. It also specifies the positive consequences for the client if the client reaches goals—usually an explicit reward such as money or additional privileges. Contracts frequently state negative consequences if the client does not meet the goals. Behavior therapists also use observational learning, the process in which the behavior of other people is modeled, to systematically teach people new skills and ways of handling their fears and anxieties. For example, modeling helps when therapists are teaching basic social skills, such as maintaining eye contact during conversation and acting assertively. For Betina, with anorexia: Implement a token economy where she earns tokens for meeting meal goals and healthy weight targets. These tokens can be exchanged for rewards that reinforce healthy eating behaviors. For Sebastian, with anger management issues: Use contingency management where he earns rewards for using alternative coping strategies (e.g., deep breathing, walking away) when he feels anger rising during interactions with his girlfriend. This reinforces adaptive responses and reduces aggressive behavior. 124. Describe using examples how behavior therapists can use averse conditioning to modify behavior. Answer: Students’ examples may vary. Averse conditioning is aversive conditioning, a form of therapy that reduces the frequency of undesired behavior by pairing an aversive, unpleasant stimulus with undesired behavior. For example, behavior therapists might use aversive conditioning by pairing alcohol with a drug that causes severe nausea and vomiting. After the two have been paired a few times, the person associates the alcohol alone with vomiting and finds alcohol less appealing. Aversion therapy works reasonably well in inhibiting substance-abuse problems such as alcoholism and with certain kinds of sexual disorders. Critics, however, question its long-term effectiveness. Also, important ethical concerns surround aversion techniques that employ such potent stimuli as electric shock, which therapists use only in the most extreme cases, such as patient self-mutilation. Clearly, though, aversion therapy offers an important procedure for eliminating maladaptive responses for some period of time—a respite that provides, even if only temporarily, an opportunity to encourage more adaptive behavior patterns Behavior therapists use aversive conditioning to modify behavior by pairing a stimulus with an unpleasant or aversive experience, aiming to decrease the likelihood of the behavior recurring. For example, to help someone quit smoking, a therapist might pair smoking with a noxious stimulus like a bad taste or odor. Over time, the smoker associates smoking with the unpleasant experience, reducing the desire to smoke. Another example could be treating nail-biting by applying a bitter-tasting substance to the nails, creating an aversive response that discourages the behavior. Aversive conditioning is effective when carefully applied to target specific behaviors and is used alongside other behavioral techniques for comprehensive treatment. 125. Describe the general aim of cognitive therapy. Write a note on Ellis's rational-emotive therapy. Answer: The following ideas should be mentioned: The goal of cognitive therapy is to help people learn to think in more adaptive ways by changing their unreasonable, irrational cognitions about the world and about themselves. Cognitive therapy often incorporates basic principles of learning; in this case, treatment is referred to as cognitive-behavioral approach. Ellis's rational-emotive therapy attempts to restructure a person's belief system into a more realistic, rational, and logical set of views. According to Ellis, people are unhappy and suffer from disorders because they hold irrational, unrealistic ideas, such as the notion that we have to succeed in all we do to be worthwhile people. In rational-emotional therapy, the therapist actively challenges and argues against these sorts of beliefs when the client expresses them. By challenging these views, the therapist is helping the patient adopt more realistic ideas. The general aim of cognitive therapy is to identify and change negative thought patterns and beliefs that contribute to psychological distress and maladaptive behaviors. Ellis's rational-emotive therapy (RET) focuses on challenging irrational beliefs and replacing them with rational, constructive thoughts. It emphasizes that our emotions and behaviors are influenced by our interpretations of events, rather than the events themselves. RET aims to help individuals develop healthier emotional responses and coping strategies through cognitive restructuring and rational analysis. 126. Identify (a) one advantage, strength, or contribution, and (b) one disadvantage, weakness, or limitation of each of the following types of psychotherapy: behavior therapy and cognitive therapy. Answer: The answer should mention some of the following points: Behavior therapy Advantages/strengths/contributions. Works well for eliminating anxiety disorders, treating phobias and compulsions, establishing control over impulses, and learning complex social skills. It provides tools nonprofessionals can use to change their own behavior. It is efficient because it focuses on solving carefully defined problems. Disadvantages/weaknesses/limitations. Because it focuses on changing external behavior, behavior therapy does not help people gain insight into the maladaptive thought patterns that might drive their problem behavior. Cognitive therapy Advantages/strengths/contributions. Cognitive approaches have been successful in treating a wide range of disorders, including anxiety disorders, depression, substance abuse, and eating disorders. The approach is open to incorporating elements from other treatment approaches, making it more flexible and effective than some other approaches. Disadvantages/weaknesses/limitations. The goal of making people more reasonable and logical ignores the fact that life really is absurd and irrational sometimes. It may not always be possible to bring about true cognitive change through therapy. For behavior therapy: (a) Advantage: Behavior therapy provides concrete, measurable outcomes by focusing on observable behaviors, making progress easily quantifiable. (b) Disadvantage: Its limitation lies in potentially neglecting underlying cognitive processes that may contribute to behavioral issues, leading to incomplete treatment. For cognitive therapy: (a) Advantage: Cognitive therapy helps individuals develop long-term coping skills by targeting negative thought patterns, which can lead to sustained improvement in mental health. (b) Disadvantage: It may require significant time and effort from clients to identify and change deeply ingrained cognitive patterns, which can slow progress compared to more immediate behavior-focused interventions. 127. Briefly describe the humanistic perspective. Applying what you know about humanistic psychology, how would a humanistic psychologist help someone with low self-esteem? Answer: Humanistic therapy draws on this philosophical perspective of self-responsibility in developing treatment techniques. The many different types of therapy that fit into this category have a similar rationale: We have control of our own behavior, we can make choices about the kinds of lives we want to live, and it is up to us to solve the difficulties we encounter in our daily lives. Humanistic therapists believe that people naturally are motivated to strive for self-actualization. As we discussed in the chapter on motivation, self-actualization is the term that clinical psychologist Abraham Maslow used to describe the state of self-fulfillment in which people realize their highest potentials in their own unique way. Instead of acting in the more directive manner of some psychodynamic and behavioral approaches, humanistic therapists view themselves as guides or facilitators. Therapists using humanistic techniques seek to help people understand themselves and find ways to come closer to the ideal they hold for themselves. In this view, psychological disorders result from the inability to find meaning in life and from feelings of loneliness and a lack of connection to others. Humanistic approaches have produced many therapeutic techniques. Among the most important is person-centered therapy. 128. Describe the aim of person-centered therapy. Identify several ways that therapists try to achieve this goal. How does contemporary person-centered therapy differ from the therapy as it might have been practiced in Rogers' day? Answer: The answer should make such points as: Aim of person-centered therapy - As a humanistic therapy, person-centered therapy attempts to help clients move toward self-actualization—a state of self-fulfillment in which people realize their highest potentials. Methods - Person-centered therapists act as guides or facilitators. They provide a warm and supportive environment through nondirective counseling, in which they reflect and clarify the client's statements, and through providing unconditional positive regard by expressing warmth and acceptance. Contemporary person-directed therapy is somewhat more directive than it was in its classic Rogerian form. Person-centered therapy aims to facilitate personal growth and self-discovery by creating a supportive therapeutic environment where clients feel accepted, understood, and valued. Therapists achieve this goal by demonstrating empathy, unconditional positive regard, and genuineness towards their clients. Contemporary person-centered therapy has evolved to include more focus on cultural sensitivity, diversity, and the integration of techniques from other therapeutic approaches, reflecting a broader understanding of individual needs beyond Rogers' original framework. 129. Briefly compare and contrast interpersonal therapy with traditional psychodynamic therapy. Answer: Interpersonal therapy (IPT) considers therapy in the context of social relationships. Although its roots stem from psychodynamic approaches, interpersonal therapy concentrates more on the here and now with the goal of improving a client's existing relationships. It typically focuses on interpersonal issues such as conflicts with others, social skills issues, role transitions (such as divorce), or grief. Interpersonal therapy is more active and directive than traditional psychodynamic approaches, and sessions are more structured. The approach makes no assumptions about the underlying causes of psychological disorders but focuses on the interpersonal context in which a disorder is developed and maintained. It also tends to be shorter than traditional psychodynamic approaches and typically lasts only 12-16 weeks. During those sessions, therapists make concrete suggestions on improving relations with others and offer recommendations and advice. Because interpersonal therapy is short and structured, researchers have been able to demonstrate its effectiveness more readily than longer-term types of therapy. Evaluations of the approach have shown that interpersonal therapy is especially effective in dealing with depression, anxiety, addictions, and eating disorders. 130. Briefly describe the pros and cons of group therapy. Are there any disorders where group therapy appears to be more effective than one on one? Please defend your answer. Answer: Although most treatment takes place between a single individual and a therapist, some forms of therapy involve groups of people seeking treatment. In group therapy, several unrelated people meet with a therapist to discuss some aspect of their psychological functioning. People typically discuss with the group their problems, which often center on a common difficulty, such as alcoholism or a lack of social skills. The other members of the group provide emotional support and dispense advice on ways they have coped effectively with similar problems. Groups vary greatly in terms of the particular model they employ; there are psychoanalytic groups, humanistic groups, and groups corresponding to the other therapeutic approaches. Furthermore, groups also differ with regard to the degree of guidance the therapist provides. In some, the therapist is quite directive; in others, the members of the group set their own agenda and determine how the group will proceed. Because several people are treated simultaneously in group therapy, it is a much more economical means of treatment than individual psychotherapy. On the other hand, critics argue that group settings lack the individual attention inherent in one-to-one therapy and that especially shy and withdrawn individuals may not receive the attention they need in a group setting. 131. One of the most controversial treatments in the field of psychology is electroconvulsive therapy. Briefly describe its illustrious history and if it is still used today. What are the justifications for using this type of treatment? Answer: First introduced in the 1930s, electroconvulsive therapy (ECT) is a procedure used in the treatment of severe depression. In the procedure, an electric current of 70-150 volts is briefly administered to a patient's head, which causes a loss of consciousness and often causes seizures. Typically, health-care professionals sedate patients and give them muscle relaxants before administering the current; such preparations help reduce the intensity of muscle contractions produced during ECT. The typical patient receives about 10 ECT treatments in the course of a month, but some patients continue with maintenance treatments for months afterward. ECT is a controversial technique. Apart from the obvious distastefulness of a treatment that evokes images of electrocution, side effects occur frequently. For instance, after treatment patients often experience disorientation, confusion, and sometimes memory loss that may remain for months. Furthermore, ECT often does not produce long-term improvement; one study found that without follow-up medication, depression returned in most patients who had undergone ECT treatments. Finally, even when ECT does work, we do not know why, and some critics believe it may cause permanent brain damage. Despite the drawback, therapists still use it because in many severe cases of depression, it offers the only quickly effective treatment. For instance, it may prevent depressed, suicidal individuals from committing suicide, and it can act more quickly than antidepressive medications. The use of ECT has risen in the last decade with more than 100,000 people undergoing it each year. Still, ECT tends to be used only when other treatments have proved ineffective, and researchers continue to search for alternative treatments. 132. What is transcranial magnetic stimulation (TMS)? Answer: One new and promising alternative to ECT is transcranial magnetic stimulation (TMS). TMS creates a precise magnetic pulse in a specific area of the brain. By activating particular neurons, TMS has been effective in relieving the symptoms of major depression in a number of controlled experiments. However, the therapy can produce side effects, such as seizures and convulsions, and it is still considered experimental. 133. Briefly describe psychosurgery. Answer: A technique used only rarely today, psychosurgery was introduced as a "treatment of last resort" in the 1930s.The initial form of psychosurgery, a prefrontal lobotomy, consisted of surgically destroying or removing parts of a patient's frontal lobes, which surgeons thought controlled emotionality. In the 1930s and 1940s, surgeons performed the procedure on thousands of patients often with little precision. For example, in one common technique, a surgeon literally would jab an ice pick under a patient's eyeball and swivel it back and forth. Psychosurgery often did improve a patient's behavior—but not without drastic side effects. Along with remission of the symptoms of the mental disorder, patients sometimes experienced personality changes and became bland, colorless, and unemotional. In other cases, patients became aggressive and unable to control their impulses. In the worst cases, treatment resulted in the patient's death. With the introduction of effective drug treatments—and the obvious ethical questions regarding the appropriateness of forever altering someone's personality—psychosurgery became nearly obsolete. However, it is still used in very rare cases when all other procedures have failed and the patient's behavior presents a high risk to the patient and others. For example, surgeons sometimes use a more precise form of psychosurgery called a cingulotomy in rare cases of obsessive-compulsive disorder in which they destroy tissue in the anterior cingulate area of the brain. In another technique, gamma knife surgery, beams of radiation are used to destroy areas of the brain related to obsessive-compulsive disorder. Occasionally, dying patients with severe, uncontrollable pain also receive psychosurgery. Still, even these cases raise important ethical issues, and psychosurgery remains a highly controversial treatment. 134. Briefly describe the community psychology movement originating in the 1960s. Answer: The answer should mention the following points: Community psychology. The community psychology approach began in the 1960s with the aim of preventing or reducing the incidence of psychological disorders rather than at alleviating psychological disorders. Mental health professionals planned a network of low-cost community mental health centers to provide education and low-cost mental health services. The community health movement and the availability of drug therapies spurred the deinstitutionalization of many mental health patients. Unfortunately, the resources necessary for the network of community health centers and so on were never made available, resulting in deinstitutionalized patients simply being dumped into the community with little or no support. Many of these individuals remained homeless; many became involved in substance abuse and criminal activity. The community psychology movement emerged in the 1960s with a focus on understanding and promoting mental health within the context of communities. It emphasized prevention and intervention strategies that address social and environmental factors influencing individuals' well-being. Community psychologists aimed to empower communities to identify and solve their own problems, advocating for social justice and systemic change to improve overall mental health outcomes. Test Bank for Essentials of Understanding Psychology Robert S. Feldman 9780077861889, 9781259255786, 9781260829013

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