Deck 17: Outcomes And Issues In Psychological Intervention

Question 1

Young's schema-focused therapy is a combination of CBT and client-centered techniques.

Answer 1

False

Question 2

Canadians are more likely to receive empirically supported pharmacological therapies than empirically supported psychological therapies for the treatment of mental health issues.

Answer 2

True

Question 3

A strong therapeutic alliance is one of the most important elements for treatment success.

Answer 3

True

Question 4

Transference is a key element of both classical psychoanalysis and brief psychodynamic therapy.

Question 5

The dodo bird effect refers to various therapies leading to similar outcomes.

Question 6

Research tends to support the efficacy of both long- and short-term psychodynamic therapy.

Question 7

Intermittent reinforcement makes new behaviour more enduring.

Question 8

The demoralization hypothesis is used to explain why some people do not respond to therapy.

Question 9

Desensitization is appropriate to use for all cases of anxiety and fear.

Question 10

If a person is not motivated to change, therapy cannot help them.

Question 11

Jonas is seeking therapy for comorbid depression and anxiety. His treatment is deemed a success, even though he still has lingering symptoms after weeks of therapy.

Question 12

Therapy research is usually more restrictive than what is seen in the community.

Question 13

Motivational interviewing can be used in therapy to help people develop a readiness for change.

Question 14

Ethical clinicians only use treatments that have been supported in research.

Question 15

Core competencies are considered essential skills needed by therapists.

Question 16

According to the client-centered view, people become disordered when they guide their behaviour according to their inner nature.

Question 17

Therapists with a fearful attachment style are less effective.

Question 18

Fearful attachment style is associated with poorer therapy outcomes.

Question 19

If a treatment for depression is said to be effective, that has been determined through controlled research studies.

Question 20

When working from a stepped care model, the most severe cases receive the most extensive treatment from the start.

Question 21

A factor in psychotherapy process and outcome that is more important than previously believed, as stated by Greenberg et al. (2006), is:

A) Client's personality
B) Client's level of dependency toward the therapist
C) Client's sense of mastery
D) Client's therapy outcome expectations

Question 22

REBT began as a form of marital therapy.

Question 23

One client factor influencing the strength of the therapeutic alliance has recently been identified as:

A) Attachment style
B) Psychotherapeutic mindedness
C) Conscientiousness
D) Involvement in therapy

Question 24

Nora is thinking about seeking therapy. She has been feeling pretty depressed for a while, but isn't sure it's severe enough to warrant seeking help. She's also not sure therapy can really help. If she decides to seek help, which client factor mentioned will most likely play a role in her therapy's success (or failure)?

A) Therapist competence
B) Motivation for change
C) Therapy outcome beliefs
D) Client personality

Question 25

Motivational interviewing and compassion focused therapy are rooted in a Rogerian approach.

Question 26

Couples therapy is effective across all levels of dysfunction in a relationship.

Question 27

In virtuo exposure is used as a pre-cursor to in vivo exposure for treating phobias.

Question 28

Theoretical integration is when a therapist practices primarily from one orientation, but also draws on techniques from others.

Question 29

Therapy delivered via the internet tends to have little efficacy.

Question 30

Motivational interviewing (MI) is most similar to:

A) Psychodynamic therapy because of its focus on motivations
B) Gestalt therapy because its use of the empty-chair technique
C) Dialectical behavioural therapy because of its emphasis on emotional dysregulation
D) Client-centred therapy, but MI is directive rather than non-directive

Question 31

A key feature of couples therapy is to improve communication between partners.

Question 32

Carl Rogers was the originator of psychotherapy research.

Question 33

CBT and integrative behavioural couples therapy (IBCT) work about equally well.

Question 34

In the therapy outcome case study that opens Chapter 17, the patient (as a child) watched her father drown a litter of kittens. This patient was treated with:

A) Psychoanalytic therapy
B) Emotion-focused therapy
C) Interpersonal therapy
D) Cognitive-behaviour therapy

Question 35

Research (Joyce et al., 2010) in individual differences in _____ showed that clients with a(n) _____ have less favourable treatment outcomes.

A) personality; low openness to experience
B) personality; neuroticism
C) attachment style; insecure attachment
D) attachment style; dismissive attachment

Question 36

Motivational interviewing was initially designed for use in:

A) Anxiety disorders
B) Addictions
C) Depression
D) Psychosis

Question 37

Frand and Frank (1985) argued that people seek psychotherapy not only because of their symptoms but also because these symptoms are accompanied by feelings of alienation, hopelessness, helplessness, loss of self-esteem and incompetence. They named this phenomenon:

A) Demoralization hypothesis
B) Individual-difference hypothesis
C) Mental-severity hypothesis
D) None of the above

Question 38

Among client factors affecting therapy outcomes, which of the following has been found to account for 40% of beneficial outcomes?

A) Client's personality
B) Client's level of dependency toward the therapist
C) Client's sense of mastery
D) Client's therapy outcome expectations

Question 39

One therapy outcome belief factor that has a positive influence is:

A) Helpfulness
B) Hope
C) Positive affect
D) Motivation to change

Question 40

Most therapists practice primarily from one orientation, but also draw on theories or techniques from others.

Question 41

In order to be consistent with evidence-based clinical practice, treatment manuals should be __________ based.

A) disorder-
B) theory-
C) ecologically-
D) intervention-

Question 42

According to Parry et al. (2010), what frustrates clinicians and health services researchers in regard to research outcomes?

A) They do not reflect pragmatic concerns.
B) Although well designed, some experimental approaches are inappropriate, impossible and inadequate.
C) Research projects contains samples that do not reflect patients encountered in clinics.
D) All of the above

Question 43

Brian is thinking about attending graduate school to study clinical psychology. His friends and family have always told him that he is a good listener and gives off good vibes. Brian is genuinely interested in helping people. Based on research:

A) Brian is unlikely to be a good therapist - being a good listener isn't enough
B) Brian may or may not be a good therapist - there isn't enough information to judge
C) Brian will probably be a good therapist - people find him warm and easy to talk to
D) Brian may or may not be a good therapist - it depends on his attachment style more than anything else

Question 44

Motivational interviewing is increasingly combined with _____ in treatment of diverse disorders, such as anxiety and depression.

A) CBT
B) REBT
C) Gestalt
D) Client-centred

Question 45

In a recent survey of practitioners, Ogrodniczuk et al. (2010) revealed that 60% of practitioners endorsed which of the following?

A) That psychotherapy research does not reflect the complexities of group therapy.
B) Research procedures tend to support the typical therapy process.
C) Randomized control trials are appropriately emphasized.
D) Therapist, patients, and settings tend to reflect real life clinics.

Question 46

Studies of therapeutic alliance indicate that ___________ in predicting positive treatment outcome.

A) the therapist's view is more important than the client's view
B) the client's view is more important than the therapist's view
C) both client and therapist views are equally important
D) neither the client's nor therapist's view is important

Question 47

The earliest treatment manuals were developed:

A) By Freud and his followers.
B) For evaluating outcome of psychodynamic therapy among Neo-Freudians.
C) In evaluating systematic desensitization trials.
D) For cognitive therapy outcome studies.

Question 48

Joe has a choice between two therapists - Hal, who has been in clinical practice for 20 years, or Michael, who recently completed his training as a counselor. Assuming all other variables are the same, if Joe wants to have a better experience, based on research, which therapist should he choose?

A) Hal
B) Michael
C) Either one - therapist experience is unrelated to treatment outcome
D) Neither - Joe will have more success with a female therapist

Question 49

A review of the client-therapist relationship by Adam Horvath from Simon Fraser University revealed that therapy outcome was best predicted by:

A) The patient's perceptions of the therapist's behaviour
B) The therapist's perceptions of the patient's behaviour
C) The therapist's actual behaviour in the therapeutic relationship
D) The patient's actual behaviour in the therapeutic relationship

Question 50

Early in therapy, Tom has found that he enjoys meeting with his therapist. The two seem to be working toward a common goal, and the time appears to go quickly. This would characterize a good:

A) Rapport.
B) Initial symptom reduction.
C) Process.
D) Working alliance.

Question 51

One problem with treatment manuals is that the majority are ___________ based.

A) disorder-
B) theory-
C) ecologically-
D) intervention-

Question 52

According to an edited book by Arkowitz and colleagues (2007), motivational interviewing is believed to be particularly appropriate for patients:

A) Who have insight
B) Who are already well-prepared to make changes in their lives
C) With a comorbid disorder that has an element of addiction
D) Who have a single diagnosis

Question 53

Comparative investigations (Stirman et al., 2003) of research participants in randomized control trials in clinical research versus general community outpatients show that:

A) There are more similarities than differences between research participants and community outpatients
B) Most common diagnoses in outpatients are represented in psychotherapy research
C) It is quite risky to generalize from research studies to the actual practice of psychotherapy
D) None of the above

Question 54

By current standards, in order to conduct a therapy trial, a researcher must:

A) Have a therapy manual.
B) Have access to licensed therapists.
C) Be affiliated with a medical school.
D) Be familiar with psychopharmacological agents.

Question 55

Research indicates that therapeutic alliance:

A) Is unrelated to client treatment preferences
B) Ratings by clients and therapists are generally highly correlated
C) Is associated with rapid decline in maladjustment across different treatment modalities
D) Tends to change substantially throughout the course of treatment

Question 56

Which of the following concerns have been noted about the use of treatment manuals?

A) They encourage unqualified individuals to perform therapy
B) They promote rule-governed behaviour
C) Each manual usually covers only a single method or type of therapy, which may not be appropriate in all instances
D) Minimal clinical judgment is used because of the abstract representations of the typical patient

Question 57

Which of the following is true about the "working alliance" in therapy?

A) It is a specific rather than a non-specific factor that is related to the quality of treatment.
B) It involves an agreement between patient and therapist about the goals and tasks of therapy.
C) It is inversely related to client satisfaction.
D) It is a cause rather than outcome of therapeutic change.

Question 58

Jenna and Jill both enter into therapy at their university counseling centre for the treatment of anxiety. In addition to problems with anxiety, Jenna also has a problem with gambling. After 8 sessions of treatment, both women terminate therapy successfully. Who will likely continue to have symptoms of anxiety, if either?

A) Jenna
B) Jill
C) Both of them
D) Neither of them

Question 59

What percentage of surveyed practitioners (Ogrodniczuk et al., 2010) believe that randomized control trials were overemphasized?

A) 30%
B) 40%
C) 50%
D) 60%

Question 60

All counselors go through training programs that train them in:

A) Cognitive-behavioural theory
B) Core competencies
C) Cultural competencies
D) How to treat depression effectively

Question 61

What is offered to and received by people in the everyday world is referred to as the ___________ of an intervention, according to Dobson and Hamilton (2002).

A) reliability
B) efficacy
C) etiology
D) effectiveness

Question 62

International experts who conduct psychotherapy research agree that:

A) No clients get worse as a result of treatment
B) Most therapists learn more about effective therapy techniques from their research rather than from their personal experiences
C) The client-therapist relationship is the best predictor of treatment change
D) All of the above

Question 63

As part of a study of consensus beliefs about psychotherapy research, Boisvert and Faust (2003) recommended that clients must be informed explicitly that:

A) The client-therapist relationship is the best predictor of treatment change
B) Different therapies tend to achieve comparable results
C) They may actually get worse as a result of treatment
D) Most clients achieve some change relatively quickly in therapy

Question 64

When a researcher determines, objectively, an outcome of a study on schizophrenia associated with reduction in negative symptoms, that is referred to as:

A) Effectiveness
B) Efficacy
C) Positive effects
D) Grant-funded

Question 65

It has been suggested that therapist manuals increase which type of validity?

A) Internal validity
B) External validity
C) Ecological validity
D) Experimental validity

Question 66

According to Seligman's (1995) summary, what did Consumers Reports find with regard to psychotherapy effectiveness?

A) There was no statistical difference between long-term and short-term treatment
B) In terms of perceived effectiveness, psychotherapy plus medication was more beneficial than psychotherapy alone
C) Family doctors were just as effective as mental health professionals in the short-term and long-term
D) No particular type of psychotherapy treatment was perceived as more effective or superior than another

Question 67

According to Dobson and Hamilton (2002), what should effectiveness researchers try to maximize in their studies?

A) Internal validity
B) External validity
C) Ecological validity
D) Experimental validity

Question 68

Stepped care models of treatment may be most appropriate to use when:

A) Resources are scarce
B) Resources are plentiful
C) Problems are intense
D) Problems are non-existent

Question 69

Which of the following diagnoses is commonly overlooked in controlled research studies?

A) Major depression
B) Panic disorder
C) Adjustment disorder
D) Borderline personality disorder

Question 70

What do the non-representative samples that are inherent to clinical trials suggest?

A) The treatment method used in any given study may not be equally therapeutic to all participants
B) Prevalence rates of many disorders may be incorrect
C) Community treatment orders are ineffective
D) It is risky to generalize from controlled studies to the actual population

Question 71

The dodo bird effect refers to:

A) Historical therapies that were once popular but have fallen out of favour
B) Situations in which the therapist's personal needs wrongly impact the quality of treatment
C) The tendency for different therapies to achieve similar effects
D) The tendency for therapies to work without knowing which specific aspects were effective

Question 72

Why don't therapists deliver empirically supported treatment for PTSD?

A) There are no empirically supported treatments for PTSD
B) Empirically supported treatments for PTSD require expensive software and equipment
C) They are not aware of such treatments
D) They don't feel competent delivering such treatments

Question 73

International experts who conduct psychotherapy research estimate that ________ of clients get worse as a result of therapy.

A) 2%
B) 10%
C) 15%
D) 25%

Question 74

What is the underlying notion to stepped care models of treatment?

A) Patients should be assessed on a series of levels before entering treatment.
B) The level of treatment should be "stepped up" if a patient has good insurance benefits
C) Less costly treatments should be given initially followed by more complex interventions if the former are not helpful.
D) The most intensive treatments should be given as a first step to reduce the likelihood of a person's problems escalating

Question 75

In terms of the attempt to link clinical practice to the empirical literature on the effectiveness of therapies, in contrast to the U.S. who is redeveloping lists of empirically supported therapies, the Canadian Psychological Association Task Force:

A) Provided information about the limitations of current empirical knowledge.
B) Did not do anything about this issue.
C) Tried to find out what treatments are typically used for particular disorders.
D) Looked for more funding for evidence-based treatment programs.

Question 76

The term "The Dodo Bird Effect" derives from the famous book:

A) The Wind in the Willows
B) Alice in Wonderland
C) The Lord of the Flies
D) One Flew Over The Cuckoo's Nest

Question 77

According to Dobson and Hamilton (2002), what should efficacy researchers try to maximize in their studies?

A) Internal validity
B) External validity
C) Ecological validity
D) Experimental validity

Question 78

The advent of managed care has changed what aspect of practice for psychologists?

A) Theoretical orientation
B) Focus upon underlying causes
C) Accountability
D) Efficacy

Question 79

Research from Stirman and colleagues (2003) confirmed that the participants in randomized controlled psychotherapy studies tended:

A) To have higher comorbidity rates than the general population
B) To be forced into therapy by their families or by community treatment orders (CTOs)
C) To have different disorders compared with the majority of patients in psychotherapy
D) To be recruited from hospital inpatient settings rather than community outpatient settings.

Question 80

Jamal is seeking treatment for combat-related PTSD. If his experience is much like others, he will receive:

A) Exposure based treatment
B) Empirically supported treatment
C) Whatever treatment his therapist is most comfortable delivering
D) No treatment, as the military denies the existence of PTSD