Deck 16: Therapy

Question 1

The outcome of psychotherapy is usually dependent on whether the therapist and client achieve

A) a certain similarity of personal style.
B) mutual self-disclosure.
C) an explicit therapeutic contract.
D) a productive working alliance.

Answer 1

a productive working alliance.

Question 2

Therapy outcome studies depend on ratings of the changes seen in clients. One reason that therapists' ratings may be unreliable is because

A) they cannot see the client's behavior in a range of settings.
B) they have a limited range of clients on whom to compare an individual client's improvement.
C) they usually base their judgments on superficial personality tests.
D) they are not in a good position to compare behavior before and after treatment.

Answer 2

they cannot see the client's behavior in a range of settings.

Question 3

To summarize what is known about psychotherapy effectiveness, we can say that

A) the chances of an average client benefiting significantly are impressive.
B) for disorders that have a brief duration, treatment provides no obvious benefit.
C) degree of improvement and number of therapy sessions are unrelated.
D) all therapy outcomes are positive or neutral, none are negative.

Answer 3

the chances of an average client benefiting significantly are impressive.

Question 4

Which of the following would be the most objective way of evaluating treatment success?

A) Gathering information about the therapist's impression of the changes that have occurred
B) Looking at the client's reports of change
C) Asking the client's family and friends to report on the progress they have observed
D) Measuring the change in through personality tests and other instruments

Question 5

Which statement about negative outcomes in psychotherapy is accurate?

A) Nearly one-half of all therapeutic encounters are rated by clients as "negative" or "harmful."
B) The primary reason for negative outcomes is a lack of training and therapeutic skill on the part of the therapist.
C) When a sexual relationship occurs between therapist and patient, it is harmful to the patient.
D) The vast majority of negative outcomes turn out to be reported in fraudulent or frivolous lawsuits brought by clients.

Question 6

In what way does therapy differ from simply talking to a friend or family member about a problem?

A) Therapy takes time, while a friend's guidance is more likely to lead to a "quick fix" of the problem.
B) Friends provide empathy, while a professional therapist does not.
C) A therapist's interaction with a client is guided by theory.
D) Therapists will seek to determine the underlying issues that have created the problem.

Question 7

In general, psychiatrists tend to treat mental disorders by ________ and psychologists by ________.

A) examining and changing behavior and thought patterns; prescribing medications
B) prescribing medications; examining and changing behavior and thought patterns
C) supportive therapy; behavior therapy
D) hospitalization; supportive therapy

Question 8

What two professional groups deal extensively with emotional problems but typically do not have specific training in counseling?

A) Physicians and the clergy
B) Physicians and psychiatrists
C) The clergy and psychiatric social workers
D) Psychiatrists and the clergy

Question 9

Which of the following statements about therapy is TRUE?

A) Even people who are happy and successful can benefit from therapy.
B) Few therapies have been found to be effective.
C) Therapy is usually the most expensive approach to a problem.
D) Each therapist has his or her own approach to therapy and does not alter this approach for different clients.

Question 10

The current practice of providing treatment stresses

A) the value of confining a patient to a mental hospital.
B) the individual's responsibility for finding a personal solution to his or her problems.
C) the coordination of services in the community.
D) turning over to the patient's family the responsibility for behavior change.

Question 11

Which of the following is a disadvantage of psychotherapy?

A) It is ineffective in treating severe mental disorders.
B) It takes time.
C) It is significantly more expensive than all other forms of treatment.
D) It is generally less effective than talking out your problems with a friend or family member.

Question 12

Which of the following is the best example of a "model" therapy session?

A) A child with ADHD is taught ways to filter out distractions.
B) A woman with an anxiety disorder is taught relaxation techniques.
C) An alcoholic sees a therapist, attends AA meetings, and is taking an antidepressant medication.
D) There is no "model" therapy.

Question 13

Which of the following is the most significant challenge to establishing that therapy is effective?

A) Placebo effects commonly occur.
B) It is impossible to determine what component of a treatment plan is responsible for a positive outcome.
C) Many people improve without formal treatment.
D) Few psychotherapies are more effective than medical treatments.

Question 14

Which of the following is NOT an element of a therapeutic alliance?

A) A sense of working together to solve a problem
B) Client acceptance of the therapist's theoretical orientation
C) Agreement between client and therapist about the goals of therapy
D) An affective bond between the client and therapist

Question 15

Individuals vary tremendously in their degree of motivation for psychological treatment. Which of the following is likely to be the most motivated?

A) Harvey, who is going through a job layoff and feels overwhelmed by the crisis.
B) Jennifer, who was referred by the court to undergo therapy because of a drunk driving charge.
C) Marvin, whose wife has said she will divorce him unless he gets treatment for his compulsive gambling.
D) Barry, who is sure he has a heart condition but whose cardiologist suggests he needs psychotherapy to cope with stress better.

Question 16

Andrea begins therapy and expects that the therapy will help her. This expectancy

A) is necessary to produce positive change.
B) may be enough by itself to produce positive change.
C) is helpful in psychodynamic therapy, but irrelevant to cognitive and behavioral interventions.
D) is irrelevant to the change process.

Question 17

The advantage of using outside independent observers or pre/post test comparisons to evaluate a client's progress is that

A) they take less time and are less costly.
B) they increase the objectivity of ratings over those given by the people involved in treatment.
C) they ensure that there is no "regression to the mean" phenomenon.
D) they provide a valid prediction of how the client will behave in real life.

Question 18

Which of the following is believed to be essential for effective treatment?

A) A warm and loving relationship between the therapist and client
B) Family involvement
C) Client reliance on the therapist for direction and guidance
D) Agreement between the client and therapist about the goals of treatment

Question 19

What recent changes have altered the types of therapy that are available?

A) There is an increased need to prove that therapy is effective.
B) Psychiatrists are hesitant to write prescriptions for many drugs.
C) The increased use of nurses as therapy providers has increased the use of drugs in many community health settings.
D) Many popular therapies have been found to do more harm than good.

Question 20

Which person described below is the "typical" client in psychotherapy?

A) A middle-aged woman with a long history of psychotic behavior
B) An attractive and verbal college student
C) A man who has been coerced into treatment by the legal system
D) There is no "typical" client

Question 21

What do the medications used to treat mental illnesses do?

A) Cure the illness
B) Restore brain chemistry to normal functioning
C) Replace depleted neurotransmitters
D) Treat the symptoms of the illness with biochemical changes

Question 22

It was once commonly believed that

A) drugs only treat symptoms.
B) drugs and therapy cannot work together.
C) therapy was the quickest solution to most problems.
D) self-help groups are the best approach to most problems.

Question 23

A major advantage of the atypical antipsychotic drugs is that

A) they work better than the conventional ones.
B) they work for more people than the conventional ones.
C) they have a low risk of movement-related side effects.
D) they last longer than the conventional ones.

Question 24

Prozac is a

A) GABA agonist.
B) monoamine oxidase inhibitor.
C) neuroleptic.
D) selective serotonin reuptake inhibitor.

Question 25

Which of the following is a type of "classical antidepressant"?

A) GABA agonists
B) monoamine oxidase inhibitors
C) neuroleptics
D) selective serotonin reuptake inhibitors

Question 26

Atypical antipsychotics are more commonly used today than ever before because they

A) are not addictive.
B) work more quickly than the typical antipsychotics.
C) produce no side effects.
D) may effectively treat both positive and negative symptoms of schizophrenia.

Question 27

Under what circumstances might the use of medications prior to psychotherapy be essential?

A) When the patient is suicidal
B) When the patient won't admit that they have a problem
C) When the patient's symptoms are so severe that they make psychotherapy impossible
D) When a quick cure is needed

Question 28

Why is a drug that is long-acting desirable?

A) It will work quickly.
B) It will need to be taken less frequently.
C) The likelihood of side effects is decreased.
D) It will be quickly metabolized or excreted.

Question 29

Which of the following is a disadvantage of the use of drugs to treat psychological disorders?

A) Relapse is likely when drugs use is terminated.
B) Drugs are rarely effective in controlling psychotic symptoms.
C) They decrease the need for hospitalization.
D) They alter brain chemistry.

Question 30

The conventional antipsychotic drugs have a problematic side effect involving abnormal movement. This side effect is called

A) agranulocytosis.
B) monoamine oxidase.
C) tardive dyskinesia.
D) atypical neuroleptics.

Question 31

What has research on the use of a combined approach to the treatment of depression demonstrated?

A) Medication alone yields the best results.
B) Psychotherapy alone yields the best results.
C) Psychotherapy in combination with a placebo or medication yields the best results.
D) Medication in combination with therapy yields the best results.

Question 32

The time course of the effects of antidepressant medications suggests that

A) low dopamine levels are the underlying problem in depression.
B) the effectiveness of the TCAs and SSRIs is largely a placebo effect.
C) altered synaptic activity is not the source of a depressed mood state.
D) changes in cellular functioning are necessary to alleviate the symptoms of depression.

Question 33

Why are the SSRIs the most commonly used antidepressants today?

A) Because they only have minimal effects on dopamine, they are less likely to produce side effects.
B) They are more effective than the classic tricyclic antidepressants.
C) Their side effects are more tolerable than those of the first-generation antidepressants.
D) They are not addictive.

Question 34

A randomized clinical trial

A) is a study where all subjects are treated the same to see what percentage of the total gets better, stays the same, or gets worse.
B) is a study where people are assigned to different types of treatment by the flip of a coin to see which treatment is best.
C) is a study where people go through different treatments in random order to see which one works best.
D) is a study where people are assigned to different groups by a flip of a coin, one-half to a treatment group and one-half to a seemingly identical placebo group.

Question 35

Which of the following is a challenge of conducting randomized clinical trials of the effectiveness of therapy?

A) The client will never find out whether or not he or she was treated.
B) Most clients will never improve on their own without treatment.
C) There is little variation between different types of therapy.
D) Even therapists who use the same techniques will differ in their delivery.

Question 36

Julia has just been prescribed a monoamine oxidase inhibitor to treat her depression. What warning should her doctor give her?

A) Stay out of the sun.
B) Be careful what you eat.
C) Don't try to drive a car.
D) You may find that you can't achieve orgasm.

Question 37

What does it meant to say that a study is "double-blind"?

A) Each patient receives both the drug being tested and a placebo, so that the effects of the drug can be compared to the effects of the patient's expectations.
B) While the patient is aware to what treatment he or she is receiving, his or her family, friends, and therapist are not.
C) Both the patient being given the drug and whoever will evaluate the drug's effects do not know whether the patient was given the treatment or the placebo.
D) Two conditions are used, a treatment and a placebo.

Question 38

What is usually used as a placebo in a study of psychosocial treatments?

A) A sugar pill
B) A wait list
C) Self-help meetings
D) Group therapy

Question 39

How commonly are medications and therapy combined today?

A) Combined treatments tend to only be used in an inpatient setting.
B) Approximately 75 percent of those with a mental illness are treated with therapy alone, 10 percent use medications only, and just 15 percent are treated with both.
C) While the combined approach is commonly used in the treatment of children, the same is not true in the adult population where the "quick fix" of a medication is the norm.
D) Research suggests that over half of those in treatment receive both psychotherapy and medication.

Question 40

Drugs that block dopamine receptors are most likely to be used to

A) distort perception.
B) alleviate depression.
C) stabilize mood.
D) treat psychotic disorders.

Question 41

The main use of lithium is for

A) anxiety disorders.
B) personality disorders.
C) major depressive disorder.
D) bipolar disorder.

Question 42

Valium exerts its anxiolytic effects by increasing the activity of

A) acetylcholine.
B) dopamine.
C) epinephrine.
D) GABA.

Question 43

While most antianxiety drugs act on ________, Buspar acts primarily on ________.

A) serotonin; GABA
B) serotonin; epinephrine
C) GABA; serotonin
D) GABA; epinephrine

Question 44

Oscar has been prescribed the following drugs over the years: Valium, Serax, Xanax, and Ativan. We can guess that Oscar has had problems with

A) positive symptom schizophrenia.
B) mood swings.
C) depression and anger control.
D) anxiety and insomnia.

Question 45

Psychological and physiological dependence is a well-documented danger of using

A) anxiolytics.
B) neuroleptics.
C) antipsychotics.
D) lithium.

Question 46

Sarah has just received her first treatment of electroconvulsive therapy. She is most likely to

A) experience auditory hallucinations for a brief time afterward.
B) suffer tonic and clonic seizures over the next week.
C) feel more clearheaded and less depressed following the first two to three sessions.
D) experience amnesia and confusion for an hour after the treatment.

Question 47

The use of lithium in the United States was delayed due to

A) the stigma associated with mental illness.
B) its addiction potential.
C) a lack of evidence to demonstrate that it was effective.
D) the fact that it could not be patented.

Question 48

Antidepressants are used to treat all of the following EXCEPT

A) panic disorder.
B) bulimia.
C) borderline personality disorder.
D) schizophrenia.

Question 49

The newer anti-anxiety drug Buspar has the advantage that

A) it has a low potential for abuse.
B) it works better than other anti-anxiety drugs.
C) it works on more anxiety disorders than the other drugs.
D) it works faster than the other drugs.

Question 50

Lithium was once used

A) to treat anxiety.
B) as a salt substitute.
C) to alleviate constipation.
D) as an appetite suppressant.

Question 51

What do lithium carbonate, carbamazepine (Tegretol), and valproate (Depakote) have in common?

A) They are benzodiazepines.
B) They are used in the treatment of anxiety disorders.
C) They are atypical antipsychotic drugs.
D) They are all mood-stabilizing drugs.

Question 52

____________________ is not a problem associated with the benzodiazepines.

A) Risk of withdrawal symptoms if the patient stops them suddenly
B) High relapse rates when stopped
C) Tardive dyskinesia
D) Psychological dependence

Question 53

For bipolar patients, the risk of relapse after discontinuing lithium is

A) roughly 50 percent within six months.
B) not much higher than when people remain on the medication.
C) extremely unlikely.
D) about 15 percent, but only for people who have experienced repeated bouts with mania.

Question 54

Which of the following would be the most likely candidate for ECT?

A) A 22-year-old schizophrenic
B) A middle-aged depressed woman who has just begun taking antidepressants
C) A pregnant and depressed 25 year-old
D) A 30-year-old man who has generalized anxiety disorder

Question 55

Because much of Donald's depression is a result of his lack of a healthy sexual relationship with his wife, Dr. Jones figured that the best drug to treat him with would be

A) Chlorpromazine.
B) Prozac.
C) Wellbutrin.
D) Zoloft.

Question 56

The use of electroconvulsive therapy can be traced to

A) the observation that people were rarely depressed after being struck by lightning.
B) the belief that schizophrenia and epilepsy are rarely comorbid disorders.
C) the recognition that electricity could be used to alter brain chemistry.
D) the use of electrical shock as an instrument of torture.

Question 57

The process by which lithium reduces the likelihood of mood swings

A) involves changes in stress hormones including cortisol.
B) alters GABA levels, although exactly how it does this is unknown.
C) is a combination of reuptake inhibition and receptor site blockades among serotonin and dopamine tracts.
D) is unknown at this time.

Question 58

A doctor prescribing lithium should NEVER say

A) "This drug has a narrow range of effectiveness, so you need to have your blood levels monitored often."
B) "In order for this drug to work, you need to take quantities that are within the range of potentially dangerous side effects."
C) "We are going to 'target dose' your lithium: When you feel symptoms coming on, take your medication."
D) "Along with the benefits of mood stabilization, you may experience increased thirst and weight gain along with a sense of lethargy."

Question 59

Suzanne is taking a benzodiazepine to treat her anxiety. She should be concerned that

A) mania is a relatively common side effect.
B) she may become physically dependent on the drug.
C) while her anxiety is likely to be diminished, her adaptive behaviors also are likely to become increasingly impaired.
D) when taken in high dosages, the drugs have potentially serious effects on a woman's reproductive ability.

Question 60

ECT has been found to be an effective treatment for

A) anxiety disorders.
B) depression.
C) epilepsy.
D) schizophrenia.

Question 61

Lawrence, a hypochondriac, gains a great deal of attention from his family when he complains about health problems; they tend to ignore him when he talks about other topics. A behavior therapist has instructed the family to reverse these responses: ignore the complaints and reinforce other topics. What kind of treatment does this best illustrate?

A) Aversion therapy
B) Contingency management
C) Guided exposure
D) Systematic desensitization

Question 62

Which of the following is an advantage of behavior therapy?

A) It targets specific emotions and thoughts.
B) It works well if a problem is vague and ill-defined.
C) It works even though there is no scientific support for it.
D) It usually achieves results in a relatively short period of time.

Question 63

A Nobel Prize winning treatment for schizophrenia was

A) the SSRIs.
B) prefrontal lobotomies.
C) ECT.
D) token economies.

Question 64

Which of the following is a form of behavior therapy that is commonly used in the treatment of anxiety disorders?

A) Rational emotive behavior therapy
B) Stress-inoculation therapy
C) Gestalt therapy
D) Systematic desensitization

Question 65

For which client is behavior therapy most likely to be effective?

A) Wilson, whose complaint is premature ejaculation.
B) Angela, who has a variety of personality disorders.
C) Colin, who is struggling with vague concerns about his career and marital prospects.
D) Tamara, who is trying to understand the origins of her personality.

Question 66

Hart says, "For me, the goal of treatment is not to uncover inner conflicts, but to help the client achieve adaptive responses that he or she can control and maintain through self-monitoring." Dr. Hart probably considers herself a ________ therapist.

A) behavior
B) psychodynamically oriented
C) humanistic
D) family systems

Question 67

Dennis has disorganized type of schizophrenia. He has lived in an institution for years. He rarely shows any attempt at socializing. A new program is started - every time Dennis speaks to another person he is given a piece of red paper. At the end of each week, he can use the red papers to get cigarettes or extra privileges. This new program is

A) an in vivo exposure program.
B) a token economy.
C) guided exposure.
D) modeling.

Question 68

Abby is participating in cognitive-behavioral therapy to treat her depression. Her therapist

A) will help her conduct "experiments" to test a variety of hypotheses about the accuracy of her cognitions.
B) will use empathy and accurate reflection so that Abby will come to accept the ways she interprets her experience.
C) will be nondirective in helping her change.
D) will demonstrate ways of acting and then ask her to imitate these.

Question 69

Cognitive-behavioral therapy

A) denies the importance of reinforcement and punishment.
B) assumes that thinking influences emotion, motivation, and behavior.
C) assumes that behavior must change before cognitive changes can occur.
D) suggests that the therapist should take a less active role than is typically the case in behavior therapies.

Question 70

In the mid-1900s, prefrontal lobotomies were popular as a treatment because

A) there were not many other available treatments.
B) they worked so well.
C) they worked faster than any other treatment.
D) they worked for so many disorders.

Question 71

Yuko is painfully shy. Her therapist first shows her appropriate social skills so she can interact competently with others. Then Yuko attempts the same behavior while getting feedback. This illustrates the behavior therapy technique called

A) guided exposure.
B) covert sensitization.
C) modeling.
D) contingency management.

Question 72

While ________ can be used in treatment, it also a means by which problematic behaviors are acquired when others' behavior is problematic.

A) imaginal exposure
B) systematic desensitization
C) modeling
D) contingency management

Question 73

The text reported the case of a 6-year-old boy who hated school and showed off in class. His parents and teacher were instructed to ignore the showing-off behavior while reinforcing appropriate behavior. This is an example of

A) systematic use of reinforcement.
B) modeling.
C) aversion therapy.
D) systematic desensitization.

Question 74

Punishment is a component of

A) EMDR therapy.
B) modeling.
C) aversion therapy.
D) systematic desensitization.

Question 75

Chrissy and her therapist together wrote a list of ten scenes involving Chrissy's fear of flying. After teaching her a relaxation technique, Chrissy's therapist told her to imagine herself in the least frightening scene while she made herself feel relaxed. Chrissy was undergoing

A) exposure in vivo.
B) systematic desensitization.
C) modeling therapy.
D) rational emotive therapy.

Question 76

The basic assumption of cognitive-behavior therapy is

A) problems develop because people view themselves and their world in biased ways.
B) abnormal behavior is learned like normal behavior and can be unlearned.
C) people have the freedom and responsibility to control their own lives.
D) only observable behaviors can really be changed.

Question 77

The use of drugs that have noxious effects and viewing movies that elicit disgust are both techniques associated with

A) token economies.
B) aversion therapy.
C) guided exposure therapy.
D) EMDR therapy.

Question 78

A token economy is

A) a form of imaginal exposure therapy.
B) a type of in vivo exposure therapy.
C) a type of contingency management.
D) a form of modeling therapy.

Question 79

Today, neurosurgery

A) is still used, including prefrontal lobotomies, on patients who have not responded to any other treatment.
B) is used as a last resort and involves the destruction of only tiny areas of the brain.
C) is done frequently for certain types of psychological illnesses, such as obsessive compulsive disorder.
D) is no longer done for any psychological disorder.

Question 80

Behavior therapy is based on the belief that

A) medications cause more harm than good.
B) internal states, such as thoughts and feelings, are not as important as overt behavior.
C) abnormal behavior is learned the same ways as normal behavior and can be unlearned.
D) thoughts influence behavior and thoughts can be changed.