Clinical Interviewing 6th Edition by John and Rita Sommers Flanagan Test Bank by Ace Test Banks

Clinical Interviewing 6th Edition by John and Rita Sommers Flanagan Test Bank

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Test Bank for Clinical Interviewing, 6th Edition By John Sommers-Flanagan Emily Sidor Hansen The University of Montana

TEST QUESTIONS FOR CHAPTER 1 AN INTRODUCTION TO THE CLINICAL INTERVIEW 1.

The clinical interview is considered: a. The most fundamental component of mental health training b. Exclusively an assessment interview c. An optional first-session experience d. Both a and b e. None of the above

Who originally designed a “semi-clinical” interview that included both tightly standardized questions and spontaneous questioning? a. Sigmund Freud b. Carl Rogers c. Jean Piaget d. Karen Horney e. Constance Fischer

What are the two primary functions or goals of clinical interviewing? a. Testing and Assessment b. Assessment and Helping c. Case Formulation and Referral d. Listening and Talking e. Intervention and Disposition

Clinical interviewing may also be known as: a. Intake interviews b. Initial interviews c. Psychiatric interviews d. Diagnostic interviews e. All of the above

Which of the following factors do the authors NOT include in their definition of clinical interviewing? a. A positive relationship between client and interviewer is established. b. The client and interviewer work collaboratively (more or less) to establish and achieve mutual goals. c. Clients are required to modify their perspective and behavior based on the interviewer. d. The interviewer and client interact verbally and nonverbally. e. Client-interviewer interactions are influenced by culture, personality, attitudes, and goals.

Which of the following is true regarding clinical interviewing? a. Clinical interviewing involves an explicit agreement between parties for provision of services. b. It is best to avoid being friendly towards clients, especially clients who are culturally different.

3 c. There really isn’t much difference between a friendship relationship and a therapy relationship. d. Clinical interviewing involves only behavior that would be considered appropriate under normal social circumstances. e. None of these are true about clinical interviewing. 7.

The authors note that, “. . . when done well, clinical assessment is or can be” a. Problematic b. Therapeutic c. Enigmatic d. Theoretical e. Pragmatic

Ethical professional relationships include which of the following: a. Informed consent b. Compensation for services c. Minimal relationship boundaries d. All of the above e. Only a and b

What are the main reasons why people seek mental health services? a. Personal growth b. Subjective distress c. Someone is forcing the issue d. All of the above e. Only a and b

10.

What do solution-focused therapists call clients who attend therapy only when coerced? a. Visitors to treatment b. Complainants c. Customers for change d. A pain in the backside e. Both a and b

11.

How do solution-focused therapists refer to clients who are highly motivated to attend therapy? a. Complainants b. Customers for change c. Difficult customers d. Resistant clients e. Visitors to treatment

12.

Which of the following is true about collaborative goal-setting? a. Although ideal, it doesn’t occur very often because therapists and clients usually disagree on goals b. It hasn’t been the subject of much empirical research c. It’s considered an evidence-based practice d. It’s not conducive to effective problem-solving in therapy e. None of the above are true

13.

From a cognitive-behavioral perspective, collaborative goal setting is initiated when:

4 a. The therapist takes note of all the concerns the client mentions and then chooses one to focus on. b. The therapist works with the client to develop a problem list. c. The therapist listens nondirectively to the client in hopes that the client will identify the specific concerns he/she wants to work on. d. The therapist chooses a goal and then asks the client if s/he is okay with the selection. e. None of the above. 14.

Which of the following are reasons a client and therapist may not agree on therapy goals? a. Poor client motivation. b. Questionable therapist motives or insight. c. Social-cultural differences. d. All of the above. e. None of the above.

15.

Which of the following statements is true regarding establishment of common goals during an interview? a. Client insight is often limited, so therapists should trust their own insight. b. Clients and interviewers usually have different and incompatible goals. c. Clients’ perspectives should be valued because they are the experts on their issues. d. If client and interviewer cannot establish common goals, the client should realign his or her goals to match those of the therapist. e. Typically a consultant should be called in to help therapist and client agree on therapy goals.

16.

Which of the following might contribute to negative outcomes? a. When clinicians are overconfident b. When clinicians conduct reasonably thorough assessments c. When clinicians feel pressured to fix clients’ problems quickly d. All of the above e. Only a and c

17.

When your expert opinion conflicts with your client’s perspective, it’s good practice to: a. Defer to your client, at least initially b. Acknowledge the differences, but emphasize your expertise and authority c. Openly argue with your client d. Submit to your client for the duration of therapy e. Refer your client to another provider

18.

What is the first skill interviewers should learn in order to conduct effective clinical interviews? a. How to focus on their own thoughts and feelings b. How to obtain diagnostic and assessment information about their clients c. How to quiet themselves and listen to clients d. How to build rapport with clients e. How to decide which shoes to wear for the first interview

19.

The authors consider it the therapist’s professional responsibility to ___________ client selfexpression. a. Limit b. Encourage c. Forbid

5 d. Both a and b e. None of the above 20.

According to the authors, “Having and holding a nonjudgmental attitude—toward all clients”—is: a. Impossible b. Required c. Realistic d. Only b and c e. None of the above

21.

Regardless of their theoretical orientation, what do almost all counselors and psychotherapists agree on? a. The need for a structured interviewing style. b. The importance of developing a positive relationship with clients. c. The importance of obtaining diagnostic information as soon as possible. d. The need for the client to modify his or her worldview to fit the interviewer’s perspective. e. None of the above

22.

Quieting yourself in an interview is important because: a. It helps clients to open up and express themselves. b. It allows you to focus more clearly on your own thoughts. c. It allows you to listen well to the clients. d. All of the above are correct. e. Only A and C are correct.

23.

A positive working relationship has a better chance of being developed between interviewer and client if, during the initial interview, the interviewer: a. Identifies the most appropriate intervention technique to use with the client. b. Focuses on how to be with the client instead of what to do with the client. c. Assures the client that his or her problems will be solved. d. Gives good advice to the client to demonstrate competence and experience. e. Provides his or her services for free.

24.

When should therapists begin using specific counseling or psychotherapy interventions? a. Once they have quieted themselves and listened to the client’s communications. b. Once they have developed a positive relationship with their clients. c. Once they have identified their client’s needs and therapy goals through diagnostic and assessment procedures. d. All of the above e. Only A and B

25.

The process of assessment + diagnosis + treatment plan = goal attainment is: a. Straightforward and linear b. Complex and not perfectly linear or unidimensional c. Unrelated to clinical interviewing d. Exclusively relegated to session 2 e. None of the above

26.

Which of the following is a principle of multicultural competence? a. Self-awareness b. Cultural knowledge

6 c. Culture specific expertise d. All of the above e. Only b and c 27.

Developing cultural self-awareness can be especially challenging from members of what culture? a. The minority culture b. The dominant culture c. The majority culture d. Developing self-awareness is equally difficult for members of any culture. e. None of the above

28.

Which of the following is a culture-specific skill essential for mental health professionals? a. Scientific mindedness b. Dynamic sizing c. Speaking multiple languages d. All of the above e. Only a and b

29.

When a therapist is forming and testing hypotheses rather than coming to premature and faulty conclusions about clients he/she is employing which culturally-specific skill? a. Dynamic sizing b. Developing cultural knowledge c. Scientific mindedness d. Developing self-awareness e. None of the above

30.

When using the culturally-specific skill of dynamic sizing, a therapist is: a. Comparing the differences between cultural groups b. Recognizing when generalizations based on group membership are appropriate and when they’re not. c. Knowing when to come to scientific conclusions about clients. d. All of the above e. Only b and c

31.

The authors claim that it may not be possible to ever: a. Completely reach “multicultural competence.” b. Learn too many psychoanalytic techniques c. Be too directive with a client. d. All of the above e. None of the above

32.

Culture-sensitive advocacy refers to: a. Attaining knowledge about specific cultures b. Employing scientific mindedness c. Employing dynamic sizing d. Nurturing your cultural self-awareness e. None of the above

33.

Microaggressions refer to: a. Negative thoughts about minority persons that are never enacted b. Small negative behaviors that have little or no effect on minority persons

7 c. Brief and commonplace communication of prejudice and discrimination d. Both a and b e. None of the above 34.

Multicultural humility includes which of the following? a. An other-orientation instead of a self-orientation b. Respect for others and their values/ways of being c. An attitude that includes a lack of superiority d. All of the above e. None of the above

35.

Stereotyping is: a. A natural, but inadvisable phenomenon b. Unavoidable c. Avoidable in all circumstances d. All of the above e. Only a and b

Answers 1. a 2. c 3. b 4. e 5. c 6. a 7. b 8. e 9. d 10. a 11. e 12. c 13. b 14. d 15. c

8 16. e 17. a 18. c 19. b 20. a 21. b 22. e 23. b 24. d 25. b 26. d 27. b 28. e 29. c 30. b 31. a 32. e 33. c 34. d 35. e

TEST QUESTIONS FOR CHAPTER 2 FOUNDATIONS AND PREPARATIONS 1. Which of the following is consistent with what the authors say about the effect of environmental factors on interviewing process and outcome? a. Interviews can take place anywhere because the relationship connection outweighs the specific setting b. The setting in general, and the room, seating, office clutter, and other factors can have a significant effect on the interview c. Using technology in your office can adversely affect rapport building d. Both b and c are true e. None of the above are true 2. In a clinical interview, the physical surrounding (e.g., the room): a. Is not an important factor. b. Should provide privacy and freedom from distractions. c. Is important and should not be underestimated. d. Both a and b are true. e. Both b and c are true. 3. Which of the following is most true of seating arrangements? a. Interviewers should arrange seating in a way that optimizes their task and shouldn’t give clients a choice. b. Choice of seating arrangements doesn’t vary based on theoretical considerations. c. The interviewer should be sensitive to the client’s preferred seating arrangement. d. Having a large desk between the interviewer and the client is a good idea because most clients prefer having a safety barrier. e. All of the above are equally true. 4. Who should be primarily in control of the physical surroundings during the interview? a. The interviewer, with sensitivity to individual client needs. b. The client should lead this. c. The outside consultant. d. It doesn’t matter. e. Usually neither interviewer nor client has any influence over office settings. 5. If an adult client ignores the interviewer’s obvious seating arrangement and chooses an unusual seat, what should the interviewer do? a. Immediately ask the client about the choice, because this can provide valuable diagnostic information. b. Make a mental note of the client’s behavior and continue with the interview as usual. c. Ask the client to sit in the usual arrangement but continue with the interview if the client refuses. d. Ask the client to sit in the usual arrangement, and if he or she refuses, politely ask him or her to leave the room. e. Where clients sit is basically irrelevant to the clinical interviewing process. 6. Which of the following is/are true about note taking during the clinical interview?

2 a. Mental notes are acceptable but writing notes in the client’s presence is distracting and should be avoided. b. It should be done with the awareness that clients may ask to read what you’ve written. c. It should be done discretely so clients cannot easily see what you’ve written. d. None of the above is true. e. Only a and c are true. 7. Which of the following statements is NOT true about note taking? a. Notes should be kept brief and succinct. b. A common format used to take notes is the S-O-A-P. c. Notes can be used as a defense if an interviewer is accused of malpractice. d. All of the above are true. e. Only a and b are true. 8. You’re taking notes and your client, Caitlin, asks if she can see them. What’s your best option? a. Just say no. b. Quickly stop taking notes and put them away. c. Let her know that the notes are for your benefit and shouldn’t mean anything to her. d. Interpret her curiosity as paranoia. e. Let her see your notes. 9. In a recent study, researchers reported that different note-taking strategies, including using technology: a. Had no effect on therapeutic alliance. b. Was preferred by younger clients. c. Was viewed by all clients as a threat to confidentiality. d. Was, somewhat surprisingly, NOT preferred by younger clients. e. Was preferred by older clients. 10. Which requirement should you follow when planning to record a session? a. Obtain the client’s permission to do so before actually recording. b. Clients must not know they are being recorded, as it will skew the interview. c. Begin to record before clients arrive so that you have their permission on the recording. d. Make sure you have obtained the client’s permission after you’ve finished the recording of the session. e. Recording clients is always unethical and sometimes illegal. 11. When considering the appropriate grooming and attire for the beginning therapist, which of the following is/are true? a. It’s important to remember that your clients will judge you by the way you look and dress. b. Any type of attire is acceptable by today’s standards. c. Beginning interviewers should err on the side of casualness. d. Both a and c are true. e. Before choosing your attire, you should consult with the professional journal, Vanity Fair. 12. Jessica is working with a young male client. She tends to wear tops that have low necklines and show cleavage. Her supervisor suggests that she avoid showing cleavage during her professional counseling sessions. How should Jessica respond? a. What Jessica wears is her own business.

3 b. Jessica should ask her young male client what he thinks. c. Jessica should accuse her supervisor of sexual harassment. d. Jessica should openly discuss the issue with her supervisor and consider modifying her clothing choices. e. Both a and c are true. 13. Maxwell likes to wear tight shorts when he does counseling. He has a boring and conservative female supervisor who tells him to “dress it up.” How should Maxwell respond? a. What Maxwell wears is his own business. b. Maxwell should ask his clients what they think. c. Maxwell should accuse his supervisor of sexual harassment. d. Maxwell should openly discuss the issue with his supervisor and consider modifying his clothing choices. e. Both a and c are true. 14. If you think your client might benefit from a light touch on the arm, but you aren’t entirely sure, what would be the best action? a. Nothing; continue with the session as usual without touching the client’s arm. Then talk with a colleague or supervisor about it later. b. Directly ask the client before you touch in order to obtain permission. c. Trust your instincts and touch the client’s arm, but apologize sincerely if the client reacts adversely. d. Wait a few minutes and then go with your genuine impulse. e. Any of the above actions would be fine. 15. Which of the following statements is most true about therapists’ sexual attraction to clients? a. It’s a sign of positive countertransference and should be explored directly with clients. b. It’s almost a universal phenomenon. c. Saying to a client “I feel sexually attracted to you” is NOT recommended. d. You should keep it to yourself and definitely don’t tell your supervisor. e. Both b and c are true. 16. With regard to introducing yourself as a therapist, which of the following statements is the most true? a. Remember to refer to yourself as “only a student” to put the client at ease. b. It is permissible to imply that you have more experience than you really do in order to put the client at ease. c. You should give your full name and an accurate description of your status. d. It is best to avoid this subject if possible, so as not to alarm the client. e. When asked about your professional background, simply respond by saying, “No comment.” 17. Which of the following IS TRUE regarding time management during a clinical interview? a. Boundaries are relatively loose and flexible according to the needs of the moment. b. Time limits should be rather strictly adhered to except in emergencies. c. If the client arrives early, then it’s a good idea to start the session early. d. It is appropriate to extend the session of you think that the client is on the verge of a breakthrough. e. Time is relative. 18. If a client arrives early and asks if you are free to start the interview, what should you do?

4 Agree to begin the session early if you’re not busy. Agree to begin the session early if the client is willing to reimburse you for extra time. Scold the client for making an inappropriate request. Politely inform the client that you will be available at the scheduled appointment time, unless there is a crisis, in which case you can see the client early. e. Use the behavioral technique of ignoring inappropriate behavior in an effort to extinguish it. a. b. c. d.

19. A client arrives late for a session and therefore would like extra time with you. What should you do? a. Be empathic but inform the client that it is important to stick to the scheduled appointment time and you look forward to a full session next week. b. Agree to extend the session as long as the client has a genuine reason for being late and usually arrives on time. c. If available, offer an additional appointment to the client later in the week to make up for the lost time. d. Both a and c are acceptable. e. None of the above. 20. How should clinicians handle time issues when working with clients from cultures that have a different perspective on time? a. Clinicians should stay consistent across all clients, regardless of culture. b. Be clear from the beginning that you’re operating based on a Western model of time and time boundaries. c. Be as flexible as your clients need you to be. d. None of the above. e. Both a and b are true. 21. When should clinicians inform clients of the legal limits of confidentiality? a. At the beginning of the first session. b. At the end of the first session. c. As soon as the client talks about suicide, homicide, or child and elder abuse. d. As soon as the client asks whether the information shared will be kept private. e. None of the above is true. 22. Confidential information may be disclosed in the following situation(s): a. You have the client’s permission. b. The client is suicidal and in danger of hurting himself or herself. c. The client is homicidal or a threat to others. d. All of the above. e. None of the above. All information disclosed during an interview is confidential. 23. Maryann reports she has increasingly angry feelings toward her husband. She tells you that she has a gun and she might feel inclined to “blow him away one of these days.” Assuming you take her statement seriously, which of the following actions should you consider? a. Contact Maryann’s husband because you fear for his life and have a duty to warn him of the danger from Maryann. b. In order to protect confidentiality, pay a visit to Maryann’s home and try to persuade her to give you the gun. c. Contact a colleague to discuss the ethical dimensions of Maryann’s case. d. Both a and c.

5 e. Both b and c. 24. Which of the following is/are true about written informed consent? a. It helps educate clients about the therapy process. b. It can give the client a more favorable impression of the interviewer’s expertise. c. It should be written in plain language, as opposed to professional jargon. d. All of the above are true. e. Only a and b are true. 25. Which part of S-O-A-P would the following statements correspond to if written by an interviewer? Carlos stated, “I’ve been depressed since Friday. Getting out of bed is difficult and making me late for work.” a. S b. O c. A d. P e. None 26. Which organization has an extensive online guide to record keeping? a. The American Psychiatric Association b. The American Psychological Association c. The American Counseling Assocation d. The National Association of Social Workers e. None of the above 27. Which of the following is the cross-disciplinary mantra for multicultural preparation a. Multicultural humility precedes multicultural competency b. Multicultural competency precedes multicultural humility c. Advocacy is at the heart of multicultural preparation d. Awareness-knowledge-skill-advocacy e. We all share a common heritage

28. Which of the following is/are true? a. b. c. d. e.

All American Indians are highly spiritually oriented. Many Native American cultures emphasize generosity and non-materialism. Machismo is a central concept in American Indian culture. a and b are true. None of the above is true.

29. Which of the following statements best describes Native Americans’ beliefs about time? a. b. c. d. e.

They view time in a linear fashion. They’re more oriented to the here and now than to the future. They believe it is important to always arrive on time for appointments. Their beliefs about time parallel those of the dominant white culture. Both c and d

30. When interviewing Native American clients, it may be preferable if the interviewer does which of the following? a. Asks a lot of questions. b. Arranges seating to facilitate maximum direct eye contact.

6 c. Refrains from silence. d. All of the above. e. None of the above.

31. The term invisibility syndrome refers to individuals from which minority group? a. b. c. d. e.

African American White Hispanic American Indian Asian American

32. Which of the following is true about African American women? a. b. c. d. e.

They believe a woman’s place is in the home. They occupy strong roles in the family. They have little input in family decision-making. They have a lower life-expectancy than African American males. All of the above.

33. Which of the following is true of fatalism? a. b. c. d. e.

It is a belief that one cannot do much about one’s fate. It is irrelevant to counseling. It must be strongly challenged for counseling to be effective. It absolves individuals of blame for traumatic circumstances that are out of their control. All of the above are true.

34. Charlar refers to: a. Respect b. Family relationships c. Closeness d. Small talk e. A personable and friendly demeanor 35. Personalismo refers to: a. Respect b. Family relationships c. Closeness d. Small talk e. A personable and friendly demeanor 36. Among which of the following groups is Catholicism most influential? a. Asian b. Hispanic/Latino c. African American d. American Indian e. None of the above 37. Which of the following is NOT true about Asian cultures? a. They are generally more egalitarian than other minority cultures.

b. Decisions that affect the family should be decided by the family rather than the individual. c. Direct eye contact is seen as invasive and disrespectful. d. All of the above are true e. None of the above are true 38. In Asian cultures, what does filial piety refer to? a. Wealth being handed down to the first-born son. b. Honoring and obeying those hierarchically above you. c. Respecting the male members of the household. d. A collectivist orientation. e. None of the above is correct. 39. Which of the following may add relational/role strain in an Asian family living in the United States? a. The children are bilingual and therefore assume power in the family b. Some members of the family may be living in the home country while others are in the United States c. The children may integrate into the American culture more readily than their parents d. Both a and c e. All of the above 40. In Asian cultures, decisions should be made: a. By the entire family b. By the individual c. After considering how the decision will affect the family as a whole d. a and b e. a and c 41. Which of the following is NOT a way a therapist can show his/her sensitivity toward people with non-heterosexual orientations? a. GLBTQ-friendly pamphlets or literature in the waiting room/office b. Avoid using gender-specific words indicating the assumption of heterosexuality c. Ask general questions about romantic relationships or romance in general d. Encourage the client to come out to his/her family. e. Use gentle exploration to learn more about the client’s relationships and family issues 42. Which therapy approach is a major movement (and preference) for counseling GLBTQ clients? a. Emotion-focused therapy b. Psychoanalytic psychotherapy c. Affirmative psychotherapy d. Attachment-based therapy e. Behavior therapy

43. The most important prerequisite for working with individuals with disabilities is: a. Competence in working with people with disabilities. b. Sufficient formal education and training related to persons with disabilities. c. An open and accepting attitude. d. All of the above. e. Only a and b. 44. Even though ignoring a person’s disability may be an attempt at politeness, the negative message it can send the person with the disability is: a. That their disability should have no direct impact on emotional and interpersonal functioning. b. That you’re very knowledgeable about working with people with disabilities. c. That you didn’t notice the disability. d. Both a and b e. None of the above 45. Maria is interviewing a new client who has deep religious faith. She should be sure to: a. Begin with a debate regarding her client’s faith. b. Ignore issues of spirituality or religion. c. Disclose her own faith immediately. d. Let the client know that faith is irrelevant to therapy. e. None of the above. 46. When unknowledgeable about relevant cultural information, therapists should: a. Feel free to ask their clients as much as they need to. b. Be sensitive to the client’s level of patience and use other sources of information as well. c. Never use clients as a source of information; use other sources exclusively. d. Discretely contact the individual’s family for answers and hope the client does not find out. e. Both c and d. Answers 1. b 2. e 3. c 4. a 5. b 6. b 7. d

9 8. e 9. a 10. a 11. a 12. d 13. d 14. a 15. e 16. c 17. b 18. d 19. d 20. d 21. a 22. d 23. d 24. d 25. a 26. b 27. d 28. b 29. b 30. e 31. a 32. b 33. a

10 34. d 35. e 36. b 37. a 38. b 39. d 40. e 41. d 42. c 43. d 44. a 45. e 46. b

TEST QUESTIONS FOR CHAPTER 3 AN OVERVIEW OF THE INTERVIEW PROCESS 1. The clinical interview involves a sequential or organized set of interactions between clinician and client. It should be: a. Conducted using a rigid step-by-step approach. b. A relatively smooth and continuous process. c. Conducted without any direct questioning. d. Both c and d. e. None of these are true because the clinical interview is unstructured. 2. According to Shea, clinical interviews have an inherent sequence. The stages of this sequence include: a. Introduction, plot, and theme. b. Theme, body, and termination. c. Introduction, opening, body, closing, termination. d. Opening, closing, and theme. e. None of the above 3. Foley and Sharf identified five important parts of a clinical interview; they include all of the following EXCEPT: a. Putting the client at ease. b. Structuring and determining outcomes. c. Eliciting information d. Maintaining rapport. e. Bringing closure. 4. When setting up appointments, a therapist must do all EXCEPT which one of the following? a. Express that he or she is looking forward to meeting the client. b. If he or she has a conflict in scheduling, explain in full detail why he or she cannot meet with the client. c. Make sure to repeat the appointment time. d. Tell the client what to do when arriving at the clinician’s office. e. All of the above are appropriate things for a therapist to do when setting up appointments. 5. When scheduling the initial appointment with a client, therapists should: a. Arrange their schedule to fit that of the client. b. Request that clients arrange their schedule to fit the interviewer. c. Collaborate with the client to find a suitable time. d. Ask the client to drop by the office whenever the client is in the area. e. Have the receptionist take care of this detail. 6. Which of the following defines the Introduction Stage? a. It involves first contact. b. It involves the first face-to-face meeting. c. It includes initial rapport-building and putting clients at ease. d. All of the above. e. Only a and b.

7. The pace of the clinical interview is an important issue. The pace needs to: a. Be in the firm control of the interviewer from beginning to end. b. Give the client a sense of safety and shared control. c. Be set entirely by the client so as to give the interviewer important information about the client. d. B and C e. None of the above 8. How would you describe this therapist statement? “How about since you’re here, we try out working together today and then toward the end of our time together I’ll check back in with you and you can be the judge of whether this might be helpful or not? a. It’s a confrontation. b. It’s an introduction. c. It’s an invitation for collaboration. d. It’s not recommended to give clients so much power. e. It’s an example of progress monitoring. 9. How would Maria convey the Latino principle of personalismo during an interview? a. Express her own unique personality throughout the interview b. Using a vocal tone and gestures particular to the client’s culture c. Talking in a casual and friendly way about commonalities between herself and the client d. By pointing out differences between herself and the client e. Both b and d 10. Similar to personalismo, some African Americans refer to concepts of _________ a. “person to person connection” b. “respect and reciprocity” c. “learning about each other” d. All of the above e. None of the above 11. The introduction stage of a clinical interview: a. Involves putting the client at ease. b. Ends when the interviewer asks the client for his or her paperwork. c. Cannot be begun on the phone. d. Should not include scheduling an appointment. e. Both b and c are true. 12. When addressing clients, it’s a good idea to: a. Offer coffee. b. Call all clients by their first names to establish an informal atmosphere. c. Shake every client’s hand. d. Both b and c. e. None of these are always advisable. 13. Putting the client at ease is an integral part of the therapist’s job. Using small talk is one way to accomplish this. Safe and nonjudgmental subjects to talk about with adults include all of the following EXCEPT: a. Recent news events b. Sporting events c. Clothing they are wearing

d. The weather e. All of the above are safe topics to broach with adults. 14. During the introduction stage, clients should be informed of everything EXCEPT which of the following? a. The length of the session b. Your credentials c. The limits of confidentiality d. The purpose of the interview e. All of these are part of the introduction stage. 15. The opening stage of the interview may be best described as: a. The use of direct questions to gather basic client information. b. A nondirective or unstructured interview stage lasting about five to eight minutes c. A brief period of informal and casual small talk that allows therapist and client to get acquainted with one another. d. The use of specific questions to assess the client’s concerns. e. None of the above 16. The opening statement of the therapist should consist of: a. A direct inquiry about the referral source. b. Reassurance that the client’s problems will be solved. c. A direct inquiry into the client’s concerns. d. A statement about therapist theoretical orientation. e. Nothing, the therapist should stay silent and let the client talk first. 17. Which of the following is true about the opening statement? a. Most clinicians use a standard opening. b. Your opening should vary, depending on a variety of factors. c. “What brings you here” is a common opening. d. Both a and c are true. e. Both b and c are true. 18. Letting clients struggle with an unstructured opening may be important because: a. It allows you to evaluate their coping skills. b. It allows clients to recover from a faltering start and demonstrate their ability to express themselves. c. It allows you to see how much help clients need in expressing themselves. d. All of the above. e. None of the above—you should not let clients struggle. 19. Which of the following is/are recommended as evidence-based relationship guidelines for responding to clients who struggle with their opening statement? a. Articulate positive expectations about the helpfulness of therapy. b. Express empathy and positive expectations c. Encourage the client take the lead d. Emphasize collaboration e. All of the above 20. Miguel is working with a client who is very verbal. What might he try to control the client’s verbal output?

a. b. c. d. e.

Use psychoeducation Directly tell the client to be quiet Progressively ask more closed questions All of the above Only a and c

21. Ricardo says that his main problem is his chemistry professor. He says that she makes his life miserable on purpose and if he could only change majors or get a different professor his life would be great. Ricardo could be described as a(n) ___________________ client. a. Self-blaming b. Resilient c. Internalizing d. Externalizing e. Verbose 22. The body stage of an interview includes which of the following? a. A focus on assessment b. A focus on intervention c. Unstructured listening d. Depending on the circumstances and setting, it could be a, b, or a combination e. Only a and c 23. A main purpose of obtaining information during the body of the interview is to: a. Assess the client’s level of functioning. b. Put the client at ease. c. Develop a contract with the client. d. Establish rapport. e. All of the above 24. The general criteria for judging whether a client is experiencing a mental disorder include: a. Behavior the client finds distressing. b. Behavior that is disturbing to the client or others. c. Behavior that is rationally justifiable. d. All of the above. e. Both a and b 25. A therapist using the Universal Exclusion Criteria uses which of the following questions to help aid in diagnosis? a. Is the client’s behavior rationally, culturally justifiable? b. Is the client’s behavior caused by a medical condition? c. Is the client’s behavior dysfunctional? d. The Universal Exclusion Criteria has nothing to do with diagnosis e. Only a and b. 26. Yoshimo is explaining the use of clinical interviews as assessment tools to her new classmate, Cindy. Which of the following would be an accurate statement that she might share? a. Clinical interviews allow clinicians to gather information to accurately predict human behavior. b. All interviews fall short of knowing the truth about clients. c. More structured (standardized) clinical interviews produce more reliable and valid data. d. All of the above.

e. Only b and c. 27. In which stage would a therapist do the most work to facilitate client change? a. Introduction b. Body c. Plot d. Closing e. Therapists do equal work to facilitate client change in any of the stages. 28. Which theoretical orientation views assessments and interventions as inseparable? a. Psychoanalytic b. Person-centered c. Solution-focused d. Cognitive-behavioral e. None of these 29. Which clinician behaviors are linked to the closing stage? a. Reassurance and support. b. A revisiting of role induction c. Summarizing of crucial themes and issues d. All of the above e. Only a and b 30. Olin wants to offer reassurance to a client during the closing stage. Which statement is NOT recommended? a. Don’t worry; I’m sure I can help you. b. Many of my clients have concerns similar to yours, and they usually benefit from counseling. c. It’s natural for this to feel a bit uncomfortable or weird at the beginning of therapy. d. Lots of people feel uncomfortable at first, but it usually gets better as we get to know each other more. e. These are all appropriate statements of reassurance. 31. Role induction should be revisited when: a. Clients are unclear about how they should behave in therapy b. Clients are motivated c. Clients have been cooperative and insightful d. None of the above e. Only b and c 32. If a therapist can provide an accurate case formulation for the client the client will often experience: a. Insight b. The sense of being known or understood c. Enhanced motivation d. Hope for change e. All of the above 33. Before offering to share a case conceptualization, therapists should: a. Ask the client to offer his conceptualization of his case b. Consult with another mental health professional c. Ask the client’s permission

d. Tell the client “brace yourself” e. None of the above 34. Which of the following would NOT be included in the closing stage of the intervention? a. Reassuring and supporting the client b. Applying a new intervention c. Summarizing crucial themes d. Guiding and empowering the client e. Instilling hope 35. Progress monitoring has been shown to: a. Increase treatment failure rates b. Decrease treatment failure rates c. Decrease client motivation d. Have no distinct effect on treatment e. Increase client insight 36. The ending or termination stage of the clinical interview includes which of the following issues? a. Being able to observe and evaluate the client’s termination behavior b. Watching the clock to make sure there is enough time to terminate on schedule c. The realization that many clients find termination difficult d. All of the above e. None of the above 37. Doorknob statements are usually described as: a. Statements made by clients as they enter the room. b. Statements made by clients when they schedule the initial appointment. c. Statements made by clients as they leave the room. d. Statements made by clients that provide an insight or doorway to their unconscious conflicts. e. Statements made by clinicians as clients exit the room.

Answers 1. b 2. c 3. b 4. b 5. c 6. d 7. b 8. c 9. c 10. a 11. a 12. e 13. e 14. e 15. b 16. c

17. d 18. d 19. e 20. e 21. d 22. e 23. a 24. e 25. a 26. e 27. b 28. c 29. d 30. a 31. a 32. d 33. c 34. b 35. b 36. d 37. c

TEST QUESTIONS FOR CHAPTER 4 BASIC ATTENDING, LISTENING, AND ACTION SKILLS 1.

Which of the following is most consistent with Carl Rogers’s view on what therapist qualities helps clients make changes in therapy? A. Therapist listening skills B. Therapist empathy skills C. Therapist attitudes D. Therapist listening behaviors E. None of the above are true

What does neurogenesis refer to? A. The birth of neurons B. The death of neurons C. The transformation of neurons D. Changes inside neurons associated with effective therapy E. Changes inside neurons associated with effective medication treatment

Compassion or lovingkindness meditation is associated with which of the following? A. Improvements in auditory sensory skills B. Thinning of the insula C. Thickening of the insula D. Decreased neural activity in the insula E. Both b and d are true

What was recommended as an empathic attitude training regimen in the text? A. Empathy is natural and so no such training regimen was recommended B. Males need to participate in more activities that are socially defined as feminine C. Developing an empathic listening practice and engaging in empathy development activities D. Watching more dramatic love stories on television and in the movies and watching fewer action films/shows E. Both b and d are true

What is meant by the statement: “You cannot not communicate?” A. Communication is always happening B. Communication only occurs through the verbal modality C. Nonverbal communication is more powerful than verbal communication D. You are communicating unless you tell someone, using words, that you’ve decided not to communicate E. None of the above

Which of the following is/are true about positive attending behavior? A. It usually opens up communication and encourages free expression.

B. It refers to the technique of saying as many positive things as you can about the client. C. It serves as the foundation for effective listening. D. Both A and C are true. E. None of the above are true. 7.

Which of the following best describe(s) attending behaviors? A. Therapist behaviors that convey interest and concern to the client B. Therapist behaviors that invite the client to speak openly and freely C. Client behaviors that convey genuine interest in the therapy session D. Both A and B E. Both B and C

Which of the following is NOT one of the four categories of attending behavior? A. Visual/eye contact B. Vocal qualities C. Verbal tracking D. Reflection of feeling E. Body language

Proxemics and kinesics are terms associated with: A. Vocal qualities. B. National defense. C. Accurate empathy. D. Body language. E. Verbal tracking.

10.

Positive body language may include which of the following? A. Relaxed but attentive posture B. Leaning slightly away from the client C. Facial expressions that match your feelings more than the client’s feelings D. All of the above E. Only A and B

11.

Mirroring is a technique that: A. Involves consistency or synchrony between interviewer and client. B. Is often used effectively by beginning interviewers. C. May be perceived by clients as mimicking or mocking. D. Both A and C are true. E. Both A and B are true.

12.

“Pacing the client” refers to: A. Expressing the same emotions as the client throughout the interview. B. Limiting the client’s expression of negative emotions during an interview. C. Speaking in a similar volume and tone to the client. D. Speaking at a dissimilar rate or frequency of speech to the client.

E. None of the above. 13.

Which of the following is/are true regarding vocal qualities? A. They are important in the expression and perception of emotion. B. They may be referred to as paralinguistics. C. They consist of loudness, pitch, rate, and fluency. D. All of the above are true. E. Only B and C are true.

14.

Verbal tracking: A. Involves sticking closely with client speech content. B. Is a simple and easy procedure. C. Involves keeping clients on track by directing them to relevant subjects. D. Is only possible once the therapist knows the client very well. E. All of the above are true.

15.

Negative attending behavior may consist of: A. Any positive attending behavior taken to an extreme. B. The persistent and excessive use of criticism. C. Inattentive or distracting verbal or nonverbal behavior. D. Both A and B E. Both A and C

16.

Excessive head nods, making too much or too little eye contact, overuse of mirroring, and constantly saying “Uh-huh” are all examples of what? A. Poor verbal tracking B. Negative attending behavior C. Repetitive attending behavior D. Inappropriate listening behavior E. Positive attending behavior

17.

Which of the following is the best example of a nondirective listening response? A. It looks like that is painful for you. Have some tea if you like. B. It looks like that is painful for you. Let’s talk a bit more about when it all started. C. It looks like that is painful for you. I bet it was painful for your mother as well. D. If looks like that is painful for you. E. A and C.

18.

Why is nondirective listening also considered directive? A. There aren’t enough categories available to organize all the possible listening behaviors B. Even when listening nondirectively, you can inadvertently or purposefully pay more attention to certain topics and therefore lead clients C. Solution-focused therapists discovered this in the 1980s D. Because of therapist unconscious countertransference E. None of these are right

19.

Which of the following is NOT one of the three parts of the listening continuum? A. Listening Neutrality B. Nondirective listening behaviors C. Directive listening behaviors D. Directive action behaviors E. There are really four parts to the listening continuum

20.

According to the text, nondirective listening behaviors facilitate A. Client insight B. Client talk C. Client action D. Client movement E. Client growth

21.

Silence should be avoided in the following circumstances: A. When the client tends toward extraversion. B. When the client appears to be confused. C. When the client appears to be withholding information. D. When the client needs time to experience his or her emotions. E. None of the above are true. Silence should not be avoided.

22.

Your first interview with Jack has had frequent uncomfortable silences, which you suspect stem from the fact that Jack is generally confused. Which of the following strategies would be most helpful to Jack? A. Remain silent in order to evaluate just how confused Jack can become. B. Be supportive and help Jack clarify and sort out important issues in his life. C. Interpret Jack’s silence as representing resistance to therapy. D. Ask Jack to move on to another theme or area that is more important to him. E. Both C and D

23.

Therapeutic silence is defined as well-timed silence that: A. Respects the client’s oneness B. Facilitates client talk C. Respects the client’s emotional space D. All of the above E. Only B and C

24.

Why might silence be used as a technique in interviewing? A. It puts pressure on clients to talk. B. It allows for a cooling-off time. C. It provides time for interviewers to consider their next response. D. All of the above are true. E. Only A and C are true.

25.

Which of the following statements is NOT true about paraphrasing?

A. It involves rewording what the client has said. B. It is a nondirective listening technique. C. It involves overstating the feelings expressed by the client. D. It can feel as if you are simply restating the obvious. E. All of the above are true. 26.

An awareness of a client’s representational system will assist you in which nondirective listening technique? A. The metaphorical paraphrase B. The sensory-based paraphrase C. Feeling validation D. Therapeutic silence E. None of the above

27.

Your client says: “I’m depressed all the time and I feel like ending it all,” and then you respond with: “So you’re depressed a lot of the time and you have sometimes felt like ending it all,” what technique is the therapist using? A. Nondirective reflection of feeling B. Feeling validation C. Simple paraphrase D. Carl Rogers with a twist or an intentionally leading paraphrase E. Summarization

28.

If the client says: “I always feel anxious in the grocery store,” and the therapist responds with: “Is it only in the grocery store that you feel anxious or do you feel that way in other places as well?” what technique is the therapist using? A. Carl Rogers with a twist B. A simple paraphrase C. Metaphorical questioning D. Feeling validation E. None of the above

29.

A clarification response is used to: A. Help clients achieve greater insight B. To check on and make clear for yourself and the client precisely what was said C. To confront clients on the accuracy of their disclosures D. To summarize what clients have said E. Clarify whether getting therapy is a good fit for client expectations

30.

A reflection of feeling response is also referred to as: A. Empathy B. Summary C. Summarization D. Clarification E. Reflection of meaning

31.

Stan is obviously angry. His counselor wants to use a reflection of feeling. Which of the following is the best example of a reflection of feeling? A. Stan, you look and sound angry B. What’s under the anger, Stan? C. I hear anger Stan, but I can also feel the hurt under your anger D. What you’re feeling is anger Stan . . . and that’s perfectly normal under these circumstances. E. What happened, Stan, that makes you so angry?

32.

When using reflection of feeling, emotional accuracy is your ultimate goal. However, if you miss the emotional target, it’s better to miss with a(n) ________________ . A. Overstatement B. Understatement C. Confrontation D. Distraction technique E. Validation

33.

In the text, summarization is defined as: A. An expanded clarification B. An expanded reflection of feeling C. An expanded confrontation D. An expanded paraphrase E. None of these

34.

Which of the following is an advantage of an interactive summary? A. The interactive approach models a collaborative relationship B. It places responsibility on clients to state what they think is important C. It takes pressure off of the therapist to remember everything D. All of the above E. Only B and C

35.

You may feel a pull to offer compliments or reassurance to clients. If so, you should keep the following in mind. A. Compliments and reassurance are appropriate social behaviors, but may not be appropriate during a clinical interview B. Compliments and reassurance are appropriate social behaviors and are also appropriate during a clinical interview C. Compliments and reassurance are both techniques that should be used thoughtfully and in moderation D. Only A and C E. None of the above

Answers 1. C

2. A 3. C 4. C 5. A 6. D 7. D 8. D 9. D 10. A 11. D 12. C 13. D 14. A 15. E 16. B 17. D 18. B 19. A 20. B 21. B 22. B 23. E 24. D 25. C 26. B 27. A 28. A 29. B 30. A 31. A 32. B 33. D 34. D 35. D

TEST QUESTIONS FOR CHAPTER 5 DIRECTIVE LISTENING SKILLS 1.

According to the text, directive listening behaviors facilitate A. Client insight B. Client talk C. Client action D. Client movement E. Client growth

Which of the following is NOT a type of a directive listening behavior? A. Feeling validation B. Interpretation C. Agreement/Disagreement D. Immediacy E. Only a and b are directive listening behaviors

Directives that are therapist-centered are designed to shift clients toward what they: A. Really want from therapy B. Are not yet talking about C. Are planning to talk about D. Talked about previously E. Think the therapist wants them to talk about

The goal of a feeling validation is to: A. Uncover emotions that the client may be only partially aware of. B. Convey to the client whether you think his or her emotional responses are appropriate. C. Help the client identify his or her cognitive distortions. D. Confront clients with the “invalid” nature of their emotions E. All of the above

Which of these is a feeling validation? A. “You feel sad about losing your mom” B. “You wish you could change how things worked out between you and your mother” C. “Underneath your sadness, I sense a little resentment” D. “It’s okay to feel sad about losing your mother. That’s perfectly normal.” E. “There’s just no replacing her.”

Samantha is using lots of feeling validation with her clients. Her supervisor, Nelson, is concerned that she may create which of the following? A. Narcissism in the client B. Disagreement in the counseling relationship C. Conflicts outside counseling with people who are less validating D. Dependency on a validating therapist

E. A reduction in her clients’ anxiety 7.

The goal of interpretive reflection of feeling is to: A. Make clients feel heard. B. Go deeper and uncover emotions that clients may be only partially aware of. C. Convey to clients whether you think their emotional responses are appropriate. D. Help clients identify their cognitive distortions. E. All of the above

Which statement best describes the difference between nondirective feeling reflections and interpretive feeling reflections? A. Nondirective feeling reflections are used more by beginning interviewers, and interpretive feeling reflections are preferred by more experienced interviewers. B. Nondirective feeling reflections reflect only what the client has said, whereas interpretive feeling reflections may include the interviewer’s feelings. C. Nondirective feeling reflections reflect only what the client has said, whereas interpretive feeling reflections may uncover hidden emotions. D. Nondirective feeling reflections are more powerful and promote therapeutic breakthroughs. E. None of the above

Mickey wants to use an interpretive reflection of feeling. What would you tell him he needs to do first? A. Offer an interpretation first B. Wait until he has rapport, has listened well, and has evidence C. Consult with a collateral informant D. Get in touch with his own resentment of authority E. Get his own therapy otherwise his interpretive reflections of feeling will be laced with countertransference

10.

Psychoanalysts say that timing is most important when using which of the following listening techniques? A. Interpretation B. Sensory-based paraphrase C. Silence D. Feeling validation E. Timing is equally important for all of the above techniques.

11.

What’s the purpose of an interpretation? A. To help something conscious become unconscious B. To help something unconscious become conscious C. To get clients in touch with their true sensory experiences D. To validate client feelings E. To stop clients from repeating adaptive behaviors

12.

What is the simplest form of a trial interpretation?

A. Asking permission B. Commenting on a discrepancy the client is exhibiting C. Noticing a repeating pattern D. Commenting on how a current behavior probably represents unresolved conflicts from childhood E. Affirmation and sublimation 13.

Which of the following statements is NOT true about reframing? A. It can help clients to view their problems or complaints from another perspective. B. Clients may first respond to it with denial. C. It is often used by psychoanalysts to uncover unconscious conflicts. D. Interviewers should have a reasonable alternative hypothesis when using this technique. E. All of the above are true

14.

Luis loves to use post-modern reframing techniques. Unfortunately, he uses it too soon because he doesn’t adequately develop: A. Rapport with his clients B. An alternative hypothesis (or new frame) that is reasonable C. The appropriate condescending attitude D. All of the above E. Both A and B are of possible

15.

16.

17.

What is the primary goal of confrontation? A. To help clients face their fears B. To uncover hidden emotions that the client may not be aware of C. To enhance rapport between client and interviewer D. To force your client to make a change in his/her behavior E. To help clients perceive themselves and reality more clearly Dr. Jay says to her client: “On one hand, you say you have compassion for your child, but on the other hand you continue to put her out in the hall where you force her to stand for three or more hours. How do you put that together?” What type of therapist technique is Dr. Jay using? A. Condemnation B. Reflection of meaning C. An indirect question D. Clarification E. Confrontation Confrontation works best when it is used: A. Right away during the initial clinical interview B. When you have a working relationship with the client and ample evidence to demonstrate the client’s emotional/behavioral discrepancies C. When you start to feel annoyed with your client and want to set them straight D. Confrontation is never a good idea and should not be used

E. Only A and C 18.

19.

Immediacy involves an integration of here-and-now self-disclosure, confrontation, and _________. A. Feeling reflections B. Interpretations C. Feedback D. Paraphrasing E. Summarization Immediacy can be used for which purpose(s)? A. As a means of confrontation B. To lead clients toward specific action C. As a means of expressing support D. All of the above E. None of the above

20.

Which of the following is most representative about how the authors feel about questions? A. Questions should be avoided. B. Questions are not the same thing as listening. C. Asking questions can get in the way of gathering important information from clients. D. All of the above. E. Only B and C.

21.

Which of the following is most true about questions? A. They never put the client on the spot. B. They are difficult to control. C. They are too easy for clients to answer. D. They give the counselor more control regarding the direction of the interview. E. None of the above is true.

22.

Joan wants to ask a question to bring out the client’s thoughts and feelings about a particular issue. Her best option would be to ask a question beginning with: A. Did B. Do C. How D. Why E. None of the above

23.

Tom wants to ask questions that are likely to bring out the facts in a situation. What type of questions will he be asking? A. Open B. Closed C. Swing D. Indirect

E. Projective 24.

Open questions usually begin with ________ or ___________. A. How; why B. What; how C. Why; what D. How; when E. When; what

25.

In which situation(s) can closed questions be particularly useful? A. When trying to limit the verbal output of a client who is excessively talkative B. When trying to elicit detailed information from a particularly quiet client C. When conducting diagnostic interviews D. All of the above E. Only A and C

26.

“Can you tell me more about your relationship with your brother?” is what type of question? A. Open B. Closed C. Indirect D. Swing E. Projective

27.

You should be careful when you use Why questions in an interview because: A. They can make the client defensive. B. The client’s personal motivation is none of your business. C. They often elicit very intellectual responses. D. All of the above are true. E. Only A and C are true.

28.

Initially, you might avoid using swing questions with _____________ clients. A. Elderly B. Children and adolescents C. Asian and African-American D. Severely mentally ill E. Males

29.

“It must be tough hearing your parents argue with each other every night” is what type of question? A. Indirect B. Projective C. Closed D. Swing E. It’s not a question.

30.

31.

Clarice’s supervisor tells her to use fewer questions and more paraphrasing. When Clarice asks, “Why?,” her supervisor says: A. I’m worried that you’re leading so much that your client won’t be spontaneous. B. You need to pressure your client more. C. You need to take a more expert role. D. Because your questions focus on the client, you’re not getting your own interests and values into the room. E. Your questions are over-valuing your client’s perspective. Which of the following is a good guideline for using questions? A. Use projective questions more often than open questions B. Prepare your clients for questions C. Avoid mixing questions with nondirective listening D. Use questions to elicit intellectual responses E. Only A and C

32.

Manny wants a client to provide a concrete behavioral example. What sort of interviewing behavior will he use? A. Providing clarification B. Confrontation C. Asking questions D. Nonverbal attending behaviors E. Interpretation or reframing

33.

If you find out during an interview that a client grew up in the same neighborhood as you, what type of question should you definitely ask about the specific neighborhood? A. What elementary school he or she went to B. How he or she liked growing up in that area C. What street he or she lived on D. How long he or she lived in the area E. You might not ask any questions about the neighborhood because doing so is more about your interests than the client’s interests.

34.

35.

The Latina/o concept of Charlar refers to: A. The initial charm needed to establish rapport B. The idea that eating together facilitates connection with clients C. Small talk D. The rationale for avoiding inappropriate questions E. None of the above Which of the following is true about questions like, “Have you thought about leaving your husband?” A. There’s nothing wrong with this question B. This is a leading question and could be unethical C. This question is a manifestation of the counselor’s values/beliefs and leads clients to take action and therefore is both risky and objectionable

D. This question is recommended as a method to help clients engage in problem-solving E. Both B and C are true 36.

Which issues should you reflect on when using questions to lead clients? A. If your colleagues (or some attorneys) were listening, would they consider your questions appropriate or inappropriate? B. Are you leading your clients toward acting in a way that’s consistent with your personal values? C. Are you guiding your clients toward the absolute truths in human functioning? D. Only A and B E. None of the above

37.

Which strategy or frame is recommended as a way for you to ethically ask leading questions? A. A problem-solving frame B. Charlar C. Personalismo D. Choice theory E. Only B and C

Answers 1. A 2. C 3. B 4. B 5. D 6. D 7. B 8. C 9. B 10. A 11. B 12. C 13. C 14. E

15. E 16. E 17. B 18. C 19. D 20. E 21. D 22. C 23. B 24. B 25. E 26. D 27. E 28. B 29. A 30. A 31. B 32. C 33. E 34. C 35. E 36. D 37. A

TEST QUESTIONS FOR CHAPTER 4 DIRECTIVES: QUESTIONS AND ACTION SKILLS 1.

Which of the following statements is true about client readiness to change? A. Directives are probably more effective with clients who are in the action or maintenance stages B. Directives are probably more effective with clients who are in the precontemplation or contemplation stages C. If clients come to therapy, they are, by definition, ready for change D. All clients begin therapy in the precontemplation stage E. The readiness to change concept is part of motivational interviewing theory and has substantial empirical support

Which of the following stages are included in Prochaska’s readiness to change model? A. Precontemplation B. Contemplation C. Preparation D. Action E. All of the above

What stage is associated with thinking about (but not yet acting on) positive change? A. Precontemplation B. Contemplation C. Preparation D. Action E. All of the above

Marlon is in the ________________ stage. He will likely react negatively to directive techniques like advice-giving and psychoeducation. A. Precontemplation B. Contemplation C. Preparation D. Action E. All of the above

When clients are in the action or maintenance stages of change which directive techniques are appropriate to use? A. Paraphrasing B. Psychoeducation C. Advice D. B and C E. No directive techniques should be used during these stages.

The purpose of Adler’s “The Question” is: A. To help clients envision themselves and their lives without their primary problem.

B. To identify what forces make it easier for clients to give up their maladaptive behavior patterns. C. To learn what specific motive or purpose was sustaining specific unhealthy behaviors D. A and C. E. All of the above 7.

Alfred is working with Raissa and he asks: “What would be different if you were well?” Which technique is he using? A. The first of the four big questions of choice theory B. The pre-treatment change question C. Adler’s “The question” D. The solution-focused exception question E. The solution-focused miracle question

Which of the following is NOT one of the four essential questions associated with choice theory and reality therapy? A. What do you want? B. What are you doing? C. Why do you act the way you do? D. Is it working? E. Should you make a new plan?

10.

11.

The “P” in Wubbolding’s acronym “WDEP” stands for: A. Procedure B. Plan C. Paraphrase D. Productivity E. None of the above When working with Japanese clients, Wubbolding discovered that clinicians should use which of the following questions for the “E” in “WDEP?” A. What do you want? B. Why do you act the way you do? C. Is it working? D. Should you make a new plan? E. None of the above Which of the following statements is true about solution-focused and narrative therapists? A. They rarely use questions B. They often use questions C. They like to find out about the origins of the client’s problems before discussing solutions D. They often use direct confrontations and challenge clients in order to find solutions E. They only use open ended questions

12.

Latisha is working with a new client who reports positive change (“I got together with an old friend”) in response to the pre-treatment change question. Which question(s) are good examples of follow-up questions that stimulate “solution” talk? A. What was good about seeing your friend? B. How did you manage to get the excellent idea of getting together with your friend? C. What other excellent ideas have you had since you went out with your friend? D. All of the above E. Only A and C

13.

Autumn asks her client: “What, exactly, would be different if you came in next week and told me that you’re handling your anger at a 5?” Which type(s) of solution-focused question is she using? A. Scaling questions B. Projective questions C. Presuppositional questions D. All of the above E. Only A and B

14.

From a cognitive therapy perspective, which of the following questions provide an intervention for the black-white thinking often associated with depressive symptoms? A. Scaling questions B. Percentage questions C. Presuppositional questions D. All of the above E. Only A and B

15.

Which of these is an example of a unique outcomes or re-description question? A. How did you beat the fear and go out shopping? B. How did you manage to stay calm? C. What exactly were you thinking? D. All of the above E. Only A and B

16.

17.

Why is it that using solution-focused and narrative techniques isn’t always straightforward and requires practice, supervision, and feedback? A. There’s no problem, nearly everyone responds well to solution-focused and narrative techniques B. Many clients identify with their negative symptoms and prefer talking about them C. Solution-focused techniques are simple and don’t require much practice or supervision D. All of the above E. Only A and B Presuppositional questions are virtually the same as: A. Externalizing questions B. Projective questions

C. Exception questions D. All of the above E. Only A and C 18.

Francie asks her client: “Suppose you were to go home tonight, and while you were asleep, something strange happened and this problem was solved. How will you know your problem was solved? What will be different? A. An externalizing question B. A presuppositional question C. The miracle question D. None of the above E. Both A and C

19.

Which statement best describes the constructive view on traditional diagnostic interviewing? A. It is a useful method for diagnosing symptoms which is key to developing solutions. B. It fails to take into consideration the health care system. C. It wrongly places the cause of psychiatric symptoms outside of the self. D. It wrongly internalizes symptoms as medical disorders. E. None of the above

20.

If a solution-focused therapist uses some kind of metaphor or symbol when referring to a client’s depression, for example, a “black cloud,” which type of question is the therapist most likely using? A. Externalizing question B. Exception question C. Metaphorical question D. Unique outcome question E. Presuppositional question

21.

Wendy is having trouble sleeping and cannot think of any solutions she has used in the past to cope with her insomnia. What type of question might the therapist use to help Wendy recall those times where she was able to sleep without any problems? A. Scaling question B. Presuppositional question C. Exception question D. Externalizing question E. None of the above

22.

What is a potential disadvantage of using only solution-focused questions designed to help the client focus on the positive perspective? A. The questions do not provide any clear guidelines regarding what to say. B. Solution-focused questions place the therapist in the expert role. C. Clients may feel that their negative experiences are being dismissed as unimportant. D. Both A and B E. Both B and C

23.

What is the primary purpose of directive action responses in clinical interviewing? A. To build rapport B. To encourage clients to change the way they think, feel, and act C. To encourage clients to open up more in therapy D. To control client verbal output E. Both A and D

24.

Psychoeducation is similar to: A. Role induction B. Interpretation C. Suggestion D. The counseling process E. None of the above

25.

Psychoeducation can be used to educate clients about which of the following? A. Diagnosis B. Treatment process C. Prognosis D. Intervention strategies E. All of the above

26.

Based on her initial assessment, Amber decides her client needs to learn something about study skills and methods for coping with text anxiety. Which technique(s) is she likely to use? A. Visual imagery B. Interpretation C. Psychoeducation D. Suggestion E. None of the above

27.

What do the authors recommend with regard to using the technique of suggestion in clinical interviewing? A. Use it only with the miracle question. B. Offer only suggestions that you are certain the client will like. C. Use it with caution because it can backfire. D. Offer only suggestions that you would agree with if they were offered to you. E. The technique of suggestion is generally helpful so therapists should use it freely.

28.

Which of these is the best definition of suggestion? A. It’s the same as advice-giving only gentler B. It’s a clinician statement that directly or indirectly suggests, implies, or predicts something will occur C. It’s a clinician technique that requires a formal hypnotic induction D. It’s a series of statements that can be used with or without hypnosis, but, like confrontation, must include the resolution of a discrepancy.

E. None of the above is true 29.

Which of the following statements is NOT true regarding the use of agreement in clinical interviewing? A. Agreement enhances rapport. B. Agreement puts the therapist in the expert role. C. Agreement enhances client self-exploration. D. Agreement is a common directive action skill. E. All of the above ARE true.

30.

Generally, therapists should not use disagreement as a technique because: A. It can result in a personal argument between interviewer and client. B. It can be used in ways that are unethical. C. It can be an abuse of therapist power. D. All of the above E. Only B and C

31.

When should a therapist give advice to a client? A. In the initial stages of therapy when clients are anxious. B. If it is consistent the therapist’s theoretical orientation, any time is fine. C. After finding out what solutions the client has already tried. D. When the therapist has experienced a similar situation. E. All of the above are true.

32.

Which of the following is a problem associated with advice? A. It can shut down clients from further exploring problems and solutions B. Many clients want and need advice to improve their functioning C. Advice is best given in the action and maintenance stages D. Clients are usually aware of when they need advice E. None of the above is a problem

33.

Luis’s client is asking for advice about a behavioral problem. Which of the following is a prudent first response? A. Luis should immediately give the client the advice B. Luis should ask, “Why do you want this advice?” C. Luis should ask, “What options or ideas have you thought of already?” D. Luis should say, “I hear you saying you want advice, but I don’t really believe you.” E. Luis should remain silent and listen for what the client says next

34.

The textbook recommends which of the following regarding self-disclosure? A. Self-disclosure is recommended as standard practice B. Self-disclosure is an advanced and complex technique worthy of personal reflection C. It’s a good idea to talk about self-disclosure in class and with supervisors D. Both A and B E. Both B and C

35.

________________is an uncommon interview technique used primarily in crisis situations. A. Persuading B. Urging C. Advice giving D. Approval E. None of the above

36.

Approval refers to: A. Clinician sanction of client thoughts, feelings, or behavior B. Clinician status with regard to their state licensing board C. Standard ethical practice D. Both B and C E. None of the above

37.

Openly disapproving of clients’ behavior on the basis of your personal values is: A. Required by state law B. Standard ethical practice C. Unethical D. Ethical if you’re not competent to treat someone E. None of the above

38.

When used appropriately, approval might also be viewed as: A. Encouragement B. Manipulation C. Risky D. A paradoxical technique E. All of the above

39.

Which of the following is true about using disapproval in an interview? A. Disapproval has to be verbal for it to count B. Nonverbal behavior has been cited as communicating disapproval in legal proceedings C. Disapproval is part of congruence and should be expressed D. Disapproval is powerful and can be used as a paradoxical change technique E. All of the above

40.

How does the American Psychological Association address psychologist values? A. Directly by saying that counselors avoid imposing their own values, attitudes, beliefs, and behaviors B. Indirectly by focusing on eliminating bias, emphasizing respect, and clinician awareness C. Indirectly by emphasizing precaution against bias and unjust practice D. All of the above E. Only B and C

41.

How does the American Counseling Association address professional counselor values? A. Directly through the beneficence principle B. Indirectly by focusing on eliminating bias, emphasizing respect, and clinician awareness C. Indirectly by emphasizing precaution against bias and unjust practice D. None of the above E. Only B and C

42.

How does the text recommend that students and clinicians avoid situations where clinician values may harm clients? A. Directly and immediately inform your clients if you have a values conflict B. Systematically refer all clients based on class C. Recognize that making referrals based on lack of competency is always unethical D. All of the above E. None of the above

43.

Barbara is a conservative Christian and doesn’t endorse LGBTQ behaviors. When she’s faced with a situation where her new client is bisexual, her best first step is: A. Tell the client bisexuality is immoral and make a referral B. Make a referral, but say nothing about why C. Tell the client about what the Bible says about bisexuality D. Try her best to “bracket” her values and remain nonjudgmental E. None of the above is acceptable

44.

When offering advice across a cultural divide, which of the following is recommended? A. Seek consultation B. Offer advice using the best practice guidelines for offering advice across cultures C. Offer advice and emphasize to clients that your advice is based on empirical research D. Offer no advice because doing so is always unethical E. None of the above

45.

When offering self-disclosure across a cultural divide, which of the following is recommended? A. Self-disclose freely B. Do not self-disclose C. Call time out and consult before self-disclosing D. Self-disclose in a way that offers a chance at joining or connecting with clients E. Self-disclose in a way that offers specific advice to clients

Answers 1. A 2. E 3. C 4. A 5. D

6. D 7. C 8. C 9. B 10. E 11. B 12. D 13. A 14. E 15. E 16. B 17. B 18. C 19. D 20. A 21. C 22. E 23. B 24. A 25. E 26. C 27. C 28. B 29. C 30. D 31. C 32. A 33. C 34. E 35. B 36. A 37. C 38. A 39. B 40. B 41. D 42. E 43. D 44. A 45. D

TEST QUESTIONS FOR CHAPTER 5 EVIDENCE-BASED RELATIONSHIPS 1. The “Great Psychotherapy Debate” Refers to: A. Whether counseling and psychotherapy is efficacious B. Whether counseling is more effective than psychotherapy C. Whether empirically validated procedures or therapeutic relationships are more important to positive outcomes D. Whether randomized control trials or effectiveness studies are more appropriate for establishing a scientific foundation for therapy E. None of the above 2. Supporters of the psychotherapy-as-relationship position in the “Great Psychotherapy Debate” criticize empirical approaches because: A. They are manualized B. They are not shown to be effective C. They are not shown to be efficacious D. They are based on qualitative research E. Both B and C are true 3. In 1957, Carl Rogers claimed that which of the following was “necessary and sufficient” for positive change in psychotherapy? A. A corrective emotional experience B. Collaborative goal-setting C. A certain type of relationship D. An accurate diagnosis E. Both B and C 4. Which of the following is NOT one of Carl Rogers’s core conditions? A. Congruence B. Unconditional positive regard C. Accurate empathy D. Expertness E. These are all Rogerian core conditions 5. Which of the following is NOT true regarding congruence in the clinical interview? A. Congruence means that a person’s thoughts, feelings, and behaviors match. B. Congruence should be accompanied by an examination of your motives. C. Congruence means honestly saying whatever comes to your mind. D. Congruence should always be combined with good clinical judgment. E. All of above are true regarding congruence in the clinical interview. 6. Based on person-centered theory, congruence is: A. Less a skill and more an experience. B. A skill that is best taught via behavior modification

C. Best guided by the clinician’s spontaneous intuition D. Clear and concrete E. To be avoided at all costs 7. Based on their meta-analysis focusing on congruence, Kolden and colleagues (2011) concluded: A. Minority therapists should avoid using congruence with non-minority clients B. Congruence is the most statistically robust of all relationship factors C. Congruence produced a medium positive effect D. Both A and B E. Both A and C 8. Which of the following is/are offered by the authors as a guideline(s) for using congruence in a clinical interview? A. Initial spontaneous thoughts and reactions to clients should stimulate personal reflection, not immediate disclosure B. If you have a negative reaction to a client, try to transform it to your internal experience and find a way to express it in a positive manner C. Be congruent and express your inner feelings to your clients—even if they’re sexual in nature D. All of the above E. Only A and B 9. Allison is conducting an initial interview. She feels an impulse to act transparent/congruent. What’s the most important questions to ask herself? A. Am I being completely honest? B. Would my disclosure help facilitate my client’s work? C. What sexual feelings am I having that I should share? D. What don’t I like about this client? E. Is the time up yet? 10. Unconditional positive regard: A. Includes a nonjudgmental acceptance of the client. B. Includes positive feelings toward the client. C. Should be directly expressed. D. Both A and B E. Both A and C 11. Which of the following would NOT be an appropriate way of expressing of positive regard? A. Showing that you remember parts of a client’s life story. B. Making an effort to accept and respect clients. C. Telling clients directly that you will like and accept them unconditionally. D. Giving your clients a hug at the beginning of each session. E. Both C and D are inappropriate.

12. In their meta-analysis of research on unconditional positive regard, Farber and Doolin (2011) noted that: A. Non-minority therapists may use unconditional positive regard to help improve trust with minority clients B. Unconditional positive regard is the most statistically robust of all relationship factors C. Unconditional positive regard produced a medium positive effect D. Both A and B E. Both A and C 13. Which of the following are components of Carl Rogers’s definition of empathy? A. Therapist ability or skill B. Therapist attitude or willingness C. Entering the client’s frame of reference or perspective-taking D. Sensing meanings of which the client is barely aware E. All of the above 14. Which of the following is NOT true regarding accurate empathy? A. Empathy requires inference and runs the risk of possible projection. B. Empathy is both an intellectual and an affective process. C. Empathy is a relatively simple process that is achieved merely by asking Carkhuff’s “empathy question.” D. Empathy should initially be stated in a tentative manner. E. All of the above are true 15. Meta-analyses of research on empathy indicate: A. That empathy contributes only a small influence on treatment outcomes B. That empathy is a simple and easily measured construct C. That empathy probably accounts for as much and perhaps more outcome variance than specific interventions D. That empathy is unknowable and unmeasurable E. Both A and B 16. Empirical research on empathy suggests that it contributes to positive treatment outcomes in four ways. Which of the following is NOT mentioned as one of these ways? A. Empathy improves the therapeutic relationship. B. Empathy directly encourages clients to think and behave in more adaptive ways. C. Empathy can provide a corrective emotional experience. D. Empathy facilitates client self-exploration. E. These are all ways that empathy contributes to positive outcomes. 17. Definitions of empathy can be broken down into multiple core sub-processes; which of the following is NOT one of these sub-processes? A. Emotional simulation B. Perspective-taking C. Cognition matching

D. Emotion regulation E. All of the above have been identified as sub-processes 18. As a neuroscientific phenomenon, empathy appears to: A. Primarily involve the motor cortex B. Engage many different brain structures, chemicals, and hormones C. Continue to be completely neglected by neuroscientists D. Be facilitated by the medulla oblongata E. None of the above are true 19. “I know how you feel” and “I’ve been through something just like that” are examples of what? A. Unconditional positive regard B. Accurate empathy C. Misguided empathic statements D. Empathic understanding E. Paraphrasing 20. Transference involves: A. A client responding with actions, thoughts, or feelings that feel inappropriate (e.g., too intense) B. Inappropriate reactions from the therapist. C. An outdated, vague, and elusive concept. D. An interviewing situation that should be ignored and avoided. E. Gender or cultural based discrimination. 21. Research on transference has shown: A. Transference reactions during sessions can be reliably and validly measured That empathy is a simple and easily measured construct B. Transference in therapy tends to be highly similar to contemporary relationship patterns observed outside therapy C. Transference cannot be reliably and validly measured D. Working directly with transference in therapy provides no positive contribution to therapy outcomes E. Both A and B are supported 22. Maria attends her first therapy session and brings drawings for her therapist to view. When the therapist acts neutral she gets angry and demands that the therapist tell her what he thinks. Maria is most likely experiencing: A. Countertransference. B. Transference. C. Corrective emotional experience. D. Self-disclosure. E. None of the above

23. As a beginning therapist dealing with transference the authors suggest you keep in mind which of the following principles? A. Be aware that repeating inappropriate transference reactions may occur during an interview. B. Notice repeating patterns internally and then when a pattern is very clear, notice it with an explicit comment. C. Collaboratively explore repeating patterns that may be significant. D. All of the above E. None of the above 24. Contemporary definitions of countertransference have been divided into categories; which of the following is NOT one of those categories? A. Classical B. Totalistic C. Complementary D. Relational E. Interpersonal 25. Research on countertransference (CT) has shown: A. Unaddressed CT tends to be associated with slightly poorer treatment outcomes B. CT reactions can teach therapists about their own important underlying conflicts Transference cannot be reliably and validly measured C. CT is considered a natural phenomenon and useful source of information that can contribute to therapy process and outcome D. All of the above are supported E. Only A and B are supported 26. Countertransference (CT) management refers to: A. An unfilled management position for a psychoanalytic therapy outcome researcher B. Clinicians’ efforts to do something about or with their CT reactions C. Clinicians’ efforts to do something or “counter” their clients transference reactions D. All of the above E. None of the above 27. Richard comes to a second interview session and tells you he has failed to complete the homework assignment you gave him. This reminds you of the same trouble you’re having with your son. You begin feeling very impatient and disappointed in Richard and scold him. What label is usually given to describe the feelings you feel toward Richard? A. Transference B. Countertransference C. Resistance D. Reaction formation E. None of the above

28. Which of the following is true regarding countertransference (CT) management? A. Countertransference is essentially unmanageable B. Having a history of meditation practice can lower your reactivity to clients and improve CT management C. Personal psychotherapy for clinicians has been shown to have no effect on countertransference D. To be effectively managed, CT should be kept private; DO NOT consult with colleagues or supervisors about it E. CT reactions are a sign that you’re in the wrong profession 29. Bordin’s model of the working alliance consists of which of the following dimensions? A. Goal consensus or agreement B. Collaborative engagement in mutual tasks C. Development of a relational bond D. All of the above E. Only A and B 30. Regardless of the theoretical orientation, length of treatment, and type of problem, what does research suggest that all therapists should try to maintain with their clients? A. Corrective emotional experience B. A positive perspective C. A working alliance or positive therapeutic relationship D. Vague treatment goals E. None of the above 31. Research on the working alliance has shown: A. Higher alliance ratings were related to better treatment outcomes B. Clinician-client goal consensus has no relationship to treatment outcomes C. When clinicians solicit feedback about the clinician-client relationship, they’re viewed as weak by their clients D. None of the above are supported E. Only B and C are supported 32. In addition to Bordin’s three dimensions that help create a strong working alliance, which of the following can also contribute to positive outcomes? A. Physical touch B. Progress monitoring C. Humor D. All of the above E. None of the above 33. Which of the following strategies were recommended for developing a positive working alliance? A. Role induction B. Clinicians keeping separate goals from clients C. Collaborative goal-setting

D. All of the above E. Only A and C 34. Relationship ruptures are defined as: A. Tensions or breakdowns in the clinician-client collaborative relationship B. Inadequate role induction C. A psychoanalytic concept D. A strain in the clinician-supervisor relationship E. All of the above 35. Research on the relationship ruptures has shown: A. Rupture repair can sometimes be achieved B. Best practice is to not address ruptures or strains and hope they will spontaneously resolve C. Clinician-client goal consensus has no relationship to treatment outcomes D. Spontaneous rupture resolution is empirically supported E. Both B and D 36. What are the two types of relationship ruptures? A. Stress and strain B. Pressure and input C. Withdrawal and confrontation D. Collaborative and mismatch E. Mental and physical 37. Everett has a client who is expressing discontent during his initial session. His client has questioned Everett’s competence. This may be a rupture that can be classified as: A. Confrontation B. Withdrawal C. Melt down D. Strain E. Hostile 38. Which of the following is NOT RECOMMENDED as a rupture repair strategy? A. Gentle questioning B. Self-disclosure/immediacy C. Acknowledgement of an empathic failure D. Counter-confrontation E. Conceding to the client’s experience 39. Therapeutic modeling works through which of the following mechanisms? A. Feedback processing B. Feed-forward C. Self-efficacy D. No one knows the exact mechanism E. Both A and C

40. Therapeutic modeling might also be considered as involving: A. Identification B. Interpersonal mirroring C. Internalization D. Interpersonal processing E. Both A and C 41. Which of the following is/are true of the concepts of identification and internalization? A. Identification is a precursor to internalization. B. They are psychoanalytic and object relations theoretical constructs. C. They are fixed at birth. D. Both A and B are true. E. Both B and C are true. 42. Leon and his client Murph, hold vastly different worldviews. This might make the likelihood of _____________ occurring difficult. A. Identification B. Internal knowing C. Empowerment D. Countertransference E. Empathic understanding 43. Which of the following is true about mutuality? A. It involves a sharing process B. It means that power, decision making, goal selection, and learning are shared C. It focuses on having feminist therapists take the lead in interviewing interactions D. Both A and B are true E. None of the above is true 44. Why do therapists with a feminist orientation engage in mutuality? A. To empower clients B. To make the therapist-client relationship more egalitarian C. To demonstrate the fact that they view the client as the expert D. All of the above E. Both A and B 45. How is mutual empathy defined? A. As clients seeing-experiencing-knowing their emotional effect on their therapists within a safe environment B. As clients being able to see their therapists experiencing empathic resonance C. As a too-close emotional symbiosis D. All of the above are true E. Only A and B are true Answers

1. C 2. A 3. C 4. D 5. C 6. A 7. C 8. E 9. B 10. D 11. E 12. E 13. E 14. C 15. C 16. B 17. C 18. B 19. C 20. A 21. E 22. B 23. D 24. E 25. D 26. B 27. B 28. B 29. D

30. C 31. A 32. B 33. E 34. A 35. A 36. C 37. A 38. D 39. D 40. E 41. D 42. A 43. D 44. D 45. E

TEST QUESTIONS FOR CHAPTER 8 INTAKE INTERVIEWING AND REPORT WRITING 1.

Which of the following words best describes the function or purpose of an intake interview? A. Introductory B. Informal C. Assessment D. Intervention-focused E. None of the above

Which of the following is/are NOT usually a part of the intake interview? A. Obtaining information to determine whether or what type of treatment is best suited to the client B. Assessment in general C. Team interviewing D. Both A and B E. None of the above

Intake interviewing involves getting to know the client and his or her circumstances. It is recommended to follow a certain order or organization to achieve these objectives. Which of the following is the suggested order? A. Problem, person, goals B. Person, problem, current functioning C. Person, time frame, circumstance D. Problem/goals, person, current functioning E. Person, current functioning, problem

Which of following does NOT represent one of the three basic objectives of the intake interview? A. Identify, evaluate, and explore the chief complaint. B. Confirm the clinical impressions in the testing report given by the referral source. C. Obtain a sense of the client’s interpersonal style and personal history. D. Evaluate the client’s current life situation.

At what point in the intake interview will the therapist generally switch from a more nondirective listening style to a more structured, directive approach? A. When the client starts rambling about things that aren’t important. B. When the therapist begins helping a client identify problems or goals. C. When the therapist needs to finish the interview early. D. When the client begins to show a lot of emotion. E. Both B and D

What is the purpose of transitioning from client free expression to more structured interactions?

A. It allows for the therapist to check for any additional problems that the client has not yet talked about. B. The transition ends the process of goal setting and problem prioritization. C. It allows for the therapist to evaluate for current functioning. D. Both A and B E. Both A and C 7.

After several client problems have been identified, which is the best way for a therapist to decide which problem to deal with first? A. Choose the problem the therapist believes is causing the client the most distress. B. Choose the problem that can be dealt with most effectively. C. Choose the problem the client identifies as his or her main concern. D. Choose the problem the referral source listed as the presenting problem. E. Choose the problem the therapist feels he/she has the best chance of fixing.

Lazarus’s multimodal conceptualization system: A. Is mainly concerned with clients’ relationships. B. Is designed to analyze clients’ problems. C. Is psychoanalytically based. D. Is not concerned with clients’ current functioning. E. All of the above

Which of the following is true of Lazarus’s BASIC ID model? A. It does not cover cognitive domains very well. B. It is most useful to interviewers with an object relations theoretical orientation. C. It deemphasizes spiritual, cultural, and recreational domains. D. It includes the categories of attention and insight.

10.

The question “What thoughts go through your mind when you are lying in bed unable to sleep?” would correspond to which letter of Lazarus’s BASIC ID conceptualization system? A. B B. A C. S D. I E. C

11.

Thoresen and Mahoney’s behaviorally oriented problem conceptualization model does NOT emphasize which of the following? A. Antecedents B. Consequences C. Predictions D. The behavior itself E. All of the above are emphasized in the model

12.

Which type of theorist emphasizes the importance of antecedents and consequences in problem development? A. Psychoanalytic B. Behavioral C. Solution-focused D. Person-centered E. Existential

13.

Which of the following is least likely to be required information to evaluate a client’s problem in most situations? A. Input from the client’s family members B. The client’s main source of distress C. The client’s self-reported hierarchy of problems D. Antecedents and consequences of the problem E. Direct observation of the client’s behaviors.

14.

Why is it preferable for therapists to initially be nondirective when asking about a client’s history? A. It gives the client time to reminisce about past memories and experiences. B. Therapists can observe what the client chooses to talk about and what she or he avoids, which can reveal significant information. C. Therapists can observe the client’s facial expressions as he or she relives past traumatic memories. D. The client will feel less anxious when an therapist is nondirective. E. Both A and B

15.

After a client has expressed his or her main reasons for seeking counseling, what could a therapist ask to begin a transition of the interview to personal history? A. Could you tell me why you decided to come to counseling at this particular time? B. Can you explain your decision to come to this particular office/agency? C. Have you considered any alternatives to counseling? D. Could you tell me a bit about your life growing up or your parents? E. None of the above

16.

When a client discloses a painful memory, the best thing a therapist can do is: A. Reassure the client that the past is behind him or her now. B. Ask a different question to direct the client toward more positive material. C. Listen well and empathize. D. Listen well and sympathize. E. Continue to question the client so he/she can learn more about the memory.

17.

What would be a good strategy to begin directively exploring a client’s personal history? A. “Tell me about your personal history.” B. “Tell me about one of your earliest childhood memories.” C. “What do you remember about your first elementary school teacher?” D. “Say whatever comes to mind.”

E. “What was the most significant thing you experienced as child?” 18.

A therapist should do all EXCEPT which of the following when probing for a client’s personal history? A. Point out the client’s strengths. B. Allow the client time to freely discuss what he or she feels is significant. C. Ask about the client’s earliest memory. D. Have the client relive his or her painful memories.

19.

Which of the following areas should the therapist explore when evaluating the client’s interpersonal style and personality? A. Vocational preference B. Client’s readiness for change C. Evaluation of mental status D. The current situation E. None of the above

20.

Therapists practicing from a __________ or __________ perspective tend to reject the concept of personality and believe that behavior is the function of a situation or a person’s cognitions about a situation. A. behavioral; cognitive B. psychoanalytic; person-centered C. behavioral; person-centered D. psychoanalytic; cognitive E. None of the above

21.

The authors suggest that the main purpose of exploring interpersonal and historical issues during an intake interview is so that the therapist can: A. Provide definitive case formulations B. Advocate specific client actions or solutions C. Formulate hypotheses D. All of the above E. Both A and B

22.

When clients first begin articulating their concerns, it is preferable for therapists to use which of the following responses? A. Nondirective listening responses B. Directive listening responses C. Directive action responses D. All of the above E. Only A and C

23.

It can be helpful for interviewers to reframe clients’ problem statements into positive statements about what clients want, because client problems are intimately linked with client: A. Feelings

B. Emotions C. Goals D. Attitudes E. Cognitions 24.

Therapists should specifically focus on discussing clients’ goals at the __________ of an intake interview. A. Beginning B. Middle C. End D. Whenever the therapist thinks he/she understand the client’s problems best E. Both A and C

25.

Toward the end of an intake interview, it is important to: A. Encourage the client to disclose memories he or she may have been avoiding. B. Offer the client a provisional diagnosis. C. Review client goals and encourage the client to focus on personal strengths and resources. D. Do all of the above. E. Do none of the above.

26.

Therapists practicing from a _________ theoretical orientation are less likely to make use of client registration forms, computerized interviewing procedures, or standardized questionnaires. A. Person-centered B. Psychoanalytic C. Behavioral D. A and B E. B and C

27.

When conducting brief intake interviews, therapists must make three primary modifications. Which of the following is NOT one of those modifications? A. Therapists must limit their use of questions. B. Therapists must rely more heavily on information from client registration forms. C. Therapists must spend less time collecting information about personal history. D. Therapists must restrict the time allowed for client self-expression. E. Only A and B.

28.

When writing an intake report, therapists must consider all of following dimensions, EXCEPT: A. Keeping the report confidential. B. Writing clearly and concisely. C. Choosing the structure and content of the report. D. Sharing the report with the client. E. All of the above must be considered.

29.

The intake report must be written for a diverse audience, including all of the following EXCEPT: A. The client’s insurance company. B. The state and local ethics board. C. The client’s family and friends . D. The client’s attorney. E. All of the above would be included.

30.

Which of the following statements is true of the intake report? A. It begins with diagnostic issues and later includes relevant historical information. B. It will always include a complete mental status report. C. It begins with more objective data and later includes more subjective judgments and recommendations. D. It should not include a client’s medical history. E. B and D are both true.

Answers 1. C 2. C 3. D 4. B 5. B 6. A 7. C 8. B 9. C 10. E 11. C 12. B 13. A 14. B

15. D 16. C 17. B 18. D 19. E 20. A 21. C 22. A 23. C 24. E 25. C 26. D 27. A 28. E 29. C 30. C

TEST QUESTIONS FOR CHAPTER 9 THE MENTAL STATUS EXAMINATION 1.

Which of the following is the PRIMARY purpose of the mental status exam? A. To make a firm diagnosis of the client’s problem. B. To accurately evaluate the client’s current cognitive processing. C. To gather enough information to be able to refer the client. D. To plan treatment for the client. E. All of the above

Which of the following describes a situation in which the administration of a mental status exam is appropriate? A. For clients with a desire to know their intelligence level. B. For all outpatient clients. C. When there is an indication of significant client psychopathology. D. Whenever a client has spent time in a medical setting. E. All of the above are appropriate

Why is the mental status examination useful? A. It is a standardized procedure for organizing clinical observations. B. It allows clinicians to establish hypotheses about current cognitive functioning. C. It allows mental health professionals to communicate information about clients in a format that is universally understood within psychiatry and medicine. D. All of the above are true. E. Only B and C are true.

Which statement is true when applied to studying humans? A. It is possible to have complete objectivity but not complete emotional neutrality. B. It is possible to have complete emotional neutrality but not complete objectivity. C. It is not possible to have complete objectivity or complete emotional neutrality. D. The MSE allows for an unbiased and objective assessment. E. None of the above is true.

Care should be taken when using MSEs with clients from diverse cultures because: A. Specific cultural beliefs, especially spiritual beliefs, can sound like madness (or delusions) to outsiders B. MSEs are likely to underestimate psychopathology for minority group members C. Minority group IQ scores are notoriously low D. Minority group members don’t have specific mental deviances, such as perceptual disturbances E. All of the above are true

What strategy is recommended as a way for clinicians to resist the temptation of making single symptom generalization? A. Dynamic sizing

B. Scientific mindedness C. Cultural specificity D. Mindfulness meditation E. Cardio workouts 7.

Carlos meets with a new client. The client is unshaven. Which of the following is a reasonable hypothesis for Carlos to make? A. The client is obviously depressed B. The client is obviously a movie star C. More information is needed before Carlos can make a reasonable hypothesis D. The client will need social skills training E. Carlos needs to shave less to be able to have rapport with this client

What strategy is recommended as a way for clinicians to resist the temptation of making single symptom generalization? A. Dynamic sizing B. Scientific mindedness C. Cultural specificity D. Mindfulness meditation E. Cardio workouts

The authors offer which of the following guidelines for avoiding making inappropriate overgeneralizations based on minimal symptoms? A. When you notice a single-symptom of particular interest, begin the scientific mindedness process B. Remember that hypotheses are not conclusions C. Consult with supervisors/colleagues before making wild inferential leaps D. All of the above E. Only A and B

10.

Which of the following is NOT an area of client functioning that’s included during a mental status exam? A. Appearance B. Memory and intelligence C. IQ score D. Perceptual disturbances E. All of the above must be assessed during a mental status exam

11.

Which physical characteristics are commonly noted on a mental status exam? A. Personal grooming B. Mustache style C. Make-up D. Tattoos and piercings E. All of the above and more

12.

Which of the following statements is/are true?

A. Dilated pupils are sometimes associated with drug intoxication B. Pinpoint pupils are sometimes associated with drug withdrawal C. Mustache style predicts personality disorder D. All of the above E. Only A and B 13.

What behavioral or psychomotor activities do mental status examiners take note of? A. Physical behavior isn’t a part of the MSE B. Eye movements C. Excessive body movements D. All of the above E. Only B and C

14.

“Attitude toward the examiner” refers to: A. The client’s feelings toward the examiner. B. How the client behaves in relation to the examiner. C. The type of language the client uses with the examiner. D. The client’s opinions of the examiner. E. All of the above

15.

When interviewing a client and making a judgment of the client’s attitude, the clinician should do which of the following? A. Realize that an aggressive attitude is very common. B. Judge the attitude only by the client’s words. C. Exercise caution before labeling the client. D. Try to stir the client’s feelings up to see the reaction. E. Both A and B

16.

Sophie is interviewing a new client. Sometimes the client refuses to answer questions. Other times he openly disagrees with Sophie. Sophie is left feeling as if she can’t say anything that this client will agree with. Which statement might she use to describe the client’s attitude toward the examiner? A. The client’s attitude toward the examiner was seductive B. The client’s attitude toward the examiner was indifferent C. The client’s attitude toward the examiner was cooperative D. The client’s attitude toward the examiner was ingratiating E. None of the above appear accurate

17.

What is the primary difference between affect and mood? A. Affect is the client’s self-reported emotional state, and mood is the emotional state observed by the interviewer. B. Affect is the emotional tone observed by the interviewer, and mood is the client’s self-reported emotional state. C. Affect refers to thoughts as well as feelings, whereas mood refers only to feelings. D. Affect always includes a wider range of emotional states than mood does. E. Affect is more cognitive in nature than mood.

18.

“Euphoric,” “labile,” and “blunted” are words used to describe: A. Attitude B. Mood C. Affect range D. Affect content E. Cognitions

19.

An absence of emotion in clients is referred to as: A. Blunted mood B. Labile affect C. Flat affect D. Blank mood E. None of the above

20.

If a client begins crying while talking about her terminally ill son, what could the therapist conclude? A. Her affect is appropriate with respect to her speech content. B. Her mood is appropriate with respect to her speech content. C. Her behavior is consistent with her mood. D. Her affect is inappropriate with respect to the content of her speech. E. None of the above

21.

What does “la belle indifference” refer to? A. An therapist’s lack of concern for the interview. B. A condition in which clients act out a wide range of emotional states. C. A condition in which clients talk about severe problems with little emotionality. D. A condition in which clients are excessively emotional about everything. E. None of the above

22.

The evaluation of speech during a mental status exam can have implications for which of the following? A. Client thought process and content B. Possible disturbances in brain functioning C. The possibility of drug or alcohol use D. All of the above E. None of the above

23.

Which of the following is NOT used to describe client speech in a mental status exam? A. Rate B. Volume C. Amount D. Appropriateness E. Lability

24.

If a client’s speech is referred to as “pressured,” how would the client be talking?

A. Softly B. Quickly C. Loudly D. Anxiously E. None of the above 25.

Clients who resist speaking openly and are resistant to direct questioning are referred to as having: A. Speech dysprosody B. Poverty of speech C. Resistant speech D. Speech dysarthria E. None of the above

26.

Thought process constitutes the _________ of client thinking. Thought content constitutes the _________ of client thinking. A. What; how B. When; what C. How; why D. Why; what E. How; what

27.

Anthony is working with Salim, a client who speaks English as a second language. He observes repeated long response latencies. Which of the following is a reasonable hypothesis? A. Salim is being resistant or oppositional. B. Salim is engaging in thought blocking. C. Salim may be struggling to understand Anthony. D. Salim is likely depressed. E. Salim may be suffering from schizophrenia.

28.

Ideas of references are most often associated with: A. Paranoid delusions B. Somatic delusions C. Grandiose delusions D. Could be any of the above E. Only A and B

29.

Which of the following is NOT a true statement about obsessions? A. They are recurrent ideas, thoughts, and images. B. They seem rational to the one who is experiencing them. C. They are characterized by a feeling of loss of control over one’s thoughts. D. They are always considered clinically significant. E. All of the above are true

30.

Which of the following is true of delusions?

A. They are defined as false beliefs. B. They can be a healthy way to release emotions. C. They are always “delusions of grandeur.” D. They usually are very temporary or time limited due to naturally occurring discrepancies between the client’s beliefs and objective reality. E. Both B and C are true 31.

Tom tells the interviewer that stars in the sky are in fact satellites tracking his every move and reporting back to the CIA. What does Tom appear to be experiencing? A. Delusions of persecution B. Loosening of associations C. Obsessions D. Delusions of alien control E. None of the above

32.

Robinson (2007) suggests a three-part approach to questioning clients about delusions and hallucinations that includes all of the following EXCEPT: A. Greasing the wheels to make the client feel comfortable. B. Uncovering the client’s logic surrounding the delusion or hallucination. C. Pointing out evidence contrary to the delusion or hallucination. D. Determining the client’s insight concerning the delusion or hallucination. E. All of these were recommended by Robinson.

33.

Which of the following is NOT true of hallucinations? A. They can occur in any of the major sensory modalities. B. They are most often auditory. C. Clients with normal functioning never experience them. D. Their presence may indicate a mood disorder or schizophrenia. E. All of the above are true.

34.

Which of the following should you do when questioning clients about delusional or hallucinatory experiences? A. Don’t be afraid to let your personal reactions show. B. Don’t let the client off the hook about describing these experiences; probe this area diligently and aggressively. C. Adopt a neutral stance and question the client gently. D. Relate your own similar experiences to the client. E. Do your best to convince the client that their experience is not reality.

35.

Which of the following is true about flashbacks? A. They are core symptoms of post -traumatic stress disorder B. They are typically triggered by current sensory input C. They may be fleeting and mild D. All of the above are true. E. Only A and C are true.

36.

Flashbacks are a core symptom of: A. Bipolar disorder B. Post -traumatic stress disorder C. Organic brain syndrome D. Major depressive disorder E. Obsessive-compulsive disorder

37.

Which of the following is NOT related to orientation and consciousness? A. Alert or clouded B. Oriented times three C. Questions about self, place, and time D. Questions about events in the past E. These are all related to orientation and consciousness

38.

Which of the following describes the order in which disoriented clients usually become disoriented? A. Place, time, situation, person B. Situation, time, place, person C. Person, place, time, situation D. Place, person, situation, time E. There is no particular usual order of disorientation.

39.

Delirium refers to: A. Shifting consciousness B. Dissociation C. Dementia D. Loosening of associations E. Word salad

40.

Which of the following is a type of memory assessed in the mental status exam? A. Remote B. Recent C. Immediate D. All of the above E. None of the above

41.

_______________ memory refers to events, information, and people from the distant past, and ______________ memory refers to events, information, and people from the past week or so. A. Long-term; short-term B. Distant; recent C. Remote; immediate D. Long-term; immediate E. Remote; recent

42.

Confabulation presents a problem in which part of a mental status examination?

A. Assessment of remote memory B. Assessment of consciousness C. Assessment of intelligence D. All of the above E. None of the above 43.

Which of the following statements is NOT true of intelligence? A. Few people agree on one definition of intelligence. B. Nearly everyone agrees on the definition of intelligence. C. People can express their intelligence in many different ways. D. In a mental status examination, intelligence should be measured cautiously using multiple dimensions. E. All of the above are true.

44.

Which of the following do therapists focus on to assess client cognitive abilities? A. The focus is on specific social impairments. B. The focus is strictly on remote and recent memory. C. Neuropsychological tests are administered. D. Memory and general intelligence are assessed. E. Both C and D

45.

Which of the following is NOT associated with the assessment of client intelligence? A. Congeniality B. Distractibility C. Serial sevens D. Digit span E. These are all used

46.

Which of the following factors can affect performance on cognitive assessments such as digit span and serial sevens? A. Native language B. Education level C. Cultural background D. All of the above E. Only A and C

47.

Mitra is assessing Jake’s memory. After hearing Jake recall events in his childhood, she suspects that he either has a memory impairment or is fabricating stories. What could Mitra do to help her assess his remote memory? A. Ask Jake about objective events that occurred during his childhood. B. Obtain releases of information and then ask Jake’s family to confirm historical information. C. Ask Jake to count backwards by sevens from 100. D. All of the above E. Only A and B

48.

Reliability refers to: A. Adaptive decision-making B. Credibility and trustworthiness C. Understanding of one’s problems D. Disorientation E. None of the above

49.

Insight refers to: A. Adaptive decision-making B. Credibility and trustworthiness C. Understanding of one’s problems D. Disorientation E. None of the above

50.

Judgment refers to: A. Adaptive decision-making B. Credibility and trustworthiness C. Understanding of one’s problems D. Disorientation E. None of the above

51.

A therapist asks Hazel if she has any idea what might be causing her panic attacks, and Hazel states that she doesn’t really know but maybe her new kitten has something to do with it. Hazel can be said to have poor: A. Reliability B. Judgment C. Insight D. Orientation E. None of the above

Answers 1. B 2. C 3. D 4. C 5. A 6. B 7. C 8. B 9. D 10. C 11. E 12. E 13. E

14. E 15. C 16. E 17. B 18. C 19. C 20. A 21. C 22. D 23. E 24. B 25. B 26. E 27. C 28. A 29. D 30. A 31. A 32. C 33. C 34. C 35. D 36. B 37. D 38. B 39. A 40. D 41. E 42. A 43. B 44. D 45. A 46. D 47. E 48. B 49. C 50. A 51. C

TEST QUESTIONS FOR CHAPTER 10 SUICIDE ASSESSMENT 1.

If you’re working with a client who talks about suicide, the law requires that you: A. Hospitalize the client as soon as possible. B. Immediately begin calling family and relatives. C. Do whatever is in the best interests of the client, whether that means siding with life or siding with suicide. D. Conduct an assessment to see if the client is imminently suicidal and whether you have a professional duty to protect. E. Both A and D.

According to the Centers for Disease Control and Prevention, suicide rates over the past 14 years in the U.S. are: A. Rising B. Falling C. Staying steady D. Fluctuating E. Not something that can be reliably tracked

Which of the following statements about predicting suicide is the most true? A. Suicide risk factors can accurately predict suicide in most cases B. Death by suicide is essentially impossible to predict C. Suicide prediction is possible among recently hospitalized patients D. About 1% of the U.S. population will die by suicide E. None of the preceding are true

Which of the following statements about risk factors is true? A. An absence of risk factors and warning signs in individual clients is no guarantee of safety from suicidal impulses. B. An absence of risk factors and warning signs in individual clients is a good guarantee of safety from suicidal impulses. C. An absence of protective factors indicates extremely high risk of suicide D. The presence of protective factors overrides the influence of risk factors. E. Risk and protective factors are completely unhelpful to suicide prevention

The authors contend that: A. The proliferation of suicide risk factor checklists isn’t particularly helpful B. Suicide risk factor checklists are essential in predicting suicide C. What’s important is to spend time understanding suicide risk factors and how and why they contribute to suicide risk D. Suicide risk and protection is a mental health myth E. Both A and C

Which of the following mental disorders were listed as conferring greater suicide risk?

A. Depression B. Post-traumatic stress disorder C. Bipolar disorder D. Schizophrenia E. All of the above 7.

Which of the following is/are NOT a risk factor associated with death by suicide? A. Marital status B. Physical health C. Birth order D. The weather E. Both C and D

Which of the following is NOT listed by the authors as a suicide risk factor for people diagnosed with schizophrenia? A. Having a higher education level B. Being female C. Active hallucinations and delusions D. Family history of suicide E. Presence of insight into one’s problems

In the context of other mental disorders _____________ has long been known to increase suicide risk. More recent data indicates this problem is also an independent risk factor. A. High externalizing behavior B. High internalizing behavior C. Hypersomnia D. Insomnia E. Nightmares

10.

Which of the following psychiatric medication types has been identified as contributing to suicidality? A. Serotonin Specific Reuptake Inhibitors B. Analgesics C. Benzodiazipines D. Anticonvulsant medications E. Psychiatric medications don’t contribute to increased suicidality

11.

Sam comes to an interview and he’s single and never married. Based only on this information, which statement most accurately expresses his suicide risk? A. He’s at the same risk as married males B. He’s at twice the risk of married males C. He’s at twice the risk of married females D. He’s at half the risk of married males E. This information isn’t related to suicide risk

12.

Marcy is engaging in repeated and increasingly dangerous self-harm. Which statement is true about her suicide risk? A. Her risk is low B. Her risk is low because self-harm is related to emotional regulation and not suicidality C. Her risk is high because she may be experimenting with suicide D. Her risk is unknowable E. Both A and B are true

13.

For people admitted to the hospital because of a mental disorder, the period of time __________ discharge carries increased suicide risk. A. During B. Directly before C. Directly after D. 1 month after E. All of the above carry the same level of risk

14.

Which of the following psychiatric treatments may increase suicide risk? A. Treatment with SSRI antidepressants. B. Cognitive-behavioral therapy. C. Discharge from a psychiatric hospital. D. None of the above will increase suicide risk. E. Both A and C can increase risk.

15.

Which of the following factors is/are associated with an increased suicide risk? A. Alcohol abuse/dependence B. Anorexia nervosa C. Social trauma and bullying D. Borderline personality disorder E. All of the above

16.

Which of the following is an example of a protective factor? A. Frequent religious service attendance B. Social trauma and bullying C. Higher global functioning D. All of the above E. Only A and C

17.

Bonnie is a male-to-female transgender adult. Which of the following factors is likely a protective factor against suicide? A. Moderate alcohol use B. Religious affiliation C. Coming out or disclosing her transgender identity D. Physical exercise E. All of the above

18.

The “P” in the acronym IS PATH WARM represents which suicide warning sign? A. Plan B. Proximity C. Purposelessness D. Place E. None of the above

19.

IS PATH WARM is an acronym for remembering suicide warning signs and has: A. Strong predictive validity B. Good validity, but poor reliability C. Minimal empirical support D. An inverse relationship to suicidal behaviors E. None of the above

20.

Which of the following factors did Shneidman posit as contributing to suicidality. A. Psychache B. Mental Constriction C. Perturbability D. All of the above E. Only A and C

21.

Mental constriction is best thought of as a: A. Problem-solving deficit B. Form of agitation C. Form of psychic pain and suffering D. Any of the above could be the essence of mental constriction E. Only A and C

22.

According to Joiner’s interpersonal theory of suicide, why might factors such as unemployment, divorce, and widowhood increase an individual’s suicide potential? A. They are socially embarrassing events. B. They result in a downward spiral of self-blame and depression. C. They result in a diminished sense of belongingness and a self-perception of being a burden to others. D. They result in feelings of hopelessness and a lack of self-worth. E. All of the above

23.

Which of the following interpersonal factors did Joiner (2005) propose as proximal causes of suicidal intent? A. Thwarted belongingness (social isolation) B. Perceived burdensomeness C. Thwarted retribution D. Agitation E. Only A and B

24.

When it comes to suicide assessment and treatment, the authors emphasize that clinicians should: A. Adhere to the medical model for understanding and treating suicide ideation B. Have a stronger emphasis on clients’ strengths, resources, and potentials. C. Move away from illness-based weaknesses, deficits, and limitations and instead D. Both A and B E. Both B and C

25.

Which of the following is a risk associated with using the medical model when working with suicidal clients? A. Holding the belief that suicide ideation is pathological can create distance between clinician and client B. If clients sense negative judgments, they’ll be more open and honest about their suicidal thoughts C. The medical model allows both clinician and client to work more effectively on the problems leading to the suicidal impulses D. The medical model helps create closeness and connection between clinician and client E. Only B and C

26.

Monique has an attitude that enables her clients to speak openly with her about their suicidal thoughts and plans. What beliefs does she hold? A. She wants her clients to share their suicidal thoughts B. She believes deeply in the medical model C. She encourages her clients to use antidepressant medications D. All of the above E. Only B and C

27.

Which of the following might steer individuals toward a more depressive mood state? A. Watching too many television commercials advertising antidepressants. B. When clinicians focus excessively on and overemphasize depressive and suicidal thoughts and behaviors. C. Engaging in too many social activities D. All of the above E. Only A and B

28.

Obtaining a verbal or written contract from a suicidal client should be done within the context of which of the following? A. Hospitalization B. Residential treatment C. Private practice settings D. A medical setting E. None of the above, no-suicide contracts are not considered appropriate.

29.

Jobes (2007) developed a model for suicide assessment known as CAMS (collaborative assessment and management of suicidality). Which of the following statements is NOT true of the CAMS approach? A. The CAMS approach has both empirical and theoretical support. B. Clients are seen as the experts on their suicidal thoughts. C. Suicidal behaviors are seen as representing a deviant mental state requiring medical intervention. D. Client and interviewer work together to develop an individualized treatment plan. E. All of the above are true

30.

Noriko wants to follow the gold standard for assessing suicide risk. Which approach will she use? A. A comprehensive and collaborative suicide assessment interview B. The Beck Hopelessness Scale C. The Beck Depression Scale D. The Columbia Teen Screen E. Only B and C

31.

Ned is a very skilled interviewer. Which of the following methods for assessing suicide ideation is he LEAST likely to use? A. Directly ask: “Have you been thinking about suicide?” B. He will use a normalizing frame C. He will use gentle assumption D. He will ask about mood using a rating scale with a suicidal floor E. All of the above are equal in sophistication

32.

Which of these is an example of a normalizing frame? A. “I’ve read that up to 50% of teenagers have thought about suicide. Is that true for you?” B. “When was the last time when you had thoughts about suicide?” C. “Have you been thinking about suicide recently?” D. “Please rate your mood right now, using a zero to 10 scale” E. None of these

33.

Which of these is an example of gentle assumption? A. “I’ve read that up to 50% of teenagers have thought about suicide. Is that true for you?” B. “When was the last time when you had thoughts about suicide?” C. “Have you been thinking about suicide recently?” D. “Please rate your mood right now, using a zero to 10 scale” E. None of these

34.

Dan’s client admits to having suicidal thoughts. First off, Dan should: A. Call 9-1-1 B. Empathically validate and normalize his client’s disclosure C. Ask the client who would be a good person to contact about this information

D. Recommend antidepressant medications E. Administer the Beck Hopelessness Scale 35.

Theresa asks her client, “How long do these suicidal thoughts stay with you once they start?” What is she trying to assess? A. Suicide ideation frequency B. Suicide ideation duration C. Suicide ideation intensity D. Suicide ideation triggers E. Suicide ideation safety plan

36.

Anhedonia refers to: A. Loss of interest and pleasure in usually enjoyable activities B. Loss of interest in psychotherapy C. Depressive physical symptoms related to eating and sleeping D. No words for emotion E. No words to describe sadness

37.

Neurovegetative signs of depression include: A. Loss of interest and pleasure in usually enjoyable activities B. Loss of interest in psychotherapy C. Depressive physical symptoms related to eating and sleeping D. No words for emotion E. No words to describe sadness

38.

Which of the following symptoms is NOT a physical symptom of depression? A. Unintentional weight loss B. Insomnia C. Hypersomnia D. Hyperventilation E. All of the above are physical symptoms of depression

39.

Which cognitive factor is most strongly associated with increased suicidality? A. Hopelessness B. Automatic thoughts C. Internal locus of control D. Low self-efficacy E. None of the above

40.

Which of the following is a one of the cognitive triad of depression symptoms? A. Negative thoughts about the self, B. Negative thoughts about others C. Negative thoughts about the future D. All of the above E. Only A and B

41.

When conducting a suicide assessment, you find your client has no suicide risk factors; what should you do? A. Discontinue the suicide assessment because the client is not at risk. B. Seek information from the client’s family to confirm the absence of risk factors. C. Continue with the assessment and remain attuned to possible suicidal impulses. D. Continue with the assessment with full confidence that the client is unlikely to be at risk of suicide. E. None of the above

42.

Tracy states to her therapist that she has always felt like ending her life for as long as she can remember and she doesn’t think that she will ever feel differently. She states that nothing in the world could make her feel any better. What important cognitive symptom of depression is Tracy expressing? A. Worthlessness B. Preoccupation C. Hopelessness D. Guilt E. None of the above

43.

The acronym SLAP provides an easy way to remember four areas of inquiry into a client’s _________________. A. Suicide ideation B. Suicide plan C. Suicide risk factors D. Self-control E. Self-esteem

44.

When an therapist asks a client how she intends to kill herself, for example with firearms or by using pills, which of these is the therapist NOT assessing? A. Lethality of the method B. Extent of suicidal intent C. Differential activation D. Specificity of the plan E. None of the above

45.

Which of the following is a component that’s included in an assessment of client selfcontrol? A. A direct question about client self-perception of self-control B. Observation for agitation C. Determination of hopelessness D. Both A and B E. Both B and C

46.

Suicide intent is usually evaluated __________ a suicide attempt. A. Following B. Preceding

C. During D. All of the above E. None of the above 47.

Previous attempts are considered: A. The strongest of all suicide predictors B. Something to avoid talking about C. Something that should always be discussed in grueling detail D. Irrelevant to suicide assessment E. Both A and C

48.

What should you do if your client states: “Nothing helped. Nothing ever helps.” A. Ask about lethality and firearms B. Ask “Yes-no” questions about what has helped and not helped C. Avoid “Yes-no” questions and use a continuum to assess what has helped more or less D. More or less focus on the positive, because it’s obvious that your client is incapable of doing so. E. Panic and let your client you need to take a break to call your supervisor

49.

Which of the following is an example of outside information that can be used to initiate risk and protective factor assessment? A. Client Records B. Assessment Instruments C. Collateral Informants D. All of the above E. Only A and C

50.

What’s the first rule of working therapeutically with suicidal clients? A. Listen and be empathic B. Use standardized assessment instruments C. Make referrals early and often D. Develop a safety plan E. Identify alternatives to suicide

51.

According to Shneidman’s theory, the primary thought disorder in suicide involves the following: A. The client is suffering from paranoid thinking. B. The client has narrowed his or her focus, seeing only two choices— enduring something terribly painful, or death. C. Death is always seen as impermanent to a suicidal person. D. Both A and C are correct. E. Both B and C are correct.

52.

If a client states that there’s no hope and he feels like killing himself, a good intervention strategy includes which of the following?

A. Talk about the finality of death and the moral issues at stake. B. Agree that suicide is one choice, but that there are many other options as well. Then try to explore these other options. C. Ask the client to complete a questionnaire. D. Ask about firearms. E. These are all bad ideas. 53.

Instead of the traditional no-suicide contracts, contemporary approaches to suicide intervention emphasize: A. Hospitalization B. Commitment to individualized treatment or safety plans C. Medication D. A and C E. None of the above

54.

Which suicide intervention approach is based on the idea that many suicidal clients really desires to eradicate the feelings of intolerable pain rather than to eradicate the self? Hospitalization A. Separating the psychic pain from the self B. Alternatives to suicide C. Safety planning D. Neodissociation E. Becoming directive

55.

Some clinicians are not well-suited to working with suicidal clients. Which of the following individuals might want to avoid working with a lot of suicidal clients? A. An individual who suffers from depression. B. An individual with strong religious beliefs against suicide. C. An individual with strong pro-suicide philosophical beliefs. D. All of the above. E. Only A and B

56.

Which of the following need not be thoroughly documented when working with a suicidal client? A. The fact that you consulted with other professionals. B. The fact that you obtained historical information about the client. C. The fact that you provided the client with resources (i.e., hotline number). D. You should document all of these actions. E. Only B and C

Answers 1. D 2. A 3. B

4. A 5. E 6. E 7. E 8. B 9. D 10. A 11. B 12. C 13. C 14. E 15. E 16. E 17. C 18. C 19. C 20. D 21. A 22. C 23. E 24. E 25. A 26. A 27. B 28. E 29. C 30. A 31. A 32. A 33. B 34. B 35. B 36. A 37. C 38. D 39. A 40. D 41. C 42. C 43. B 44. C 45. D 46. A 47. A 48. C 49. D 50. A 51. B

52. B 53. B 54. A 55. D 56. D

TEST QUESTIONS FOR CHAPTER 11 DIAGNOSIS AND TREATMENT PLANNING 1.

Which of the following are the two main systems for diagnosing mental disorders in the U.S.? A. The PDM and ICD B. The ICD and DSM C. The DSM and RDoc D. The RDoc and ICD E. The DSM is the sole authoritative guide

Which statement(s) is/are true of the Diagnostic and Statistical Manual of Mental Disorders? A. It’s the authoritative guide for all mental health professionals throughout the United States. B. It has been phased out; the DSM-IV-TR was the final edition C. The new edition provides detailed treatment plans for most major mental disorders. D. Both A and C are true of the DSM. E. None of the above are true

Which statement(s) is/are true of the relationship between the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases10-CM? A. These are equivalent manuals and either can be used. B. The DSM-5 is the standard in the U.S. C. The ICD-10-CM codes should be used and both manuals can be used to aid in diagnosis D. The ICD-11 is now the appropriate manual to use for mental disorder diagnosis E. Both A and C are true

What is true regarding the use of the terminology mental illness and mental disorder in the DSM and ICD systems? A. The DSM and ICD authors view mental illness as more problematic terminology. B. Both terms are used interchangeably C. Mental illness is the preferred terminology D. Mental disorder isn’t used because it’s too vague E. Both C and D are true

Which of the following is/are NOT part of the formal DSM definition of mental disorder? A. Subjective distress B. Nonconforming social behavior C. Disability or impairment in functioning D. All of the above are part of the DSM definition of mental disorder. E. Both B and C are not part of the DSM definition of mental disorder.

Miguel’s client, Thomas, has been arrested many times for protesting political and religious freedoms. Assuming that his social deviance is NOT caused by a personal dysfunction, what is his appropriate diagnosis? A. Oppositional defiant disorder B. Conduct disorder C. Adjustment disorder with a disturbance in conduct D. No diagnosis is appropriate E. Either A or B would fit

Maxine is a mental health provider. She hates diagnosis, but she uses it anyway because of some of the benefits of using diagnostic systems: A. It helps her predict her clients’ prognosis B. She finds it helps her and her clients to closely monitor specific symptoms and diagnostic indicators C. She uses it to communicate with other professionals D. All of the above E. Only B and C are benefits of using diagnosis

Caitlin is one of Maxine’s clients. After Maxine worked collaboratively with her to identify an appropriate diagnosis of Panic Disorder, which positive outcome was Caitlin most likely to feel? A. Relieved that what she was experiencing had a name or label B. Happy to be hospitalized C. Pleasantly surprised by an immediate recovery D. Happy to have a label that would stay with her for a long time E. There are no positive outcomes associated with diagnosis

Practical advantages of diagnosis include which of the following? A. It can be a relief for clients to have their problems named and defined. B. It allows practitioners to communicate efficiently with other professionals and insurance companies. C. It is a working hypothesis that can be tested with appropriate use of theories, techniques, and interventions. D. All of the above are correct. E. Both B and C are correct.

10.

Which of the following is NOT a symptom of Generalized Anxiety Disorder? A. Apprehension B. Motor tension C. Auditory hallucinations D. Blank mind or problems with concentration E. These are all symptoms of Generalized Anxiety Disorder

11.

When a client is presenting with confusing symptom clusters, therapists must tease out possible __________ in order to establish an accurate diagnostic label. A. Client misinformation

B. Interviewer countertransference C. Differential diagnoses D. Confounding cultural factors E. All of the above 12.

Which of the following factors do(es) NOT present a problem when trying to establish an accurate diagnosis for clients? A. Clients may not be honest. B. Diagnostic comorbidity. C. Confounding cultural factors. D. Interviewer countertransference. E. All of the above factors present a problem

13.

A semi-structured interview is best described as: F. A predetermined series of questions, followed by unplanned questioning or an exploration period A. A tight protocol wherein clinicians ask a series of predetermined questions B. A loosely structured interview where the clinician asks only a few pre-determined questions C. Could be A or C D. None of the above

14.

The central focus of structured or semi-structured diagnostic interviews is on: A. Establishing rapport with new clients B. Gathering reliable and valid data to support accurate mental disorder diagnoses C. Identifying the client’s core conflictual relationship theme D. Exploring the BASIC I.D. E. None of the above

15.

The Hamilton Rating Scale for Depression (HSRD) is an example of: A. A circumscribed structured or semi-structured diagnostic interview protocol B. A core values assessment protocol C. A broad or comprehensive interview protocol D. A depression scale that actually is more effective in identifying anxiety E. An unreliable interview protocol

16.

The SCID-I is a good example of a: A. Circumscribed structured and semi-structured diagnostic interview protocols B. A core values assessment protocol C. A broad or comprehensive semi-structured diagnostic interview D. A depression scale that actually is more effective in identifying anxiety E. An unreliable interview protocol

17.

Which of the following is true about the SCID-I? A. There are separate research and clinical versions available B. It is a good example of a loosely structured or unstructured interview

C. It’s not used much among practitioners D. Only A and B E. Only A and C 18.

Which of the following is/are true regarding the science of diagnostic interviewing? A. The current DSM diagnostic criteria are marginally more reliable and valid than the original DSM previously published criteria. B. If you stick closely with the DSM criteria, you have a better chance of producing a reliable diagnosis. C. Formal training in diagnostic procedures increases your chances of producing reliable diagnoses. D. All of the above are true. E. Only A and C are true

19.

Advantages of structured diagnostic interviewing include which of the following? A. Generally higher inter-rater reliability B. Being well suited for scientific research C. Fast administration D. A and B are correct. E. All of the above are true.

20.

Disadvantages associated with structured diagnostic interviews include all of the following EXCEPT: A. They are not very suitable for scientific research. B. They require a lot of time to administer. C. They de-emphasize rapport building. D. They exclude important information about client personal history and personality. E. There are no disadvantages.

21.

Concerning reliability and validity of interview procedures, which of the following statements is true? A. If an interview procedure is reliable, it’s unlikely to be valid. B. A valid interview procedure will consistently produce the same results. C. It is possible for an interview procedure to be very reliable but invalid. D. A highly reliable interview procedure will produce more accurate results than a highly valid interview procedure. F. Both B and C are true

22.

Which of the following components is LEAST likely to be included in a diagnostic interview? A. An introduction characterized by warmth and active listening. B. An analysis of the client’s problem. C. A review of the client’s symptom history. D. A discussion of potential intervention strategies. E. All of the above must be included.

23.

Phillip complains to his therapist, Angelique that he’s been depressed lately. Which of the following is a reasonable next step for Angelique in her assessment of Phillip? A. Clients are usually correct in their self-diagnoses, so it’s safe for her to conclude that Phillip suffers from depression B. She could administer the Hamilton Rating Scale as a method for gathering additional information. C. She should consider Phillip’s input, but also continue gathering information about Phillip’s various symptoms, including his depressive symptoms D. All of the above E. Only B and C are reasonable options

24.

When assessing a client’s current functioning as part of a diagnostic interview, clinicians are LEAST likely to inquire about which of the following areas? A. Coping skills B. Differential activation C. Social support network D. The client’s typical day E. Personal strengths

25.

Sam told his therapist that he experiences extreme panic every time he goes to the grocery store. Sam’s therapist asks him to imagine that he is going grocery shopping while he is in the interview room, so that he can observe Sam’s behavior. What is the therapist trying to assess by doing this? A. Sam’s current anxiety level B. Sam’s social skills C. Sam’s coping skills D. Sam’s personal strengths E. All of the above

26.

Many people believe that diagnosing individuals is dehumanizing because it attaches labels to individuals, ignoring their unique characteristics. This is sometimes referred to as: A. Derealization. B. Depersonalization. C. Pigeonholing. D. Diagnostic proliferation. E. None of the above.

27.

Which of the following can be used for gathering diagnostic-relevant information? A. Diagnostic interviewing B. Physical examinations C. Projective techniques D. All of the above can be used for gathering diagnostically relevant information. E. Only A and C can be used for gathering diagnostically relevant information.

28.

The authors note that one consistent problem with the biopsychosocial model is that:

A. Medication treatments are downplayed B. Biomedical case formulations and treatments dominate C. There’s an overemphasis on the psychological domain D. There’s an overemphasis on the social domain E. No one uses the biopsychosocial model 29.

Becca comes for therapy and has several symptoms of Moderate Depressive Disorder. Which of the following would be a reasonable treatment goal? A. Elevate or improve Becca’s mood B. Increase Becca’s interest and enjoyment in recreational activities C. Reduce Becca’s initial insomnia D. All of the above E. The only reasonable goal is to eliminate Moderate Depressive Disorder

30.

To be labeled an empirically supported treatment (EST), the treatment must: A. Be manualized B. Have client testimonials based on qualitative research C. Be cognitive-behavioral D. Show itself superior to placebo controls or another treatment in one well-controlled study E. Both A and C

31.

Which of the following might arise as a problem or complicating factor in matching ESTs to client diagnosis in your clinical work? A. There are comorbid conditions that complicate treatment selection B. Your client is opposed to using an EST C. You’re not trained in an EST connected to your client’s diagnosis D. Culture or ethnicity complicates the straightforward application of an EST E. All of the above may complicate the application of an EST

32.

Research has shown that client preferences for treatment type and therapist type are: A. Unrelated to therapy outcomes B. Inconsistent and immeasurable C. Significantly associated with improved outcomes and decreased drop-out rates D. Ironically related to poorer outcomes E. There’s no research on this topic

33.

Charlie has a new client who behaves in ways that appear “resistant.” Based on his knowledge of Beutler, Harwood, Michelson, Song, and Holman’s (2011) meta-analysis, Charlie should probably: A. Use tasks that “bolster patient control and self-direction” B. Use “rigid and graded homework assignments” C. Present homework assignments as mandates D. Provide more education to his client E. Provide more and repeated instructions

34.

Overall, research has shown that when clients are more resistant or opposed to therapy, clinicians should: A. Become more directive B. Consider using motivational interviewing techniques C. Avoid rigid homework assignments D. Both A and B E. Both B and C

35.

Which matching variables are likely to improve treatment outcomes? A. Matching religious clients with secular-only therapy B. Matching resistant clients with directive therapy C. Matching religious clients with religious or spiritually-oriented therapy D. Both A and B E. Both B and C

36.

Whether to integrate spiritual or religious content into therapy should be done based on: A. The desires and needs of the therapist B. The desires and needs of the client C. The reactance level of the client D. The client’s coping style E. None of the above

37.

Larry is a new client. He is an “externalizer.” Which therapy approach is the best fit for him? A. A religious or spiritual approach B. A skill-building therapy C. An approach that focuses on symptom reduction D. Both A and B E. Both B and C

38.

Internalizing clients tend to respond best to which approach? A. A religious or spiritual approach B. A skill-building therapy C. An approach that focuses on symptom reduction D. All of the above are equal E. None of the above is a good match

39.

Research on positive expectations in therapy yielded which of the following recommendations? A. Assess client outcome expectations at the beginning of therapy B. Use gentle, empathic, but positive statements about likely outcomes C. Notice and comment on previous or in-session client accomplishments D. All of the above E. Only A and C

40.

When it comes to culture and therapy, research has shown that the most effective treatments tend to be: A. Spiritually oriented B. Those with greater numbers of cultural adaptations C. Those that emphasize a medical or biomedical approach D. Offered by older therapists E. A and D in combination is the best answer

41.

Based on a meta-analysis, which recommendations for cultural adaptation were provided: A. Align treatment with clients’ cultural background B. Conduct therapy in the client’s native or preferred language C. Make efforts to align therapy with client culture along multiple dimensions D. All of the above E. Empirically supported treatments are consistently the treatment of choice with clients from diverse cultures

42.

Which of the following do the authors claim is the “bridge” between client diagnosis and specific treatments? A. Collaboration B. Therapeutic alliance C. Case formulation D. A and B E. None of the above

43.

Person identified four case formulation steps from the CBT perspective. Which of the following is NOT one of those steps? A. Create a problem list B. Identify possible mechanisms causing the problems C. Consider how much current distress the client is experiencing D. Identify triggers that currently activate the problem E. Consider historical origins of the client’s problem

44.

Which of the following is/are a step(s) identified by Person for determining mechanisms underlying specific problems? A. Select a symptom to focus on B. Select a theory to explain the symptom C. Use your theory to extrapolate to the individual case D. All of the above E. Only B and C

45.

In the “Case of Michael,” which of the following is an example of a problem? A. Michael’s distorted, maladaptive beliefs. B. Designing a hierarchy of Michael’s feared situations. C. Normalizing social anxiety D. Both A and B E. Both B and C

46.

In the “Case of Michael,” which of the following is an example of an intervention? A. Michael’s distorted, maladaptive beliefs. B. Designing a hierarchy of Michael’s feared situations. C. Normalizing social anxiety D. Both A and B E. Both B and C

47.

The Cultural Formulation Interview (CFI) is a: A. Semi-structured interviewing protocol to aid in diagnostic assessments. B. Method for assigning clinical diagnoses C. A depression-oriented interview designed to aid in diagnosis D. Both A and B E. Both B and C

Answers 1. B 2. E 3. C 4. A 5. B 6. D 7. D 8. A 9. D 10. C 11. E 12. E 13. A 14. B 15. A 16. C 17. E 18. D 19. D 20. A 21. C 22. D 23. E 24. B 25. C 26. C 27. D 28. B 29. D 30. A 31. E 32. C

33. A 34. E 35. C 36. B 37. E 38. E 39. D 40. B 41. D 42. C 43. C 44. D 45. A 46. B 47. A

TEST QUESTIONS FOR CHAPTER 12 CHALLENGING CLIENTS AND DEMANDING SITUATIONS 1.

Which of the following statements is NOT true of client resistance? A. Freud believed that resistance was inevitable and occurred in virtually all clients. B. The clients themselves are always solely responsible for resistance. C. Some contemporary practitioners and writers believe that resistance does not exist. D. Therapist behavior can sometimes produce resistance in clients. E. All of the above are true

Traditionally, signs of client resistance included: A. Talking too much. B. Talking too little. C. Being unprepared for psychotherapy. D. All of the above. E. Only A and B.

Which therapy approach views resistance as an unhelpful linguistic creation that developed because sometimes clients don’t want to do what their “bossy-pants” therapists want them to do? A. Solution-focused therapists B. Psychoanalytic therapists C. Person-centered therapists D. Cognitive-behavioral therapists E. Jungian therapists

From the motivational interviewing approach of Miller and Rollnick (2013), a key concept in understanding why clients might be resistant to change is: A. They are in the contemplation stage. B. They are in the precontemplation stage. C. They are ambivalent. D. They are not yet customers for change. E. None of the above

In the text it is emphasized that resistance can emanate from: A. The client B. The therapist C. The situation D. All of the above E. Only A and B

In the text it is emphasized that resistance is: A. Natural B. Unnatural

C. Always the clinician’s fault D. Obvious E. Only A and D 7.

“Natural resistance” refers to: A. Client resistance to something that is natural and good in his or her life. B. Therapist resistance to working with clients who do not want to be in therapy. C. Client resistance that stems from being in an uncomfortable situation but that also acknowledges the fact that clients are behaving in ways that challenge the therapist. D. Client resistance to paying for psychotherapy. E. None of the above.

Autumn says to her interviewer, “I should quit smoking because smoking is expensive and unhealthy.” According to the motivational interviewing model, Autumn also might be having an ambivalent thought like: A. I should keep smoking because it’s pleasurable and gives me good feelings B. Smoking is an unnatural act C. Smoking will motivate me to get a better job D. Being unhealthy will be expensive E. Only A and D

Which of the following is the central MI hypothesis for resolving client ambivalence and activating motivation? A. Therapists stimulate motivation through lecturing clients B. Therapists should stay completely nondirective and let clients discover their own motivation C. The client should be voicing the arguments for change D. Confrontation stimulates change E. Therapists must voice the arguments for change

10.

Which of the following is NOT an example of a goal-oriented question? A. “What would make this a helpful visit?” B. “If we have a great meeting today, what will happen?” C. “What would need to happen for this to be productive?” D. “What would you like to talk about today?” E. All of the above are goal-oriented questions

11.

One rule (or rhythm) about open questions when using motivational interviewing is: A. Use three times as many questions as reflections B. Ask an open question and then reflect what the person says, perhaps two reflections per question C. Use one question and one reflection and one question and so on. D. Ask no more than one question per minute E. There are no rules about open questions in motivational interviewing

12.

Miller and Rollnick claim that which of the following can be “deadly for engagement?”

A. Using repeated open questions B. Chaining together a series of closed questions C. Chaining together a series of reflections D. Mixing more reflections than questions into an interview E. Both C and D 13.

Sometimes when working with resistant clients, therapists intentionally overstate the client’s position in an effort to get clients to clarify or articulate the more positive side of an issue. Motivational interviewers refer to this technique as: A. Motivational reflection. B. Motivational paraphrase. C. Amplified reflection. D. Extreme reflection. E. Confrontation

14.

Amplified reflection involves: A. Intentionally overstating the client’s main message B. Intentionally emphasizing or amplifying the healthy side of the client’s ambivalence C. Strengthening the healthy side of the client’s ambivalence D. Using microphones and recordings in an interview for playback and review E. Both B and C

15.

Undershooting involves: A. Intentionally overstating the client’s main message B. Intentionally emphasizing or amplifying the healthy side of the client’s ambivalence C. Strengthening the healthy side of the client’s ambivalence D. Using microphones and recordings in an interview for playback and review E. None of the above

16.

What term do Miller and Rollnick use to describe paradox? A. Coming alongside B. Amplified reflection C. Undershooting D. Concession E. Radical acceptance

17.

Which of the following is an example of emotional validation or feeling validation? A. “It pretty much sucks that the judge required you to come and see me.” B. “What brings you here?” C. “How would you feel if we just ignore the judge’s order and you don’t have to come to therapy?” D. “It’s time for you to get serious about getting your life in order.” E. “Are you aware of how much harm you’ve caused your loved ones?”

18.

At the beginning of his first appointment, Bobby says to his interviewer, “I’m not talking and you can’t make me.” Bobby’s interviewer’s response, “You’re absolutely right—I

sure can’t make you talk,” is an example of which of the following? A. Amplified reflection B. Reflection of feeling C. Feeling validation D. Concession E. None of the above 19.

_____________________ involves the therapist’s efforts to accept and welcome all client comments, even hostile or provocative comments. A. Radical validation B. Emotional acceptance C. Radical acceptance D. Coming alongside E. None of the above

20.

Which technique is characterized by the statement, “Thank you for being honest with me and telling me what you really think”? A. Emotional validation B. Amplified reflection C. Coming alongside D. Radical acceptance E. Confrontation

21.

Allen’s client is hostile toward him from minute one in the interview. Allen’s response is: “Thanks for being so honest about how you feel about being here. I appreciate you just telling me directly what you think of me and of counseling. Which technique is Allen using? A. Coming alongside B. Amplified reflection C. Undershooting D. Concession E. Radical acceptance

22.

Mika says, “Yes it’s true that coming to counseling is a hassle and I hear you saying that you don’t want to be here. But can I just be totally blunt and direct with you for a moment?” Which technique is Mika preparing to use? A. Coming alongside B. Amplified reflection C. Undershooting D. Genuine feedback E. Radical acceptance

23.

Which of the following therapist responses would NOT be appropriate with a hostile client? A. Genuine feedback B. Lecturing

C. Emotional validation D. Reframing E. All of the above are appropriate 24.

When working with clients who may be lying, it’s important for therapists to use which of the following principles? A. Ignore the possibility of deceit and proceed as usual. B. Tell the client, “I believe you.” C. Let your client know that you’re keeping an open mind about his or her truthfulness, but avoid becoming a judge who must determine whether the client is telling the truth. D. Directly tell the client, “I don’t believe what you’re saying.” E. Any of the above would be appropriate

25.

Which of the following basic interviewing responses is most likely to facilitate cooperation and reduce resistance? A. Confrontation B. Clarification C. Interpretation D. Suggestion E. Reflection

26.

When using motivational interviewing with substance-using clients, it is recommended that therapists do all of the following EXCEPT: A. Ask the client about a typical day or session. B. Confront the client about his or her substance use. C. Provide addiction information in a gentle, collaborative manner. D. Ask the client about past and present substance use. E. Interviewers should do all of the above.

27.

Which of the following is/are the most commonly used brief interview technique(s) for assessing for alcohol problems? A. The CAGE questionnaire B. The SASSI questionnaire C. The NIAAA criteria D. Both A and C E. None of the above

28.

How is the TRADITIONAL substance abuse interviewing approach usually described? A. As collaborative and empowering B. As directive and confrontive C. As motivational interviewing D. As clever and suggestive E. As manipulative and directive

29.

Which of the following is the clearest rationale for reporting potential violence to the authorities and warning potential victims?

A. When the client makes a specific threat. B. When the client has a history of family violence. C. When you hear about the potential for violence from an outside source. D. When your clinical intuition dictates. E. It is never ethical to break confidentiality for this reason 30.

The research suggests that the prediction of violence is: A. Simple and straightforward. B. Best predicted when clients make specific threats. C. Best predicted by actuarial approaches. D. Best predicted via clinical judgment. D. Completely unpredictable.

31.

Leonys has a client who has a history of firesetting. During the initial session, the client makes threatening remarks about getting revenge on the owner of a local business. If he becomes violent, which behavior is Leonys’s client most likely to engage in? A. He’s most likely to use a firearm to seek revenge. B. The biggest danger is that he’ll set a fire. C. There’s really no danger as the client is likely blowing smoke. D. Violence is violence; he’s likely to seek revenge, but the method is unpredictable. E. None of the above.

32.

In the large-scale Pittsburgh study, which of the following variables was associated with homicidal violence? A. Carrying a weapon B. A conduct disorder diagnosis C. Selling hard drugs D. All of the above E. Only A and C

33.

Dae-Ho has a new client with a diagnosis of schizophrenia. Which of the following statements is true? A. The client is much MORE likely to engage in violence than clients without a schizophrenia diagnosis B. The client is much LESS likely to engage in violence than clients without a schizophrenia diagnosis C. Whether the client is likely to commit violence depends on other factors, such as the intensity and frequency of the client’s psychotic symptoms D. Dae-Hos’ client is more likely to engage in firesetting E. None of the above.

34.

Without specialized training, a therapist working with people who have experienced a disaster: A. May experience vicarious trauma. B. May actually do a better job because he/she won’t be held back by rigid techniques. C. May do more harm than good.

D. Only A and B E. None of the above 35.

Which of the following statement is most accurate regarding the evidence-base of psychological first aid (PFA)? A. It hasn’t been sufficiently evaluated to determine its benefit B. It has strong empirical support C. Initial research indicates it may be contraindicated in the treatment of trauma D. One well-controlled study showed it to be more effective than critical incident debriefing E. None of the above

36.

Which of the following is/are the goal(s) of psychological first aid? A. Reduce initial post-trauma distress B. Support short- and long-term adaptive functioning C. Give mental health diagnoses to all people that have experienced a disaster as soon as possible D. Only A and B E. All of the above

37.

Psychological first aid can be administered in: A. Shelters B. Schools C. Hospitals D. War zones E. All of the above

38.

Psychological first aid was developed as an alternative to: A. Trauma focused cognitive behavioral therapy B. Person-centered therapy C. Critical incident stress debriefing D. Solution-focused therapy E. None of the above

39.

All mental health service providers should enter disaster situations as part of: A. An authorized helping organization B. Cognitive-behavioral team C. Critical incident stress debriefing team D. Loosely organized group of helpers E. A for-profit corporation

40.

When initiating contact with a person who has experienced a disaster a therapist should: A. Tell the person that everything will be alright. B. Explain his/her role in the situation C. Ask permission to initiate the contact D. Only B and C

E. All of the above 41.

Which statement is NOT true regarding interviewing clients in crisis or disaster environments? A. People in crisis or disaster situations often need more structure and direction than clients in a usual psychotherapy interview. B. Therapists should exercise caution when applying diagnostic labels to people in disaster situations. C. Therapists must not recount the stories of people in disaster situations unless they receive permission from the interviewee. D. All of the above are true. E. Only A and B are true.

42.

Human responses to trauma and crisis vary across three domains. Which of the following is NOT one of those domains? A. The nature of the crisis B. Coping skills, ego strength, and resources available to individual survivors C. Cultural beliefs and practices associated with trauma D. Level of psychopathology E. Human responses vary across the four preceding domains

43.

Vicarious trauma can include: A. Flashbacks or nightmares B. Self-blame C. Hypervigilence D. Any or all of the above E. Vicarious trauma is vicarious and doesn’t include any symptoms

44.

Which of the following is a reason a victim of trauma may be reluctant to talk to a mental health professional? A. Thinking/talking about trauma brings up extremely uncomfortable feelings B. Victims of trauma may have a hard time trusting in a stranger C. Trauma survivors may feel ashamed or guilty about what they experienced D. All of the above are reasons a trauma victim may be reluctant to speak with a mental health professional. E. Victims of trauma are never reluctant to talk about their experience.

45.

It is beneficial for trauma survivors to talk about their experiences within _____ hours after the traumatic event. A. 1 B. 24 C. 48 D. 72 E. 144

46.

Which is the most true with regard to cultural knowledge and crisis/disaster work?

A. Cultural knowledge is not needed during crises B. It’s good to acquire general multicultural knowledge before you arrive on the scene C. Unfortunately, there are no guides to cultural competency is disaster work D. Both A and C are true E. None of the above 47.

What standards are available for cultural competencies in disaster mental health? A. There are many different competency standards for disaster personnel B. There are only the DHHS competency standards C. Unfortunately, there is no guide to cultural competency in disaster work D. Both A and C are true E. None of the above

48.

James is an interviewer with his cultural humility. Which attitudes would you expect that he holds? A. He values the cultural practices of others B. He actively teaches everyone about his moral and religious perspective C. He has let go of any ideas about his own superiority D. Both A and B are true E. Both A and C are true

Answers 1. B 2. D 3. A 4. C 5. D 6. A 7. C 8. A 9. C 10. D 11. B 12. B 13. C 14. A 15. E 16. A 17. A 18. D 19. A 20. D 21. E 22. D 23. B 24. C 25. E

26. B 27. D 28. B 29. A 30. C 31. B 32. D 33. C 34. C 35. A 36. D 37. E 38. C 39. A 40. D 41. D 42. D 43. D 44. D 45. C 46. B 47. A 48. E

TEST QUESTIONS FOR CHAPTER 13 INTERVIEWING AND WORKING WITH YOUNG CLIENTS 1.

What sort of countertransference reactions are clinicians likely to have toward children? A. Withdrawal B. Over-identification C. Regressive D. Both A and B E. Both B and C

Which of these is a minimal foundation for working with children? A. Being a parent B. Familiarity with developmental theory C. Familiarity with the generativity dynamic in Erickson’s psychosocial theory D. Experience as a nanny E. None of these are directly relevant to working with children

Vincent is working with a young boy and started thinking, “I want to take this child home and provide a better living environment.” What does this indicate? A. Vincent is having a rescue fantasy B. The child needs a better home C. Vincent is an excellent mental health professional D. Vincent is having a withdrawal fantasy E. Vincent should turn himself into the ethics board

Children can often be considered __________ clients. A. Voluntary B. Involuntary C. Difficult D. Easy E. None of the above

Children are USUALLY referred to mental health professionals by all of the following EXCEPT: A. Schoolteachers B. Parents C. Caretakers D. Themselves E. All of the above are common referral sources

Which approach to an initial interview should a clinician use? A. Meet with the child and caretaker(s) together B. Meet with the caretaker(s) alone C. Meet with the child alone D. Any of the above is acceptable if you have a rationale

E. Family therapy is always the treatment of choice with children 7.

Why might it be important to schedule an extended initial interview session with a child and his/her parents? A. So that the child has adequate time for self-expression B. So that the caretakers feel their concerns have been sufficiently addressed C. So that the therapist has plenty of time to assess the level of psychopathology in each family member D. All of the above E. Only A and B

Emily is meeting with a parent and teen for an intake session. The parent is rather dominating. Emily needs to be prepared to: A. Shut the parent down B. Set appropriate limits with reasonable explanations C. Dismiss the parent D. Recommend individual therapy for the teen E. Wait until she’s alone with the teen and then comment disparagingly about the parent’s behavior

Which of the following statements is true regarding the involvement of parents and guardians in children’s therapy? A. It’s unethical to not let parents and guardians be as involved as they wish in the therapy process. B. Therapists should let parents and guardians guide the therapy sessions and the treatment plan because this can reveal significant information about family dynamics. C. Unless doing family therapy, the therapist should manage the involvement of parents and guardians in the therapy process, because the therapist’s primary allegiance is with the child. D. Children should be able to decide the extent of their parents’ involvement in the therapy process. E. All of the above are true

Which of the following gestures would NOT help an interviewer to make a good first impression when working with a child? A. Offering the child something to eat or drink. B. Talking to the child as if he or she were an adult. C. Conveying to the child that you have been looking forward to meeting with him or her. D. Having some trendy toys in the office. E. Getting down to the child’s level when talking with him/her.

11.

Which of the following clothing choices is likely to be viewed as LESS cool by young clients? A. Popular name-brand or label clothing. B. Business suits.

C. Comfortable clothing that allows for playful interactions. D. Both A and C. E. None of the above. 12.

When allowing children to hold toys or objects during session, it is usually best to: A. Only offer the child toys that are developmentally appropriate. B. Tell children that they can only play with the toy/object for the first 10 minutes of session. C. Leave toys/objects out in your office and let children discover toys/objects on their own. D. Children shouldn’t be playing with toys/objects during a therapy session. E. Both A and B

13.

When interviewing young clients, which of the following statements is/are true regarding the physical surroundings of an interview room? A. Displaying items such as puppets and stuffed animals can increase the comfort level of young clients. B. Having something to play with can reduce client anxiety; however, if toys become too distracting they should be put away. C. It is better to make sure there are no objects visible in your office that the child might mistake for a toy D. All of the above are correct. E. Only A and B are correct.

14.

Which of the following is true regarding confidentiality with child or adolescent clients? A. Parents should hear everything their child has to say. B. Confidentiality should be discussed separately with young clients and with their caretakers. C. Confidentiality should be discussed at the beginning of the first session with parents/caretakers and children. D. Confidentiality need not be discussed with very young children. E. None of the above are true

15.

Soria is meeting with a teen client and parent. Which issues should she address up-front? A. Appropriate clothing for parents and children to wear to counseling B. The parent’s legal right to access their teenager’s records C. How to balance the teen’s privacy with the parent’s need and desire to be informed D. Both A and C E. Both B and C

16.

What should you do if you’re planning to share referral information with young clients? A. Inform and educate your referral sources in advance. B. Be sure to have some positive feedback to share with the client. C. You should avoid sharing referral information, because doing so violates the confidentiality of the referral source. D. Both A and B are correct.

E. Both A and C are correct. 17.

What does “acknowledging reality” in an initial session with teens and parents refer to? A. Telling young clients exactly why they were referred B. Adding positive feedback to share with the client. C. This phrase refers to questions that assess the “orientation” domain for an MSE D. Both A and B are correct. E. Both A and C are correct.

18.

Which of the following is/are a reason(s) that some young clients simply remain quiet when asked about why they came for counseling? A. They are unable to understand the question. B. They are unable to formulate a response. C. They are unaware of or strongly resistant to admitting any personal problems. D. All of the above are reasons a young client may remain silent. E. Only A and C

19.

Which strategy for establishing treatment goals involves using language that young people are more likely to accept? A. Life planning B. Wish making C. Framing of complaints D. Storytelling E. None of the above

20.

Using the wishes and goals technique, clinicians can obtain goals from young clients in which of the following areas? A. Family change B. School change C. Self-change D. All of the above E. B and C

21.

Madelyn is in an intake interview with a parent and child. The parent begins listing the child’s problems. What should Madelyn do? A. Gently limit the parent to listing a maximum of one goal B. Gently limit the parent to listing a maximum of three goals C. Gently limit the parent to listing a maximum of five goals D. Place no limits on the problem list or goal setting E. Ask the parent, “How would you like it if your child decided to list all your problems?

22.

Madelyn hears and observes a parent engaging in dysfunctional parenting behavior in an intake session. What should Madelyn do? A. Ideally, if there’s no immediate danger, she should wait to develop a stronger therapy alliance with parent before offering feedback B. Offer feedback to the parent immediately

C. Ignore the behavior and hope that it will eventually change D. Confront the parent because parents can usually handle confrontation E. Report the parent for child abuse 23.

If the parent of one of your clients displays disturbing interaction patterns with his or her child, what would you do? A. Ignore it during the first session, but provide feedback in later sessions when rapport has been established. B. Inform the parent that you are legally obligated to report child abuse. C. Gather further information to determine whether the child is in immediate danger. D. Any of the above actions might be appropriate, depending upon the severity of the disturbing interaction patterns. E. Only A and C would be appropriate

24.

When it comes to assessment with young clients, which statement is the best guidance? A. Explicitly discuss the rationale for assessment and therapy with parents and young clients B. Have parents immediately fill out questionnaires in the waiting room C. Surprise young clients with several assessment strategies D. You really shouldn’t use assessment with young clients E. Obtain the parent’s advice on which assessments to administer

25.

Which of the following is a way to obtain family contingency-related data? A. Observe for positive and/or dysfunctional reinforcement patterns during the caretaker/child session B. Ask caretaker and child to discuss “what happens next” during family conflicts while together in the session C. Separate caretaker and child and then inquire about “what happens next” during family conflict D. All of the above could help E. None of the above

26.

Which of the following is one of the most powerful forms of positive reinforcement a caretaker can use with a child? A. Buy the child his/her favorite toy B. Sticker charts C. Letting the child spend extra time playing his/her favorite video or computer game D. Spending time with the child E. All of the above are equally powerful

27.

Which of the following techniques offer(s) an alternative to traditional assessment and feedback? A. The “What’s Good about You?” game B. Offering rewards C. Projective drawings D. A and C are correct.

E. All of the above are correct. 28.

Which of the following statements is NOT true of radical acceptance when used with parents of young clients? A. It involves actively welcoming and accepting all parent comments. B. It involves teaching the parent a new, more adaptive way of thinking and behaving. C. It is more directive than traditional person-centered approaches. D. It allows clinicians to communicate their commitment to openness during the assessment and therapy process. E. All of the above are true

29.

Which of the following assessment techniques is/are especially useful for generating hypotheses and communicating playfully with young clients? A. Personality tests B. Projective drawings C. Questionnaires D. All of the above E. Only B and C

30.

Charlene is a counselor who sometimes has trouble setting limits in child sessions. What guidelines might help her improve in that area? A. Plan ahead by thinking through what behaviors are acceptable and unacceptable. B. Have simple ground rules she states in advance C. Generate and review a multitude of rules that cover every possibility D. All of the above E. Only A and B would be helpful

31.

When buying toys and dolls for young clients to play with in the interview room, what should therapists do? A. Buy expensive toys that children are likely to appreciate more than cheap toys. B. Buy toys that are not easily broken. C. Avoid buying toys with racial features so all children will be comfortable playing with them. D. All of the above are correct. E. It makes no difference what types of toys a therapist has in his/her office.

32.

Arts and crafts can be helpful when working with children; however, when choosing art modalities, which of the following should therapists be aware of? A. Some children may refuse to engage in art and craft activities. B. The parents or guardians might not approve of their children using arts and crafts in therapy. C. Arts and crafts can give the interview a playful tone, distracting from the assessment process. D. Some art modalities can stimulate high emotionality and a loss of control in some children. E. All of the above

33.

Virginia likes to use nondirective play with children, even during initial sessions; in contrast, Brenda prefers using play as a direct and behavioral method for teaching empathy and other adaptive behaviors. Which approach is better? A. Nondirective play therapy is better for all children B. Directive play therapy for teaching purposes is better for all children C. Children can benefit from either nondirective or directive play therapy D. Neither approach has any empirical support and so both should be avoided E. Directive play therapy is more appropriate for internalizing children

34.

Which approach is best when it comes to whether you should include toys designed for aggressive expression? A. Aggressive toys shouldn’t be used B. Children should be encouraged to play with aggressive toys C. Given the reality of aggressive and violent behavior in our society, including some aggressive toys is reasonable as it can add to assessment and therapeutic alternatives D. Artistic modalities should be used instead of aggressive toys, because it’s impossible to use art for aggressive purposes E. It all depends on whether or not you’re working with a military family

35.

During the closing of an interview with a young client, it is especially important that the therapist: A. Initiates a new game or activity with clients to keep them engaged until the very end of the session. B. Changes the nature of the informed consent and confidentiality again. C. Provides supporting and reassuring feedback to let clients know they’re appreciated. D. Expresses countertransference reactions to the client. E. Give children feedback on ways they can behave more appropriately in the next session.

36.

Why might it be important for therapists to meet with the child’s parent or guardian during the closure of an interview? A. The interviewer can discuss recommendations for the child with the caretaker. B. The interviewer and caretaker can schedule the next appointment for the child. C. The interviewer can discuss payment options with the caretaker. D. All of the above are correct. E. None of the above. Therapists should not meet with parents or guardians during closure.

37.

Which of the following questions would a therapist NOT ask when trying to give a young client a sense of power and control? A. “You know, I’ve asked lots of questions. Do you have any questions?” B. “Has our time together been like you thought it would be?” C. “Is there anything you’d like to say that I should have asked about?” D. “What might you do better next time so that our session runs more smoothly?” E. Any of the above

38.

The main difference between the termination phase of an interview with a child and that with an adult is: A. Children are often more extreme and likely to act on their feelings. B. Children are often less extreme and less likely to act on their feelings. C. Children are more likely to make significant doorknob statements. D. Children are more likely to be aware that the time is up. E. There’s really no difference in dealing with termination.

39.

What are the most important closing tasks with young clients? A. Summarizing your understanding of the problem areas B. Making connections between the problems and possible counseling interventions C. Confronting young clients about taking responsibility for their behaviors D. All of the above E. Only A and B

40.

Ryan is working with a young client who is also a member of a minority group. Which of the following ideas should guide his work? A. Find ways to show genuine interest in the young client, while also focusing on strengths or assets B. Remember that the core conditions of person-centered therapy are contraindicated with young clients C. Avoid explaining the rationale for specific techniques because that can bore young clients D. Remind the client of his vast experience in working with young clients E. Only B and C

Answers 1. D 2. B 3. A 4. B 5. D 6. D 7. E 8. B 9. C 10. B 11. B 12. C 13. E 14. C 15. E 16. D

17. A 18. D 19. B 20. D 21. B 22. A 23. D 24. A 25. D 26. D 27. D 28. B 29. B 30. E 31. B 32. E 33. C 34. C 35. C 36. D 37. E 38. A 39. E 40. A

TEST QUESTIONS FOR CHAPTER 14 PRINCIPLES AND TIPS FOR INTERVIEWING COUPLES AND FAMILIES 1.

Which of the following is/are an irony of working with couples and families? A. You have more clients and less time to work. B. There is disagreement about how to define couples and families. C. Gay and lesbian couples are never referred to as couples. D. Both A and B are true. E. Both B and C are true.

On average, couples and families stay in counseling: A. For more time than individuals. B. For less time than individuals. C. For the same amount of time as individuals. D. For the same amount of time as individual child clients. E. No information is available on this.

Why do the authors choose to use the word couple when referring to relationship and marriage counseling? A. Couple is more stigmatizing. B. Couple is more accurate and more inclusive. C. Research has shown that romantic partners prefer to be called couples. D. None of the above is true. E. Both B and C

A mother and daughter receiving therapy together to improve their relationship would be most aptly referred to as: A. Family therapy. B. Couple therapy. C. Relationship enhancement therapy. D. Mediation. E. None of the above

Which of the following is considered a family for the purposes of family therapy? A. Children and their kinship system B. Gay and Lesbian couples with children C. A biologically-related family of procreation D. Children in co-parenting situations E. All of the above

Which of the following is an activity associated with the introduction stage of interviewing a couple or family? A. Preparation and planning B. The opening question or statement C. Limit-setting with couples/families

D. All of the above E. Only B and C 7.

Angelo is a beginning therapist. He is heterosexual and comes from a strong ItalianCatholic family. Based on the text, Angelo should reflect on how his family background might: A. Shape what he considers normal and abnormal B. Cause him to have blind spots or issues that he’s not comfortable asking about C. Give him greater upward mobility in the professional world D. All of the above E. Only A and B

Initial telephone contact with couples is: A. Generally simple and straightforward. B. A time when one partner may try to gain your favor. C. An excellent source of information about motivation. D. Both B and C are true. E. None of the above is true.

Which of the following is true of coalition building? A. It is potentially damaging to the therapy process. B. It is a dynamic that involves two family members, but not the therapist. C. It is always a sign of significant psychopathology. D. Both A and C are correct. E. Both B and C are correct

10.

All of the following statements regarding meeting and greeting couples are true EXCEPT: A. Therapists must take care to treat each member of the couple equally. B. Even discussing relatively neutral small-talk topics may evoke an argument or emotional tension between the couple. C. Potential coalition-building makes meeting and greeting couples a relatively easy task. D. Therapists should avoid comments that suggest a stronger identification with one member of the couple than the other. E. All of the above are true

11.

Amrita is interviewing a couple, Gina and Leslie. Gina tells Amrita in private that she is planning to leave Leslie but she does not want Leslie to know about this. Now Amrita doesn’t know whether she can tell Leslie or not. What procedure should Amrita have used to handle this situation effectively? A. Suggest that Leslie seek individual therapy to discuss this matter further. B. Use an informed consent form that explains the counselor will not keep secrets between romantic partners. C. Use a total confidentiality agreement. D. Provide both parties with a copy of the IAMFT ethical guidelines.

E. None of the above would be appropriate 12.

Coalition-building is: A. A common, but less-than-optimal strategy for gaining power B. Easy to deal with using direct educational techniques C. Something that requires direct education to prevent and resolve D. Both B and C are true. E. None of the above is true.

13.

Which of the following will determine whether family or individual therapy is the treatment of choice? A. Theoretical orientation B. Research evidence C. Always follow the clients’ lead on this D. Both A and B E. Both B and C

14.

Lark is trying to convince her co-therapist that they should actively limit the impulsive and destructive styles of the couple with whom they’re working. Which of the following statements does NOT support her argument? A. Susan Johnson the developer of Emotion-Focused Couple Therapy agrees with her B. Limits can prevent the couple or family from engaging in damaging behavior in session C. Applying reasoned and thoughtful limits models how to stop destructive exchanges D. There’s a chance that gentle and well-reasoned external limits can be internalized E. Conflict can distract clients and keep them from focusing on underlying issues

15.

From an attachment perspective, alliance-building is viewed as: A. The same thing as joining B. The therapist being a secure base toward which both partners feel trust and connection C. A principle based on repeated behavioral reinforcement D. A principle based on repeated aversive conditioning E. A common, but less-than-optimal strategy for gaining power

16.

The opening of a couple’s interview should include: A. Instructions on what to expect from the interview B. A question or prompt to get the couple talking why they’ve come to counseling and their counseling goals C. A complete account of the couple’s history. D. A discussion of the positive and negative qualities of each member of the couple. E. Both A and B

17.

Scott asks his couple to tell each other ways in which they’d like to see each other change. Which statement is true about this strategy? A. It’s an effective way to help couples set goals

B. It’s a focusing technique C. This interaction should be avoided because it is mutually punishing D. Because couples begin arguing when they do this, it’s a great assessment tool E. Both A and B 18.

Which of the following is an activity usually associated with the opening stage of interviewing a couple or family? A. Preparation and planning B. The opening question or statement C. Limit-setting with couples/families D. All of the above E. Only B and C

19.

What exactly should you be balancing during the opening and throughout a couple interview? A. The romantic history B. Your attention and eye contact C. Your flirtation responses D. Your modeling of effective criticism E. None of the above

20.

The main goal in a family opening is to get everyone in the family to: A. Complete a genogram B. Make direct eye-contact with you C. Answer basic questions about family functioning, expectations, and hopes D. Smile or laugh E. Provide each other constructive criticism

21.

In family work, what does the “identified patient” phenomenon refer to? A. A situation wherein one family member has a problem that affects the whole family system. B. A situation wherein every family member claims to have a mental disorder. C. A situation wherein one family member must receive individual treatment in order to resolve the problems of the family as a whole. D. A situation wherein the whole family claims that one member is the cause of all family problems. E. The term “identified patient” does not apply to family work.

22.

Dylan begins asking a series of questions of the couple he’s seeing. One question is: “When did you notice first feeling attracted to your partner?” Which of the following techniques is he using? A. Tracking interaction patterns B. The romantic history C. Reframing partner motives D. Reflecting on emotional bids E. The behavioral exchange

23.

Genevieve uses attachment theory to understand the meaning of the repetitive negative interactive patterns her couples display. What is her theoretical approach? A. Solution-focused B. Cognitive-behavioral C. Emotion-Focused D. The Gottman method E. Psychoanalytic

24. Based on the EFCT model, couples inadvertently push one another’s: A. Underlying attachment insecurity buttons B. Behavioral activation buttons C. Cognitive hot-points D. Emotional bids E. Psychodynamics 25. Most clinicians specifically inform couples that they’re not doing therapy on either individual, but instead, are working on: A. The relationship B. The exchange pattern C. Cognitions D. Developing a family history E. Developing mutual respect 26. Instead of blaming either partner, it’s advisable for interviewers to reframe the problem as emanating from: A. Psychopathology in the relationship B. Underlying partner needs aren’t being adequately articulated and therefore not addressed C. Underlying partner motives are being misunderstood D. All of the above E. Only B and C 27. Therapists with a(n) _________________ orientation would be most likely to ask each partner what they’re willing to do to provide more regular positive reinforcements in the relationship. A. Behavioral B. Person-centered C. Feminist D. Cognitive E. Existential 28. Gottman has emphasized that loving partners offer up _______________to each other and, if the relationship is healthy, they receive and respond empathically. A. Behavioral exchanges B. Emotional bids

C. Attachment pleas D. Existential needs E. Cognitive distortions 29. Which of the following is NOT one of Gottman’s four horsemen that predict divorce? A. Criticism B. Stonewalling C. Defensiveness D. Contempt E. Each of these is one of the four horsemen 30. Psychoeducation with couples can focus on many issues, including the fact that couples shouldn’t expect to have a productive discussion when: A. One or the other has been critical B. Heart rate is too high C. When conflict arises D. Soft start-ups are used E. The behavior exchange ratio is high 31. Which of the following is/are a key issue for most couples? A. Money B. Sex C. Commitment D. All of the above E. Only A and C 32. Regardless of theoretical orientation, certain domains should generally be assessed during the body of a couple’s interview. Which of the following is NOT one of those domains? A. Money B. Sex C. Extensive personal history information D. Level of commitment E. All of the above should be assessed during the body of the couple interview. 33. Most family therapists broadly employ: A. Social learning theory B. Systems theory C. Psychoanalytic theory D. Adlerian approaches E. Cognitive-behavior therapy 34. Many family theorists have a systems or ecological perspective. How are these perspectives different from more traditional theoretical orientations? A. These perspectives view the pathologies of individuals as equally important or more important than the problems of the family system.

B. These perspectives see the systemic context of the problem as equally important or more important than the problem itself. C. These perspectives encompass the extended family when assessing family problems, whereas traditional perspectives give more attention to the immediate family. D. These perspectives view all families as suffering from the same fundamental problem. E. Both B and C are true 35. Which of the following areas might a therapist include when working with couples? A. The couple’s willingness to make changes. B. Concerns about drug and alcohol use. C. The influence of outside factors on the couple, such as neighbors, parents, and friends. D. All of the above E. Only A and B 36. Matt is an Adlerian counselor. During his first session with a couple he is likely to use ___________ to explore family history, birth order, etc. A. Genograms B. Family constellations C. The Draw-A-Person test D. Rorschach inkblots E. A long questionnaire 37. __________ are especially vulnerable to cultural stressors. A. Unmarried couples B. Married couples C. Sexual minority couples D. Cisgender family members E. None of the above 38. When closing a session with a family or couple, which of the following is important? A. Allowing plenty of time to “put things back together” before the end of the session B. Summarizing the content and feelings that came up in session C. Assigning homework D. Acknowledging how the members’ lives will continue in new and interesting ways after the session. E. All of the above are important 39. Rosa is asking her supervisor how she should end her couple and family counseling sessions. Which of the following is her supervisor likely to tell her to AVOID? A. Make concluding comments brief and reassuring. B. Express respect for their choice to come to counseling. C. Thank them for their hard work in session. D. Take note of upcoming plans in the family’s or couple’s week E. Only allow for a couple of minutes for the conclusion of the session so that you can fit in as much content as possible before the family or couple has to leave.

40. ___________________ refers to what is argued about, and ____________________ refers to how people argue. A. Argument style; argument content B. Conflict process; conflict style C. Conflict content; conflict process D. Conflict substance; conflict process E. Argument content; conflict style 41. Which of the following is something therapists should be aware of about themselves when working with couples or families in conflict? A. They should be aware of any specific conflict topics that push their emotional buttons. B. They should be aware of any biases they have about how couples should behave in a partnership. C. They should be aware of whether or not they tend to carry conflict from sessions home with them. D. They should be aware of the conflict issues and process styles that were characteristic of their family while growing up. E. All of the above 42. Which of the following is the main reason a therapist would allow couples or families to argue and fight during session? A. To let the members blow off some steam before diving into more important content. B. To let them get their fighting done in session in hopes that they won’t fight as much out of session. C. To gather assessment information about negative interaction patterns D. All of the above E. Only A and B 43. Melinda is working with a high-conflict couple or family. She should become: A. More structured and less active B. More structured and more active C. Less structured and more active D. Less structured and less active E. Any of the above would be fine. 44. Requests to function as both a family therapist and an individual therapist: A. Should never be accepted because it is never ethical to take on such dual roles. B. Should be carefully considered because of the potential for loyalty conflicts. C. Should be accepted because of an assumed loyalty to the client. D. Should be refused so that other therapists in town can make a living too. E. Both B and C 45. When it comes to mixing individual with couple/family therapy, the textbook authors advocate which rule? A. Once an individual client, always an individual client

B. Dual roles are an artifact of old ethics guidelines C. Contemporary therapists should be able to navigate dual roles effectively D. A client in the hand is worth two in the waiting room E. Both B and C 46. When working with minority couples and families, it’s important to: A. Remember your multicultural competencies B. Collaborate with clients C. Be sure to gather feedback and monitor progress D. All of the above E. Only A and B Answers 1. D 2. B 3. B 4. A 5. E 6. A 7. E 8. D 9. A 10. C 11. B 12. A 13. D 14. A 15. B 16. E 17. C 18. E 19. B 20. C 21. D 22. B 23. C 24. A 25. A 26. E 27. A 28. B 29. E 30. B 31. D 32. C

33. B 34. B 35. D 36. B 37. C 38. E 39. E 40. C 41. E 42. C 43. B 44. B 45. A 46. D