1
Q
Define middle stage of therapy.
A
The phase where clients explore deeper issues and work on implementing changes.
2
Q
What is the goal of intervention in the middle stage?
A
To facilitate insight, promote change, and strengthen coping strategies.
3
Q
True or false: Cognitive restructuring is used in the middle stage.
A
TRUE
It helps clients challenge and change negative thought patterns.
4
Q
Fill in the blank: Role-playing is a technique used to enhance _______ skills.
A
social
5
Q
What is emotion regulation in therapy?
A
Techniques to help clients manage and respond to emotional experiences.
6
Q
Define goal setting in the context of therapy.
A
The process of identifying specific, measurable objectives for client progress.
7
Q
True or false: Homework assignments are common in the middle stage.
A
TRUE
They reinforce skills learned in sessions and promote practice.
8
Q
What is the purpose of feedback in therapy sessions?
A
To provide clients with insights on their progress and areas for improvement.
9
Q
Fill in the blank: Mindfulness techniques help clients focus on the _______.
A
present
10
Q
What is self-disclosure in therapy?
A
When therapists share personal experiences to enhance the therapeutic relationship.
11
Q
Define motivation enhancement.
A
Strategies to increase a client’s willingness to change and engage in therapy.
12
Q
True or false: Supportive counseling is not used in the middle stage.
A
FALSE
It provides emotional support while addressing deeper issues.
13
Q
What is the role of group therapy in the middle stage?
A
To provide peer support and facilitate shared experiences among clients.
14
Q
Fill in the blank: Behavioral interventions focus on changing _______ patterns.
A
maladaptive
15
Q
What is the significance of therapeutic alliance?
A
A strong relationship between therapist and client enhances treatment outcomes.
16
Q
Define exposure therapy.
A
A technique that involves gradual exposure to feared situations to reduce anxiety.
17
Q
True or false: Coping skills training is irrelevant in the middle stage.
A
FALSE
It equips clients with strategies to handle stressors effectively.
18
Q
What is the purpose of journaling in therapy?
A
To encourage self-reflection and track emotional progress over time.
19
Q
Fill in the blank: Assertiveness training helps clients express their _______.
A
needs
20
Q
What is solution-focused therapy?
A
An approach that emphasizes finding solutions rather than focusing on problems.
21
Q
Define narrative therapy.
A
A therapeutic approach that uses storytelling to help clients reframe their experiences.
22
Q
True or false: Cognitive-behavioral techniques are not applicable in the middle stage.
A
FALSE
They are essential for addressing cognitive distortions.
23
Q
What is the role of relapse prevention in therapy?
A
To equip clients with strategies to maintain progress and prevent setbacks.
24
Q
Fill in the blank: Interpersonal therapy focuses on improving _______ relationships.
A
interpersonal
25
What is the significance of **cultural competence** in therapy?
To ensure that interventions are respectful and relevant to clients' cultural backgrounds.
26
Define **client empowerment**.
Encouraging clients to take an active role in their own healing process.
27
Delbert comes to the first session of therapy asking for help with his depression. He admits that he "self-medicates" with pot and beer "almost every day." What interventions would the clinician use in the middle stage of therapy?
Select one:
A.
Explain to Delbert that therapy cannot happen while he is using and make a contract for complete sobriety.
B.
Assess Delbert' drug and alcohol usage and do a suicide screening since he is so depressed.
C.
Help Delbert become clean and sober and learn to handle his emotions.
D.
Help Delbert understand the triggers that cause him to use, and teach him how to handle the thoughts that trigger his negative emotions.
The Correct Answer is D.
The case is asking about interventions (things that you do) in the middle stage of therapy to help Delbert with his substance abuse and depression.
This answer describes middle stage interventions that deal with both of Delbert' presenting problems: depression and substance abuse.
28
Your client Sherri is a 15-year-old dancer. She has had anorexia for approximately 7 months and weighs 87 pounds. She has been in and out of town over the last few months and it is hard to see her regularly. During your appointments with her, she generally complains about her weight and how "fat" she thinks she is in her leotard. She keeps trying to talk her parents into liposuction and doesn't understand why they can't see that it is "for my career." What would be the best set of interventions for Sherri?
Select one:
A.
Regular medical monitoring.Family sessions. A journal of accomplishments.
B.
Regular individual sessions.Identifying dysfunctional beliefs regarding normal amounts of food.Paradoxically agreeing with her feelings of being "too fat."
C.
Regular individual sessions. A journal of accomplishments. A contract to gain weight.
D.
Regular medical monitoring. Identifying fears of failure. Family sessions.
The Correct Answer is D.
D: Having Sherri participate in regular medical monitoring would be helpful. Medical monitoring in addition to psychotherapy is a MUST for anorexics because of the array of health risks involved with Anorexia Nervosa. Helping Sherri to identify her fears of failure may help change her obsessions with perfection. Family sessions have been shown to be particularly effective with anorexics because the root of the problem often starts in the family relationships.
29
Kathy, age 20, comes to see you self-referred. She and her 3-year-old son have been living with her parents since she separated from her husband 2 months ago. She says she is desperate for a job but is afraid and can't imagine going to job interviews alone. Since moving back with her parents, she has been having trouble sleeping at night, so she rests during the day; however, her son bothers her. She avoids eye contact with you and says that it is culturally inappropriate to seek help, but that she is desperate. If using the empty chair technique was not effective in helping Kathy express her feelings about her husband, how would you proceed?
Select one:
A.
Explore how her cultural values inhibit her ability to express herself. Have Kathy recount when and how she and her husband met. Have Kathy speak to you as if you are her husband. Teach Kathy relaxation exercises to help her fall asleep at night.
B.
Consider the possibility that this intervention may be culturally inappropriate. Have Kathy recount when and how she and her husband met. Have Kathy journal her feelings about her husband. Have Kathy speak to you as if you are her husband.
C.
Explore how her cultural values inhibit her ability to express herself. Have Kathy recount when and how she and her husband met. Ask Kathy to bring in pictures of her husband. Teach Kathy relaxation exercises to help her fall asleep at night.
D.
Consider the possibility that this intervention may be culturally inappropriate. Have Kathy journal her feelings about her husband. Have Kathy recount when and how she and her husband met. Ask Kathy to bring in pictures of her husband.
The Correct Answer is D.
Answer D: It would be important to consider how Kathy's cultural background may affect her reaction to different interventions. Kathy states that coming to therapy is culturally inappropriate. Considering and exploring this issue with Kathy, in a non-blaming manner, would be useful. Journaling may help Kathy get in touch with her feelings about her husband in a safe, non-threatening manner and, eventually, she may want to bring in and share her writings with you. Having Kathy tell stories about her husband and their relationship may be a good way to help Kathy begin expressing her feelings about the relationship. Pictures often trigger memories of events and the stories that go along with them. Having Kathy bring in pictures may help her get in touch with her feelings as she shares them with you.
30
Alexandra, age 30, is brought in by her mother who is worried about her recent behavior. Alexandra has been increasingly agitated, has difficulty sleeping and is withdrawing. Based on this information, what is her most likely DSM diagnosis?
Select one:
A.
Cannabis Intoxication
B.
Bipolar I Disorder
C.
Schizophrenia
D.
Stimulant Use Disorder
The Correct Answer is D.
D: Stimulant Use Disorder presents with psychomotor agitation or retardation, tension, restlessness, and impaired social or occupational functioning. Of the choices given, Stimulant Use Disorder could contribute to the symptom picture presented.
31
A family of four is in their second session with you. One of the children always starts the session by talking about her day. Her mother tells you that she likes her new school and she does that because everyday when she gets home, either she or her father ask about how her school day went. Her mother says, "she is not trying to get attention. It just means she is comfortable with you." Which of the following would most likely NOT apply to therapy conducted by a Structural family therapy perspective?
Select one:
A.
A detailed family history.
B.
Mapping.
C.
Attention to arrangement of family members, body postures.
D.
Attention to the family's developmental phases.
Incorrect
The Correct Answer is A.
Answer A: Structural family therapy is oriented to the here-and-now; a detailed family history is not reflective of this approach.
32
Your client was diagnosed with Major Depressive Disorder a year ago but the main symptoms have abated. She now reports that she feels sad and discouraged, and is afraid that the severe symptoms she had before will make her lose her job. She has been staying in almost every night because she doesn't feel like making the effort to go out, get dressed up and do her hair. Most of her contact with the outside world is through social media. Which DSM-5 diagnosis would be appropriate?
Question 14Select one:
A.
Other Specified Depressive Disorder
B.
Chronic Depressive Disorder
C.
Major Depressive Disorder, Recurrent
D.
Unspecified Depressive Disorder
Feedback
The Correct Answer is A.
A: The client meets the criteria for Other Specified Depressive Disorder because the time frame and the number of symptoms are fewer than required for Major Depressive Disorder but there are identifiable depressive symptoms.
33
Kendall, age 19, comes to you complaining of depression and anxiety. His symptoms have intensified since he left home and he reports, "I've been depressed and anxious all my life, just like my mother." He is working a full-time job and living with two roommates in an apartment downtown. Which of the following statements is true?
Select one:
A.
A Solution-Focused therapist would bring the mother in to support Kendall in finding the best solutions to his problem. They would talk about all the times when they could get along without having feelings of depression or anxiety.
B.
A Cognitive-Behavioral therapist would use shaping techniques to relieve the maladaptive cognitions leading to depression and anxiety. Kendall would be assigned homework in the middle stage of therapy.
Incorrect
C.
A Narrative therapist would help Kendall deconstruct the story of the depression and anxiety. The therapist and Kendall would map the times when depression is not a part of his life.
D.
A Family Systems therapist would challenge the equifinality of Kendall's assessment about the origins of his anxiety and depression. The therapist would also reframe Kendall's assumptions so that he can make second order change.
The Correct Answer is C.
C: Kendall's story--that he is just like his mother and therefore needs depression and anxiety as coping mechanisms--is just a story from the Narrative perspective. So a Narrative therapist would help Kendall to challenge the taken-for-granted truth of Kendall's story in a process known as "deconstruction." Mapping the influence of the problem is a Narrative intervention.
34
Dan calls you after not seeing you for 8 years. He remembers that he always felt better when he would come to talk to you and therefore wants to return to therapy. Lately, he has been feeling as though nothing is important to him. "I feel worthless," he tells you. Dan is 36 and has never been married. You remember that he used to drink heavily and smoke pot daily. He says that he is now clean and sober and out of debt. As a Client-centered therapist, what would be your initial treatment plan for Dan?
Select one:
A.
Reconnect to make sure that Dan feels safe. Assess for suicide ideation. Refer to a psychiatrist for a medication evaluation. Promote insight into how the past is affecting the present.
B.
Establish a collaborative relationship. Identify what goals Dan is looking to achieve and prioritizing them on a problem list. Do a thorough assessment. Make the proper referrals.
C.
Provide unconditional positive regard. Provide empathy and congruence. Facilitate Dan's self-awareness and trust. Make the proper referrals.
D.
Use here-and-now "I" statements for Dan to be in the moment. Conduct a Mental Status Exam. Set boundaries. Make the proper referrals.
The Correct Answer is C.
C: Providing unconditional positive regard would be typical of Client-centered (Humanistic) therapy. Providing empathy and congruence would be typical of Client-centered (Humanistic) therapy. Facilitating Dan's self-awareness and trust would be typical of Client-centered (Humanistic) therapy. Making the proper referrals is correct but generic.
35
Edward, age 37, comes in to see you because the guys at work at his used car lot are upset that he smashes windshields and screams at them when he loses a sale. Edward says that he's dissatisfied with his job. Edward is a recovering alcoholic with one year of recovery. He's in the third year of his second marriage that he says is "breaking down just like the first one." He is afraid his wife will leave him. They have a 1-year-old daughter. What crisis issues and psychosocial stressors would you consider in this case?
Select one:
A.
Marital problems, Job dissatisfaction, Possible divorce, Raising a young child.
B.
Child abuse, Spousal abuse, Substance abuse, Explosive anger.
C.
Child abuse, Spousal abuse, Marital problems, Job dissatisfaction.
D.
Potential Tarasoff due to explosive anger, Substance abuse, Raising a young child, Possible divorce.
The Correct Answer is C.
Given Edward's explosive anger, child abuse is a crisis concern in this exhibit. Given Edward's explosive anger and the marital conflict, spousal abuse is a crisis issue that needs to be considered in this exhibit. Edward reports that his marriage is breaking down and is afraid his wife is going to leave him. Job dissatisfaction is another psychosocial stressor presented in this exhibit.
36
A Mexican-American family comes in because their teenage son has been acting out. They were referred by their son's school and have been in therapy for a couple of sessions. They have three children and want him to be more respectful of his role in the family. He is the oldest and they tell you that he needs to start acting like a man, not a boy. Both of his parents work outside of the home and he is responsible for taking care of his younger sisters. You would:
Select one:
A.
Encourage participation from all family members so that they can each have an equal voice.
B.
Encourage the children so that they can express their feelings.
C.
Present them with a plan and gauge their reaction to it.
D.
Understand that the process this family is going through is due to acculturation.
Feedback
The Correct Answer is C.
C: Presenting them with a plan and gauging their reaction to it would be respectful to the decision-making power that the father (generally) has in the Mexican-American culture.
37
You have been seeing George for 7 months. For the past few sessions there seems to have been no therapeutic movement. He mentions that he really enjoys therapy and trusts you. INITIALLY, you would:
Select one:
A.
Refer George to another therapist. Explain that it is important that he get therapy where he can make progress.
B.
Talk to a colleague. Process the client's transference before you terminate.
C.
Begin giving George homework. Consider any cultural variables that may slow his progress.
D.
Explore with George the quality of the therapeutic relationship. Alter the treatment plan to create different opportunities for him to benefit.
The Correct Answer is D.
D: Exploring the therapeutic relationship with the client can elicit possible projections or other issues that may be causing a problem in the therapy. This would be the best initial intervention. Altering the treatment plan would be an option.
38
Burt came into therapy because his latest television series had been cancelled. He tells you that his wife divorced him six months ago. Currently he's living with his mother who is always nagging him about being a failure as an actor. Burt recently signed a deal for a new sitcom. He tells you that he thinks he's going to stop therapy now because his life is on track. Your BEST intervention would be to:
Select one:
A.
Full-heartedly support his decision to leave therapy.
B.
Suggest that he consider continuing therapy to work on any issues that come up.
C.
Explain that he may benefit from examining the issues that led to his divorce and his return to his mother.
D.
Support his decision to leave therapy and remind him that the door is always open for him to return.
The Correct Answer is C.
C: Burt does not appear to have addressed his divorce and his relationship with his mother and it is in his interest that you point this out before assuming that termination is appropriate.
39
Noemi is a 14 year-old brought in by her mother. She appears very thin and openly tells the therapist that she has been using "stuff" to help her study. She states she is "tired of everyone telling me what to do all of the time," and says her mother nags her constantly. She wishes everyone would just "leave me alone." When the therapist asks her if she is depressed, she replies, "Who isn't?" What should the therapist assess for in this case?
Select one:
A.
Suicidality, depression, mother-daughter relational problem
B.
Drug abuse, depression, scholastic problems
C.
Drug abuse, on-line bullying, mother-daughter relational problem
D.
Depression, drug abuse, scholastic problems
Feedback
The Correct Answer is D.
D: "Using 'stuff' to help her study" = direct indicator of substance use, possibly stimulants. This alone requires full substance use assessment, including frequency, source, and impact on functioning. The response "Who isn’t?" implies a normalization or dismissal of depressive symptoms — a red flag, especially when paired with her emotional withdrawal. Flat affect, irritation, and social withdrawal are classic signs. While not explicitly stated, the use of substances to enhance studying suggests academic pressure or struggles.
40
Marcus is in therapy because he has not been able to stay sober and is at risk of violating his probation. He has been making extra money selling drugs and has been caught trying to sell drugs at his AA meetings. He has threatened to hurt anyone who makes him go to anymore of those "meetings of whiners." If the therapist assessed for violence they would do all of the following EXCEPT___.
Select one:
A.
Teach anger management skills
B.
Determine if there is an intended victim
C.
Inquire if there is a past history of violence
D.
Explore if the client has a plan
The Correct Answer is A.
This question is about ASSESSMENT.
Answer A: Teaching is not assessment. The question asked for "assessment".
41
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