Deck 3: Ongoing

Question 1

Which of the following inventories can be used to gauge progress during the therapeutic process or to determine whether further therapy is necessary?

A)Beck Depression Inventory
B)Young Mania Rating Scale
C)Beck Anxiety Inventory
D)All of the above

Answer 1

All of the above

Question 2

Bullet Bob wants therapy to be a quick fix. He is in quite the hurry. After six weeks, Bob is getting anxious. He doesn't see any improvement and so he asks you as his therapist if you see any improvement. One of the best ways to handle this question is to:

A)Avoid it; therapy takes time
B)Turn the question back to the client, letting them sit with their feelings
C)Forget how long the client has been in therapy
D)Refer Bob to a solution-focused practitioner

Answer 2

Turn the question back to the client, letting them sit with their feelings

Question 3

One misconception about solution-focused brief therapy is that problems get solved right way. Instead, as the name implies, there is a focus on finding the solution. Oftentimes, in the middle of therapy, that could mean:

A)Asking the question again, to see if the priority needs to change
B)Stopping for a period of time
C)Adding additional homework assignments
D)Finishing the client's sentences

Answer 3

Asking the question again, to see if the priority needs to change

Question 4

There could be a large difference between when the clinician feels the work is done and when the client feels the work is done. The clinician may be able to see other issues at play. If the clinician sees other issues at play:

A)He says nothing. What came in broken is fixed.
B)He is ethically obligated to point them out.
C)He decides to continue treatment, even after client has set termination.
D)He should take it up with the client next week, after he has sorted it out.

Question 5

Talkative Tyler is a terribly tormented teenager. However, as much as things are bothering him, he is ritually refusing his requirement to release his ranting and raving. When something like this happens, the therapist must be able to:

A)Leave his personal feelings out of it
B)Empathize before deciding to end treatment
C)Terminate therapy without any hard feelings
D)Provide the best level of care (including empathy and attention) that is possible

Question 6

As you are coming to the end of your therapeutic relationship with Daisy Debts, you realize that she has not paid you for your last six sessions. Since this is the last time you will see Daisy, it would be best to:

A)Let it go; cut your losses
B)Confront Daisy about her behavior
C)Attempt to work out a payment plan
D)Take Daisy to court to recoup your losses

Question 7

At the end of your time together, Maria is remarkably thankful for the work that you have done with her family, but especially with her children. As a sign of her appreciation, she has baked you a very special cake that has cultural significance to her. How do you handle such a gift?

A)Accept the gift, knowing that it is important to her culturally
B)Take it, but throw it away later
C)Decline the gift
D)Ask her to reconsider another more appropriate gift

Question 8

As your treatment with Frisky Frank continues, he begins to share with you how he has been engaging in unprotected sex with his girlfriend. Frank is seventeen, almost eighteen. You know that his parents do not approve of his girlfriend. What is your place as a therapist?

A)Tell Frank to stop having unprotected sex
B)Examine his reasons and weigh the risks with him
C)Share what you've heard with his parents
D)Terminate therapy immediately. Frank's behavior is dangerous.

Question 9

You are an intern who works for free at a non-profit agency and you have just received an offer for full-time employment with your local county health department. In order to ensure that your clients at the non-profit continue receiving the best care, you decide to:

A)Keep both jobs, even if it means one will suffer
B)Decline the job offer
C)Work to facilitate transition of your caseload to appropriate therapists
D)Don't tell the clients that you're leaving

Question 10

You are working with Brett, a sixteen year old who recently transferred to the local public high school where you are a therapist. Brett comes from a wealthy Connecticut suburb, where private school was the norm. After six months of working with him on an Adjustment Disorder, you should:

A)Add a specifier in order to increase the amount of time that can be spent
B)Re-evaluate the diagnosis for something more appropriate
C)Contact his parents for some family therapy
D)Encourage him to branch out and make friends

Question 11

You are working with Jeanine, whose husband, Peter, refuses to come to therapy. Your main concern revolves around whether or not this marriage will work. Peter still refuses to come in, even after eight weeks of therapy. How do you continue treatment?

A)Shift focus to give Jeanine power to make individual change
B)You don't; it would be leading her on to think there was hope.
C)Demand that Peter become a part of the work.
D)Think of it as helpful if you were to broach divorce.

Question 12

You have seen a client for fifteen sessions, the maximum on his insurance policy for the year. You've made great progress, but he's still interested in pursuing some of the areas that you've uncovered. When he doesn't have the money for your fee, how do you proceed?

A)Find a good point to wrap things up
B)Attempt to work out a sliding scale fee
C)Make a referral to another therapist
D)Encourage him to keep talking this out with friends who will listen

Question 13

An urgent matter has come up for one of your clients and she needs to have a surgical procedure done in the next few days that will result in her being home-bound for the next several weeks. You are at an impasse with therapy, where she is not responding and resistant to certain challenges so far. You might recommend:

A)Providing a referral
B)Providing therapy for her in her home while she recovers
C)Resuming therapy when she feels up to it again
D)Any of these could be considered reasonable steps

Question 14

One of your clients, who is court-mandated, has just reached the conclusion of his twenty sessions with you. He has gotten to know you over the last several weeks and lets you know that he appreciates the time you've spent together. He's thought it over and he'd like to end at the mandatory twenty sessions. You feel that he has quite a bit of potential left to explore a lot of his residual issues. What makes for a good option?

A)Hope that he changes his mind in the next few weeks
B)Recommend to the judge that he could benefit from ten more weeks
C)Talk with him about the progress you think he's capable of
D)Frame your conversation in the context of disappointment

Question 15

When writing treatment plans, it is often important to establish when the goal will be considered achieved or when the symptom will be considered stabilized. For example, symptoms will be considered stabilized when client reports zero auditory hallucinations for a period of xx." Of the following options, which may be best suited for a stabilization goal?

A)One month
B)Six months
C)Six weeks
D)One year

Question 16

About six weeks into therapy with a family, you are tempted to ask "How is this for you?" fully expecting the answer you've always heard. Instead, you change your mind and instead choose to ask the parental unit, "What are you learning about your son?" In this way, you have effectively:

A)Shamed the parents into feeling stupid
B)Changed the focus of the evaluation from therapist to family unit
C)Empowered the teen to feel as if he doesn't need therapy
D)Left room for an answer that benefits only one party

Question 17

You live in a small, rural town in northeastern Michigan, where you are one of two practicing therapists in town. You are in the market for a new car and realize that the only dealership in town is owned by a former client. Do you buy your car locally or not?

A)Never. There has to be a dealership in the next town over.
B)It depends upon whether or not power, duration, and termination tests have been met.
C)Absolutely. Folks in rural areas understand the conflict.
D)It depends on whether or not it comes in a convertible.

Question 18

What is one essential question to ask in order to gauge whether or not behavior might be considered an ethical violation or cause for termination?

A)Is there a foreseeable risk?
B)How would it make me feel?
C)How would it make the client feel?
D)Who will find out?

Question 19

Your informed consent document never included a section that defined what you would not be able to do for clients. A client is approaching you and is asking you to serve as a couples therapist for her and her husband, while continuing individual therapy with her only. Your response would be:

A)Flattered; she thinks of you as good enough to conduct both kinds of therapy.
B)Terminate the therapy based upon the awkwardness.
C)To ask her to pick one or the other; it can't be both.
D)That it would call into question any ongoing treatment she might receive.

Question 20

Nate has been coming in to see you for about eighteen weeks. At the end of eighteen weeks, he finds that he isn't benefitting from therapy. When he shares this with you, you examine what has kept him coming back for eighteen weeks if there is no progress. One common reason might be:

A)A client who is unsure of how to address lack of efficacy with a therapist
B)Clients are afraid of some sort of retaliation for leaving therapy
C)Client was not informed of potential drawbacks of therapy
D)A and B

Question 21

Faye makes it very clear to you that she only has the money for 15 sessions. After that, she couldn't get benefits for more therapy. When you propose a sliding scale, she balks at the idea as some kind of charity. Do you consider taking the case?

A)Since she can't adhere to the limit even before it's set, it is best to avoid it.
B)Yes, there is a lot that can be done in 15 sessions.
C)No, you will likely not work hard enough, since you know your time is limited.
D)No, since you know that she will likely need to be seen for more than 4 months.

Question 22

If you used the Beck Depression Inventory and the Beck Anxiety Inventory to assess at the beginning of treatment, what tools would you use to assess progress in the middle of treatment?

A)The same scales, so that you are able to make a comparison
B)The same scales, but this time with client feedback around what they mean
C)Use only scaling in the client's terms
D)Advanced Termination Scales

Question 23

Allison's mother is thrilled that she is receiving counseling. About eight weeks into treatment, her mother contacts you and wants Allison to stop counseling. When investigating her motives, you may discover that her mother:

A)Was pushed into counseling by school staff
B)Felt that she had not been included in the treatment planning
C)Had different expectations around confidentiality
D)Thought that results would be measured differently

Question 24

A client was diagnosed with PTSD after two traumatic car accidents. He reported wanting to be able to drive again and has achieved much of his goal, but you recognize that he could go further. When coordinating around his treatment, it is important to consider:

A)When he needs to go back to work
B)How much time has passed since his last progress
C)What needs to happen in order to consider the trauma to be eliminated
D)How much progress the client is comfortable with in a short period of time

Question 25

You're using CBT to work with a family that reports that the issues with their son are starting to dissipate. He's cleaning his room, finishing his dinner, and doing his homework. However, the couple is now noticing that there is more tension between them. How would you handle this?

A)Offer to continue working with the couple to resolve the issues that this has raised.
B)Refer them to someone who specializes in couples work.
C)Encourage them to look on the bright side; the referred problem is taken care of.
D)Explore why the couple resents their son's progress in therapy.

Question 26

You have worked with a client for almost two years and the client has shown sufficient progress that she is ready to move on. As termination moves closer, she begins to decompensate, returning closer to her initial baseline. How do you proceed?

A)Go back to square one
B)Normalize some of the behavior as expected; help her cope
C)Continue to reiterate your final dates of therapy
D)Provide her with a referral to a grief group to process your termination

Question 27

You have a client who is in denial regarding their mental illness. Progress in therapy is slow and the client's insight is not really improving. You begin viewing termination as imminent. Which is an important way you could go about building insight with the client?

A)Reiterating family accounts of the illness
B)Ask the client to consider the choice they made to seek therapy
C)Tell the client what you observe and reiterate your education and credentials
D)Building insight with this client would not be possible

Question 28

Variable Victor can never quite decide which weeks he wants to come to therapy. Whenever there is what might be considered a breakthrough, Victor makes up what feels like an excuse the next week. When working with Victor, what might be your next step?

A)Help Victor to understand your schedule
B)Treat Victor's behavior as an affront to you, personally
C)Explore Victor's resistance openly and be open to his readiness
D)Bill him for the missed appointments, even when he cancels on time

Question 29

Maggie Meds comes into therapy one day wanting to know if medication could be helpful for her. You refer her to a psychiatrist and point out that a medical evaluation could help determine if psychotropic drugs could be useful. She wants to know why she should pay to see you when a psychiatrist can perform therapy as well. You might suggest:

A)Psychiatrists provide only medication management; real issues are for therapy
B)Some things Maggie might do to prepare for her visit to make an informed decision
C)Exploring the possibility of therapy with a psychiatrist
D)It takes time to build a relationship like the two of you have

Question 30

Humanistic, or person-centered, therapy goes to great lengths in order to assist the client in feeling valuable in their own recovery. When coming to therapy, how might a person-centered therapist address therapy's progress?

A)In the context of the client's ability to do something
B)In the context of the client's willingness
C)With other individuals in the care circle before the client
D)By reminding the client that much work has been done and of the progress made