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EPPP - Clinical Psychology


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What is the most effective treatment for smoking cessation?
Nicotine replacement therapy AND Behavioral intervention
What clinical test was developed on the basis of empirical criterion keying? What is empirical criterion keying?
MMPI-2; Empirical criterion keying is a method of choosing items for a test on the basis of the items ability to distinguish between groups (i.e., depressed vs. nondepressed)
Diagnostic Overshadowing
Therapist tendency to attribute all of pt's problems to diagnosis
What is the greatest risk factor for childhood depression?
Parental depression
Directed Awareness
From Perls, the technique emphasizing increasing the client's awareness of psychological needs, feelings, and physical processes. Awareness in and of itself is therapeutic.
Health Belief Model
Health s are influenced by: 1. Readiness to take action = perceived susceptibility to the illness & perceived severity of the consequences; 2. Evaluation of costs and benefits of making a response; 3. Internal & external cues to action that trigger response
Double-Bind Communication
Refers to the conflict created when a person receives two conflicting messages at different levels (I love you, while being pushed off lap)
What is the most effective way for the police to deal with domestic violence?
Arresting the perpetrator results in the lowest rate of recidivism
4 stages of Homosexual Identity Development Model (Troiden)
4 Stages: 1. Sensitization 2. Identity Confusion 3. Identity Assumption 4. Identity Commitment
Relationship of psychology to cancer onset and recovery
Unrelated to onset but positively related to recovery and quality of life
Effects of Psychotherapy Stages (Howard et al)
1. Remoralization 2. Remediation 3. Rehabilitation
Dose Dependent Effect (Howard et al)
26 sessions = 75% show improvement 52 sessions = 85%
Stages of change
1.) Precontemplation - no change considered; 2.) Contemplation - aware of need but not committed; 3.) Preparation - clear intent to take action; 4.) Action Maintenance
CBT approach to panic disorder
Identifying and modifying interpretation of attacks and associated physical symptoms
Relationship between therapy and outcome
Moderate overall, but stronger when the symptoms are severe
White Racial Identity Development Model (Helms)
6 Stages: 1. Contact 2. Disintegration 3. Reintegration 4. Pseudo-independence 5. Immersion-Emersion 6. Autonomy
Sexual Prejudice & Heterosexism (Herek)
Sexual Prejudice = Homophobia (broader) Heterosexism = degrades any nonheterosexual behavior
Humanistic Psychology
Sometimes referred to as the "third force," humanistic schools of psychology emphasize the individual's inherent capacity for growth, creativity, and self-actualization. The focus is usually on the person's here-and-now state.
Parallel Process
Parallel process is a phenomenon in clinical supervision where the therapist in training behaves toward the supervising therapist in ways that mirror how the client is behaving toward the therapist in training.
Use: CPI (California Psychological Inventory)
Broad personality test for non-pathologic individuals
reaction formation
Defense in which an anxiety provoking impulse is replaced by its opposite. Ex: hatred by oversolicitude. Typical of obsessive disorders
In the symmetrical pattern of communication⬦
there is equality between the two parties (which can result in competition and conflict)
Existential Therapy
Struggle between individual and "ultimate concerns" of existence (death, meaninglessness, etc.) Two types of anxiety: normal (existential) anxiety and neurotic anxiety
Primary Prevention
Interventions, usually on a community-wide scale, aimed at preventing disorders by reducing the incidence of new cases.
Defense attributing unacceptable wishes to another. Includes prejudice and hypervigilance: the other person carries the guilt
In the complimentary pattern of communication⬦
there is inequality between the partners, with one assuming the dominant role
Defense: Return to an earlier stage of development under stress
projective identification
Defense: projection of unwanted aspects of self onto another creating a sense of oneness
Transactional Analysis: Who, What, How
WHO = Eric Berne. WHAT = Ego States: child, parent, adult. Interactions (transactions) are primarily between ego states. Strokes: positive or negative recognition from others. Scripts: person's life plan, characteristic pattern of giving and receiving strokes. 4 Life Positions: 1) I'm OK - You're OK; 2) I'm OK - You're not OK, etc. All children begin in 1st life position, then modified by parenting. Transactions: Complementary, Crossed (adult:child), Ulterior (dual message) Games: Ulterior transactions ("Now I've Got You, You SOB"). HOW = Alter maladaptive life positions and life scripts and integrate three ego states.
According to psychotherapy outcome research, what percentage of therapy clients shows measurable improvement?
The incidence of OCD is: A.) The same for males and females across all ages. B.) About twice as common in males than females. C.) Higher among boys but about equal among adult males and females. D.) Higher among girls but about equal among adult males an
C: Males: peak onset is between ages 6-15 Females: peak onset is between 20-29.
A man is referred for psychotherapy by his physician after ruling out sleep apnea and other medical conditions. The patient reports having vivid frightening dreams, restless sleep, chronic fatigue, and a history of alcohol abuse. His diagnosis is likely:
C: Sleep can be disturbed as a result of both alcohol intoxification and alcohol withdrawal. Initially, alcohol produces a sedative effect with increased sleepiness. However, after 3-4 hours of sleep, there is an increase in wakefulness, restless sleep, and REM, often accompanied by a vivid anxiety-laden dream for the remainder of the sleep period. Primary insomnia is not due to the direct effects of a substance and is not typically associated with vivid frightening dreams. Choice D is not a DSM-IV diagnosis.
Although considered to be an effective treatment for severe and treatment-resistant depression, ECT often produces adverse side effects including: A.) temporary retrograde amnesia B.) permanent retrograde amnesia C.) patchy anterograde amnesia D.) patchy
D: the anterograde amnesia can last up to 6 months and the retrograde amnesia is usually limited to the events that occurred several months prior to the ECT.
Research on Asians show the best predictor of higher achievement is:
fear of failure
What do most psychotherapists report as the primary source of stress from their work?
lack of therapeutic success
According to Kohlberg's theory of moral development, individuals who reach stage 5 base their moral judgments on: A.) Empathy, B.) Autonomous morality, C.) Democratic laws, D.) Universal ethical principles
C: Stage 5 begins the post-conventional level of moral devt. A person in this stage seeks to uphold democratically-determined laws, but recognizes that laws can be ignored or changed for a valid reason. Choice D is more characteristic of Stage 6 in Kohlberg's model in which morality transcends legal standards. Choice B (Autonomous morality) is used by Piaget denoting the stage when children recognize that rules are determined by agreement and are alterable.
Kernberg's account of BPD
Results from failure to develop appropriate introjects as a result of parental psychopathology or abuse. Characterized by splitting, aggression and unstable self-image
Types of Self-Control Techniques
1.) Self-Monitoring = (minor and short-term effects) & 2.) Stimulus Control = modifying existing S-R relationship, or creating a new one; examples: narrowing, cue strengthening, competing responses. Most useful when implemented at the beginning of a response chain.
Research shows that new immigrants to the US are most likely to experience symptoms of psychiatric disorders at what point:
About one or two years after they arrive in the US (related to the "social displacement syndrome")
Symmetrical vs. Complimentary Communication
Communication patterns can be characterized as either symmetrical or complimentary. In symmetrical communication there is equality between the partners, however, this can result in competition and conflict. In the complimentary communication pattern there is inequality, with one partner taking a dominant role and the other a subordinate role.
What are the 3 factors involved in Hypnotherapy?
Three factors involved: 1) absorption, 2) dissociation, 3) suggestibility. Individuals have greater confidence in memories retrieved under hypnosis, but memories are likely to be distorted. Used for: dissociative disorders, PTSD, habit or self control disorders (smoking, overeating, substance use), phobias, and generalized anxiety. Contraindicated for: psychotic disorders, paranoid and suspicious patients, OCD traits. Also, severely depressed and manic patients are hard to hypnotize. Few studies comparing with other treatments.
When is Biofeedback most successful?
Used for psychophysiological disorders (e.g., hypertension, headaches, ulcers). For many problems, not much more effective than relaxation training. However, it's the treatment of choice for fecal incontinence and Raynaud's disease. EMG biofeedback for tension headaches. Skin Temperature biofeedback for migraines.
Tertiary Prevention
Elimination or amelioration of the residual disability after the onset of the illness.
CBT techniques: Paradoxical Intention
Instructing clients to do or wish for the things they fear. Prescribing the symptom. Purpose is to circumvent anticipatory anxiety. Most commonly used to treat insomnia. Results are mixed.
Therapy Outcome Studies
Research on the differences among various treatments for specific disorders, and the interactive variables which predict therapy success, such as the necessity for a working alliance, therapist variables, patient variables, and the patient-therapy interaction.
Weitz found in his research on therapy outcomes for children & adolescents:
therapy is more beneficial for adolescents than children, especially among girls
During an initial session with an adult client, you realize that you are already treating her mother. The primary problem with continuing to see this new client has to do with: A.) Confidentiality, B.) Multiple relationships, C.) Conflict of interest, D.
C: Conflict of interest. Multiple relationships refers to having more than one type of relationship with the same person, for example, if a psychologist were to see one of his current students in psychotherapy.
Stages in Prochaska and DeClemente's Transtheoretical Model of Change
1) Precontemplation: little insight of need for change 2) Contemplation: considering change (in the next 6 months) but not committed to it. 3) Preparation: clear intent to take action within the next month; may have begun taking small steps. 4) Action: considerable time and energy devoted to change; obvious to others 5) Maintenance: change has lasted 6 months, person consolidating change and taking steps to prevent relapse. May last as long as a lifetime.
A couple comes to therapy complaining that all their conversations end in arguments. This is characteristic of which pattern of communication? Symmetrical Complimentary Pseudohostility Mystification
A: Symmetrical. Communication patterns can be characterized as either symmetrical or complimentary. In symmetrical comm. there is equality between the partners, however, this can result in competition and conflict. In complimentary comm. there is inequality and one partner takes the dominant role and the other a subordinate role. Pseudohostility presents as superficial bickering in order to avoid real conflicts. In mystification, the person uses denial to mask what is really going on.
Biofeedback exerts its relaxing effect on which system?
parasympathetic nervous system
Goal: Bowen's extended systems therapy
Differentiation of self
Motivational Interviewing
Miller and Rollnick Based on Prochaska and DeClemente's Transtheoretical Model of Change Goal: help individuals move from precontemplation stage through contemplation, toward commitment to change. Five basic principles: express empathy, develop discrepancy, avoid argumentation and direct confrontation, roll with resistance, and support self-efficacy for change.
A candidate for the psychology licensing exam wants to maximize his long-term memory of all the study materials. The most effective strategy would be to use: A.) Spaced Practice, B.) Massed Practice, C.) Elaborative Rehearsal, D.) Maintenance Rehearsal
C: Elaborative rehearsal, in which a person thinks about the meaning of new information and its relation to information already in memory, resulting in deeper learning and is considered superior to all forms of mindless repetition. Spaced practice is also generally more effective than massed practice.
A high school student, interested in an acting career, is afraid of disappointing his father who always wanted his son to follow in his footsteps by becoming a doctor. After little deliberation, the young man announces to his family that he will become a
B: Identity foreclosure: a commitment to an identity that is not a result of an identity crisis, but rather, the suggestions of a parent or another person is called identity foreclosure. Identity diffusion describes young people who have not undergone an identity crisis nor have committed to an identity. Identity moratorium occurs when a person is confused, having an identity crisis, and actively exploring different options.
From a humanistic perspective, pathology is due to:
defenses that interfere with one's natural tendency toward personal growth
Research on therapists who became sexually involved with their clients showed that:
The therapist violated other boundaries before the sexual involvement began.
A shortcoming of most curriculum-based suicide prevention programs for adolescents is that: A.) They are based on a stress model of suicide. B.) They are based on a mental illness model of suicide. C.) They tend to stigmatize suicide. D.) They minimize t
A: Most curriculum-based suicide programs for adolescents tend try to reduce the stigmatization of suicide by attributing it to stressful life events rather than (more correctly) to mental illness.
Locke and Latham's goal-setting theory focuses primarily on: A.) Ability and effort, B.) Perceived effort and performance, C.) Expectations and effort, D.) Intentions and effort
D: Intentions and effort: goal-setting theory proposes that when people accept goals, they intend to achieve them and, therefore, are willing to put forth effort to do so.
Multiple aptitude batteries such as the DAT & GATB assess:
skills, abilities, or aptitudes, and allows a counselor to help a client choose an educational or vocational course of action
Research using a "dismantling" strategy suggests that the most critical component of systematic desensitization is: A.) Counter-conditioning, B.) Gradual exposure, C.) Classical extinction, D.) Operant extinction
C: Classical extinction: repeated exposure to the CS without the presence of the US is responsible for systematic desensitization's positive effects.
Deficits on the Stroop test indicate
Loss of rsponse inhibition following frontal lobe damage
Stages of crisis intervention
1.) Formulation: crisis identification, 2.) Implementation: assessment of prior life, setting of short term goals, and implementation of goals, & 3.) Termination: progress assessment, discussion of termination, and beyond
How was the MMPI developed?
empirical criterion keying: retention of items differentiating psychiatric from non-psychiatric populations
Research suggests that __________is the single best treatment for Agoraphobia.
In-vivo flooding: exposing an individual to anxiety-provoking stimuli while preventing an avoidance response.
Therapies for the elderly:
1.) Validation therapy: acknowledges feelings whether or not they are reality-based; 2.) Reminiscence Therapy: reviewing important life events with client; 3.) Reality Orientation: reversing/preventing cognitive impairments & maximizing remaining capabilities
Thermal biofeedback for migraine headaches is mediated by the _____________nervous system. Biofeedback to induce relaxation is mediated by the ______________nervous system.
Thermal biofeedback for migraine headaches is mediated by the sympathetic nervous system. Biofeedback to induce relaxation is mediated by the parasympathetic nervous system.
Research comparing patients with schizophrenia from non-Western developing countries to those from Western industrialized countries has found that they differ in terms of: A.) Symptoms, B.) Age and gender, C.) Gender and prognosis, D.) Course and outcome
D: Course and outcome: patients from developing countries more often exhibit acute onset of sx, shorter clinical course, and a complete remission of sx. No differences were found in regards to age, gender, or type of sx.
What is parallel process?
A phenomenon in clinical supervision where the therapist in training behaves toward the supervising therapist in ways that mirror how the client is behaving toward the therapist in training.
Cognex & Aricept are used to treat Alzheimer's by:
increasing ACh levels
Which is more pronounced in aggressive children in regards to social interactions: the primacy or recency effect?
Recency effect: aggressive children are likely to focus on cues that occur at the end of the social interaction than the beginning.
A therapist is most likely to exert _________ type of power over a client.
Referent: based on the person's attraction to or desire to be like the holder of power. (Expert power is another good answer)
Individuals who retrieve memories under hypnosis, compared to non-hypnotized individuals:
Tend to have more confidence in their memories, but be less accurate in recalling memories
Reciprocity hypothesis:
people tend to like others who like them
Matching hypothesis
Proposes that people of approximately equal physical attractiveness are likely to select each other
In psychotherapy outcome research, factors that appear most responsible for lack of improvement are:
Client factors
The police inform you that they have a warrant out on one of your clients who is suspected of several felony charges of grand theft auto. They want you to provide them with the client's address and phone number. You should:
Refuse to provide them with info and notify your client since there is no indication that your client is in imminent danger to self or others. However, you should notify the client of this info and discuss the option of turning himself in to the police.
A quiet, lonely, introverted, overly sensitive teenager with few friends is at high risk for suicide, with this risk increasing when these characteristics are combined with: A.) Physical health problems, B.) Phobic anxiety, C.) Antisocial behavior, D.) A
C: suicide risk is increased in adolescents who are depressed, hostile, aggressive, or exhibit other antisocial behaviors, and/or substance abuse.
Stages of the minority development model (MID)
1.) Conformity, 2.) Dissonance, 3.) Resistance and immersion, 4.) Introspection, & 5.) Synergistic articulation and awareness
Helms' White Racial Identity Development Model
1.) Contact: lack of; 2.) Disintegration: confusing racial awareness; 3.) Reintegration: prejudice; 4.) Pseudo-independence: thoughtful revisiting of prejudice; 5.) Immersion-emersion: separate and equal, racially proud but not racist; 6.) Autonomy: integration; non-racist identity; seek interaction. Model designed to help therapists understand inter-racial tensions
Masters and Johnson found that their version of sex therapy, which incorporates education about sexuality, training in communication skills, and the technique known as sensate focus, is most effective for treating: A.) Premature ejaculation, B.) Impotenc
A: Premature ejaculation
Considerations in treating Hispanic clients
Prefer an active goal-orientation. Stress personal contact and attention. Consider family
Considerations in treating Native American clients
Importance of tribe and family. Approach: non-directive, history-oriented, accepting, cooperative. Goals: happiness, wisdom, peace with nature. Therapist attitude: reserved, open, accepting, listening
Considerations in treating Asian clients
Approach: direct, structured, short-term; address problem as academic or vocational. Education about therapy process
What is the method of loci?
A mnemonic device where you visualize names or objects to be remembered in familiar locations.
MMPI 1990 revision
Updated norms Addition of new content scales Change of cutoff from 70 to 65 Clinical scales unchanged
Research comparing the relationship between age and therapy outcome has produced mixed results. However, in their most recent meta-analysis, Weisz and his colleagues found:
Therapy is more beneficial for adolescents than children, especially among girls and when the counselor is a professional or student (not a paraprofessional).
From the perspective of Bandura's social learning theory, "functional value" refers to:
Anticipated consequences.
According to Theodore Millan, people with Narcissistic Personality Disorder rely primarily on which of the defense mechanisms?
When narcisstic people experience personal failure and public humiliation, they first rely on: REPRESSION and if that doesn't work: RATIONALIZATION PROJECTION
In implosive therapy, a client is: A: Gradually exposed, though the imagination, to a feared stimulus, one step at a time. B: Immediately exposed, through the imagination, to a feared stimulus at its maximum intensity. C: Gradually exposed, in vivo, to a
Regarding the relationship between bipolar disorder and environmental factors, environmental factors are likely to have a ________ impact during the early stages of the disorder.
Desc: SCL-90
Symptom CheckList is a self report measure of general psychiatric symptoms such as depression, anxiety, somatization, obsessive-compulsiveness and hostility Question rated on a scale of 1-5
Risk factors for adolescent suicide
Depression, use of drugs and alcohol, anti-social behavior
semantic paralexia
Dyslexic reading error in which the child responds with something semantically similar to the stimulus (eg dog in response to cat)
According to research on sex-role determinants, the characteristic that is most related to genetics as opposed to socialization is: A.) Sociability, B.) Dependency, C.) Aggression, D.) Anxiety
state dependence
Memory is maximized if we are in the same emotional state during learning and recall
Self instruction is most useful for:
Hyperactive/impulsive children (form of CBT which encourages focusing on their self statements & altering their self-defeating statements)
Based on Schachter's work, one would treat a client with obesity by: A.) Manipulating the external cues. B.) Changing the client's self-attributions. C.) Changing the social reinforcers for food consumption. D.) Manipulating the internal cues.
Individuals with antisocial personality are most influenced by:
Treatment of choice for agoraphobia
Flooding, with 75% long term improvement
Afro-American use of mental health services
For solving practical rather than emotional problems
In brief psychodynamic therapy, positive transference is
useful for maximizing a client's motivation, thus important to establish
Techniques to use in counseling Mexican-Americans
Using a high-context communication style (relying on non-verbal comm., and shared meanings), relying on inner externalizations of problems, using metaphors & humor, using compliments
According to Nancy Chodorow:
Girls are taught to remain attached to their mothers, while boys are taught to differentiate. Child rearing must be shared by parents
Hypnosis involves which 3 factors?
Absorption Dissociation Suggestibility
Efficacy of psychotherapy for children and adolescents compared to adults
Characterize Skinner's theory
Focus is on environmental contingencies. Did not feel innate urges were very important.
What is responsible for keeping people in long-term relationships?
Similarity hypothesis
self control
Repeating affirmative statements to yourself. Effective in treating children afraid of the dark.
Concepts in Transactional Analysis
1.) Ego States - (child, parent & adult); 2.) Strokes - recognition from others; 3.) Scripts - persons life plan; 4.) Life Position - One of 4 (I'm OK, you're OK)
Goal of Transactional Analysis
Alter maladaptive life positions and life scripts, and integrate the 3 ego states
the "command" level of communication (the implicit non-verbal message)
Validity Scales on the MMPI
L = Lie (defensive, endorsing socially-approved item) K = Correction (high = defensive, low = low self-image) F = Infrequency (intentionally looking bad)
Howard's Phase Model of Psychotherapy Effectiveness
1.) Remoralization = first few sessions, gives client hope; 2.) Remediation = 16 sessions, provides symptom relief; 3.) Rehabilitation = gradual improvement in overall functioning
Therapy with African-Americans
Should be problem-oriented & time limited. Multi-systems, ecostructural
Therapy with Hispanics
Patriarchal families, rigid sex roles. Prefer approach with personal contact & attention. Use active, goal-oriented approach
Therapy with Asian-Americans
Direct, structured, short-term approach. Place problem within work/school context.
Therapy with Native-Americans
Non-directive, history-oriented, accepting, cooperative approach
According to RET, irrational beliefs are acquired through:
Natural, biological tendencies

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