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Adult Intervention

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12, low statistical power
When comparing psychological treatments an investigator needs approximately 50 clients per condition in order to meet conventional 80% power (Cohen, 1988) for significance test of a medium difference between groups. A meta-analysis of psychological treatment outcome research (Kazdin & Bass, 1989) found the median sample size per treatment condition was ____ indicating _____
A typical study of _____ involves comparison of multiple component treatment and one or more of its individual parts (e.g medical intervention alone for chronic pain vs. medical interventions plus psychological treatment).
combination treatments
In examining follow up as an outcome measure, how long should naturalistic post treatment follow-ups be maintained?
there is no clean uniform answer
In general the principles outlines by Chambless and Hollon (1998) for evaluating group design psychological treatment research should also be applied to single-case experiments. However, some special issues must also be considered. These include all the following except:
Adequate diversity of research subjects
The American Psychological Association has been quite specific in indicating that the evidence base for any psychological interventions should be evaluated in terms of 2 separate dimensions. These are:
efficacy
clinical utility
The dimension of treatment ____ describes the systematic and scientific evaluation of whether a treatment works. Where as the ____ dimension includes a consideration of available research evidence and clinical consensus regarding the generalizability, feasibility (including patient acceptability), and cost and benefits of interventions.
efficacy: clinical utility
On the basis of its review of the literature and its deliberation, the APA President Task Force on Evidence Based Practice agreed on the following definition for Evidence- based practice in psychology (EBPP)
The integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences.
Major issues in integrating research in day to day practice include all but which of the following:
the degree to which the results of efficacy and effectiveness research can be generalized from primarily minority and marginalized samples to majority populations
Research has shown which of the following are vital contributions to the success of psychological practice?
- treatment methods
- individual psychologist
- the patient
Clinical expertise encompasses a number of competencies that promote positive therapeutic outcome. Central to clinical expertise is ____ which involves the flexibility to be clinically effective with patients of diverse backgrounds and is manifested in forming a therapeutic relationship, encoding an decoding verbal and nonverbal responses, creating realistic but positive expectations and responding empathically to the patient's explicit and implicit experiences and concerns.
interpersonal expertise
All of the following accurately describe Beck's cognitive therapy EXCEPT ___:
Cold, mechanical delivery
The basic principles of cognitive behavioral therapy include which of the following?
ALL FOUR A, B, C, D
During the first part of a therapy session your main goal is to ____
Reestablish the therapeutic alliance and college data so you and the patient can collaboratively set and prioritize the agenda.
According to the Cognitive Model, which of the following demonstrates a correct sequenced simplified hierarchy of cognition?
Core beliefs → intermediate beliefs (rules, attitudes, assumptions) → situation/event →Automatic thought → reaction (emotional, behavioral, physiological
You ask Sally, a new patient, to describe a typical day for you. As she walks you through her day, which of the following are you looking for?
- Variations in mood
- If and how she interacts socially with family, friends and work colleagues
- What she is actively avoiding
- How she spends her free time
According to your reading, clients, clients may enter therapy with a number of fears, including
all the above are common
In ending sessions,
all except for d
Which of the following are NOT acceptable with regard to termination of therapy?
The therapist fees that the client is not complying with the therapy regimen, and tells client she should stop coming to treatment.
Which of the following did Sommers- Flanagan & Sommer- Flanagan not include in their definition of clinical interviewing factors
It requires ongoing attention to how things are said and done, as well as, to what is said and done.
Which of the following is an acceptable excuse for not ending on time:
I was held at gunpoint.
The benefits of therapist's self applications of CBT include all of the following except:
Free treatment for family and friends.
Which of the following is not one of the six course competencies described by the Sperry model (2010) as outlined in Newman (2013).
Dysfunctional relational assessment
The Cognitive Therapy Scale is ______.
The most widely used general measure of therapist adherence and competency in the field of CBT.
A well-trained CBT therapist believed that they have all the answers
No, hypothesis testing in collaboration with the client is important
According to Cognitive Behavioral theory, psychological health is related to all of the following except:
Capacity for selecting appropriate situations
Often associated with excessive inhibition process, ____ are particularly dysfunctional when clients prefer the temporary relief brought about by avoidance (negative - reinforcement) over the long-range benefits of solving problems and feeling self-efficacious
overcontrolled behaviors
The ____level of content thinking pertains to the running commentary going through people minds at any given point in time
automatic thoughts
A young person who suffers from health anxiety and who interprets his temporarily increases heart rate after climbing the stairs as a sign of dangerous cardiac conditions is an example of which logical error in thinking process?
Selective abstraction
The competent CBT therapist's bedrock "to do list" in the first session includes all the following except:
convincing the client CBT is right for them and the therapist is the best fit, despite any objections on the part of the client
Which of the key categories of data outlined by Newman to construct a case conceptualization describe a range of current situations in which the client's manifest themselves, including stressors that brought the client into therapy?
current precipitant and situations in which client's symptoms are manifest
EC. Newman (2013) outlined some "dos and don'ts " of assigning CBT homework. Which of the following is a don't?
Abandon the enterprise of homework giving altogether simply because of the client's poor tract record in completing assignments
The first national civilian prevalence study of psychological effects of trauma (Kessler, et al., 1995) assessed 12 categories of traumatic stressors and found that majority of people had experienced at least one major traumatic event. Which trauma was identified as most likely to lead to PTSD among both men (65%) and women (46%).
Rape
Which theoretical model for PTSD focuses on perceived threat and memory where people with PTSD are unable to see the event as time-limited and assume that it has larger implication for the future (i.e overgeneralize normal events as risk, overestimate the probability of the event reoccurring).
Ehlers and Clark's cognitive theory
Working with trauma victims can have negative effects on therapists that have been labeled _____traumatization.
Vicarious
Group treatment for PTSD has several advantages that make it popular with both clients professions. Koss and Harvery (1991) discussed all the following except:
The universality of the format making it a good fit for most clients, especially those who are suicidal; self-mutilating or have never spoken about the trauma.
_____ remains one of the least successfully treated of the anxiety disorders, with most studies indicating that fewer than 65% of clients meet criteria for high end-state functioning at post treatment.
Generalized anxiety disorder
Drawing from decades of research on GAD, other anxiety disorders and broader models on psychopathology Roemer & Orsillo (2014) hypothesize that all but which one of the following learned behaviors contribute to the development and maintenance of GAD.
Maladaptive schemas: themes that result of innate temperament and early negative life experiences
Bisson and colleagues (2007) reviewed psychological treatments for chronic post-traumatic stress disorder and recommend that the first line of psychological treatment for PTSD should be ______.
Trauma -focused (TFCBT or EMDR)
Halligan and colleagues (2003) examine the role of cognitive processing, trauma memory and appraisals in post traumatic stress disorder following an assault and found that:
Cognitive processing during trauma, trauma memory disorganization, persistent dissociation and negative interpretations of trauma memories predict PTSD symptoms over and above objective and subjective measures of stressor severity.
A central therapist characteristic of ABBT for GAD involves ______.
Modeling avoidance of internal experiences.
Which clinical assessment are designed by ABBT to guide flexible application of treatment elements includes assessing how clients are functioning in their daily lives and the ways that anxiety and worry are interfering through measures like the Values Living Questionnaire (Wilson, Sandoz, Kitchens, & Roberts, 2010)?
Behavioral constriction
EC: Accordign to Newman, in order to competently monitoring clients' progress in CBT one must do all the following EXCEPT _____ when tracking of treatment responses.
Use singular method
What type of Research design was used by Heinseen, Liberman & Kopelowicz, in their article Psychosocial skills training for schizophrenia: lessons from the laboratory ...?
Systematic review or meta-analysis
What was the outcome of Van der Gaag, and colleagues 2012 study Cognitive behavioral therapy for subjects at ultra high risk for developing psychosis: a randomized controlled clinical trial?
Compared to TAU, ultrahigh risk subjective receiving CBT focusing in normalization and awareness of cognitive biases, reduce subclincal psychotic symptoms and were less likely to transition to psychosis.
Cognitive-behavioral therapy for psychosis (CBTp) in recent years has mainly focused on the reduction of ____ and associated distress.
positive symptoms
Multiple studies have compared CBTp for schizophrenia to TAU, with TAU standing for:
Treatment as Usual
All of the following are common clinical strategies underlie the victims of CBTp for schizophrenia EXCEPT:
termination strategies that focus specifically on preventing future psychotic events and relapse reduction.
To weaken the delusional explanations that occur with schizophrenia, a therapist should use all available opportunities, through guided discovery, and socratic questioning to reappraise the evidence for the patient's explanation of events, this weakening the delusions. Pointing out the contradictory evidence in a quizzical and puzzled manner, often known as the _____ is advised, so the patient has to account for contradictory and review his/her explanation in light of this new and contradictory evidence
columbo technique
Schizophrenia, a complex disorder that may well be lifelong passes through a number of phases. For example, the ______ phase that occurs before a full blown episode is charactertized by non specific symptoms and symptoms of anxiety, depression, irritability insomnia, and quasi-psychotic experience (e.g. magical thinking, feelings of paranoia)
prodromal
When utilizing CBT for patients with schizophrenia, which of the following factors have been associated with poor outcomes?
negative symptoms of affective flattening and alogia.
The CBTp intervention for schizophrenia where "patients are taught to be aware of and monitor their positive symptoms, especially their onset" is known as:
awareness training
The CBTp intervention for schizophrenia where "patients are asked to generate an alternative explanation for an experience, then practice statements when that experience occurs" is known as"
reattribution
Which of the following aspects of homework was NOT highlighted as a reason why homework compliance is a good predictor of treatment outcome
only patients who are truly invested in outcomes do homework
Once an imaginal exposure is started it continues until ____
the anxiety and distress associated with the memory have subsided
Imaginal exposure is rarely used when treating
panic disorder
The national comorbidity survey replication study (NCS-R), which assessed over 9,000 noninstitutional individuals throughout the United States found that 12/1% of people have ____ at some point during their lives, making this the fourth most common psychiatric disorder
Social Anxiety disorder
All but which of the following is a benefit of exposure therapy for treatment of social anxiety disorder outlined by Heimberg & Magee (2014)
learn to treat thoughts and beliefs as hypotheses
Which of the following may be a potential advantage of treatment of social anxiety in a group format?
group provides multiple role play partners and a range of individuals to provide evidence to counter distorted thinking
On the basis of early experience, patients with social phobia develop a series of assumptions about themselves and their social world. According to Clark and Wells, these assumptions can be divided into three categories. Which of the following is not one of these categories?
Unconditional negative beliefs about others
Which of the following is true regarding comorbidity of OCD?
The high comorbidity of OCD with other disorders, can pose diagnostic quandaries
The prognostic picture for OCD has improved drastically since Victor Meyer first reported on two patients who responded well to _____?
Exposure and Ritual Prevention
In examining treatment outcomes for OCD, which of the following is true
optional frequency of exposure sessions has yet to be established
Luborsky and colleagues (1995) provided the relationship narrative of Mr. Quinn as a concrete example of the interrelation of the nine dynamic issues in depression. The narrative began with a thought about talking to a women (" he was "just talking" to her") and then a shift to depression occurred. In the interim, the following happened: Mr. Quinn thought, "A guy like me could be with her, or [she could be with] a stronger guy. If it's me, then I'm not strong enough. That's what bothered me." Which of the following nine dynamic issues are not evident here?
States of anger turned inward rather than directed outward
What are the most common conditions for depression as explained by Freud's (1926/1959) theory elaborated on by Engel and Schmale's (1965) and confirmed by Luborsky?
Helplessness and Hopelessness
When paying attention to the transference- related CCRT, the therapist listens for the redundant components across the session and formulates by recognizing all EXCEPT which of the following?
Patient's most redundant responses with their mother
According to Luborsky and colleagues (1995) which of the following is true in regards to the limit of treatment?
The time limit itself may accelerate the patient's growth by greenhouse effect- the growth, inducing atmosphere is stimulated by an urgency to move towards the goals in the allotted time.
Major Depressive Disorder or MDD has been the focus of multiple national and international research studies, which have documented the following?
MDD is the most common depressive illness
All but which of the following were NOT instrumental in the developmental of Interpersonal Psychotherapy for Depression?
Judith Beck
Which of the following is a distinguishing feature of interpersonal therapy as outlined by Bleiberg and Markowitz (2014)?
IPT is diagnosis-targeted
According to IPT on the four interpersonal problems areas is ______ or a change in life status, such as beginning or ending a relationship, starting or losing a hob, a geographic move, graduation or retirement, becoming a parent, or receiving a diagnosis of a medical illness.
Role transitions
_________ in the phase of IPT treatment where the goal is to work on resolving the focal problem areas and each session begins with the question, "How have you been feeling since we last met?"?
The middle phase (sessions 4-9)
Within IPT, inquiring about emotionally laden interpersonal interactions often includes ______or the reconstruction and evaluation of affectively charged interactions, to help the patient understand how they felt in the situation and what they might have done to communicate more effectively
communication analysis
Which of the following Major Treatment Modalities for Alcohol Use Disorder include AA, SMART, SOS, Women for Sobriety, and Moderation Management
Self-help groups
The model of Alcohol Use Disorder treatment that conceptualizes alcoholism as a chronic, progressive, disease to be arrested through lifelong recovery but not cured and believes that AA or 12 step group is necessary for maintaining change is known as ___?
Disease model
According to the American Society of Addition Medicine General Guidelines for Selection of Treatment Setting, which level of care is recommended for an individual who is at "serious risk for major withdrawal or withdrawal seizures or Acute or chronic medical or psychiatric problems that could interfere with treatment?
level IV. medically managed intensive inpatient treatment
Which of the following is not a principle of effective treatment by the national institute on Drug Abuse
-treatment needs to be voluntary to be effective
Within drug refusal training, all of the following are components of effective refusal outlined by Higging, Signon and Heil in 2014 EXCEPT:
not now or maybe later; should be the first thing you say
According to Johnson & Greenman (2006) an observer watching an emotionally focused therapy (EFT) session with a could would see the therapist continually engage in three tasks, which include all of the following EXCEPT:
Connecting emotional responses to maladaptive cognitive patterns
Emotionally focused therapy can best be described as
humanistic
Which of the following is not considered a core emotion?
guilt
The theory of relationships that informs emotionally focused therapy is
Attachment theory
All of the following are phases of the sexual response cycle discussed by Wincze, Bach & Barlow (2008) EXCEPT:
Plateau
Which of the following is NOT a challenge to sexual dysfunction therapy discussed by Wincze, Bach and Barlow (2008)?
Nonadherence to medication regimens
Which arousal disorders treatment method places a ban on intercourse and instead engaging in a series of increasingly sensual/sexual activities?
Sensate focus
Frank is a Native American college student who is seeking assistance with his career choice from a male counselor. The counselor notices that Frank uses very little eye contact. The counselor should recognize that Frank
May view direct eye contact as a lack of respect
Which listening response outlined by Sommers-Flanagan & Sommers- Flanagan enhances rapport and temporarily reduces anxiety by demonstrating support, affirmation, approval of, or validation for feelings articulated by a client?
Feeling validation
Research suggest that clients perceive which of the following behaviors as negative?
Folding arms across the chest
The four categories of attending behavior, or three Vs + B of listening, described by Ivery, Ivery & Zalaquett (2010) are as follows
Visual/eye contact, Vocal qualities, Verbal tracking, Body language
Observing how patients use personal and environmental space is often a better way of understanding them. Of the two most important aspects of space utilization, ____ refers to the amount of personal space a patient requires, where as ____ refers to the position a patient or clinician chooses relative to other objects in the therapy room.
Distance; position
Despite being the "gold standard" for couples distress Traditional behavioral couple therapy (TBCT), holds some limitations. For example, roughly one-third of couples fail to show measureable improvements with TBCT and the divorce rate in couples treated with TBCT is 37% four years after therapy. Integrative behavioral couple therapy (IBCT) boasts three developments directed towards making treatment more enduring and more broadly applicable. Which of the following is NOT one of these developments?
Focus on "rule governed behavior"
In Integrative behavioral couple therapy (IBCT), therapists conduct a DEEP analysis of the couple's theme or issue, an acronym that outlines the four major factors contributing to a couple's problems. All of the following are part of the DEEP acronym EXCEPT:
Eliciting automatic thoughts
Which Integrative behavioral couple therapy (IBCT) Strategy for building emotional acceptance includes positive emphasis, focus the on ways differences complement each other, preparation for inevitable slipups, faking negative behavior, and increasing one's own self-reliance or self care?
Tolerance Building
You observe an Integrative behavioral couple therapy (IBCT) therapist asking "How did you get together?", "What was your courtship like?", and "What attracted each of you to the other?" what type of assessment is occurring?
Couple's History Assessment
Matching: Marie comes to therapy in acute distress. She is a 19-year-old, single honors student who is on a pre-med track, and this is her first session. She has just found out she is pregnant. On hearing this, her therapist immediately asks her a question. See options below, and match each question with the appropriate question classification (these are a little tricky; use the BEST option, each is worth .25 of a point)
Options: A. Open B. Swing C. Closed D. Indirect
1. __A__ How are you feeling?
2. __C___Was it planned?
3. _ D___I wonder how your'e feeling about your upcoming pregnancy?
4. __B___Could you talk about how it was when you first discovered you were pregnant?
In her initial intake session with a client, Victoria posed the following question: "So what you're saying is that you are feeling angry and hurt. Why are you feeling this way?" What is it about her question that is potentially counter-therapeutic?
The questions "why" can communicate judgement, putting the client in a place where he or she must justify his or her feelings
______ refers to a state when a therapist or a client's nonvberal (i.e. facial expression) and verbal expressions (i.e. content, tone, etc. ) are in line with one another, whereas _____ refers to a therapist's ability to match --or oppose -- a client's nonverbal expressions as needed.
Congruence, synchrony
Which of the following would Brems identify as a "roadblock" to effective listening?
-Clinician is joining with his/her client in an effort to understand what a particular experience means for that client
-Clinician is very focused on exactly how to respond to the client
-Clinician is very sympathetic to client's story
-ANSWER IS: All of the above
Good active listening involves which of the following
-Focusing on what the client is saying
-Clinician's awareness of own personal reactions to a client
-Processing meaning of nonverbal expression and symbols, as well as inconsistencies in what client says and his/her body language
-ANSWER IS: all of the above
BONUS: Of the 5 means of interaction outlined by Brem's, _____ also called strengthening, is a nonverbal communication that serves to elaborate a verbalization
Complementation
Your substance use facility has decided to introduce a voucher program into their community reinforcement approach. Your patient's sign the abstinence contract during which they agree to undergo rigorous urinalysis monitoring and have their BALs assessed. What does BALs stand for?
Breath Alcohol Level
________ is an empirically based prototypical behavioral and cognitive-behavioral intervention for substance use disorder where "brief intervention [are] designed to facilitate behavior change by helping clients to identify personal values and goals, to examine whether drug us may conflict with those values and goals, and to explore how to resolve any ambivalence or conflict between personal goals and values, and ongoing drug use"
Motivational Interviewing
Which semi-structured interview for assessment of substance use disorders involves using a calendar to have clients recall their drug use on a day-to-day basis?
Timeline Follow-Back Interview
You observe a psychologist asking their client the following questions "Have you ever felt you should cut down on your drinking?", "Have people annoyed you by commenting on your drinking"?, "Have you ever felt bad or guilty about your drinking/" and "Have you ever had a drink fits thanking in the morning (eye opener)?" You have just watched an administration of the _______ which assesses for ______.
CAGE; Alcohol Use Disorder
The need for clinicians who are competent in treating alcohol and other substances use disorders will increase because of ______
The Patient Protection and Affordable Care Act and the Wellstone-Domenici Mental Health Parity and Addiction Equity Act