Download Chapter 16: Psychological Treatment LEARNING GOALS 1. Be able

Chapter 16: Psychological Treatment
LEARNING GOALS
1. Be able to explain standards for studies on psychotherapy and the gaps in the
generalizability of treatment outcome research.
2. Be able to discuss issues with adapting psychotherapies for people from diverse ethnic
and cultural backgrounds.
3. Be able to identify the specific types of psychological treatments that have empirical
support, and issues that clinicians must consider in applying these treatments.
4. Be able to describe different approaches to integrating psychotherapies and identifying
common elements across treatments.
5. Be able to discuss the goals of community psychology and political trends in that field.
Summary
Challenges in Evaluating Treatment Outcomes
●
Research on the effectiveness of various forms of psychological treatments
has been conducted for many decades. Overall, this research suggests that about 75
percent of people gain some improvement from therapy. Therapy also seems to be more
helpful than a placebo or the passage of time.
●
Efforts have been made to define standards of research on psychotherapy
trials and to summarize the current state of knowledge on which psychological treatments
work. These standards typically include the need to randomly assign participants to
treatment or a control, to use a treatment manual, to define the treated sample carefully,
and to use reliable and valid outcome measures. It is hoped that these efforts will help
disseminate the best available therapeutic practices to clinicians and their clients, as well
as provide insurance companies with the data to support the use of psychotherapy.
●
Controversy exists about the research standards. A large portion of clients
are excluded or will not take part in clinical trials, cultural diversity is lacking in most
trials, many treatment approaches remain untested, and treatment manuals can constrain a
talented therapist. A broader concern is that a huge gap exists between what happens in
the research world and the real world. Efficacy research focuses on how well therapies
work in carefully controlled experiments, whereas effectiveness research focuses on how
well therapies work in the real world.
The Importance of Culture and Ethnicity in Psychological Treatment
●
Clinicians offering treatment to minority individuals must be sensitive to
the values and political events that shape the way people may approach relationships,
therapy, and emotional expression. Little empirical research is available on how
psychotherapies work for people from diverse backgrounds, but minority status is
associated with less use of therapy. Researchers have developed modifications of some
treatments to be more culturally sensitive.
Specific Treatment Approaches: Issues and Treatment Outcome Research
● Experiential psychotherapies, based on humanistic and existential psychology,
emphasize the freedom to choose, personal growth, and personal responsibility .
Variants of these approaches include Rogers’ client-centered therapy, existential
therapy, Gestalt therapy, and emotion-focused therapy.
●
Treatment outcome research supports the efficacy of psychodynamic,
experiential, and cognitive behavioral approaches compared to no treatment or treatment
controls. Behavioral approaches offer a clear advantage for the treatment of anxiety and
may be slightly more helpful than experiential approaches in other disorders. Generally,
the literature on how these different active forms of psychotherapy compare to each other
is quite limited.
●
Cognitive behavioral treatments have evolved over the past 10 years, and
several manuals incorporate broader themes such as spirituality and meaning. Although
there is less research available, the research findings about cognitive behavioral
treatments are promising.
●
Marital or couples therapy helps distressed couples resolve the inevitable
conflicts in any ongoing relationship of two adults living together. Behavioral therapies
are clearly better than no treatment, but within a matter of a couple years, at least half of
couples return to significant distress. Promising evidence exists for integrative behavioral
marital therapy and insight-oriented marital therapy as compared to standard behavioral
marital therapy.
●
Family therapy includes many different techniques. These therapies have
been shown to be particularly successful in the treatment of externalizing disorders in
children and adolescents, in helping people with substance abuse accept the need for
treatment, and in reducing relapse in adults with schizophrenia and bipolar disorder.
Psychotherapy Integration
●
There are three different approaches to therapy integration: technical
eclecticism, theoretical integration, and common factorism. Technical eclecticismrefers to
borrowing techniques from other approaches while maintaining a focused conceptual
approach. Theoretical integration is exemplified by Wachtel’s cyclical psychodynamics,
or by the recent inclusion of a focus on acceptance within cognitive behavioral therapies.
Common factors research identifies variables that predict outcomes across a broad range
of therapies, such as the quality of the therapeutic alliance or therapist empathy.
Community Psychology
●
Community psychology aims primarily at the prevention of disorder on a
large-scale. Political issues have shaped the popularity of this approach.
1. Which of the following statements are true?
a. Generally speaking, psychotherapy is effective.
b. Less than 25% of people who enter psychotherapy treatment improve.
c. Psychotherapy is more effective with women and children than with men.
d. Outcome research is designed specifically to find the best treatment for Axis II
disorders.
Answer: A Type: Factual Page: 530
2. Research shows that people who enter psychotherapy show improvement
a. most of the time.
b. about half the time.
c. most of the time if their problems are minor.
d. equal to the support of good friends.
Answer: A Type: Factual Page: 530
3. A no-treatment control group allows researchers to test which of the following?
a. whether random assignment is effective.
b. whether the data is valid.
c. whether the passage of time helps a person recover as much as the active treatment
does.
d. whether the data is reliable.
Answer: C Type: Factual Page: 530
4. Most treatments on the APA task force list of empirically supported treatments are
a. rational-emotive.
b. cognitive-behavioral.
c. interpersonal.
d. psychodynamic.
Answer: C Type: Factual Page: 531
5. By current standards, in order to receive grant funding for treatment outcome research
in psychotherapy, 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.
Answer: A Type: Factual Page: 532
6. Manuals in psychotherapy outcome research provide greater internal validity meaning
that
a. the within-study results are more reliable.
b. researchers can more confidently attribute results to the specific treatment offered.
c. researchers can confidently generalize results to psychotherapy practiced outside of the
controlled study.
d. researchers can specify the exact mechanism of change.
Answer: B Type: Factual Page: 532
7. Therapy conducted using a manual has ______ internal validity and_____ external
validity.
a. high; high
b. high; low
c. low; high
d. low; low
Answer: B Type: Factual Page: 532
8. Therapy manuals are used to ensure that therapists use
a. procedures tailored to the individual.
b. optimal procedures in therapy.
c. the same procedures in research.
d. procedures validated by research.
Answer: C Type: Factual Page: 532
9. Theoretically, the use of manuals
a. does little to account for differences in therapists.
b. controls for different levels of therapist skill.
c. is only appropriate during a randomized clinical trial.
d. None of the above are correct.
Answer: B Type: Factual Page: 532
10. The purpose of treatment manuals is to
a. clearly define the independent variable.
b. allow for greater external validity.
c. limit the amount that therapists vary in how they deliver the treatment.
d. Both a and c are correct.
Answer: D Type: Factual Page: 532
11. A problem with the use of treatment manuals is
a. the client may feel that his or her particular concerns are not being addressed.
b. they do not provide good internal validity.
c. they are often convoluted and difficult to follow.
d. they are only useful for psychodynamic research.
Answer: A Type: Factual Page: 532
12. Tom feels that he meets criteria for social phobia. He learned of these symptoms
from ads for a free trial of therapy. He decides he would like to participate in the study.
Tom might be excluded from participating in the study if he
a. is depressed because of his social phobia .
b. smokes cigarettes.
c. also has post-traumatic stress disorder.
d. has a relative with social phobia.
Answer: C Type: Applied Page: 533
13. When a researcher determines that the outcome of a randomized controlled treatment
study on schizophrenia is associated with reduction in negative symptoms, he or she is
referring to the________ of the treatment.
a. effectiveness
b. efficacy
c. positive effects
d. grant-funded nature
Answer: B Type: Applied Page: 533
14. When considering the outcome of therapy trials, who is in the best position to
determine effectiveness?
a. the client
b. the therapist
c. the grant-funding agency
d. the research assistants
Answer: A Type: Factual Page: 533
15. The advent of managed care has changed what aspect of practice for psychologists?
a. theoretical orientation
b. focus on underlying causes
c. accountability
d. efficacy
Answer: C Type: Applied Page: 534: Focus on Discovery 16.1
16. Yoshi is receiving therapy for social phobia. As part of therapy, he is instructed to
imitate a series of target behaviors demonstrated by his therapist. Yoshi will be best able
to model these behaviors if
a. the therapist is of the opposite sex.
b. his symptoms are mild.
c. the therapist has cultural competence
d. All of above are correct.
Answer: C Type: Applied Page: 535
17. Cultural competence refers to whether therapists
a. are effective within their own culture.
b. understand the culture of their clients.
c. are certified in the study of cultures.
d. come from a similar culture to their clients.
Answer: B Type: Factual Page: 535
18. Which of the following factors may be more important in contributing to good
outcomes in therapy than ethnic matching?
a. agreement on theoretical orientation between therapist and client
b. same age bracket for therapist and client
c. same gender for therapist and client
d. cultural competence
Answer: D Type: Factual Page: 535
19. African American patients
a. are less satisfied with ethnically-similar therapists.
b. have likely experienced prejudice.
c. will inevitably run into insurmountable barriers in therapy.
d. All of the above are correct.
Answer: B Type: Factual Page: 536
20. The text urges white therapists working with Latino clients to be especially sensitive
to which of the following cultural issues?
a. personal and family losses.
b. importance of religion.
c. anger at majority culture.
d. respect for authority.
Answer: B Type: Factual Page: 536
21. Which of the following is a characteristic of Asian Americans?
a. They tend to talk about stress in psychical terms.
b. They do not experience discrimination like other ethnic minorities.
c. They are individualistic people.
d. All of the above are correct.
Answer: A Type: Factual Page: 536
22. Unlike other cultural groups, Asian Americans may
a. feel more shame regarding the necessity of therapy.
b. feel that some areas are 'off-limits' in therapy.
c. identify a need for greater formalities in treatment.
d. All of the above are correct.
Answer: D Type: Factual Page: 536
23. Tim is a Native American child in therapy for ADHD. He frequently avoids eye
contact with his therapist. This is likely a sign of
a. low self-esteem.
b. shame about therapy.
c. respect.
d. guilt.
Answer: C Type: Applied Page: 537
24. Empirically supported treatments for specific minority groups
a. have not been effective.
b. are overwhelmingly psychodynamic.
c. rarely include a control group.
d. are few and far between.
Answer: D Type: Factual Page: 538
25. According to Duran (2004), culturally sensitive interventions may need to be
modified to change
a. the role of the therapist.
b. the types of intervention strategies used.
c. the content of the intervention and how to present aspects of the content.
d. All of the above are correct.
Answer: D Type: Factual Page: 538
26. The major goal of psychoanalytic approaches to therapy involves
a. removal of repressions.
b. the interplay of behavioral events and internal attributions.
c. identifying associations between unconscious motivations and superego functioning.
d. determining accurately the operative defense mechanisms.
Answer: A Type: Applied Page: 539
27. Psychoanalysis primarily focuses on
a. presenting symptoms.
b. unconscious conflicts from earlier in life.
c. cognitive biases associated with neuroticism.
d. None of the above are correct.
Answer: B Type: Factual Page: 539
28. If two different people were in therapy, one seeing a traditional psychoanalyst and
one seeing a more contemporary psychodynamic therapist, you would
a. be able to decipher who saw which kind of therapist from their descriptions of the
clinicians.
b. have difficulty deciphering who saw which kind of therapist from their descriptions of
the clinicians.
c. see a greater focus on childhood from the contemporary psychodynamic therapist.
d. find the traditional psychoanalyst to be more emotionally invested than the
contemporary psychodynamic therapist.
Answer: B Type: Applied Page: 539
29. A major problem of outcome research in psychoanalytic therapy is
a. methodological flaws.
b. the large number of studies makes it difficult to determine for whom therapy is best
suited.
c. the low education level of most of the study participants.
d. All of the above are problems in outcome research on psychoanalytic therapy.
Answer: A Type: Applied Page: 540
30. One problem with studying outcomes of brief psychodynamic treatments is
a. evaluating transference effects.
b. comparing them to lengthier approaches.
c. the lack of agreed treatment manuals.
d. which approaches to include.
Answer: D Type: Factual Page: 540
31. Sara is in psychoanalytic therapy. She will do best in treatment if
a. she is well educated.
b. she has schizophrenia.
c. she is middle-aged.
d. All of the above factors will be associated with better outcome.
Answer: A Type: Applied Page: 540
32. Client-centered therapy suggests
a. problems arise from inner disturbance associated with ego-conflicts.
b. disorders are a result of failing to attend to one's own experiences..
c. psychological problems arise from interpersonal difficulties exclusively.
d. cognitive errors create neurotic disturbance.
Answer: B Type: Factual Page: 541
33. Sandra is a graduate student in clinical psychology. As part of her training, she is
encouraged to develop good listening skills and unconditional positive regard, exhibit
empathy and genuineness, and hold clients in a positive light. These are all central
features of which therapeutic paradigm?
a. psychodynamic
b. cognitive
c. behavioral
d. client-centered
Answer: D Type: Applied Page: 541
34. Lucy is currently a patient and a subject in a psychotherapy outcome study being run
by a Rogerian therapist. Lucy is most likely to
a. complete self-report questionnaires about herself, have her family interviewed, and
have a medical exam.
b. be self-actualized.
c. have her functioning rated by her family and friends only.
d. suffer from severe psychopathology.
Answer: B Type: Applied Page: 541
35. Which of the following therapies emphasize the notion that each of us are ultimately
alone in the world and that we must create our own existence?
a. existential
b. client-centered
c. Gestalt
d. psychoanalytic
Answer: A Type: Factual Page: 541
36. In which of the following ways are gestalt therapy and client-centered therapy
similar?
a. Both emphasize inner conflict as the root cause of psychological disturbance.
b. Each encourage structured behavioral exercises to alleviate inner distress.
c. Both focus on an innate goodness in the client.
d. None of the above are correct.
Answer: C Type: Applied Page: 541-542
37. In Gestalt therapy, a “here and now” focus refers to a focus on
a. events in the session.
b. the therapeutic alliance.
c. the client’s current life.
d. reactance.
Answer: A Type: Factual Page: 542
38. Alison is in therapy with a Gestalt therapist. As part of therapy, she is asked to
imagine that her mother is in the room, and she is instructed to communicate to her how
she feels, while gazing at a seat in the room. This is also known as the
a. empty-chair technique.
b. enacted interaction method.
c. analogue interaction.
d. accurate empathy.
Answer: A Type: Applied Page: 543: Focus on Discovery 16.2
39. Gestalt therapy is widely recognized for its
a. extensive theoretical basis.
b. reliance on validated principles.
c. creative therapy techniques.
d. research on therapy outcome.
Answer: C Type: Factual Page: 543: Focus on Discovery 16.2
40. Emotion-focused therapy focuses on
a. the client’s emotional reaction to discussing his or her childhood.
b. what is happening at that exact moment.
c. the most important event in the client’s life.
d. maladaptive emotions.
Answer: D Type: Factual Page: 542
41. Timbo is in therapy for depression. Timbo’s therapist is trying to get him to recognize
that some of his emotions are adaptive, while other emotions are maladaptive. Timbo is
most likely being treated by a therapist who practices
a. client-centered therapy.
b. Gestalt therapy.
c. emotion-focused therapy.
d. brief psychodynamic therapy.
Answer: C Type: Applied Page: 542
42. Outcome research on experiential approaches has indicated that
a. experiential therapies are more likely to relieve symptoms of less severe problems.
b. experiential therapies are more likely to relieve symptoms of more severe problems.
c. these therapies are largely ineffective in relieving symptoms of anxiety or depression.
d. exposure is a very effective approach for treating anxiety disorders.
Answer: A Type: Factual Page: 542
43. Operant techniques have been effective in treating symptoms of
a. depression.
b. substance abuse.
c. childhood behavior problems.
d. All of the above are correct.
Answer: D Type: Factual Page: 544
44. In which area have operant methods been especially effective?
a. self-help programs.
b. for low-income people.
c. depression.
d. for children.
Answer: D Type: Factual Page: 544
45. Which technique has been especially successful in the treatment of many problems of
children?
a. client-centered
b. operant
c. cognitive
d. Children are hard to treat with any technique.
Answer: B Type: Factual Page: 544
46. A behavioral treatment for school phobia is to reinforce school attendance by
throwing a party every day the child attends school. Later the parties are dropped while
making sure that classroom activities are reinforcing. Switching to classroom activities is
a behavioral technique for
a. behavioral activation.
b. easing termination.
c. maintaining gains.
d. documenting success.
Answer: C Type: Factual Page: 545
47. Owen cannot get to sleep at night. He discusses it with his therapist who tells him that
he must try to keep himself awake all night. This is an example of
a. Gestalt therapy.
b. motivational interviewing.
c. stepped care.
d. a paradoxical intervention.
Answer: D Type: Applied Page: 546: Focus on Discovery 16.3
48. Tina is being treated for a spider phobia. Her therapist instructs her to become more
anxious about spiders, and she actually becomes less anxious. Tina’s response is an
example of
a. paradoxical intervention.
b. self-efficacy.
c. reactance.
d. ego control.
Answer: C Type: Applied Page: 546: Focus on Discovery 16.3
49. Motivational Interviewing was originally developed for
a. schizophrenia.
b. substance abuse.
c. couples therapy.
d. depression.
Answer: B Type: Factual Page: 546 Focus on Discovery 16.3
50. According to rational-emotive behavior therapists,
a. irrational beliefs are any ideas that are not objective.
b. irrational beliefs must be constructed on empirical grounds.
c. emotional distress comes from demanding perfection from oneself and relationships.
d. None of the above are correct.
Answer: C Type: Factual Page: 547
51. Cognitive therapy, according to Beck, suggests
a. that people make assumptions about their lives that lead to distress.
b. that schemas control unstated verbalizations leading to distress.
c. that cognitive biases maintain negative beliefs about oneself and the world.
d. All of the above are correct.
Answer: D Type: Applied Page: 547
52. Beck's cognitive therapy and Ellis' rational emotive behavior therapy differ in that
a. Beck favors using adjectives like irrational or nutty.
b. Ellis' methods are ground more in scientific methods.
c. Ellis’ approach is more didactic; he often uses mini-lectures.
d. Beck believes that forceful interventions are needed to disrupt well-learned thought
patterns.
Answer: C Type: Factual Page: 547
53. Henry is a recovering alcoholic and has been sober for the past four months. After
hearing about the death of his close friend, Henry finished a bottle of red wine.
According to Marlatt, Henry’s “slip” will not result in him returning to alcoholism if
a. Henry makes a pact with his therapist never to drink again.
b. Henry blames his own weaknesses for the relapse.
c. Henry considers the death of his friend as an external factor that drove his relapse.
d. his therapist reprimands him.
Answer: C Type: Applied Page: 548
54. The third wave of cognitive behavioral therapy can be characterized by
a. a strict behavioral approach.
b. a strict cognitive approach.
c. incorporating focus on spirituality and acceptance.
d. incorporating operant conditioning techniques.
Answer: C Type: Factual Page: 549
55. What is the name of the recent cognitive behavioral technique in which people are
encouraged to be highly aware of their emotions without acting impulsively on them?
a. unconditional regard
b. response inhibition
c. schemas
d. mindfulness
Answer: D Type: Factual Page: 549
56. Incorporating spirituality, values, emotion and acceptance into CBT
a. is a hallmark of the third wave of cognitive behavioral therapy.
b. is known as emotion-focused therapy.
c. have been found to be ineffective in reducing depression symptoms.
d. characterizes the first wave of cognitive behavioral therapy.
Answer: A Type: Factual Page: 549
57. Empirical work evaluating the outcome of cognitive therapy
a. universally supports cognitive therapy as superior to medication.
b. suggests that CBT is as effective as medication in treating severe depression.
c. by and large shows medication to be a more effective treatment than cognitive therapy.
d. rarely compares the therapy to a medication group.
Answer: B Type: Factual Page: 549
58. Investigators hypothesize that CBT may help to prevent future episodes of depression
because
a. it teaches clients coping skills they can use even after therapy ends.
b. it teaches clients how to think about negative childhood experiences in a more positive
way.
c. it helps clients come to terms with their own imperfections.
d. it promotes healthy relationships among friends and co-workers.
Answer: A Type: Factual Page: 549
59. Changes in patients’ cognitions
a. are seen in patients treated with cognitive therapy.
b. are seen in patients treated with medication treatment.
c. Both a and b are correct.
d. Neither a nor b is correct.
Answer: C Type: Factual Page: 549
60. In the demand-withdraw cycle,
a. one partner has the tendency to make large demands on the other and then quickly
withdraws his or her requests resulting in conflict.
b. one partner attempts to discuss a problem and the other withdraws from the discussion.
c. men are usually in the “demanding” role, and women are in the “withdrawing” role.
d. the therapist trains one partner to be more demanding and the other to be more
withdrawing based on their respective personalities.
Answer: B Type: Factual Page: 550
61. Couples therapists often use videotapes to
a. show couples how they interact.
b. give couples homework assignments.
c. study complex couple interactions.
d. remind couples of good times together.
Answer: A Type: Factual Page: 550
62. Fred and Jana are experiencing distress in their relationship. They will do best in
treatment if
a. Fred and Jana are both depressed and seek individual therapy for their depression.
b. one is anxious regarding treatment outcome for the relationship.
c. they are seen for treatment together.
d. they do not have children.
Answer: C Type: Factual Page: 550
63. Which of the following statements is true?
a. Outcome research on couple’s therapy suggests that about 75% - 80% of treated
couples are happily married at the end of treatment.
b. In many studies, behavioral couple’s therapy has been shown to better relieve
relationship distress than no treatment or placebo-treatment.
c. Psychodynamic couple’s therapy has been shown to be more effective than behavioral
couple’s therapy.
d. When there is distress in a relationship, couples are usually better off if they seek
individual therapy, at least initially.
Answer: B Type: Factual Page: 551
64. A recent development in behavioral couples therapy has been
a. acknowledging divorce.
b. a growing appreciation of the role of acceptance.
c. a resurgence of traditional breadwinner/homemaker models.
d. revisiting past conflicts in vivo with the therapist.
Answer: B Type: Factual Page: 552 Focus on Discovery 16.5
65. Acceptance in behavioral couple’s therapy
a. emphasizes simultaneous encouragement of change.
b. does not promote resignation.
c. seeks to promote greater closeness and intimacy.
d. All of the above.
Answer: D Type: Factual Page: 552: Focus on Discovery 16.5
66. A recent modification to behavioral marital therapy involves
a. reinforcing the partner for negative behaviors, as in paradoxical interventions.
b. accepting, and even embracing, certain negative behaviors.
c. providing compliments.
d. ignoring problem behaviors and focusing upon positive behaviors.
Answer: B Type: Factual Page: 552: Focus on Discovery 16.5
67. Family therapy
a. emphasizes that usually one family member causes the majority of the problems.
b. has not been shown to be effective in treating the symptoms of bipolar disorder or
schizophrenia.
c. is based on the notion that improving parental monitoring and discipline will help the
family unit.
d. is based on the idea that the problems of the family influence each member and that the
problems of each member influence the family.
Answer: D Type: Factual Page: 554
68. The primary focus of technical eclecticism is
a. to establish interventions that work from other therapy orientations, but conceptualize
it from a singular paradigm.
b. an effort to determine interventions that all schools of therapy share.
c. an effort to ultimately blend theories into one coherent paradigm.
d. an effort to bind all treatments to a single therapy school.
Answer: A Type: Factual Page: 555
69. A therapist who practices technical eclecticism
a. fails to identify incompatibilities in techniques.
b. uses whatever technique works.
c. integrates various theories in therapy.
d. attempts theoretical integration prematurely.
Answer: B Type: Factual Page: 555
70. The approach to therapy espoused by Lazarus encourages
a. using multiple techniques to solve a client’s problems.
b. focusing largely on cognitions and behavior.
c. selecting items from a menu of distressing behaviors to focus treatment upon.
d. determining unconscious factors and establishing biological links.
Answer: A Type: Factual Page: 555
71. Lazarus’ approach to treatment was one of the first to use
a. eclecticism.
b. a distinct multi-axial system.
c. integration.
d. None of the above are correct.
Answer: A Type: Factual Page: 555
72. Dr. Swanson reviews the literature on psychotherapy to find what aspects of therapy
are found in all major theories of psychotherapy. He is researching
a. eclecticism.
b. common factors
c. integrationism.
d. multimodal psychotherapy.
Answer: B Type: Applied Page: 556-557
73. The work of Paul Wachtel is an example of
a. eclecticism.
b. common factorism.
c. integrationism.
d. multimodal psychotherapy.
Answer: C Type: Factual Page: 556
74. Wachtel aimed to integrate
a. behavior therapy and cognitive therapy.
b psychoanalysis and interpersonal therapy.
c. behavior therapy and psychoanalysis.
d. interpersonal therapy and cognitive therapy.
Answer: C Type: Factual Page: 556
75. The idea that people’s repressed problems are both expressed in and maintained by
current behavior is an example of
a. contemporary psychodynamic theory.
b. traditional psychoanalytic theory.
c. psychodrama.
d. cyclical psychodynamics.
Answer: D Type: Applied Page: 555
76. Whose theoretical position is illustrated by the following? Marta struggled with her
college classes. She sought therapy where she learned better study skills. As a result, her
grades improved. As they did so, she began to realize her anger at her parents who had
never praised her childhood accomplishments.
a. Lazarus
b. Perls
c. Bandura
d. Wachtel
Answer: D Type: Applied Page: 556
77. Saul, in treatment for anger, has found that anger control methods have helped him
function at work and in relationships better. However, he has also found that identifying
the early childhood origins of his anger have helped him feel less anger overall, and the
need to control it has diminished. He has accomplished this with the same therapist.
This is an illustration of
a. cognitive therapy.
b. brief psychodynamic therapy.
c. psychotherapy integration.
d. family therapy.
Answer: C Type: Factual Page: 555
78. 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. therapeutic alliance.
Answer: D Type: Applied Page: 557
79. A strong therapeutic alliance
a. is what produces the majority of change in therapy.
b. results when patients’ symptoms improve.
c. is rare.
d. None of the above are correct.
Answer: D Type: Factual Page: 557
80. Therapists who can ______________ will be able to promote stronger therapeutic
relationships.
a. clearly articulate their theoretical orientation to their clients
b. convey empathy and positive regard
c. set strict guidelines
d. All of the above are correct.
Answer: B Type: Factual Page: 557
81. When Jacobson and colleagues offered only the behavioral activation portion of
cognitive therapy,
a. they achieved much worse results than cognitive therapy alone.
b. they achieved similar results to cognitive therapy alone.
c. clients reported feeling greater self-efficacy.
d. a stronger therapeutic relationship was established.
Answer: B Type: Factual Page: 558
82. As part of therapy, Edith begins to experience control over purging by only purging
following lunch, rather than at random. Her ______________ was/were increased in
therapy.
a. symptoms
b. reactance
c. assertion
d. self-efficacy
Answer: D Type: Applied Page: 558
83. Bandura suggests that to the extent that they are effective, all therapeutic procedures
are effective by
a. giving the person a sense of self-efficacy.
b. promoting a strong therapeutic alliance.
c. teaching the person coping skills.
d. making the person feel understood.
Answer: A Type: Factual Page: 558
84. Recently, researchers have called for more research on empirically-supported
_____________ rather than empirically-supported treatments.
a. behavioral therapies
b. principles of action
c. principles of change
d. medication regimes
Answer: C Type: Factual Page: 558
85. Which of the following has made it difficult to evaluate the effectiveness of
community psychology?
a. The goals of community psychology remain unclear.
b. Few people in a community seek psychotherapy.
c. Difficulty in establishing experimental controls.
d. Social forces that led to this approach have changed.
Answer: C Type: Applied Page: 559
86. Community psychology, unlike other forms of therapy, focuses on
a. seeking those who most need therapy.
b. those who seek therapy.
c. political activism as a means of accomplishing community change.
d. YAVIS clients.
Answer: A Type: Applied Page: 560
87. Which is a likely cause for the decline in community psychology emphasis?
a. high cost of community care
b. growth of urban centers
c. changing social values
d. poor research results
Answer: C Type: Factual Page: 560
88. Community psychology primarily concerns itself with
a. developing clinics that provide individual therapy.
b. larger scale efforts at intervention and wellness.
c. programs based in community hospitals.
d. All of the above are part of community psychology.
Answer: B Type: Applied Page: 559
Essay Questions
1. Describe some differences between how therapy research is conducted versus the
typical practice of therapy.
2. Discuss the cultural factors involved in treatment for each of the following cultural
groups: African Americans, Latinos, Asian Americans, and Native Americans.
3. Compare and contrast Ellis’ Rational-Emotive Behavior Therapy with Beck’s
Cognitive therapy.
4. How are client-centered and Gestalt therapies similar and different?
5. What have been some of the limitations in community psychology interventions, and
how might these limitations be overcome?
6. Describe the three different approaches to eclecticism (technical eclecticism, common
factorism, theoretical integration).
7. Describe the work of Paul Wachtel. What can psychodynamic therapists learn from
him? What can behavior therapists learn from him?
8. What are the conclusions from treatment outcome studies of couples therapy?
9. Discuss the aims of community psychologists and the types of programs they develop.
What are the difficulties in evaluating community psychology programs?