Deck 18: Future of Psychotherapy

Question 1

What percentage of psychotherapy practices considered "evidence based" are cognitive-behavioral treatments?

A)40-50%
B)50-65%
C)60-80%
D)over 90%

Answer 1

C

Question 2

According to the Delphi poll of mental health experts,all of the following therapy methods were predicted to increase EXCEPT:

A)relapse prevention.
B)smartphone applications.
C)aversive conditioning.
D)cognitive restructuring.

Answer 2

C

Question 3

The industrialization of mental health care employs each of the following mechanisms for managing psychotherapy EXCEPT:

A)limiting the number of therapy sessions.
B)requiring pre-approval for psychotherapy or utilization review at certain intervals.
C)allowing client's to choose their clinicians and treatments to eliminate the "middle man."
D)emphasizing outpatient care for all but dangerous mental states (e.g.,suicidality).

Answer 3

C

Question 4

An example of technological applications in psychotherapy that immerses clients in a computer-generated environment for the purposes of exposure to anxiety-provoking situations is called:

A)telepsychotherapy.
B)virtual therapy.
C)online counseling.
D)behavioral e-health.

Question 5

What two characteristics of mental health care service delivery are cited by the textbook authors as "cardinal" features of its industrialization?

A)Reductions in clinicians' income; loss of clinician control over mental health services
B)Use of evidence-based practices; focus on outpatient service delivery models
C)Reductions in the percent of managed care patients on clinician caseloads; use of low-cost providers
D)Requiring primary care physicians to refer patients; emphasis on self-help resources

Question 6

Which of the following systems of psychotherapy were predicted to decrease the most in the next decade according to the mental health experts surveyed by the text authors?

A)Integrative therapies
B)Humanistic-experiential therapies
C)Interpersonal therapies
D)Constructivist therapies

Question 7

Evidence-based practice is best defined as:

A)integration of best research evidence with clinical expertise and client values.
B)basing one's psychotherapy entirely on the firm foundation of empirical research.
C)the use of client feedback to inform the selection of therapy techniques.
D)basing one's psychotherapy on careful psychological assessment.

Question 8

The psychotherapy of the future is most likely to be more:

A)expensive,culture-informed and cognitive-behavioral.
B)long-term,problem-focused,and expensive.
C)psychoeducational,technological,and brief.
D)problem-focused,directive,crisis-oriented.

Question 9

Contemporary research has begun to examine the best matches between the therapy relationship and patient characteristics.One example comes from the work of Beutler and Harwood (2000).They found that:

A)clients presenting with low resistance experience better outcomes in a directive therapy relationship.
B)clients presenting with high resistance experience better outcomes in a directive therapy relationship.
C)clients presenting with low resistance experience better outcomes in a minimally directive therapy relationship.
D)clients presenting with high resistance experience better outcomes when therapists are highly active.

Question 10

In the Delphi poll of mental health experts on the future of psychotherapy over the next decade,each of the following systems of psychotherapy was predicted to increase EXCEPT for:

A)experiential therapies.
B)motivational interviewing.
C)cognitive-behavioral therapy.
D)multicultural therapy.

Question 11

The text authors summarize the contemporary focus of insurance carriers on clinicians as:

A)"No research,no reimbursement."
B)"No referral,no reimbursement."
C)"No medical necessity,no reimbursement."
D)"No patient satisfaction,no reimbursement."

Question 12

Which of the following is NOT among the 12 emerging themes that will shape the future of psychotherapy?

A)Reduced reliance on medications
B)Technological applications
C)Neuroscience
D)Population-based treatments

Question 13

The text authors predict that the major impact of the industrialization of mental health care will be:

A)the demise of psychotherapy as we know it.
B)reductions in the number of clinical psychologists who are willing to accept managed care patients.
C)reductions in the salaries of professional therapists.
D)the increasing conduct of therapy by subdoctoral professionals according to practice guidelines.

Question 14

One key implication of recent theory and research on the therapy relationship is that:

A)therapists will increasingly be trained in how to become authentic chameleons.
B)therapists will be expected to manage equivalently well a broader range of client relational styles.
C)therapists will be have research evidence to back up their tendency to blame clients for therapy failures.
D)therapists will be able to more clearly tailor therapy relationships to match client styles.

Question 15

The APA Interdivisional Task Force on Evidence-Based Therapy Relationships concluded,among several things,that:

A)the therapy relationship makes a modest contribution to therapy outcome and is more often than not redundant with the type of treatment.
B)that the most critical elements of an effective therapy relationship include the directiveness of the therapist.
C)practice guidelines should limit their attention to those specific factors that are most likely to resolve client problems.
D)evidence-based practice guidelines that do not address the therapy relationship risk being seriously incomplete and potentially misleading

Question 16

Results of controlled research studies indicates that use of virtual therapy for the treatment of specific phobias is:

A)positive and promising.
B)poor and disappointing to date.
C)useful for children but not adults.
D)nonexistent; there are no studies yet published.

Question 17

The text authors summarize that the largest transformation in psychotherapy treatment format is likely to continue to emphasize:

A)short treatments.
B)use of individual therapy.
C)longer treatments for complex disorders.
D)use of psychoeducational groups.

Question 18

Which of the following therapy methods was predicted to decrease the most over the next decade according to the Delphi poll of mental health experts?

A)Relapse prevention
B)Therapeutic alliance
C)Self-change methods
D)Implosion

Question 19

What percentage of Americans who get their health benefits from their jobs are covered by managed care?

A)25%
B)54%
C)85%
D)93%

Question 20

The major criticisms of evidence-based practice include each of the following EXCEPT:

A)they strongly favor randomized controlled treatment studies.
B)they tend to over-estimate the effects of the therapy relationship.
C)they ignore the complexity of client problems and context.
D)they ignore the effects of individual therapists.

Question 21

Based on a recent research study,about what percentage of contemporary psychotherapists reported recommending specific online programs to their clients?

A)25%
B)34%
C)48%
D)61%

Question 22

Meta-analytic research studies of the effectiveness of self-help resources and self-administered treatments have found that:

A)their effect sizes are generally higher than therapist-assisted interventions.
B)they are especially effective in the treatment of behavioral health disorders but not mental health disorders like anxiety,substance dependence and depression.
C)their effect sizes are almost as large as therapist-assisted interventions within the same studies.
D)they are effective for some behavioral health and mental health disorders,but not for addictive disorders.

Question 23

The text authors suggest that the relationship between religion and spirituality and psychotherapy:

A)has largely functioned to distract therapists from their most important behavioral change efforts.
B)is a tenuous one because spiritual matters are the concerns of other professionals such as clergy.
C)has declined over the past two decades as a real science of psychotherapy has emerged.
D)has grown more explicit over the past two decades.

Question 24

Compared to face-to-face CBT,Internet therapy has shown:

A)much smaller effect sizes.
B)nearly equivalent effect sizes.
C)larger effect sizes.
D)similar short-term but smaller follow-up effects.

Question 25

The text authors predict that faith-based practice of psychotherapy will include each of the following EXCEPT:

A)increased attention to religious goals such as salvation.
B)religion-accomadative therapies that are consistent with a client's religious worldview.
C)integration of religious concepts and processes like forgiveness.
D)increased attention to client religious beliefs and practices in assessments.

Question 26

The textbook authors regard self-help resources as:

A)a fad that is largely driven by the economics of the current healthcare marketplace.
B)highly variable in quality and frequently detrimental to self-change efforts.
C)indicative of a growing trend toward self-change.
D)notably inferior to therapist-guided change for the majority of client problems.

Question 27

If a population-based intervention has a success rate of 40% and a participation rate of 70%,its impact would be:

A)28%.
B)40%.
C)56%.
D)70%.

Question 28

Positive psychology has had an impact on psychotherapy as well as which of the following?

A)Executive coaching
B)Neuroscience
C)Pharmacotherapy
D)Stepped care

Question 29

Which of the following is true about medication for psychological disorders in youth?

A)In the past decade,fewer youth are being medicated to manage their difficulties.
B)The annual rate of psychotropic medication for children is nearly 30%.
C)Youth are less responsive to combined treatment than adults.
D)Youth pharmacotherapy rates nearly reach adult utilization rates.

Question 30

Which of the following statements about pharmacotherapy is true?

A)Most clients prefer medication treatment over psychotherapy.
B)Medication and psychotherapy are increasingly being combined in client treatment.
C)The prescription of medication for psychological disorders has decreased in the past decade.
D)Medication is more effective than psychotherapy for most client problems.

Question 31

According to the text authors,perhaps the most significant impact of the current focus on the treatment of health behaviors is that:

A)health promotion will be emphasized as useful targets for intervention.
B)the use of longer term mental health treatments will gradually be eliminated.
C)psychotherapists will replace primary care physicians as the most useful health care resources.
D)the types and intensity of treatments will gradually become more uniform.

Question 32

Meta-analysis of computer-mediated therapy via the Internet compared to a control condition for anxiety and depression has demonstrated:

A)insubstantial effect sizes (< .20).
B)small effect sizes (≥ .20).
C)medium effect sizes (≥.50).
D)large effect sizes (≥.80).

Question 33

Efforts to maximize the effectiveness and efficiency of resource allocations in therapy are known as:

A)self-help programs.
B)health promotion programs.
C)behavioral health care.
D)stepped care.

Question 34

Research on psychotherapy and the brain has begun to demonstrate that:

A)psychotherapy results in detectable functional changes in the brain.
B)biological treatments like medications produce greater changes in brain function than does psychotherapy.
C)specific psychotherapy interventions are related to specific changes in brain regions.
D)while changes in the brain occur in psychotherapy,there is no evidence that activity in certain brain regions can predict treatment response.

Question 35

A study by one of the text authors (Prochaska,2004)investigated a proactive population-based intervention with a representative sample of 5,000 smokers and found that services were used by:

A)20% of the targeted population.
B)40% of the targeted population.
C)65% of the targeted population.
D)80% of the targeted population.

Question 36

For most of its history,psychotherapy has been focused almost exclusively on the alleviation of distress,suffering and psychopathology.More recently,psychotherapy has begun to emphasize the development of a client's character strengths and virtues.This movement is known as:

A)proactive psychology.
B)population-based interventions.
C)practice guidelines.
D)positive psychology.

Question 37

In considering the differential impact of psychotherapy and population-based treatments,which of the following statements is true?

A)Psychotherapy typically has a higher participation rate.
B)Population-based interventions are much more effective.
C)The impact of psychotherapy is generally greater than population-based interventions.
D)The impact of population-based treatments is generally greater than psychotherapy.

Question 38

Research surveys of psychotherapists indicate that the percentage of therapists who use self-help books and other resources is:

A)20-30%.
B)between 40-50% but growing.
C)between 60-70% and steady since the mid-1990s.
D)over 85%.

Question 39

The research cited by the text authors regarding population-based intervention efforts has suggested that:

A)reaching out to patient populations is expensive and has mixed results.
B)offering services proactively can reach a greater number and more varied group of people.
C)most people are not willing to participate in any clinical services unless they are already in the contemplation stage of change.
D)as usual,those in the action stage benefited most.

Question 40

The text authors cite several converging forces that have increased the use of self-help resources.These include all of the following EXCEPT:

A)widespread availability and low cost of self-help resources.
B)a limited number of clinicians trained to treat specific problems with cognitive-behavioral therapy.
C)managed care pressures for briefer and adjunctive therapies.
D)privacy and anonymity.

Question 41

Treatment adaptations organized around each of the following patient features has been shown by meta-analysis to improve psychotherapy outcomes EXCEPT:

A)gender.
B)culture.
C)stage of change.
D)coping style.

Question 42

The Child/Adolescent Anxiety Multimodal Study (CAMS)found that combined medication and CBT treatment was:

A)not much better than placebo,as each treatment seemed to interfere with the other.
B)much better than placebo,but equivalent to each treatment alone.
C)better than each treatment alone.
D)too costly for the small gains in effectiveness.

Question 43

A meta-analysis of 35 studies comparing treatment outcomes of clients matched to their preferred treatment to those clients not matched to their preference found:

A)a surprisingly limited positive effect.
B)a medium positive effect.
C)a very large positive effect.
D)greater client satisfaction,but no difference in treatment outcome.

Question 44

Treating multiple health-risk behaviors simultaneously has been shown to:

A)be too difficult and overwhelming for both clinicians and clients.
B)take too long to be economically feasible.
C)be effective across multiple domains of well-being.
D)helpful to physical health problems,but detrimental to mental health.

Question 45

Meta-analysis has shown that combined medication and psychotherapy treatments are:

A)generally not much better than each alone.
B)generally better than each alone.
C)generally better than each alone for adult disorders,but not adolescent disorders.
D)only better than each alone for the most severe disorders,like schizophrenia or OCD.

Question 46

The text authors punctuate the closing of their book with the exclamation that "Psychotherapy works!" What they mean is that:

A)psychotherapy is effective for some people with particular kinds of problems.
B)psychotherapy is effective in the vast majority of cases,but not as effective as biomedical interventions.
C)psychotherapy yields large effect sizes that rival or exceed those in biomedicine.
D)cognitive-behavioral and interpersonal psychotherapies are effective while other therapies are less so.

Question 47

Recent research has documented the following estimated prevalence rate of psychiatric medication use among adults in the US:

A)10%.
B)20%.
C)25%.
D)35%.

Question 48

Several meta-analyses of religious-accommodative therapies have found:

A)beneficial effects in the small range.
B)beneficial effects in the medium range.
C)beneficial effects for highly religious clients only.
D)no significant beneficial effects when compared to control conditions.

Question 49

Clients matched to their treatment and relational preferences have been shown to be:

A)one-fifth less likely to drop out.
B)one-fourth less likely to drop out.
C)one-third less likely to drop out.
D)one-half less likely to drop out.

Question 50

According to the text authors,which of the following seems to be dominating the contemporary conversation in psychotherapy applications?

A)Bipolar disorder
B)Eating disorders
C)Autism spectrum disorders
D)Behavioral health problems

Question 51

The text authors close their final chapter with a call for:

A)more studies comparing different kinds of psychotherapy with control groups or medication treatments.
B)more meta-analytic studies as a way of minimizing the researcher allegiance bias.
C)more research focused on which clients will really benefit from therapy.
D)more research on what works for whom,how it works,and optimal therapist characteristics.
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Question 52

When compared to medication treatment for depression,psychotherapy for depression has been found to:

A)be inferior to medications for all but the most mild forms of depression.
B)facilitate faster improvement over the short-term,but its effectiveness is similar to medications over the long term.
C)be as effective or more effective,especially when studied over the long-term.
D)be superior in most studies,even when researcher allegiance factors are considered.

Question 53

Compared to medication treatments,psychotherapy seems to show:

A)a higher dropout but lower relapse rate.
B)an equivalent dropout rate,but lower relapse rate.
C)a lower dropout rate,but higher relapse rate.
D)a lower dropout and relapse rate.