Deck 10: Evidence-Based Cognitive-Behavioral Approaches: Dialectic Behavior Therapy and Trauma-Focused Cognitive-Behavioral Therapy

Question 1

The pretreatment state of DBT consists of ______________________________.

A) diagnosis and obtaining medical treatment if necessary before beginning treatment
B) obtaining client agreement to the terms and length of treatment
C) educating clients about the principles surrounding the problem/s they bring to counseling
D) assessing client spirituality to determine if this will be useful in counseling

Answer 1

B

Question 2

Max,a borderline client who professes to believe that all people are untrustworthy,is seeing a DBT therapist who is working to address this belief and help Max see that this expectation is not always accurate.From a DBT perspective,what is the counselor doing?

A) Attempting to relieve client suffering by applying a a strict set of interventions.
B) Providing empathy in order to encourage change.
C) Educating the client on the way the world really is.
D) Working to engage dialectic tension in order achieve synthesis and transcend the tensions.

Answer 2

D

Question 3

The dialectical world view is made up of three primary characteristics: interrelatedness or wholeness,polarity,and ____________________.

A) transformation
B) continuous change
C) enlightenment
D) integrations

Answer 3

B

Question 4

_____________________ is delivered through a comprehensive program of individual and group treatment modalities,including phone support and case consultation.

A) Cognitive-behavioral therapy (CBT)
B) Dialectical behavior therapy (DBT)
C) Trauma-focused cognitive-behavioral therapy (TF-CBT)
D) Traditional behavioral therapy (TBT)

Question 5

The dialect between acceptance and change involves ____________________________.

A) dialectic of embracing the good and bad without judgment
B) dialectic of nurturing and benevolence
C) dialectic of client and counselor agreement
D) dialectic of unwavering centeredness and compassionate flexibility

Question 6

In CBT,rigid goals are not the purpose,but rather compassionate responsiveness that allows for flexibility while maintaining unwavering clearness of purpose.This is referred to as ______________________.

A) dialectic of embracing the good and bad without judgment
B) dialectic of nurturing and benevolence
C) dialectic of client and counselor agreement
D) dialectic of unwavering centeredness and compassionate flexibility

Question 7

In addition to individual sessions and group skills training,DBT may utilize all of the following ancillary treatments EXCEPT:

A) psychopharmacology.
B) substance abuse treatment.
C) vocational counseling.
D) surgical intervention.

Question 8

RBT counseling includes _______________,which are a developed hierarchy to structure treatment,and assessment for _______________,which are necessary for the client to achieve primary goals.

A) primary behavioral targets; secondary behavioral targets
B) polarities; mental health issues
C) schemas; faulty cognitions
D) client agreements; self-harming behaviors

Question 9

Monique is growing quite emotional in session as she relays the details her fears of a new relationship to her counselor.The counselor responds,"Given your history of abuse,it makes sense that you would be afraid to try a relationship again." This is an example of which intervention?

A) acknowledgment
B) denial
C) closing
D) validating

Question 10

Regarding interventions,DBT counselors teach all of the following skills EXCEPT:

A) mindfulness and wise mind.
B) emotional regulation.
C) psychological regulation.
D) distress tolerance.

Question 11

One of the most basic assumptions of the DBT approach is that clients ______________ ______________________________.

A) seek change but do not want to let go of the old way of doing things
B) seek change and are most often ready for change
C) seek change because the they will lose someone close if they do not
D) seek to avoid change because they are happy where they are at in life

Question 12

The DBT relationship in counseling is characterized by ____________________.

A) three sets of dialectic tensions
B) personality traits that get magnified or minimized
C) a loose set of rules applied by the counselor in an unplanned way
D) a rigid set of goals

Question 13

Trauma-focused cognitive-behavioral therapy (TF-CBT)is an evidence-based short term,strengths based approach which resolves trauma and increases self-efficacy.It integrates all of the following elements EXCEPT:

A) family systems theory.
B) humanistic approaches.
C) diagnosis and the medical model.
D) child development theory.

Question 14

DBT uses contingency management procedures to make interactions between client and counselor a learning opportunity.The observing limits procedure,a specific application of contingency management,is used to _____________________________________.

A) set and maintain appropriate limits such as not extending sessions if the client is late, not accepting phone calls at home, not sharing personal information
B) correct a given behavior using aversive consequences
C) act in accordance with client wishes to ensure that a sense of safety is maintained and boundaries that are comfortable for the client are observed
D) solicit another response which the counselor can reinforce

Question 15

After the pretreatment phase,DBT consist of which of the following three stages?

A) assess client resources; reduce trauma-related symptoms; increase life-enriching behaviors
B) reduce crisis behaviors and increase coping skills; reduce trauma-related symptoms; increase life-enriching behaviors
C) reduce crisis behaviors and increase coping skills; increase psychological independence; increase life-enriching behaviors
D) reduce crisis behaviors and increase coping skills; reduce trauma-related symptoms; refer for medical evaluation

Question 16

DBT also utilizes practitioner agreements which include: every reasonable effort,ethical conduct,personal contact,respect,confidentiality,and consultation.

Question 17

Dialectical conceptualization is about finding balance between polar opposites.In the psychological realm opposites take the form of ____________,____________,or _____________.

A) conscious; unconscious; self
B) id; ego; superego
C) thoughts; emotions; behaviors
D) psychoeducation; acceptance; transformation

Question 18

Regarding interventions,the two core strategies of DBT are _____________ and ______________________.

A) assessment; intervention
B) exploring the self; integration
C) diagnosis; treatment
D) validation; problem solving

Question 19

DBT counselors use all of the following types of client agreements EXCEPT _____________________ to help manage the type of problems that arise working with clients diagnosed with borderline personality disorder.

A) a one-year commitment and attendance
B) circumstances of unilateral termination
C) suicidal, self-harming or interfering behaviors
D) substance abuse treatment

Question 20

Which of the following statements best characterizes the nature of individual sessions in DBT?

A) In individual sessions, clients are taught a standard curriculum of psychosocial skills.
B) In individual sessions a relationship is established that validates and nurtures the client while demanding behavioral change.
C) In individual sessions, techniques such as mindfulness are avoided so that the client does not become stuck on emotions rather than behavior.
D) In individual sessions, clients are faced with making behavioral change because the counselor withholds empathy in order to focus on behavior rather than symptoms.

Question 21

What is the cognitive triangle and what is it used for?

Question 22

Explain why the use of validation is important to the client.

Question 23

Regarding case conceptualization,a _________________ is typically done first in order to decide if TF-CBT is the most appropriate treatment intervention.

A) formal diagnostic assessment
B) client interview
C) trial session
D) trauma assessment

Question 24

After treatment,Alexei still has generalized fear of leaving the house.The counselor has developed a plan with the parents that will ask Alexei to take small steps toward the experience of leaving the house.This intervention is referred to as ________________________.

A) relaxation techniques
B) enhancing future safety and development
C) parent-child joint session
D) in-vivo mastery

Question 25

Which of the following is true of DBT in culturally diverse settings?

A) It can be culturally insensitive because of the use of mindfulness and wise mind.
B) It works well with ethnically diverse clients, but not sexual identity issues.
C) It is easily adaptable due to the flexibility of the model as well as the use of client centered values.
D) It does not work well with sexually diverse clients or ethnically diverse clients because it uses counseling-centered values.

Question 26

All of the following would be appropriate working phase goals in this case EXCEPT:

A) increase client's ability to regulate emotion to reduce impulsive behavior in relationships.
B) increase interpersonal effectiveness in personal and work relationships to reduce interpersonal conflict.
C) increase distress tolerance and ability to accept "what is" to reduce crisis behaviors.
D) teach client insight strategies to help develop self-respect and self-compassion.

Question 27

As part of the conceptualization process,April's counselor has asked her to help develop a step-by-step description of the events that led to April arguing with her supervisor when she felt micromanaged.The therapist is conducting a ________________ with April.

A) problem analysis
B) therapy-interfering analysis
C) behavioral chain analysis
D) quality of life-interfering behavioral analysis

Question 28

Which of the following statements is most true about the TF-CBT approach?

A) TF-CBT is comprised of ten components and reflects core values which define the process, such as respect for psychoeducation, client behavior, responsibility-focused.
B) TF-CBT is comprised of ten components and reflects core values which define the process, such as respect for diversity, adaptability, family-focused, self-efficacy focused.
C) TF-CBT is comprised of ten sequential components and reflects core values which define the process, such as respect for the counseling relationship, honoring commitments, integrity-focused.
D) TF-CBT is comprised of ten components and reflects core values which define the process, such as respect for diversity, gender and cultural equality, social-focus, integration-focused.

Question 29

What is the role of the counselor in DBT?

Question 30

The signature intervention of TF-CBT is the ____________________,a gradual exposure technique designed to unpair thoughts memories of trauma from overwhelming emotions.

A) trauma narrative
B) baseline assessment
C) contingency management
D) distress tolerance

Question 31

In addition to trauma assessment,TF-CBT assessment includes all of the following EXCEPT:

A) areas of function using the CRAFTS approach.
B) baseline narrative and functioning prior to trauma.
C) incident recall.
D) parental function.

Question 32

Regarding the case study of April,the client has a history of arriving late to sessions,missing appointments,and ending therapy abruptly.During case conceptualization these would be considered examples of which of the following?

A) therapy-interfering behaviors
B) quality of life-interfering behaviors
C) behavior chain analysis
D) avoidance

Question 33

In what ways are DBT and TF-CBT similar? In what ways are they different?

Question 34

Research indicates that successful recovery from trauma is facilitated by parental involvement,which is why __________________ is the second component of the TF-CBT.

A) parenting skills training
B) relaxation techniques
C) affect expression and modulation
D) psychoeducation

Question 35

TF-CBT uses the _______________ and _______________ both before and after the trauma narrative in order to help children learn to distinguish between thoughts and feelings and challenge unhelpful beliefs.

A) counselor; counselor empathy
B) cognitive triangle; cognitive coping skills
C) breath; focus on the breath
D) cognitive assessment; cognitive restructuring

Question 36

TF-CBT utilizes ____________________ as an intervention in order to normalize trauma responses,develop realistic expectations,beliefs,and cognitions,and inspire hope.

A) psychoeducation
B) parenting skills training
C) relaxation techniques
D) affect expression and modulation

Question 37

The overarching goal of TF-CBT in to optimize the client's adaptive function in all areas of life.

Question 38

The counseling relationship is central to TF-CBT because trauma can result in lack of safety and trust,and therefore requires ____________________________________.

A) a safe, nurturing, accepting, and reliable relationship
B) awareness of the unconscious and preparation for future problem events
C) a strong counselor presence and reality training in order to keep the client grounded in reality
D) a highly structured, rigid environment with clear expectations to create a sense of reliability and clarity of expectations

Question 39

What is synthesis?