Deck 12: Improving Relationships

Question 1

Dr. Roberts helps couples make explicit (known) the rules that guide their relationship behavior and establish new rules that are more flexible and adaptive. What model of couples therapy does she practice?

A) object relations couples therapy
B) systems therapy
C) cognitive-behavioral couples therapy
D) emotionally focused couples therapy

Answer 1

B

Question 2

Reframing is to ________ as relabeling is to ________.

A) behavior; problems
B) patterns; rules
C) problems; behavior
D) dynamics; patterns

Answer 2

C

Question 3

According to the text, in which kind of couples therapy can the treatment be seen as successful even if the relationship ends?

A) original behavioral couples therapy
B) cognitive-behavioral couples therapy
C) object relations couples therapy
D) integrative behavioral therapy

Answer 3

C

Question 4

Danica describes her mother as a caring and supportive person who was generally available for her when she was a child. She also says the way in which her mother treated her made her expect that others would also be trustworthy and available. In object relations terms, what would we call DanicaÕs views and beliefs about her mother?

A) the caregiving relationship
B) an attachment relationship
C) projective identification
D) the object

Question 5

Baljit and Tim have had difficulty adjusting to being parents. They argue constantly about what activities they are going to do with their children and hate their weekends because they are spent with each of them taking turns playing with the kids to give the other parent a break. Their therapist points out that one reason they might be so frustrated and arguing so much is that the way they have been structuring their weekends leaves them little time to nurture their relationship or to be together as a family. The arguments and frustration are signals that they value and love each other and want to connect more as a couple and as a family. What technique has the therapist used?

A) relabeling
B) empathic joining
C) reframing
D) unified detachment

Question 6

In considering the source of relationship functioning, a systems perspective is to ________ as a psychodynamic perspective is to ________.

A) the early caregiving experience; repetitive patterns of interaction
B) repetitive patterns of interaction; early caregiving experiences
C) the frequency of positive and negative behavior; early caregiving experiences
D) repetitive patterns of interaction; negative attributions

Question 7

After 23 years of marriage, Kayla and Fred have decided to seek marital therapy. Which of the following is most likely true?

A) They are more likely to seek help from a couples therapist than from a religious adviser.
B) They have likely only recently begun experiencing relationship distress.
C) The problems they present with in therapy are likely the ones therapists believe are most difficult to treat.
D) All of the above statements are true.

Question 8

Bertie is angry at his wife, Maddy, for talking with other men at a party, and she is sick and tired of his jealousy. What might a therapist using a systems perspective say in response to this situation?

A) Bertie, is it possible that you feel jealous because you always had to compete with your siblings for your motherÕs attention when you were a child?
B) Maddy, do you think that BertieÕs jealousy might be triggered by his fears that you no longer find him attractive?
C) Bertie, can you talk with Maddy about the softer vulnerable feelings that might be behind your feelings of jealousy?
D) Maddy, can you see how BertieÕs feelings are a result of his early experiences, and can you try to understand his feelings?

Question 9

The main goal of an object relations therapist is to help couples:

A) project experiences and needs that arise from positive early childhood experiences rather than from negative early childhood experiences.
B) repress early unresolved experiences so that they no longer affect the current relationship.
C) blur the boundaries between the self and the other in the relationship so that partners enter in a state of mutual dependence.
D) contain each otherÕs projected needs and to see each other as separate individuals who are able to rise above early unresolved experiences.

Question 10

According to couples therapists (summarized in the text), one of the most common problems they see in therapy is ________, and one of the least common problems is ________.

A) communication; a power struggle
B) a power struggle; serious personal issues
C) a lack of loving feelings; serious personal issues
D) a lack of loving feelings; stress

Question 11

In object relations terms, what is introjective identification?

A) when a person projects his or her relationship needs and fears onto another person
B) a personÕs response to the projections of his or her partner
C) when a person begins to see himself or herself in a new way because of how the partner has treated him or her
D) when a person identifies with the projection of a partnerÕs needs and fears and shows he or she is not threatened by it

Question 12

Which of the following statements about couples seeking therapy is FALSE?

A) Couples usually wait until their problems have become severe and entrenched before they decide to seek therapy.
B) The most common problems couples present with in therapy are also the ones that therapists believe are the most difficult to treat.
C) Most often, couples seek help from professionals who specialize in therapy for couples.
D) Relationship problems are a leading reason people seek therapy.

Question 13

In object relations terms, what is containment?

A) when a person projects his or her relationship needs and fears onto another person
B) a personÕs response to the projections of his or her partner
C) when a person begins to see himself or herself in a new way because of how the partner has treated him or her
D) when a person identifies with the projection of a partnerÕs needs and fears and shows he or she is not threatened by it

Question 14

Taslim constantly seeks reassurance from her intimate partner that he loves and cares for her. From an object relations perspective, this need could reflect:

A) projection.
B) projective identification.
C) introjective identification.
D) containment.

Question 15

After 23 years of marriage, Kayla and Fred have decided to seek marital therapy. Their satisfaction with their marriage has decreased over time, to the point where both are feeling quite unhappy. They hardly talk to each other except to argue about the children or finances, and neither can remember when they last had sex. Based on material presented in the chapter about improving relationships, which of Kayla and FredÕs problems would a couples therapist find most difficult to treat?

A) lack of loving feelings
B) communication problems
C) lack of sexual activity
D) money management and financial issues

Question 16

In the language of object relations couples therapy, an object is:

A) the problem behavior that is the focus of treatment.
B) a physical thing, such as a blanket or favorite toy, that provides comfort and security.
C) an internal representation of a caregiver from the past.
D) the person with whom one is currently in an intimate relationship.

Question 17

If the primary aim of a therapist is to weaken the harmful effects of projection, projective identification, and introjective identification on the relationship, what perspective is he or she using?

A) psychosomatic
B) object relations
C) systems
D) emotionally focused

Question 18

Katie gets mad at Adam because he has forgotten to pay an important bill. When she brings up the problem, he doesnÕt say much and begins to sulk. Katie backs down and says sheÕll take care of the problem. Then she changes the subject and begins to tell him funny stories about her bad day at work, which he finds amusing and eventually the two of them are laughing while they make fun of her inept co-worker. According to a systems perspective, what is the ÒruleÓ underlying their relationship dynamic?

A) When Adam is in a bad mood, he sulks.
B) When Katie tells funny stories, Adam laughs.
C) When problems are raised, Adam withdraws and Katie backs down.
D) Adam is serious and Katie is funny.

Question 19

According to a systems perspective, what is required for couples to make improvements in their relationship?

A) establishing new flexible relationship rules
B) insight into relationship dynamics
C) making explicit unspoken and unconscious relationship rules
D) reverting back to relationship patterns that used to work in the relationship

Question 20

Growing up, Bernardo had a difficult relationship with his father, as his father was very demanding and had high expectations. If Bernardo failed to achieve what was expected, his father was likely to be angry and to demean BernardoÕs efforts. Given an object relations perspective, what do you think is most likely about BernardoÕs current intimate relationship?

A) Because Bernardo will have repressed his experiences with his father, he will expect others to be caring and noncritical.
B) Because of repression, Bernardo may not be aware of why he expects intimate relationship partners to be critical of him.
C) Bernardo may treat his intimate partner in a critical way because of projective identification.
D) If Bernardo can contain his negative affect about his partnerÕs perceived criticism, he will not experience relationship dissatisfaction.

Question 21

Sally and Manuel are in couples therapy working on their conflict regarding Sally returning to work after maternity leave. Sally is upset about returning to work, and Manuel is angry with her for being so upset. To intervene successfully, an emotion-focused therapist would work on ________.

A) increasing positive behaviors and decreasing negative behaviors
B) communication skills training
C) expressing primary emotions
D) empathic joining around the problem

Question 22

If you wanted to conduct an effectiveness study of integrative behavioral couples therapy, what would you do?

A) bring couples into the lab to receive treatment from graduate-level supervised therapists and evaluate change in relationship satisfaction from pre- to post-treatment
B) bring couples into the lab to receive either integrative behavioral couples therapy or emotionally focused couples therapy and compare outcomes in the two treatments
C) train therapists in the community to deliver integrative behavioral couples therapy and compare the outcomes to couples who receive treatment as usual in the community
D) train therapists in the community to deliver integrative behavioral couples therapy in a laboratory-based study and compare treatment outcomes to those obtained with graduate-level therapists

Question 23

A therapist who asks a couple to start doing nice things for each other and to give each other time away from the kids and who works on communication skills is most likely practicing from a ________ perspective.

A) behavioral couples therapy
B) integrative behavioral couples therapy
C) cognitive-behavioral couples therapy
D) emotion-focused couples therapy

Question 24

Angela arrives home late from work. Her husband begins to wonder if she is having an affair. This is an example of:

A) selective attention.
B) an attribution.
C) an assumption.
D) an expectation.

Question 25

Which of the following is an example of an assumption according to a cognitive-behavioral perspective?

A) Mohinder thinks that men provide support by solving problems and giving advice, and that women provide support by listening and empathizing.
B) Abilena thinks her husband forgot her birthday because he is mad at her.
C) Julian believes that people should always be honest with each other in a relationship.
D) Renatta thinks that Bobby will ignore her opinions.

Question 26

From a cognitive-behavioral perspective, many processes determine how we interpret the words and behaviors of others. These processes include:

A) selective attention, assumptions, standards, and attributions.
B) selective attention, assumptions, accommodation, and expectations.
C) standards, assimilation, attributions, and expectations.
D) standards, assimilation, accommodation, and assumptions.

Question 27

Sandeep gives Amy the silent treatment when she fails to clean up the kitchen after dinner (it is one of her household jobs). After this happens a few times, Amy tries to remember to clean up more regularly, but over time she slips up and the cycle repeats. Which is an accurate statement about this situation?

A) The silent treatment is an example of a negative reinforcer.
B) AmyÕs failure to clean up the kitchen is an example of punishment.
C) The end of the silent treatment is an example of a negative reinforcer.
D) Amy cleaning up the kitchen is an example of a positive reinforcer.

Question 28

Sally and Manuel are in couples therapy working on a conflict regarding Sally returning to work after maternity leave. Sally is upset about returning to work, and Manuel is angry at her for being so upset. To successfully intervene, a traditional behavior couples therapist would use the technique of ________.

A) reformulation
B) behavior exchange
C) blamer softening
D) communication training

Question 29

Oliver often fails to call his partner, Mike, when he is going to be late coming home from work. On Tuesday, when Oliver is late yet again, Mike states, ÒOliver, I really wish you would call me when youÕre going to be late. When I donÕt hear from you, I start to worry and get scared that something terrible has happened to you.Ó MikeÕs statement is an example of:

A) empathic joining.
B) introjective identification.
C) primary emotional disclosure.
D) secondary emotional disclosure.

Question 30

Bob and Mike are in couples therapy because they have many fights about how much time Bob spends at work. To intervene successfully, an integrative behavior couples therapist would use the technique ________.

A) projective identification
B) relabeling behavior
C) de-escalation of negative cycles
D) empathic joining around the problem

Question 31

What is a main task of a behaviorally oriented therapist?

A) to determine the function of problematic behavior
B) to understand how past relationships affect current behavior
C) to help couples learn to accept each otherÕs shortcomings
D) to change maladaptive attributions

Question 32

Empathic joining is to ________ as unified detachment is to ________.

A) learning that undesirable aspects of the partner are unchangeable; recognizing positive aspects of negative behavior
B) recognizing positive aspects of negative behavior; learning that undesirable aspects of the partner are unchangeable
C) talking without charged emotion; removing blame
D) removing blame; talking without charged emotion

Question 33

Which of the following couples therapy models focuses on having couples engage in empathic joining and tolerance building for resolving differences?

A) behavioral
B) integrative behavioral
C) systems based
D) psychodynamic

Question 34

Which of the following is NOT a strategy or technique used in the original behavioral couples therapy?

A) analyzing the antecedents and consequences of behavior
B) communication training
C) behavior exchange
D) acceptance training

Question 35

Which is an example of a secondary emotion?

A) hopelessness
B) hostility
C) sadness
D) shame

Question 36

What is the cause of relationship distress from a cognitive-behavioral perspective?

A) unresolved conflicts stemming from childhood relationships
B) inflexible rules about relationship behavior
C) dysfunctional relationship behaviors
D) failure to understand and meet each otherÕs needs for connection and security

Question 37

According to the text, which is the most common theoretical model that couples therapists use?

A) systems models, which emphasize the rules that govern and constrain the exchange of behaviors
B) behavioral models, which emphasize the rewarding and punishing properties of exchanged behaviors and their associated cognitions
C) emotion models, which emphasize the ways in which different affective exchanges can inhibit and promote intimate bonds
D) In practice, most professionals draw from a range of perspectives when conducting marital therapy.

Question 38

Which is an example of a primary emotion?

A) anger
B) hostility
C) frustration
D) shame

Question 39

According to emotionally focused couples therapy, ________ is a primary emotion, whereas ________ is a secondary emotion.

A) hostility; sense of abandonment
B) irritation; fear
C) avoidance; helplessness
D) shame; anger

Question 40

According to the text, what is the main rationale of integrative behavioral couples therapy? Relationships will improve if:

A) partners increase the frequency of their positive behaviors and decrease the frequency of their negative behaviors.
B) partners understand how their early experiences with their family affect their current relationship needs.
C) partners change negative attributions about each otherÕs behaviors.
D) partners learn to accept or tolerate the negative aspects of each other and of the relationship.

Question 41

In a study described in the text, Halford, Sanders, and Behrens (2001) examined the effectiveness of a self-regulation version of the Self-Regulatory Prevention and Relationship Enhancement Program (Self-PREP) for couples at low and high risk for marital distress. Couples either received Self-PREP or a placebo control condition. What is an accurate description of the results of this study?

A) There was no difference between the Self-PREP and the control conditions for either high- or low-risk couples.
B) All couples who were administered Self-PREP did much better over time than couples who received the control condition.
C) Low-risk couples did well regardless of which condition they were in, while high-risk couples did much better if they received Self-PREP.
D) High-risk couples did better when they received Self-PREP, but low-risk couples were actually more likely to deteriorate over time if they received Self-PREP rather than the control condition.

Question 42

According to the text, which of the following programs could be characterized as tertiary prevention?

A) intervention for couples who are severely distressed and are at imminent risk for divorce
B) a premarital education program designed to teach couples skills that will prevent future marital distress
C) a Òmarriage checkupÓ that identifies couples at risk for future marital dissolution and provides feedback and suggestions on how to improve their marriages
D) a brochure, published by the government and mailed to all married couples, that provides useful tips on how to have a more satisfying relationship

Question 43

Bob tells his therapist, ÒMarie-Claire doesnÕt really care much about me anymore; there is no point in talking with her about my feelings, because sheÕll just accuse me of being Ôtoo sensitive.Õ Ó Of the following statements, which one is accurate?

A) According to a psychodynamic perspective, Bob is engaging in projective identification.
B) According to a cognitive-behavioral perspective, Bob is making a negative attribution.
C) According to a systems perspective, Marie-ClaireÕs accusations of being Òtoo sensitiveÓ are negative feedback.
D) According to an emotionally focused perspective, Marie-ClaireÕs lack of caring represents a secondary emotion.

Question 44

A ________ prevention is undertaken before relationship problems get worse, whereas a ________ prevention is undertaken before itÕs too late to treat relationship problems.

A) primary; secondary
B) secondary; tertiary
C) tertiary; secondary
D) primary; tertiary

Question 45

In the text the authors distinguish between effectiveness studies (which are designed to find out whether a therapy works in the real, day-to-day clinical practice) and efficacy studies. How are effectiveness studies different from efficacy studies?

A) Effectiveness studies involve unhappy couples.
B) Efficacy studies are usually experiments with some kind of control group.
C) Effectiveness studies tell us whether a therapy works in a controlled laboratory setting.
D) Effectiveness studies and efficacy studies do not differ in any important way.

Question 46

4.Andrew tells you that he is having many problems in his relationship, and he and his girlfriend want to start couples therapy. Given that you are taking a class on intimate relationships, he comes to you for advice about what kind of therapy he should seek. You suggest to Andrew that he seek a therapist who uses a behavioral model of treatment. Provide a rationale for your choice, and briefly describe the primary emphasis of the treatment.

Question 47

6.Distinguish between relabeling and reframing in systems models of couples therapy, and provide an example of each technique.

Question 48

Heather has designed a new treatment for couples in distress. She has conducted several studies in which couples were randomly assigned to receive either her new treatment or another empirically supported treatment. She now wants to look at how her treatment performs when clinical practitioners administer it to couples in the community. In other words, she wants to conduct a(n) ________.

A) clinical trial
B) effectiveness study
C) efficacy study
D) efficacy trial

Question 49

Regarding marriage enhancement, or prevention programs, which of the following statements is true?

A) There is some preliminary evidence that a variant of PREP (Self-PREP) used in Australia may actually be harmful to high-risk couples.
B) A problem with evaluating the outcome research on PREP is that most of the studies did not employ random assignment.
C) Couples who participate in PREP are better at solving problems and communicating. However, they do not tend to be any more satisfied than non-PREP couples.
D) Preliminary evidence indicates that CARE couples are more satisfied than PREP couples at the end of the 3-year follow-up.

Question 50

Which of the following statements about outcome research assessing couples therapy is accurate?

A) Two years following the end of treatment, couples who received integrative behavioral couples therapy have similar relationship satisfaction compared to couples who received the original version of behavioral couples therapy.
B) According to meta-analyses described in the text, at the end of therapy the average treated couple functions better in their relationship than about 50 percent of control couples.
C) Integrative behavioral couples therapy and traditional behavioral couples therapy have been shown to be more effective in improving relationship functioning than psychodynamic and systems models of therapy.
D) All of the above statements are accurate.

Question 51

According to your textbook authors, which of the following is the best analogy for a good intimate relationship?

A) surfing
B) climbing a mountain
C) taking a stroll
D) a sunset

Question 52

5.How are the psychodynamic and systems models of couples therapy different?

Question 53

What is the primary goal of an emotion-focused therapist?

A) to elicit and explore secondary emotions rather than primary emotions
B) to promote acceptance of emotion through empathic joining
C) to gain insight into how early attachment relationships play a role in the current romantic relationship
D) to explore and bring into focus primary emotions

Question 54

7.Compare the explanation for relationship distress with the behavioral model and the emotion-focused model.

Question 55

2.Explain why couples who often wait a long time before seeking help for a struggling relationship make couples therapy challenging for practitioners.

Question 56

How are emotionally focused and integrative behavioral couples therapy similar?

A) They both have the goal of increasing empathy in the relationship.
B) They both work toward increasing the ratio of positive to negative behavioral exchanges.
C) They both focus on creating bonds rather than bargains.
D) They both encourage discussion of the relationship using neutral descriptive terms.

Question 57

8.Compare the interventions in the original behavioral couples therapy model and the interventions in the cognitive-behavioral therapy model.

Question 58

YouÕre reading your newsfeed on Facebook when you notice an ad on the side of the web page. The ad reads, ÒAbout half of all marriages end in divorceÑdo you sometimes worry about your marriage? Click here and visit Dr.ÊVivian TangÊat the Marriage Checkup Clinic to see if your relationship is on the right track.Ó This program is an example of:

A) primary prevention.
B) secondary prevention.
C) primary intervention.
D) secondary intervention.

Question 59

3.You are an aide to the Secretary of Health and Human Services, and your first job is to prepare a brief on specific interventions to strengthen marriages. What three points will you include in your brief?

Question 60

1.You are a research scientist working for a government agency that funds social sciences research. You are developing guidelines for funding, and your group is arguing that research focusing on preventing relationship distress and dissolution should be receiving priority for funding instead of couples therapy. Discuss reasons to support the funding of preventive interventions for couples. Make sure your points are based on the empirical literature, not speculation or supposition, and focus on the question of prevention instead of therapy.

Question 61

11.Describe the stage model used in emotion-focused couples therapy.

Question 62

12.What were the four models of couples therapy described in your text? Describe the source of relationship distress from each perspective.

Question 63

13.A friend of yours is planning to marry next spring. She asks if it would be worthwhile for her to go to an enhancement and prevention workshop that focuses on skill building. What would you tell her, and why?

Question 64

10.Describe the intervention Òunified detachment,Ó which is used in integrative behavioral couples therapy.

Question 65

9.Discuss the differences between assumptions, attributions, and standards according to a cognitive-behavioral perspective. Provide an example of each.