Deck 10: Working-Through and Termination

Question 1

The single most important guideline for negotiating a successful termination to therapy is for the therapist to: ​

A)wait until the last session to approach the subject of ending.
B)unambiguously acknowledge the reality of ending and establish a final date for termination.
C)accept the client's wishes to discontinue the impending termination.
D)address termination carefully and indirectly to prevent the client from becoming angry.

Answer 1

B

Question 2

The therapist's ability to address termination forthrightly will: ​

A)leave clients feeling powerless and out of control.
B)reenact clients' past conflicted feelings over termination.
C)give clients a mastery experience by allowing them to become active, informed participants in the termination.
D)clients do not benefit by openly addressing termination.

Answer 2

C

Question 3

When therapists and clients collude to deny or avoid the impending separation: ​

A)clients' fears of abandonment are healed.
B)therapists may be acting out their own separation anxieties.
C)therapists are eliminating the problem of reenacting the client's generic conflict.
D)clients' initial presenting symptoms may return.

Answer 3

B

Question 4

The most challenging arena of change for the client is: ​

A)the relationship between client and therapist.
B)relationships with developmental figures with whom the conflicts originally arose.
C)relationships with primary others with whom conflict is currently being lived out.
D)Both relationships with developmental figures with whom the conflicts originally arose and relationships with primary others with whom conflict is currently being lived out are correct.

Question 5

Two guidelines for helping clients work through family of origin issues are: ​

A)for clients to change how they respond to current interactions with family members and for clients to grieve what they have missed developmentally.
B)for clients to get angry and blame their abusive parents and for clients to confront their parental figures directly.
C)for clients to learn more assertive communication styles and for them to approach their parental figures directly in order to openly discuss their childhood issues.
D)None of the choices are guidelines for helping clients.

Question 6

Changing how a client______   old problematic relational pattern in their current interactions with family members is a powerful influence on client growth. ​

A)interprets
B)thinks about
C)responds to
D)feels about

Question 7

When clients become discouraged by the repetitious working through process, it is helpful for the therapist to: ​

A)provide the client with a guarantee for change.
B)provide the client with a relationship that offers them a promise of change, by actively reaching out and extending their care and concern for the client.
C)assume responsibility for the client's motivation to continue, by actively reaching out and extending their care and concern.
D)completely avoid the client's transference reactions.

Question 8

One way therapists can help clients begin to discover and articulate their Dreams is to: ​

A)analyze their clients' unmet dependency needs.
B)encourage clients to experience their inner life more fully.
C)reassure them about their weaknesses.
D)help clients act on what they should do.

Question 9

The overreaching treatment goal is to assist clients in replacing defensive characterological coping strategies with the following: ​

A)attainable Dreams.
B)ways to cognitively track anxiety.
C)knowledge of defense mechanisms.
D)insight.

Question 10

For adult clients, the process of experiencing the sadness of hurtful parent-child interactions and coming to terms with these developmental losses is called: ​

A) grief work. ​
B)neurotic resolution.
C)early childhood development.
D)personal growth.

Question 11

A substantial focus of the early drop-out literature has been on the   and       characteristics  ___ of those who terminate early. ​

A)emotional; familial
B)demographic; lifestyle
C)gender; functioning level
D)familial; lifestyle.

Question 12

Research has shown that about______  percent of clients terminate therapy after completing the intake process. ​

A)10
B) ​20
C) ​30
D) ​40

Question 13

Family of origin exploration in the working through phase of therapy can be very meaningful when: ​

A)the therapist carefully points out the connections between past and current relationships.
B)clients spontaneously make links between formative and current relationships.
C)therapists interpret developmental deficits.
D)therapists patiently explain the relational connections to the client.

Question 14

In order to help clients discover their feelings, preferences, interests, values, and their "Dreams," they should repeatedly do which of the following: ​

A)ask clients to attend to what they are experiencing right now.
B)remain interested in and continue entering into the client's subjective experience.
C)acknowledge what clients do well.
D)All of the choices are helpful.

Question 15

A "differentiated sense of self" is defined as: ​

A)a sense of self that is disconnected from others.
B)a sense of self that includes taking others' advice into consideration.
C)a sense of self that connects to a coherent, reflective inner voice that is the foundation for self-efficacy.
D)All of the choices are correct.

Question 16

An important goal for clients in the working through phase of therapy is: ​

A)develop intellectual distance from the current, hurtful relationships.
B)the integration of what was good as well as what was problematic in the client's development.
C)intense analysis of the client's developmental history.
D)breaking off relationships with problematic familial members.

Question 17

Resolving conflicts over separation/termination in the therapeutic setting is: ​

A)the prototype for clients in mastering future conflicts.
B)impossible to accomplish prior to termination.
C)immobilizing of the therapist's ability to help clients change.
D)discouraging to the client who does not want any more losses or endings.

Question 18

The "working-through" is about: ​

A)gaining insight.
B)discovering changes within the self.
C)reflecting on the difficult moments in therapy.
D)linking the changes that have occurred with the therapist to significant others in the client's life.

Question 19

Despite continuous discussion in therapy, when clients do not assimilate or attempt new, adaptive responses: ​

A)the therapist and client are most likely recapitulating the generic conflict.
B)the client is simply not ready to change.
C)the therapist must remain vigilant in guiding the client towards making new responses.
D)the client is probably currently in an abusive relationship where they feel unable to respond assertively.

Question 20

According to Levinson, the "Dream" refers to: ​

A)casual daydreams.
B)night dreams.
C)the kind of life one wants to lead.
D)an unrealistic wish.

Question 21

Describe ways in which the therapist can facilitate the client's family-of-origin work during the working through phase of therapy. Also, discuss how therapists are likely to impede the client's work in this area. ​

Question 22

Explain why it is important for therapists to address termination forthrightly. How does the "countdown" contribute to a forthright termination? ​

Question 23

What are the problems graduate students must face during termination with clients? How do they differ from other therapeutic settings? How can they be productively acknowledged? ​

Question 24

Explain the importance of the articulation of the client's Dreams. How can the therapist facilitate client's definitions of their personal vision for their lives? ​

Question 25

As clients begin to understand their maladaptive relational patterns, they often become interested in family-of-origin work. Discuss how gaining this perspective can empower clients to change their current ways of responding to others? ​

Question 26

Discuss the various guidelines for negotiating a successful termination. How are these significant to the client? ​

Question 27

Describe the sequence of steps that often occurs in the working through process. Be sure to explain how the corrective emotional experience is utilized and detail the additional tasks for both therapist and client. ​

Question 28

What are some of the characteristics of clients who terminate treatment early? ​

Question 29

How does Countertransference impede Family-of-Origin work? How can a new therapist curb their own Countertransference propensities? ​

Question 30

In helping clients grieve the loss of a "wished for" caregiver, what are the therapeutic? ​