Chapter 16: Therapy Multiple-Choice Questions 1. In what way does therapy differ from simply talking to a friend or family member about a problem? a. Therapy takes time, while a friend's guidance is more likely to lead to a "quick fix" of the problem. b. Friends provide empathy, while a professional therapist does not. c. A therapist's interaction with a client is guided by theory. d. Therapists will seek to determine the underlying issues that have created the problem. Answer: c. A therapist's interaction with a client is guided by theory. 2. Which of the following is a disadvantage of psychotherapy? a. It is ineffective in treating severe mental disorders. b. It takes time. c. It is significantly more expensive than all other forms of treatment. d. It is generally less effective than talking out your problems with a friend or family member. Answer: b. It takes time. 3. What recent changes have altered the types of therapy that are available? a. There is an increased need to prove that therapy is effective. b. Psychiatrists are hesitant to write prescriptions for many drugs. c. The increased use of nurses as therapy providers has increased the use of drugs in many community health settings. d. Many popular therapies have been found to do more harm than good. Answer: a. There is an increased need to prove that therapy is effective. 4. Which of the following statements about therapy is TRUE? a. Even people who are happy and successful can benefit from therapy. b. Few therapies have been found to be effective. c. Therapy is usually the most expensive approach to a problem. d. Each therapist has his or her own approach to therapy and does not alter this approach for different clients. Answer: a. Even people who are happy and successful can benefit from therapy. 5. Individuals vary tremendously in their degree of motivation for psychological treatment. Which of the following is likely to be the most motivated? a. Harvey, who is going through a job layoff and feels overwhelmed by the crisis. b. Jennifer, who was referred by the court to undergo therapy because of a drunk driving charge. c. Marvin, whose wife has said she will divorce him unless he gets treatment for his compulsive gambling. d. Barry, who is sure he has a heart condition but whose cardiologist suggests he needs psychotherapy to cope with stress better. Answer: a. Harvey, who is going through a job layoff and feels overwhelmed by the crisis. 6. Which person described below is the "typical" client in psychotherapy? a. A middle-aged woman with a long history of psychotic behavior b. An attractive and verbal college student c. A man who has been coerced into treatment by the legal system d. There is no "typical" client Answer: d. There is no "typical" client 7. Which of the following is the best example of a "model" therapy session? a. A child with ADHD is taught ways to filter out distractions. b. A woman with an anxiety disorder is taught relaxation techniques. c. An alcoholic sees a therapist, attends AA meetings, and is taking an antidepressant medication. d. There is no "model" therapy. Answer: d. There is no "model" therapy. 8. What two professional groups deal extensively with emotional problems but typically do not have specific training in counseling? a. Physicians and the clergy b. Physicians and psychiatrists c. The clergy and psychiatric social workers d. Psychiatrists and the clergy Answer: a. Physicians and the clergy 9. In general, psychiatrists tend to treat mental disorders by ___________ and psychologists by ________. a. examining and changing behavior and thought patterns; prescribing medications b. prescribing medications; examining and changing behavior and thought patterns c. supportive therapy; behavior therapy d. hospitalization; supportive therapy Answer: b. prescribing medications; examining and changing behavior and thought patterns 10. The current practice of providing treatment stresses a. the value of confining a patient to a mental hospital. b. the individual's responsibility for finding a personal solution to his or her problems. c. the coordination of services in the community. d. turning over to the patient's family the responsibility for behavior change. Answer: c. the coordination of services in the community. 11. Which of the following is believed to be essential for effective treatment? a. A warm and loving relationship between the therapist and client b. Family involvement c. Client reliance on the therapist for direction and guidance d. Agreement between the client and therapist about the goals of treatment Answer: d. Agreement between the client and therapist about the goals of treatment 12. The outcome of psychotherapy is usually dependent on whether the therapist and client achieve a. a certain similarity of personal style. b. mutual self-disclosure. c. an explicit therapeutic contract. d. a productive working alliance. Answer: d. a productive working alliance. 13. Which of the following is NOT an element of a therapeutic alliance? a. A sense of working together to solve a problem b. Client acceptance of the therapist's theoretical orientation c. Agreement between client and therapist about the goals of therapy d. An affective bond between the client and therapist Answer: b. Client acceptance of the therapist's theoretical orientation 14. Andrea begins therapy and expects that the therapy will help her. This expectancy a. is necessary to produce positive change. b. may be enough by itself to produce positive change. c. is helpful in psychodynamic therapy, but irrelevant to cognitive and behavioral interventions. d. is irrelevant to the change process. Answer: b. may be enough by itself to produce positive change. 15. Which of the following would be the most objective way of evaluating treatment success? a. Gathering information about the therapist's impression of the changes that have occurred b. Looking at the client's reports of change c. Asking the client's family and friends to report on the progress they have observed d. Measuring the change in through personality tests and other instruments Answer: d. Measuring the change in through personality tests and other instruments 16. Therapy outcome studies depend on ratings of the changes seen in clients. One reason that therapists' ratings may be unreliable is because a. they cannot see the client's behavior in a range of settings. b. they have a limited range of clients on whom to compare an individual client's improvement. c. they usually base their judgments on superficial personality tests. d. they are not in a good position to compare behavior before and after treatment. Answer: a. they cannot see the client's behavior in a range of settings. 17. The advantage of using outside independent observers or pre/post-test comparisons to evaluate a client's progress is that a. they take less time and are less costly. b. they increase the objectivity of ratings over those given by the people involved in treatment. c. they ensure that there is no "regression to the mean" phenomenon. d. they provide a valid prediction of how the client will behave in real life. Answer: b. they increase the objectivity of ratings over those given by the people involved in treatment. 18. Which of the following is the most significant challenge to establishing that therapy is effective? a. Placebo effects commonly occur. b. It is impossible to assess anything in therapy.. c. Many people improve without formal treatment. d. Few psychotherapies are more effective than medical treatments. Answer: c. Many people improve without formal treatment. 19. To summarize what is known about psychotherapy effectiveness, we can say that a. the chances of an average client benefiting significantly are impressive. b. for disorders that have a brief duration, treatment provides no obvious benefit. c. degree of improvement and number of therapy sessions are unrelated. d. all therapy outcomes are positive or neutral, none are negative. Answer: a. the chances of an average client benefiting significantly are impressive. 20. Which statement about negative outcomes in psychotherapy is accurate? a. Nearly one-half of all therapeutic encounters are rated by clients as "negative" or "harmful." b. The primary reason for negative outcomes is a lack of training and therapeutic skill on the part of the therapist. c. When a sexual relationship occurs between therapist and patient, it is harmful to the patient. d. The vast majority of negative outcomes turn out to be reported in fraudulent or frivolous lawsuits brought by clients. Answer: c. When a sexual relationship occurs between therapist and patient, it is harmful to the patient. 21. A randomized clinical trial a. is a study where all subjects are treated the same to see what percentage of the total gets better, stays the same, or gets worse. b. is a study where people are assigned to different types of treatment by the flip of a coin to see which treatment is best. c. is a study where people go through different treatments in random order to see which one works best. d. is a study where people are assigned to different groups by a flip of a coin, one-half to a treatment group and one-half to a seemingly identical placebo group. Answer: d. is a study where people are assigned to different groups by a flip of a coin, one-half to a treatment group and one-half to a seemingly identical placebo group. 22. What does it meant to say that a study is "double-blind"? a. Each patient receives both the drug being tested and a placebo, so that the effects of the drug can be compared to the effects of the patient's expectations. b. While the patient is aware to what treatment he or she is receiving, his or her family, friends, and therapist are not. c. Both the patient being given the drug and whoever will evaluate the drug's effects do not know whether the patient was given the treatment or the placebo. d. Two conditions are used, a treatment and a placebo. Answer: c. Both the patient being given the drug and whoever will evaluate the drug's effects do not know whether the patient was given the treatment or the placebo. 23. Which of the following is a challenge of conducting randomized clinical trials of the effectiveness of therapy? a. The client will never find out whether or not he or she was treated. b. Most clients will never improve on their own without treatment. c. There is little variation between different types of therapy. d. Even therapists who use the same techniques will differ in their delivery. Answer: d. Even therapists who use the same techniques will differ in their delivery. 24. What is usually used as a placebo in a study of psychosocial treatments? a. A sugar pill b. A wait list c. Self-help meetings d. Group therapy Answer: b. A wait list 25. Which of the following is a disadvantage of the use of drugs to treat psychological disorders? a. Relapse is likely when drugs use is terminated. b. Drugs are rarely effective in controlling psychotic symptoms. c. They decrease the need for hospitalization. d. They alter brain chemistry. Answer: a. Relapse is likely when drugs use is terminated. 26. Manualized therapies first originated in order to: a. treat bipolor disorder b. to standardize psychosocial treatments for RCTs c. keep therapists acting ethically d. aid sleep researchers Answer: b. to standardize psychosocial treatments for RCTs 27. How commonly are medications and therapy combined today? a. Combined treatments tend to only be used in an inpatient setting. b. Approximately 75 percent of those with a mental illness are treated with therapy alone, 10 percent use medications only, and just 15 percent are treated with both. c. While the combined approach is commonly used in the treatment of children, the same is not true in the adult population where the "quick fix" of a medication is the norm. d. Research suggests that many of those in treatment receive both psychotherapy and medication. Answer: d. Research suggests that many of those in treatment receive both psychotherapy and medication. 28. What do the medications used to treat mental illnesses do? a. Cure the illness b. Restore brain chemistry to normal functioning c. Replace depleted neurotransmitters d. Treat the symptoms of the illness with biochemical changes Answer: d. Treat the symptoms of the illness with biochemical changes 29. Under what circumstances might the use of medications prior to psychotherapy be essential? a. When the patient is suicidal b. When the patient won't admit that they have a problem c. When the patient's symptoms are so severe that they make psychotherapy impossible d. When a quick cure is needed Answer: c. When the patient's symptoms are so severe that they make psychotherapy impossible 30. What has research on the use of a combined approach to the treatment of depression demonstrated? a. Medication alone yields the best results. b. Psychotherapy alone yields the best results. c. Psychotherapy in combination with a placebo or medication yields the best results. d. Medication in combination with therapy yields the best results. Answer: d. Medication in combination with therapy yields the best results. 31. Drugs that block dopamine receptors are most likely to be used to a. distort perception. b. alleviate depression. c. stabilize mood. d. treat psychotic disorders. Answer: d. treat psychotic disorders. 32. Why is a drug that is long-acting desirable? a. It will work quickly. b. It will need to be taken less frequently. c. The likelihood of side effects is decreased. d. It will be quickly metabolized or excreted. Answer: b. It will need to be taken less frequently. 33. The conventional antipsychotic drugs have a problematic side effect involving abnormal movement. This side effect is called a. agranulocytosis. b. monoamine oxidase. c. tardive dyskinesia. d. atypical neuroleptics. Answer: c. tardive dyskinesia. 34. A major advantage of the atypical antipsychotic drugs is that a. they work better than the conventional ones. b. they work for more people than the conventional ones. c. they have a low risk of movement-related side effects. d. they last longer than the conventional ones. Answer: c. they have a low risk of movement-related side effects. 35. An example of an atypical antipsychotic not considered as a first choice treatment is: a. haldol b. clozapine c. risperidone d. zyprexa Answer: b. clozapine 36. Which of the following is a type of "classical antidepressant"? a. GABA agonists b. monoamine oxidase inhibitors c. neuroleptics d. selective serotonin reuptake inhibitors Answer: b. monoamine oxidase inhibitors 37. Prozac is a a. GABA agonist. b. monoamine oxidase inhibitor. c. neuroleptic. d. selective serotonin reuptake inhibitor. Answer: d. selective serotonin reuptake inhibitor. 38. Why are the SSRIs the most commonly used antidepressants today? a. Because they only have minimal effects on dopamine, they are less likely to produce side effects. b. They are more effective than the classic tricyclic antidepressants. c. Their side effects are more tolerable than those of the first-generation antidepressants. d. They are not addictive. Answer: c. Their side effects are more tolerable than those of the first-generation antidepressants. 39. Julia has just been prescribed a monoamine oxidase inhibitor to treat her depression. What warning should her doctor give her? a. Stay out of the sun. b. Be careful what you eat. c. Don't try to drive a car. d. You may find that you can't achieve orgasm. Answer: b. Be careful what you eat. 40. The mechanisms of antidepressant medications suggests that a. low dopamine levels are the underlying problem in depression. b. the effectiveness of the TCAs and SSRIs is largely a placebo effect. c. altered synaptic activity is not the source of a depressed mood state. d. changes in cellular functioning are necessary to alleviate the symptoms of depression. Answer: d. changes in cellular functioning are necessary to alleviate the symptoms of depression. 41. Because much of Donald's depression is a result of his lack of a healthy sexual relationship with his wife, Dr. Jones figured that the best drug to treat him with would be a. Chlorpromazine. b. Prozac. c. Wellbutrin. d. Zoloft. Answer: c. Wellbutrin. 42. Antidepressants are used to treat all of the following EXCEPT a. panic disorder. b. bulimia. c. borderline personality disorder. d. schizophrenia. Answer: d. schizophrenia. 43. Psychological and physiological dependence is a well-documented danger of using a. anxiolytics. b. neuroleptics. c. antipsychotics. d. lithium. Answer: a. anxiolytics. 44. __________ is not a problem associated with the benzodiazepines. a. Risk of withdrawal symptoms if the patient stops them suddenly b. High relapse rates when stopped c. Tardive dyskinesia d. Psychological dependence Answer: c. Tardive dyskinesia 45. Valium exerts its anxiolytic effects by increasing the activity of a. acetylcholine. b. dopamine. c. epinephrine. d. GABA. Answer: d. GABA. 46. Oscar has been prescribed the following drugs over the years: Valium, Serax, Xanax, and Ativan. We can guess that Oscar has had problems with a. positive symptom schizophrenia. b. mood swings. c. depression and anger control. d. anxiety. Answer: d. anxiety. 47. Suzanne is taking a benzodiazepine to treat her anxiety. She should be concerned that a. mania is a relatively common side effect. b. she may become physically dependent on the drug. c. while her anxiety is likely to be diminished, her adaptive behaviors also are likely to become increasingly impaired. d. when taken in high dosages, the drugs have potentially serious effects on a woman's reproductive ability. Answer: b. she may become physically dependent on the drug. 48. While most antianxiety drugs act on ________, Buspar acts primarily on ________. a. serotonin; GABA b. serotonin; epinephrine c. GABA; serotonin d. GABA; epinephrine Answer: c. GABA; serotonin 49. The newer antianxiety drug Buspar has the advantage that a. it has a low potential for abuse. b. it works better than other antianxiety drugs. c. it works on more anxiety disorders than the other drugs. d. it works faster than the other drugs. Answer: a. it has a low potential for abuse. 50. The use of lithium in the United States was delayed due to a. the stigma associated with mental illness. b. its addiction potential. c. a lack of evidence to demonstrate that it was effective. d. the fact that it could not be patented. Answer: d. the fact that it could not be patented. 51. Lithium was once used a. to treat anxiety. b. as a salt substitute. c. to alleviate constipation. d. as an appetite suppressant. Answer: b. as a salt substitute. 52. The main use of lithium is for a. anxiety disorders. b. personality disorders. c. major depressive disorder. d. bipolar disorder. Answer: d. bipolar disorder. 53. For bipolar patients, the risk of relapse after discontinuing lithium is a. roughly 50 percent within six months. b. not much higher than when people remain on the medication. c. extremely unlikely. d. about 15 percent, but only for people who have experienced repeated bouts with mania. Answer: a. roughly 50 percent within six months. 54. The process by which lithium reduces the likelihood of mood swings a. involves changes in stress hormones including cortisol. b. alters GABA levels, although exactly how it does this is unknown. c. is a combination of reuptake inhibition and receptor site blockades among serotonin and dopamine tracts. d. is unknown at this time. Answer: d. is unknown at this time. 55. A doctor prescribing lithium should NEVER say a. "This drug has a narrow range of effectiveness, so you need to have your blood levels monitored often." b. "In order for this drug to work, you need to take quantities that are within the range of potentially dangerous side effects." c. "We are going to 'target dose' your lithium: When you feel symptoms coming on, take your medication." d. "Along with the benefits of mood stabilization, you may experience increased thirst and weight gain along with a sense of lethargy." Answer: c. "We are going to 'target dose' your lithium: When you feel symptoms coming on, take your medication." 56. What do lithium carbonate, carbamazepine (Tegretol), and valproate (Depakote) have in common? a. They are benzodiazepines. b. They are used in the treatment of anxiety disorders. c. They are atypical antipsychotic drugs. d. They are all mood-stabilizing drugs. Answer: d. They are all mood-stabilizing drugs. 57. The use of electroconvulsive therapy can be traced to a. the observation that people were rarely depressed after being struck by lightning. b. the belief that schizophrenia and epilepsy are rarely comorbid disorders. c. the recognition that electricity could be used to alter brain chemistry. d. the use of electrical shock as an instrument of torture. Answer: b. the belief that schizophrenia and epilepsy are rarely comorbid disorders. 58. ECT has been found to be an effective treatment for a. anxiety disorders. b. depression. c. epilepsy. d. schizophrenia. Answer: b. depression. 59. Sarah has just received her first treatment of electroconvulsive therapy. She is most likely to a. experience auditory hallucinations for a brief time afterward. b. suffer tonic and clonic seizures over the next week. c. feel more clearheaded and less depressed following the first two to three sessions. d. experience amnesia and confusion for an hour after the treatment. Answer: d. experience amnesia and confusion for an hour after the treatment. 60. Which of the following would be the most likely candidate for ECT? a. A 22-year-old schizophrenic b. A middle-aged depressed woman who has just begun taking antidepressants c. A pregnant and depressed 25 year-old d. A 30-year-old man who has generalized anxiety disorder Answer: c. A pregnant and depressed 25 year-old 61. A Nobel Prize winning treatment for schizophrenia was a. the SSRIs. b. prefrontal lobotomies. c. ECT. d. token economies. Answer: b. prefrontal lobotomies. 62. In the mid-1900s, prefrontal lobotomies were popular as a treatment because a. there were not many other available treatments. b. they worked so well. c. they worked faster than any other treatment. d. they worked for so many disorders. Answer: a. there were not many other available treatments. 63. Today, neurosurgery a. is still used, including prefrontal lobotomies, on patients who have not responded to any other treatment. b. is used as a last resort and involves the destruction of only tiny areas of the brain. c. is done frequently for certain types of psychological illnesses, such as obsessive compulsive disorder. d. is no longer done for any psychological disorder. Answer: b. is used as a last resort and involves the destruction of only tiny areas of the brain. 64. Behavior therapy is based on the belief that a. medications cause more harm than good. b. internal states, such as thoughts and feelings, are not as important as overt behavior. c. abnormal behavior is learned the same ways as normal behavior and can be unlearned. d. thoughts influence behavior and thoughts can be changed. Answer: c. abnormal behavior is learned the same ways as normal behavior and can be unlearned. 65. Dr. Hart says, "For me, the goal of treatment is not to uncover inner conflicts, but to help the client achieve adaptive responses that he or she can control and maintain through self-monitoring." Dr. Hart probably considers herself a ___________ therapist. a. behavior b. psychodynamically oriented c. humanistic d. family systems Answer: a. behavior 66. Which of the following is a form of behavior therapy that is commonly used in the treatment of anxiety disorders? a. Rational emotive behavior therapy b. Stress-inoculation therapy c. Gestalt therapy d. Systematic desensitization Answer: d. Systematic desensitization 67. Chrissy and her therapist together wrote a list of ten scenes involving Chrissy's fear of flying. After teaching her a relaxation technique, Chrissy's therapist told her to imagine herself in the least frightening scene while she made herself feel relaxed. Chrissy was undergoing a. exposure in vivo. b. systematic desensitization. c. modeling therapy. d. rational emotive therapy. Answer: b. systematic desensitization. 68. Punishment is a component of a. EMDR therapy. b. modeling. c. aversion therapy. d. systematic desensitization. Answer: c. aversion therapy. 69. The use of drugs that have noxious effects and viewing movies that elicit disgust are both techniques associated with a. token economies. b. aversion therapy. c. guided exposure therapy. d. EMDR therapy. Answer: b. aversion therapy. 70. Yuko is painfully shy. Her therapist first shows her appropriate social skills so she can interact competently with others. Then Yuko attempts the same behavior while getting feedback. This illustrates the behavior therapy technique called a. guided exposure. b. covert sensitization. c. modeling. d. contingency management. Answer: c. modeling. 71. A token economy is a. a form of imaginal exposure therapy. b. a type of in vivo exposure therapy. c. a type of contingency management. d. a form of modeling therapy. Answer: c. a type of contingency management. 72. Dennis has disorganized type of schizophrenia. He has lived in an institution for years. He rarely shows any attempt at socializing. A new program is started - every time Dennis speaks to another person he is given a piece of red paper. At the end of each week, he can use the red papers to get cigarettes or extra privileges. This new program is a. an in vivo exposure program. b. a token economy. c. guided exposure. d. modeling. Answer: b. a token economy. 73. While ___________ can be used in treatment, it also a means by which problematic behaviors are acquired when others' behavior is problematic. a. imaginal exposure b. systematic desensitization c. modeling d. contingency management Answer: c. modeling 74. Lawrence, a hypochondriac, gains a great deal of attention from his family when he complains about health problems; they tend to ignore him when he talks about other topics. A behavior therapist has instructed the family to reverse these responses: ignore the complaints and reinforce other topics. What kind of treatment does this best illustrate? a. Aversion therapy b. Contingency management c. Guided exposure d. Systematic desensitization Answer: b. Contingency management 75. The text reported the case of a 6-year-old boy who hated school and showed off in class. His parents and teacher were instructed to ignore the showing-off behavior while reinforcing appropriate behavior. This is an example of a. systematic use of reinforcement. b. modeling. c. aversion therapy. d. systematic desensitization. Answer: a. systematic use of reinforcement. 76. Which of the following is an advantage of behavior therapy? a. It targets specific emotions and thoughts. b. It works well if a problem is vague and ill-defined. c. It works even though there is no scientific support for it. d. It usually achieves results in a relatively short period of time. Answer: d. It usually achieves results in a relatively short period of time. 77. For which client is behavior therapy most likely to be effective? a. Wilson, whose complaint is fear of spiders. b. Angela, who has a variety of personality disorders. c. Colin, who is struggling with vague concerns about his career and marital prospects. d. Tamara, who is trying to understand the origins of her personality. Answer: a. Wilson, whose complaint is fear of spiders. 78. Cognitive-behavioral therapy a. denies the importance of reinforcement and punishment. b. assumes that thinking influences emotion, motivation, and behavior. c. assumes that behavior must change before cognitive changes can occur. d. suggests that the therapist should take a less active role than is typically the case in behavior therapies. Answer: b. assumes that thinking influences emotion, motivation, and behavior. 79. The basic assumption of cognitive-behavior therapy is a. problems develop because people view themselves and their world in biased ways. b. abnormal behavior is learned like normal behavior and can be unlearned. c. people have the freedom and responsibility to control their own lives. d. only observable behaviors can really be changed. Answer: a. problems develop because people view themselves and their world in biased ways. 80. Abby is participating in cognitive-behavioral therapy to treat her depression. Her therapist a. will help her conduct "experiments" to test a variety of hypotheses about the accuracy of her cognitions. b. will use empathy and accurate reflection so that Abby will come to accept the ways she interprets her experience. c. will be nondirective in helping her change. d. will demonstrate ways of acting and then ask her to imitate these. Answer: a. will help her conduct "experiments" to test a variety of hypotheses about the accuracy of her cognitions. 81. Dr. Lucas says to a client with anxiety disorders, "It is your unrealistic beliefs and perfectionistic values that cause you to be so anxious, not the events of your life." Dr. Lucas probably supports the assumptions of ___________ therapy. a. humanistic b. psychodynamic c. rational emotive behavior d. systematic desensitization Answer: c. rational emotive behavior 82. According to rational-emotive behavior therapy, which of the following is one of the irrational beliefs at the core of psychological maladjustment? a. Moderation in all activities leads to greater long-term satisfaction. b. One should be thoroughly competent and intelligent in all respects. c. It is undesirable when things are not the way we would like them to be. d. One should do everything possible, within one's means, to live a fulfilling life. Answer: b. One should be thoroughly competent and intelligent in all respects. 83. In Beck's cognitive therapy, an early "homework" assignment would be a. learning to relax. b. listing one's beliefs about one's competencies. c. recording one's automatic thoughts and any associated emotional reactions. d. intentionally facing situations that one believes are emotionally overwhelming. Answer: c. recording one's automatic thoughts and any associated emotional reactions. 84. Which of the following is an advantage of using Beck's cognitive treatment for depression, as compared to drugs? a. The likelihood of relapse is decreased. b. It is clearly more effective. c. It works quickly. d. The changes it produces in the brain are permanent, while the effects of drugs are only temporary. Answer: a. The likelihood of relapse is decreased. 85. ___________ therapies developed in reaction to problems of alienation, loneliness, and failure to find meaning in life. a. Humanistic-experiential b. Cognitive c. Object relations d. Family Answer: a. Humanistic-experiential 86. Humanistic-experiential therapies are based in the belief that psychopathology is a result of a. faulty learning. b. self-defeating thinking. c. early parental interactions. d. lack of fulfillment. Answer: d. lack of fulfillment. 87. Joan was surprised that, when she went to therapy, her therapist didn't ask her questions, but just listened to her talk. She said she felt very comfortable with the therapist and felt she could say anything at all and be accepted, unlike with her critical parents. She said she could try out new ideas and the therapist was always warm and nonjudgmental. Joan was probably in a. rational emotive therapy. b. psychodynamic therapy. c. systematic desensitization. d. client-centered therapy. Answer: d. client-centered therapy. 88. According to the views of Carl Rogers, what is an important component in therapy? a. Strict rules and much guidance b. Empathy with the patient c. Restructuring thought processes d. Reinforcing adaptive behaviors with rewards Answer: b. Empathy with the patient. 89. In contrast to most other forms of therapy, the client-centered therapist a. focuses on present concerns rather than past problems. b. does not give answers or interpretations nor even steer the client onto certain topics. c. teaches a new set of beliefs and values so the client can cope more effectively. d. helps make the client's unconscious concerns conscious. Answer: b. does not give answers or interpretations nor even steer the client onto certain topics. 90. Key ideas in Gestalt therapy are a. irrational beliefs, interpersonal conflicts, and unconscious impulses. b. empathy, genuineness, and unconditional positive regard. c. integration of mind and body, dream interpretation, and emotional impasse. d. genetics, early childhood training, and social stressors. Answer: c. integration of mind and body, dream interpretation, and emotional impasse. 91. Gestalt therapy is commonly conducted in which of the following forms? a. individual therapy b. pharmacotherapy c. behavior therapy d. group therapy Answer: d. group therapy 92. Which of the following is a criticism of humanistic-experiential therapies? a. Too focused on behavior b. Impersonal approach c. Too much emphasis on early experiences d. Goals are not clear Answer: d. Goals are not clear 93. Dr. Patel says this about his goals in therapy: "I want my patients to become aware of their repressed memories from childhood and come to terms with them in the light of adult realities." Dr. Patel most likely prefers ___________ therapy. a. flooding b. gestalt c. psychodynamic d. cognitive Answer: c. psychodynamic 94. A psychotherapist says to her client, "Say whatever comes to your mind, no matter how strange or painful it may seem." The psychotherapist is encouraging a. transference. b. resistance. c. free association. d. counter-transference. Answer: c. free association. 95. The technique of free association is designed to a. help the client feel understood and not judged. b. help the client fully experience his or her emotions during therapy. c. explore unconscious and preconscious material. d. keep the client in the present. Answer: c. explore unconscious and preconscious material. 96. Jack tells his therapist about a dream in which he struggles to drive a car that takes him in directions he does not want to go. The therapist interprets the dream to mean that Jack is trying to get control of his career future but feels he is being controlled by others. This suggests that the a. manifest content of the dream is the issue of Jack's career future. b. latent content of the dream is the story of trying to drive the car. c. manifest content of the dream is the story of trying to drive the car. d. the therapist is trying to get Jack to argue with him or her. Answer: c. manifest content of the dream is the story of trying to drive the car. 97. Freud called dreams "the royal road to the unconscious" because a. he believed they kept people from uncovering their true feelings. b. he believed people intentionally dreamed about material they wanted to discuss in therapy but were afraid to. c. he believed defenses were lowered during sleep and repressed material would start to come out in dreams. d. he believed people would only tell him about unimportant dreams, so he could dismiss the topics they brought up. Answer: c. he believed defenses were lowered during sleep and repressed material would start to come out in dreams. 98. According to psychoanalysts, what is the therapist's task when doing dream analysis? a. Overcome the client's natural tendency to resist change. b. Uncover the disguised meanings of the manifest content. c. Explain that the latent and manifest content have little to do with one another. d. Reduce the client's tendency to use transference when he/she remembers a dream. Answer: b. Uncover the disguised meanings of the manifest content. 99. Which of the following best illustrates the analysis of resistance? a. Noting that the client is able to talk freely about his mother but not report anything about his father b. Asking the client to say whatever comes into his/her head, regardless of how silly it sounds c. Explaining that a dream about riding a wild horse in a tunnel suggests strong sexual urges d. Reminding a client who has become insulting toward a female therapist that she is, after all, a helping professional and not the client's abusive mother Answer: a. Noting that the client is able to talk freely about his mother but not report anything about his father 100. A son of a critical father comes to therapy one day and with no provocation is extremely hostile in his remarks to the therapist. The therapist might consider that ___________ is occurring. a. free association b. countertransference c. transference d. resistance Answer: c. transference 101. How has psychodynamic therapy changed over time? a. It focuses on all relationships, not just early experiences. b. Many elements of behavior therapy have been incorporated. c. Transference is no longer used. d. It differs little from client-centered therapy. Answer: a. It focuses on all relationships, not just early experiences. 102. Psychodynamic interpersonally oriented therapies agree with classical psychoanalysis in the importance of a. focusing on the transference neurosis. b. the transformation of sexual energy into neurotic behaviors. c. understanding the present in terms of the past. d. the therapist being passive and impersonal. Answer: c. understanding the present in terms of the past. 103. An analysis of brief psychodynamic psychotherapy found that a. there is great promise in it for borderline personality disorder. b. results of this therapy are largely unsuccessful. c. those that stress traditional psychoanalytic principles have the highest degree of success. d. the interpersonal forms of treatment are among the least useful. Answer: a. there is great promise in it for borderline personality disorder. 104. Traditional behavioral couples therapy a. uses training in communication skills and problems solving to increase caring behaviors in couples. b. tries to involve spouses in the treatment of people with severe mental disorders to prevent relapse after they are released from the hospital. c. treats the couple together for any problems that only one of them has, because the couple is seen as a "system" that influences each other. d. uses training in relaxation skills and imagery to reduce anxiety in couples. Answer: a. uses training in communication skills and problems solving to increase caring behaviors in couples. 105. A clinical psychologist who said that maladaptive behaviors are shared between members of a relationship and not just the responsibility of an individual would be in harmony with therapists who take the ___________ approach. a. humanistic b. classical psychoanalytic c. cognitive-behavioral d. family therapy Answer: d. family therapy 106. One criticism of traditional behavioral couple therapy has been a. its focus on faulty role expectations. b. the assumption that a good marriage requires an underlying friendship. c. the belief that keeping channels of communication open will help solve problems. d. the emphasis on change. Answer: d. the emphasis on change. 107. What led to the development of family therapy? a. The observation that signs of mental illness often were seen in more than one family member b. The recognition that most psychological disorders can be attributed to and cause dysfunctional relationships c. The realization that the family environment played a role in whether relapse occurred d. The established importance of the interaction of nature and nurture in the development if all forms of psychopathology Answer: c. the realization that the family environment played a role in whether relapse occurred 108. The Brady family is attending family therapy sessions. The therapist has told them, "If the whole family context changes, Marcia's problem behavior will change as well." The family therapist probably agrees with the ___________ therapy approach. a. structural family b. behavioral family c. cognitive d. conjoint family Answer: a. structural family 109. In structural family therapy, a. the therapist is very directive in order to break up the existing power structure in the family. b. the focus is on past interactions as they have given rise to present problems. c. the therapist initially acts like one of the family and participates in family interactions. d. the therapist adopts a Rogerian approach, focusing on good listening skills and clarification. Answer: c. the therapist initially acts like one of the family and participates in family interactions. 110. When asked what their orientation is, what do most of today's psychotherapists say? a. Behavioral b. Cognitive-behavioral c. Eclectic d. Interpersonal Answer: c. Eclectic 111. A good example of psychotherapy being used as a guardian of the status quo a. occurs when psychotherapy is viewed as a set of tools rather than a system of ethics. b. is when a Rogerian therapist takes a nondirective approach with a client. c. occurred when psychiatry was used as a means of political control in the former Soviet Union. d. happens when therapists disregard their therapeutic approach and use whatever technique works for the client. Answer: c. occurred when psychiatry was used as a means of political control in the former Soviet Union. 112. Psychotherapy is best viewed as a. a set of tools. b. a system of ethics. c. a means of keeping society "sick." d. a form of mind control. Answer: a. a set of tools. 113. Research on the impact of matching the client's race and ethnicity with the therapist's indicates that a. racial matching is crucial to success, but ethnic matching is less conclusive. b. there is no solid evidence that outcomes are diminished when client and therapist are not matched. c. while clients do not care whether there is a match, outcomes are influenced by a lack of matching. d. racial matching is crucial to success, but matching on the client's primary language is not. Answer: b. There is no solid evidence that outcomes are diminished when client and therapist are not matched. Fill-in-the-Blank Questions 1. The term used to see if a treatment does what it is supposed to do is called its __________. Answer: efficacy 2. The type of exposure in exposure therapy that occurs in the actual environment is called __________ exposure. Answer: in vivo 3. In the psychoanalytic analysis of dreams, the type of content that is disguised in the dream is the __________ content, as the motives are too painful to express directly. Answer: latent 4. The feelings a therapist may have for a client based upon his or her unconscious motives is known as __________ in psychodynamic terms. Answer: counter transference 5. Neuroleptics are also called __________. Answer: antipsychotics 6. The major problem with benzodiazepines is that people can become __________ and physiologically dependent upon them. Answer: psychologically Short Answer Questions 1. What are the key elements of the therapeutic alliance? Answer: A sense of working collaboratively on the problem, agreement between client and therapist about goals, affective bond between client and therapist, and clear communication. 2. What is a randomized clinical trial? Answer: Randomized clinical trials are commonly used to determine whether a treatment is effective. One group of subjects is given a treatment, while another is given a placebo. Ideally, the study is double-blind, meaning that neither the subjects nor whoever is assessing whether the treatment has had an effect knows what condition the subject is in. Such procedures are designed to control for potential bias. 3. What is tardive dyskinesia? Answer: Tardive dyskinesia is a movement disorder that can develop with use of conventional antipsychotic medications. 4. What is systematic desensitization and its purpose? Answer: If anxiety is learned, it can be unlearned. This is guided exposure to anxiety provoking stimuli, either in real life or imagination. The client is confronted with his or her fear in a gradual way. The client and therapist together make a hierarchy of the clients fear. The client is taught a relaxation technique. Then the client imagines him- or herself or actually gets into the lowest fear level situation, while relaxing. Once the client can stay at that level and be relaxed, he or she moves to the next level. This pairs an incompatible behavior with anxiety - counter conditioning. 5. When discussing psychological treatments, what is flooding? Answer: Flooding is a type of exposure therapy where the patient directly faces what he or she fears. Unlike systematic desensitization, where the patients works up to facing what they fear gradually, the patient is immediately "flooded" with a direct presentation of the feared stimulus. 6. What is aversion therapy? Explain and provide an example of how it might be used. Answer: Aversion therapy is a form of therapy that is used to reduce a behavior through associating it with punishment. In other words, operant conditioning is used to decrease the frequency of an undesirable behavior by following it with unpleasant consequences. Aversion therapy can be used in the treatment of alcoholism. The alcoholic is treated with a drug that causes him or her to get sick if he or she drinks, thus drinking will come to be associated with the nausea and vomiting that occurs. 7. What is token economy? Answer: Token economies are one of the many applications of behavioral theory to treatment. Token economies employ the principles of operant conditioning and are used to increase the frequency of desirable behaviors. When a desired behavior occurs, some "token" is given that may then be exchanged for something of value to the patient. 8. What is rational emotive behavior therapy (REBT)? What kind of therapy is REBT? Answer: REBT is a form of cognitive-behavioral therapy. The focus of this therapy is to change an unhealthy thought process. Thus, this form of therapy is behavioral in that learning principles are used to change a behavior and it is cognitive in that the behavior to be changed is thought processes. 9. What are the main objectives of client-centered therapy? Answer: To help clients become able to accept and be themselves. Therapy strives to provide a climate where the client feels unconditionally accepted, understood, and valued. The therapist uses only nondirective techniques. 10. Describe the process and purpose of Freudian dream analysis. Answer: During sleep, defenses are lowered and repressed material begins to come out. However, some material is so threatening it comes out in disguised form. Dreams have a manifest content, the obvious theme of the dream, and a latent content, the actual disguised motives and impulses. Analyzing the dream helps uncover the latent content. Essay Questions 1. Discuss three different ways that the success of therapy can be assessed. What factors complicate the determination of whether treatment is successful? Answer: In order to determine whether treatment has been effective, some change needs to have occurred. Thus, some measure to effectiveness is needed, as well as a source of the necessary information. It should be noted, however, that sometimes people get well just with the passage of time. This must be considered when considering the effectiveness of treatment - did the treatment work, or would the person have improved without any care? Establishing whether improvements have occurred can be assessed with information obtained from the therapist, the client, family or friends of the client, test scores, and/or the measurement of overt behavior. Clearly, a number of these information sources are likely to be biased, either for treatment success or against it. Ideally, an independent source would assess treatment success and the measures employed would be objective. Obviously, this may or may not be possible. 2. Describe Beck's cognitive theory and therapy. Answer: This is an information-processing model of psychopathology. Problems come from the biased processing of external events or internal stimuli. These biases distort the ways people make sense of their world, leading to cognitive errors. Underlying the bias are schemas that contain dysfunctional beliefs. When these schemas become activated, they bias how the person processes information. For example, in depression, people tend to make negative interpretations about themselves, their world, and their future. In therapy, clients are made aware of the connection between thinking and emotional response. They are taught to identify their automatic thoughts, the logical errors in thinking they are making, and how to challenge their validity. Clients are encouraged to gather information on their own and test their beliefs as hypotheses. 3. Discuss the techniques used in psychodynamic therapy. What is the goal of such therapy and how has it changed over time? Answer: The goal of psychodynamic therapy is to reveal the unconscious by using numerous techniques designed to reveal that which one may or may not be aware of. Classical psychoanalysis is an intensive and long-term process that is rarely practiced today. Psychoanalytically oriented psychotherapies are more common today. These employ many of the same approaches as classical psychoanalysis, but focus more on interpersonal considerations. While the classical psychoanalyst would focus on early relationships, the more modern psychotherapist would look at how those early relationships impact today's interactions. Some psychodynamic techniques are free association, analysis of dreams, analysis of resistance, and analysis of transference. In free association, the client is asked to say whatever comes to mind - to speak without thinking. When dreams are analyzed, the therapist looks past the dream as remember and interprets the hidden meaning of the dream. All of these techniques are designed to aid the client in developing an awareness of that which lurks in his or her unconscious. Test Bank for Abnormal Psychology: DSM 5 James N. Butcher, Jill M. Hooley, Susan M. Mineka 9780205965090, 9780205944286
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