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Study Guide
Counseling Foundations and Ethics
City Vision College
Course 412
Instructor: Steven Brubaker
This Study Guide is to be used as study guide for Course: “Counseling Foundations and
Ethics.” Use this guide to take your personal notes. Answer the questions pertaining to
each chapter and submit to your instructor as directed. Use this Study Guide as a study
tool for your midterm and final exams.
Introduction to Counseling Foundations and Ethics
This course serves as the introduction to counseling theory from a Christian perspective.
While many students resist “theory” and want to “get down to the practice,” a foundation
in theory is critical. It is important for the Christian counselor to have a solid foundation
in the principles of Psychology, Christianity, and the psychology of religion as they relate
to understanding counseling and addiction.
Here are some of the concepts covered in this course:

Psychology can be defined as the scientific study of the behavior and thinking of
organisms.

Psychology was established as a discipline in 1879.

The study of how people grow, mature and change from birth to adulthood is
called Developmental Psychology.

The study of how people interact with one another and with their society as a
whole is called Social Psychology. Social psychology is concerned with social
influences upon the individual.

The diagnosis and treatment of psychological problems is called Abnormal
Psychology. Recognizing various categories of mental health disorders in
abnormal psychology and their relationship to substance abuse will be addressed.

The study of Psychology is a science. The Scientific Method is a key concept. It
consists of the following: the proposal of an idea (a hypothesis); the testing of a
hypothesis; and then the results are evaluated against the hypothesis (idea). Data
to test the hypothesis can be obtained through one or more of the following
means: observation, surveys/interviews, case study, and experiments.
This course also serves as the introduction to human developmental theories which are
foundational in understanding the implications of the age of a person when they
experienced trauma and/or the onset of behaviors leading to addiction. This critical
understanding allows students to confidently deal with the dissonant behaviors between
chronological and emotional “age” of many clients beginning recovery. This course
expands the lay leaders’ and clinicians’ understanding of significant concepts and the
vital role of normal human developmental needs.
In addition, this course addresses the wide range of ethical issues inherent in all steps
identified within the Scope of Practice for addiction professionals and found in recovery
support services. The course examines issues which may arise during initial screening,
during treatment planning, and as a client progresses through treatment implementation
and moves into recovery. The issues discussed relate to professional obligations,
interactions with family and the community, as well as the process of documentation.
Throughout this course, the participant will be asked to relate various points to their own
situations; consider the various perspectives presented; and develop an ongoing
awareness of their choices, decisions and behaviors in light of a high ethical standard.
Ethics issues to be addressed will include the following:

Addressing issues of competence

Considering the patient’s rights

Avoiding client exploitation

Wrestling with financial issues

Ensuring appropriate professional relationships
Chapter 1: Introduction to Psychology (pages 17– 38)
1. Define Psychology.
2. Who first established psychology as an independent and self-sufficient discipline in
1879 and attempted to specify components of consciousness?
3. Where was his laboratory?
4. Which American psychologist wrote a landmark textbook that emphasized the
function rather than components of consciousness?
5. Who is the famous European that emphasized early childhood experiences and whose
theory was called psychoanalytic psychology?
6. Briefly define the following approaches.
Cognitive
Humanistic
Biological
7. What does the text suggest is the popular approach to psychology today?
8. List the six ways we know what we know and briefly define each one.
9. Briefly discuss how a Christian can find value in the above ways of knowing.
10. Theories, such as those identified earlier, are developed through the use of scientific
method. A hypothesis is proposed and tested and the results of the test either confirm
or negate the hypothesis, or original idea. Various research approaches can be
incorporated in scientific method. List those identified in the text.
11. Although scientific experiments are carefully controlled, they are subject to bias or
distortion. Name three sources of bias that can affect the outcome of research.
12. Both psychology and the Bible provide information for ________________________
and about how ________________________________________________________.
13. What did Crabb (pg. 29 in text) mean by “spoiling the Egyptians”? How do we apply
such a simple principle?
14. Study the diagram of Christian eclecticism on page 30. It helps us understand the
relationship between psychology and Christianity. The following more specific
definitions may aid your understanding.
 Hermeneutics: The science of interpretation, especially the study of the principles
of Biblical exegesis.
 Exegesis: Explanation, critical analysis, or interpretation of a word, literary
passage, etc., especially of the Bible.
 Theology: Study of God and the relations between God and the universe, study of
religious doctrines, and matters of divinity.
15. Conflicts between theology and psychology are due to what?

Error in ______________________________,

Error in _________________________________, or

Both.
16. All _________________________ is God’s truth.
17. List the four sources of tension between psychology and Christianity.
18. What are the advantages a Christian psychologist/theoretician has over the secular
psychologist? Briefly address.
19. There are differing perspectives on the division of human experience and human
personality. Refer to pages 33-34. We consider the trichotomous approach—with
spirit, soul, and body components—as the most useful for grasping the operation of
the supernatural within the individual, beyond mind, will, and emotion.
20. The ________________________ were the primary caretakers of the mentally
disturbed during the Middle Ages.
21. Freud’s division of the personality duplicated _______________________________
model. Therefore, ______________________ could be considered the father of
psychiatry as well as the father of Christian psychiatry.
Process Options: You are encouraged to read Chapter 2 at your leisure, but it is not
required reading for this class.
Chapter 3: Sensation and Perception (pages 57-72)
1. List the five primary senses.
2. Define adaptation.
3. Define habituation.
4. The sensory deprivation study shared in the text reported that among the subjects who
stayed for over 48 hours, 80 percent began to ____________________________.
5. Define perception.
6. A basic principle of visual perception is that individuals tend to see what they
______________________.
7. Perception is active, not _____________________.
8. A number of factors are involved in the construction of information. List four rules
of Gestalt psychology used to organize perceptions.
9. There is an ability to rearrange sensory input to the brain in order to produce different
organization of data. This helps us understand that new converts to Christianity need
________________ to adjust to a new lifestyle and live according to changed values.
10. What four factors influence our perceptions?
11. Our perceptions are constrained by what actually exists. The goal, then, is to make
our perceptions veridical, or more consistent with the real world. List three ways we
can do this.
12. What do you see below? An old lady or a young lady?
See text pg. 67 about “figure” and “ground” to understand these perception differences.
Chapter 4: Emotion (pages 73-84)
1. Define emotion.
2. List positive emotions.
3. List negative emotions.
4. Define nonverbal communication.
5. List examples/types of nonverbal communication.
6. Identify percentages of a person’s communication which involves
Verbal Impact ________________________
Vocal Impact _________________________
Facial Impact _________________________
7. As you probably know, depression is a common and pervasive problem in our
culture. Carefully read “Common Depression” and all the Spotlights, pp. 78-83.
Also read Dr. Pierre J. Samaan’s “Identifying Teen Suicide Potential”.
8. List five possible causes of depression.
Chapter 5: Motivation (pages 85-101)
1. Name the two characteristics of motivation.
2. List the three main theories of motivation and briefly define each.
3. Fill in Maslow’s hierarchy of needs.
5._______________________
4.________________________________
3.____________________________________________
2._______________________________________________________
1._____________________________________________________________________
4. How can Christians use Maslow’s hierarchy to minister to the whole person?
5. List six biological drives that motivate human behavior.
6. What scale is used to determine the level of stress in relation to adjustment to change?
What is your score on the scale? _______________ life change units
7. List the three distinct stages that the body goes through when stressed.
Chapter 6: Learning (pages 103-124)
1. Define learning.
2. List the three basic models of learning and who is credited with the development of
each.
(continue to next page)
3. Match the following terms with their definitions. Write the letter of the correct
definition. (Definitions below.)
___ 1. classical conditioning
____ 19. Skinner
____ 2. conditioned stimulus
____ 20. Thorndike
____ 3. unconditioned stimulus
____ 21. Law of effect
____ 4. unconditioned response
____ 22. satiation
____ 5. conditioned response
____ 23. shaping
____ 6. Watson
____ 24. punishment
____ 7. Pavlov
____ 25. negative reinforcement
____ 8. discrimination
____ 26. observational learning (modeling)
____ 9. higher-order conditioning
____ 27. Bandura
____ 10. extinction
____ 28. learned helplessness
____ 11. spontaneous recovery
____ 12. avoidance conditioning
____ 13. aversive conditioning
____ 14. generalization
____ 15. contingencies
____ 16. operant (instrumental conditioning)
____ 17. Behaviorism
____ 18. reinforcement
a. A response elicited by a conditioned stimulus.
b. The model of learning that is more concerned with what occurs before the behavior.
c. A response (i.e. salivation) that reflexively follows an unconditioned stimulus (i.e.
food).
d. A stimulus that, after being paired with an unconditioned stimulus, evokes the same
response.
e. A researcher who conditioned a fear of rats and other furry objects in a boy named
Albert.
f. A stimulus that instinctually elicits an unconditioned response.
g. A physiologist who, in studying digestion in dogs, discovered classical conditioning.
h. A process by which a series of conditioned stimuli serves as a substitute for originally
conditioned stimuli.
i. An example of this type of conditioning is the use of electric shock as an unconditioned
stimulus paired with a conditioned stimulus such as a bell, so that when the
conditioned stimulus is given on its own, the response of fear is elicited.
j. A process by which a second stimulus similar to the first, presented to a subject after
acquisition, will also produce a conditioned response.
k. The process of distinguishing between relevant and irrelevant conditioned stimuli,
stopping its response to stimuli not directly associated with the unconditioned stimulus
event.
l. When there is a sudden increase in responding during the process of extinction.
m. A tendency to avoid situations where whatever people have learned to fear might
appear.
n. When a conditioned stimulus is repeatedly not followed by the unconditioned stimulus
and the conditioned response becomes weaker and weaker until it no longer occurs.
o. We do what brings us pleasure and avoids pain.
p. The model of learning that is more concerned with what happens after the behavior.
q. Five modes of relationship between responses and reinforcers that increase or decrease
the rate of an operant response.
r. Any stimulus that follows a response and increases the probability of its occurrence.
s. A researcher who began the study of instrumental conditioning and formulated the law
of effect.
t. A theory of operant conditioning “quite compatible with Christian thought in general”
which has been applied to child rearing, counseling, and the church.
u. His assumption is reported to be that operant conditioning is capable of explaining all
human behavior in naturalistic terms, leaving no room for choices and no room for
God.
v. The removal of an unpleasant or aversive situation as a result of behavior.
w. Examples are when people do not speak out on current issues because they think they
have no influence or when Christians give up on the local church because it is “beyond
help.”
x. The model that explains how much of the behavior we exhibit has been learned or
modified by watching models engage in those actions.
y. The theorist who suggests the most likely influences are those who are attractive or
perceived as similar to the observer, are available, and are engaging in important
behaviors.
z. The most powerful way of suppressing behavior, but may teach aggression. It is the
presentation of an aversive stimulus that decreases the probability of a response.
aa. The condition in which a previously desired item is no longer desired because so
much has already been acquired.
bb. The development of a single behavior by using a succession of steps.
4. Based on what you’ve learned about modeling, list three people in the church who
would likely be viewed as models?
5. List three people who have been or are currently models in your own life.
You are encouraged to read Chapters 7 & 8 at your leisure, but it is not required reading
for this course.
Chapter 9: Social Psychology (pages 163-172)
1. Define social psychology.
2. List the three main areas of social psychology.
3. Attitudes are affected by what two factors?
4. Which are more effective – one sided or two sided presentations? Briefly explain.
5. The inner tension resulting from the attempt to hold two contrasting thoughts at the
same time is called ___________________________.
6. When simply expecting something to occur in our relations with others makes the
expected happen, that is referred to as _______________________________.
7. List three phenomena of social influence.
8. How can the phenomenon of conformity influence evangelism?
9. List three other methods of influence.
10. Based on what you’ve read in this chapter, briefly discuss why you believe people
help others.
Chapter 10: Child Development (pages 173-200)
This entire chapter is foundational for coursework in Prevention, Understanding
Addiction, Family Issues, and Human Behavior. For example, understanding
developmental issues related to addiction will help the student understand that when a
person enters recovery, his or her emotional and spiritual maturity level will be the age at
which he or she started to use heavily. Addiction causes a stunting of emotional/spiritual
growth. That is why often people in treatment act like teenagers; emotionally they often
are.
1. List the characteristics of a child’s development.
2. List the five most well-known stage theories of child development.
3. List the five stages of psychosexual theory.
4. List the four stages of cognitive development proposed by Piaget.
5. List the four childhood stages of moral development
6. List the four stages of faith proposed by Fowler which are defined in the chapter.
Chapter 11: Adolescent and Adult Development (pages 201-223)
1. Define adolescence.
2. Encouragement in what two areas during the first twelve years of life can greatly
facilitate adjustment in the period of 12-16 years of age?
3. Match the following theoreticians with the appropriate description below.
____ 1. Piaget
____ 2. Erikson
____ 3. Blos
____ 4. Havighurst
____ 5. Selman
a. Adolescence, at a time of questioning, defines his role confusion versus role identity
stage.
b. His social cognition theory examines how adolescents come to distinguish between
their own and others’ perspectives and views.
c. His theory of cognitive development, and specifically the development of formal
operations, may account for the recommitment to Christ that many Christian teenagers
make.
d. He explains that inconsistency and disorder may characterize the person at this age,
due to the gap between biological and psychological maturity.
e. According to him, the learning of specific tasks society requires of its members, such
as development of more mature relationships with peers, must occur in adolescence or
may never occur.
4. How can real or perceived rejection by fathers of daughters impact a daughter later in
life?
5. What does depression in teenagers look like? How can it be treated?
6. At what age does conformity peak?
7. When is the sex drive greatest in males? In females?
8. In what part of adolescence does genuine love for someone of the opposite sex
become possible?
9. In what part of adolescence are many ready to make meaningful commitments to
Christ, think seriously about career and life goals, and define the type of person with
whom they want to spend the rest of their life?
10. List the three periods of the adult years.
11. List the crisis that must be resolved, according to Erikson, in each of these periods.
12. List the four changes necessary for successful adjustment in middle age/middle
adulthood.
13. According to Levinson, during what age is a person in transition, consistent with the
supposed “midlife crisis”?
14. List two (of the many) potential stressors for the elderly.
Chapter 12: Personality (pages 225-241)
1. Define personality.
2. List the four theories of personality dominant to the 20th century.
3. Define objective personality tests and give examples.
4. Define projective personality tests and give examples.
5. List three reasons personality tests are used.
6. Define defense mechanisms.
7. List five characteristics of defense mechanisms.
8. Match the following defense mechanisms to the appropriate definition or example
below.
____1. reaction formation
____10. repression
____2. fixation
____11. regression
____3. identification
____12. compartmentalization
____4. substitution
____13. undoing
____5. compensation
____14. overcompensation
____6. denial
____15. projection
____7. sublimation
____16. rationalization
____8. isolation
____17. intellectualization
____9. displacement
a. Instead of regressing, a person who encounters trauma remains at that level of
emotional development present during the trauma.
b. Thoughts, feelings, wishes, or motives are denied access to consciousness.
c. The adoption of attitudes and behavior contrary to an individual’s true feelings or
unconscious impulses.
d. A person models their values, behavior and attitudes after another person’s without
knowing that they are doing so.
e. An unconscious striving to make up for inferiority feelings resulting from lack of
acceptance of the way God made us.
f. There is a denial of true desires and an acceptance of partial or modified fulfillment of
those desires.
g. Used to hide ideas and impulses from awareness, the primary defense mechanism upon
which all others are based.
h. A channeling of unacceptable drives into constructive behavior without a conscious
awareness that those drives exist.
i. Experiencing attitudes as if they were unconnected and unrelated, like they are
separated, in different parts of the brain.
j. Current conflicts provoke a return to an earlier stage of emotional immaturity where
there is more of a feeling of protection from life stresses.
k. Unacceptable emotions are split off from conscious thought, isolated from conscious
awareness; i.e. all anger is sin, so anger must be isolated to relieve false guilt.
l. The transferring of an emotion to a more acceptable substitute, such as a man angry at
his boss, upon arriving at home, yells at his wife.
m. Attributing one’s wishes or impulses to someone else.
n. Excessive use of intellectual vocabulary, thinking, discussions, and philosophies to
avoid feelings.
o. Justification of unacceptable attitudes, beliefs, or behavior by the misapplication of
viable reasons or by the invention of false reasons.
p. A socially acceptable way of making up for weaknesses.
q. The unconscious carrying out of behavior or verbal communication to negate a
previous mistake, as though the mistake never occurred.
9. List alternatives to defense mechanisms?
Chapter 13: The Psychology of Religion (pages 243-263)
1. Define psychology of religion.
2. Match the four theorists with the appropriate brief statement about their theory.
____1. Jung
____2. Freud
____3. Allport
____4. Maslow
a.
b.
c.
d.
Subjective and somewhat mystical, or peak experiences are the core of religion.
There is a collective unconscious in which are hidden symbols called archetypes.
Religious people are more prejudiced than nonreligious people.
Religion can be compared with neurosis, and religious rituals ease guilt fostered
by religion.
3. Briefly explain the difference between true and false guilt.
4. List four differences between rituals and compulsions.
5. Briefly explain the difference between intrinsically and extrinsically religious people.
Development of Religious Concepts
Infants
6. Define transitional objects.
7. Define RIGS.
8. Define UBO
Preschoolers
9. Young children project ___________________ upon God. The characteristics of
God are closely related to experiences the child has had with _______________.
5-6 Year Olds
10. God Becomes more than a typical _______________, and becomes more of a
________________, ________________, or ____________________.
6-8 Year Olds
11. God’s outward ____________ appearance is the focus; God sees people as all
_________________ or all _________________.
9-10 Year Olds
12. God is authority, he gives out concrete _________________ and _______________.
11-12 Year Olds
13. God is basically human while possessing _______________________ abilities. God
sees people not as all good or all bad, but a mixture. He is more personal; more of a
______________ and less _________________.
Adolescents
14. God is the upholder of natural ________________. He acts out of ____________ for
people rather than just _______________ them.
15. Share some Scripture that addresses the parents’ role in facilitating spiritual growth.
16. Distinguish spiritual development from the development of religious concepts.
17. List the stages and possible alternatives in Darling’s model of spiritual development.
18. What steps along the way insure continual progress in spiritual growth through
Darling’s stages?
19. List three spiritual problems that may be considered the source of some emotional
problems.
20. Discuss symptoms that distinguish demon possession from psychological problems
and what a Christian counselor should do if demon involvement is suspected.
Chapter 14: Abnormal Psychology (pages 265-296)
The term “dual diagnosis” is one you will frequently hear discussed in the field of
addictions work. While dual diagnosis will not be covered in depth by this course, this
chapter on abnormal psychology provides the opportunity to introduce this concept. Dual
diagnosis can be identified when there is at least one mental health disorder, such as
depression, present with and underlying a substance abuse disorder. The disorders are
said to co-exist and thus a person is dually diagnosed—diagnosed with both issues to be
addressed in counseling and overall treatment. Be sure to read this chapter carefully; in
this course we will highlight the mental health issues most commonly associated with
substance abuse: psychotic, affective or mood, anxiety, and personality disorders.
Be aware that the standard guide used by psychologists and therapists is the Diagnostic
and Statistical Manual of Mental Disorders, which is now in a revised fourth edition—no
longer “revised third” as to which the book refers. Currently, you will hear the DSM IVR discussed in professional circles. The DSM IV and DSM IV-R do reflect some
changes in diagnoses; for example, there is no longer passive-aggressive personality
disorder. We will focus on commonly seen disorders in dual diagnosis, which have
remained the same.
Multiaxial Assessment Based on the DSM-IV-TR
Diagnosing mental health and substance abuse disorders is both a science and an art.
There are more than 300 different diagnoses in the DSM so many disorders have signs
and symptoms in common with each other. A DSM diagnosis is made based upon
information gathered during the biopsychosocial interview and upon the professional’s
knowledge of mental health and substance abuse disorders. Please note that only trained
and licensed professional counselors are able to diagnose an individual with a mental
health or substance use disorder.
A diagnosis is written out in the format of a Multiaxial Assessment that is common
among mental health and substance abuse treatment professionals. The system involves
assessment on multiple axes where each axis refers to a different domain of information.
The Multiaxial Assessment format allows for information to be clearly disseminated and
understood amongst the treatment team and any other medical personnel.

Axis I is where clinical disorders and other conditions that may be of focus of
clinical attention are recorded. Examples of disorders recorded on Axis I include
Substance Dependence or Abuse, Depression, Anxiety, Bipolar, and Dysthymic
disorder and is often the reason the client seeks treatment.

Axis II is where Personality Disorders and Mental Retardation diagnoses are
recorded.

Axis III is where General Medical Conditions are indicated. Medical conditions
are potentially relevant to the understanding or management of the individual's
mental disorder. Examples of Axis III disorders could be Cardiac Arrest, Asthma,
Diabetes, or even Obesity.

Axis IV is where Psychosocial and Environmental problems are recorded.
Problems with primary support group, problems related to the social environment,
educational problems, occupational problems, housing problems, economic
problems, problems with access to health care services, problems related to
interaction with the legal system/crime, and other psychosocial and environmental
problems are examples that would be recorded on Axis IV (American Psychiatric
Association, 2000).

Axis V is the Global Assessment of Functioning or GAF. A GAF score ranges
from 1 to 100 (where one is the lowest score and 100 is the highest score) and is
based on the clinician’s judgment of the individual's overall level of functioning.
This information is useful in planning treatment and measuring its impact, and in
predicting outcome.
1. List the four perspectives one can take regarding a person who has psychological
problems.
2. Briefly discuss how Christians may be considered “abnormal” but “functional”.
3. The DSM is careful to emphasize that people are not disordered but _____________.
4. It suggests a person is not an alcoholic but rather has an _______________________.
5. The first step toward ultimate normality—normality as God intended it from the
beginning—is ____________________________.
6. Total health in a whole person demands healthy relationships in three directions.
These are:
7. List twelve characteristics identified as found in a person who is mentally healthy.
8. List the three factors that appear to contribute to psychological problems.
Anxiety Disorders
A number of anxiety disorders are often found to co-exist with substance abuse. The
defining characteristics of these disorders are people exhibit anxious arousal and
avoidance of the anxiety-provoking situation. The anxiety disorders typically seen with
substance abuse include obsessive-compulsive disorder, posttraumatic stress disorder,
and generalized anxiety disorder. Other possibilities are phobic disorders such as
agoraphobia, social phobia or specific phobias such as those listed on page 276. Anxiety
disorders are common both in the general population and among substance abusers.
9. What percent of children have experiences that create anxiety? _______________
10. Problems begin when much of the anxiety is not dealt with at the time of the
experiences but is _______________________.
11. Match the following disorders with their descriptions.
____ 1. Posttraumatic stress disorder
____ 2. Obsessive-compulsive disorder
____ 3. Panic disorder
____ 4. Agoraphobia
____ 5. Generalized anxiety disorder
____ 6. Social phobia
____ 7. Simple phobia
a. Characterized by re-experiencing (i.e. through a flashback) a traumatic event such as
rape or a war experience.
b. Fear of a specific object or situation.
c. Characterized by intense anxiety attacks during which a person may feel dizzy and
have fear of dying.
d. An irrational fear of leaving the home setting.
e. Recurrent irrational thoughts and irrational actions interfere with daily functioning, and
the person is aware they are a problem.
f. The source of this anxiety is unknown but it is chronic, generalized and persistent.
g. There is a fear of social situations in which the individual fears embarrassment or
humiliation.
12. List the four classifications of mood disorders.
These disorders are frequently seen with substance abuse.
13. Increases in mood, speech and motor ability characterize the _____________ phase
of bipolar disorder. The euphoric mood resembles the “high” of an _____________.
14. Psychiatrists treat more cases of ___________________ than any other emotional
disturbance.
15. Distinguish between cyclothymia and dysthymia.
Refer back to Chapter 4 on emotion and feelings for more on depression and suicide.
16. A major cause of discouragement among dedicated Christians is ________________.
17. The best known of the psychotic disorders is _________________________. It
begins is ____________________ or early ___________________.
18. List and briefly define the four classical symptoms of schizophrenia.
19. The maladaptive behavior pattern associated with the use of psychoactive drugs is
reflected in what three characteristics?
20. Distinguish between substance abuse and substance dependency.
21. Depressive symptoms common in alcohol dependency may partially account for the
high rate of ______________ among alcohol-dependent persons.
22. Define personality disorders.
23. Personality disorders can be understood on a continuum where a spectrum of
behavior is involved ranging from the full-blown personality ______________ ,which
is rare in the population, to the presentation of personality _____________, which are
common.
Antisocial Personality Disorder and Borderline Personality Disorder are commonly
diagnosed with substance abuse disorders. The former is discussed in the book.
24. Another term used for the antisocial personality is _______________________.
25. Such individuals engage in repeated ________________ with other members of
society. The most prominent characteristic of this disorder may be the relative
absence of ____________________.
26. Apart from salvation, what is the likelihood of significant improvement in this
disorder?
Although not discussed in detail in this book, borderline personality disorders are a great
challenge for the treatment provider. People with this disorder may be considered semipermanently unstable—in their affect, relationships, self-image, and marked impulsivity.
Females make up the majority of theses diagnosed cases. Indicators of this disorder
include five or more of the following: (1) frantic efforts to avoid real or imagined
abandonment; (2) a pattern of unstable and intense interpersonal relationships, sometimes
extremely idealizing, sometimes devaluing the other person involved; (3) identity
disturbance; (4) impulsivity; (5) recurrent suicidal or self-mutilating behavior or threats;
(6) marked mood reactions; (7) feelings of emptiness; (8) intense inappropriate anger or
difficulty controlling anger; and (9) transient stress-related paranoid ideation or severe
dissociative symptoms. Substance use is associated with increased symptoms among
borderline clients.
Chapter 15: Psychotherapy and Personal Counseling / Counseling
Theories (pages 297-320)
It is important to know that states have differing laws in regard to the terminology one is
permitted to apply to oneself. For example, in the state of Florida, one cannot call
oneself a “mental health counselor” unless one is licensed by the state. You should learn
the restrictions and freedoms specified in your state’s laws. Chapter 15 begins with a
discussion on the various professionals involved in the discipline of psychology.
1. List five of the various types of clinicians who practice in the discipline of
psychology.
2. List the three functions performed by the Christian counselor.
3. Match the following types of therapy with their descriptions below.
____
____
____
____
____ 1. Psychoanalysis
____ 2. Transactional analysis
____ 3. Behavior modification
____ 4. Rational-emotive therapy
a. An extension of behaviorism in which the goal of therapy is to minimize a selfdefeating outlook and help an individual acquire a more realistic, total philosophy of life.
b. Life positions, games, ego states, rackets, structural analysis
c. Freud practiced hypnosis as part of this theory in his early years; “memory healing” or
“inner healing” may be considered a Christian alternative to hypnosis.
d. This theory emphasizes changes in overt behavior.
e. The problem with this theory, from a Christian viewpoint,t is that Christ is not
included; and without Christ, change is difficult and no one is really “OK”.
f. Emotional consequences, “C,” are attributed primarily to “B,” an individual’s belief
system, although they follow “A,” an activating event.
g. The goal is to come to understand the role of the unconscious mind in current
problems.
h. It is suggested that Jay Adams’ Christian counseling approach includes principle of
this theory because desired behavior is rewarded and undesired behavior punished.
4. Match the following terms with their descriptions below.
____ 1. Humanistic psychology
____ 2. Secular humanism
____ 3. Client-centered therapy
____ 4. Gestalt therapy
____ 5. Reality therapy
____ 6. Adlerian psychotherapy
____ 7. Logotherapy
____ 8. Integrity therapy
a. Refers to the importance of the individual person and the positive value of human
beings.
b. Viktor Frankl, a Holocaust survivor, focused on the importance of the meaning of life
in this form of psychotherapy.
c. Glasser identified the “three Rs” of responsible behavior: face reality; do right; and be
responsible.
d. Fritz Perls sought to create experiences that increase self-awareness and promote full
discovery and acceptance of whom one is.
e. Carl Rogers emphasized the goal of helping people regain contact with their true
feelings and values.
f. Alfred Adler promoted the explanation that people are affected by social rather than
biological factors, are discouraged rather than sick, and search for significance through
mastering their environment.
g. Emphasizes the importance of the individual while ignoring or denying God.
h. O. Hobert Mowrer recognizes the importance of sin and forgiveness in this approach
and makes an assumption that all mental illness is due to sin.
5. List three physical interventions used in the treatment of mental disorders.
6. For which mental disorder are these usually used? (see previous question)
7. What is the predominant approach to counseling and therapy that involves a
combination of theories, methods and viewpoints?
Ethics in Addiction Counseling
Note: This study guide assumes that the participant begins with the Forward (page vii)
and continues through the end of the text, including the Bibliography. No designation is
provided to indicate chapter breaks. This strategy is designed to reinforce the concept that
all of the issues discussed are relevant at all times for the addiction professional and that
all are of equal importance to the profession and of specific importance to the participant,
based on their own situation.
1. The addiction field has become an independent profession for a number of reasons.
List at least three of them.
2. The “Americans with Disabilities Act” is identified as having a major impact on what
two areas; and how does that relate to the addiction professional?
3. The text includes discussion of seemingly conflicting approaches to reporting child
abuse. What are the two perspectives?
4. The authors indicated that the need to make ethical decisions needs to be kept
separate from what kinds of pressures?
5. Why is it important to state the issues clearly, rather than keep them “in the closet”?
6. True or False: The key purpose of this book is to give you all the answers to ethical
dilemmas so that you can be an ethical practitioner.
7. As you read through Chapter 1: The Worker, you will find many ways in which the
addiction profession is different from other helping professions. List 4 to 6 of them
here?
8. A profession is defined as a group of people who share what three things?
9. Is the following statement true or false? Explain why. “The best way to do no harm
is to do nothing about which you have any questions.”
10. For the purpose of this text, “ethics” is defined as: the science of _______________
derived from an analysis of _________________ by the light of _______________.
11. The authors distinguish between a “business” and a “profession” relative to the
primary purpose of each. Business is associated with what purpose? What purpose is
a profession associated with? Given your current work situation, or the types of
positions you hope to have upon completing your studies, how does this difference fit
with your ‘world view’ of work?
12. Why is it important to carefully consider your motives for entering the addiction
field?
13. In your own words, explain “reverse discrimination”.
14. The Americans with Disabilities Act includes addiction as a disability. What types of
questions are raised when an addiction professional is on staff of a treatment center
and has a relapse? (See pages 9 and 10 for a list of issues)
15. The primary difference between working in a treatment center, or with a staff of
people, and opening a private practice is in the level of __________________
required.
16. The level and type of competence needed is influenced by four dimensions of any
treatment interaction. What are they?
17. Based on several surveys, what is the one element that seems to be lacking in most
treatment programs? What does this have to do with ethics and competence?
18. Referring patients to another service provider is defined as an ethical practice. What
three advantages does this practice provide?
19. Define “dual diagnosis”.
20. What’s unethical about sticking with what you know works and avoiding alternative
treatments?
21. Explain the problem with the following “equation.” Chemical dependency = Disease
= Not your fault, so no responsibility.
22. What ethical issues might be raised by a “full service” treatment facility?
23. “Chapter Two” presented a number of areas in which competency must be developed.
After reviewing those areas, identify at least one in which you may need to focus
additional professional development.
24. Define, in your own words, the “myth of choice.”
25. What kind of questions come up for consideration when a decision is made to
mandate substance abuse treatment for drunk driving?
26. Alcoholism and other chemical dependencies are characterized by what two types of
faulty reasoning?
27. What three decision-maker characteristics set up a dangerous situation for patients?
28. Describe the differences between “overt, concealed, real or apparent” conflicts of
interest.
29. The text lists a number of treatment facility specialties, such as specializing in
women, older adults, adolescents, family, psychiatric care, pain management and/or
extended stays. Which specialization would be most comfortable for you at this
point?
30. List at least five steps that are typical during a treatment process and indicate the type
of documentation necessary to ensure accurate evaluation of treatment effectiveness
kind of questions come up for consideration when a decision is made to mandate
substance abuse treatment for drunk driving?
31. Why would you even want to track treatment results?
32. The basic principle of confidentiality can be described as: the __________________
information divulged by patients in the course of ______________________ may
______________ be used or repeated in any way that can be ___________________.
33. It is said that even if a patient has waived his legal right to confidentiality, the
professional must protect the patient’s best interests. Give an example of such
concerns.
34. Define the term “implied contract”.
35. It is suggested that you may ethically breach confidentiality under what three
conditions?
36. If you are currently working in substance abuse recovery, find the segments of your
organization’s policy document dealing with “confidentiality”.
37. Explain the subtle distinction made in the statement “Federal rules allow the courts to
authorize disclosure of confidential information, but this only removes the prohibition
and does not require disclosure”.
38. If you, or your organization, are required to share documents containing confidential
patient information, what words should be used on the document?
39. On a personal level, and then from a professional perspective, what position would
you take relative to the rights of patient confidentiality vs. the requirement to report
child abuse?
(personal)
(professional)
40. What policy does your organization follow regarding this issue? (Note: State laws
vary)
41. Typical drug testing (ex: pre-employment screening) does not differentiate between
what three levels of drug interaction?
42. Indicate where you stand on the continuum diagramed below. Then describe/defend,
from an ethical perspective, the position on either side of yours.
We should NEVER
have mandatory drug testing
0
1
0 = Never
2
3
All employees should be tested for drugs
on a Mandatory and Random basis.
4
5
6
7
8
9
10
Always = 10
43. The authors refer to a statement by former US Surgeon General, C. Everett Koop,
regarding AIDS in the public schools. Find that statement and respond to it.
44. The typical time between HIV infection and the presence of AIDS is _____________
years.
45. After you finish reading page 39 – STOP and examine your responses.
How do you physically feel?
What emotional reaction have you had to the last paragraph?
What were you thinking in response to the reading?
What implications might be indicated from your answers?
46. “Chapter 4: Exploitation,” lists five areas in which the dependent patient is vulnerable
to exploitation. List them here as you read through the chapter.
47. Why do patients leaving a residential treatment program require more time prior to
being asked for a contribution or recommendation than those leaving other treatment
programs?
48. Under what conditions would “going public” be ethical? When is it unethical?
49. What are the two unhealthy dynamics that may be at play when a sexual relationship
develops between a counselor and a previous patient?
50. Describe two factors that complicate the issue of potential sexual relationships
between former patient and counselor.
51. What does the term “shared A. A.” mean?
52. Where do you stand on the question that a recovered alcoholic should/should not ever
drink? Why?
53. After describing “diagnostic subterfuge” and describing its “benefits,” the text lists
three reasons why this practice is both unethical and bad for the system. List them
here.
54. Describe the primary focus of a family-based residential program.
55. What do the following terms mean, and how are they related to substance abuse
treatment?
ACOA:
Co-dependent:
56. What two negative outcomes arose from the practice of admitting family members
into treatment under a false mental illness diagnosis?
57. When describing the current state of treatment services as “the mess we are in,” the
authors refer to a number of groups who “all share the blame.” Who are they?
58. In your own words, describe any possible ethical conflict that might arise as a result
of “prearranged referrals.”
59. What four professional relationships are discussed in Chapter Six?
60. The text lists three typical problems associated with addiction professionals and their
relationship with A. A. What are they?
61. Why is anonymity important to A. A. members?
62. Identify the following statement as True or False and explain why. “Alcoholics have
no right to be involved in defining laws related to their dependency.”
63. What happens if those who have experience with substance abuse do not get involved
with community affairs and politics?
64. How does ethical advertising by treatment providers help the public?
65. If the addiction field is a profession, and professions are characterized by a concern
for peers, then what kind of ethical conflicts might occur if treatment staff shows
signs of relapse, mental health issues, or other similar problems?
66. What single factor differentiates between an ethical and an unethical recording and
sharing of a speaker’s comments?
67. As a professional, you have an ethical obligation to the organization for which you
work. What two elements within that organization must you respect?
68. Provide an example of a situation in which a professional (of any type) may be
limited in what they can say publicly. Explain the professional obligation to “not
speak.”
69. What are the ethical requirements for those who use animals for research purposes?
70. After reading the code of ethics provided as a “starting point,” identify any one item
that you believe could cause you the most difficulty. Do not be afraid to indicate that
you may have a problem with one of the statements. Remember, this is about
considering, developing perspective and being prepared – the challenge will present
itself at some point in your career. Be ready. “Right action” is not always easy
action!