Deck 14: Psychotherapy: Behavioral and Cognitive-Behavioral Perspectives

Question 1

Exposure and response prevention has been found to be particularly effective at treating

A) panic disorder.
B) social phobia.
C) obsessive-compulsive disorder.
D) generalized anxiety disorder.

Answer 1

obsessive-compulsive disorder.

Question 2

Data suggest that the client's perception of the therapeutic relationship

A) is not very important to the outcome of any type of psychotherapy.
B) is more important to the outcome of behavioral psychotherapy than to other types of psychotherapy.
C) is less important to the outcome of behavioral therapy than to other types of psychotherapy.
D) is very important to the outcome of behavioral and other forms of psychotherapy.

Answer 2

is very important to the outcome of behavioral and other forms of psychotherapy.

Question 3

A study comparing the effectiveness of two forms of treatment for panic disorder with agoraphobia (Craske et al.,1997)found that

A) interoceptive exposure resulted in a better outcome than breathing retraining.
B) breathing retraining resulted in better outcome than interoceptive exposure.
C) interoceptive exposure and breathing retraining were associated with similar outcomes.
D) interoceptive exposure and breathing retraining were associated with similar outcomes at post-treatment, but interoceptive exposure was superior at follow-up.

Answer 3

interoceptive exposure resulted in a better outcome than breathing retraining.

Question 4

Definitions of behavior therapy are diverse,but all of them tend to emphasize

A) an experimental approach to the study of human behavior.
B) clinical inference.
C) mentalism over science.
D) mentalism and science equally.

Question 5

__________ procedures attempt to alter behavior by controlling the consequences of the behavior.

A) Classical conditioning
B) Operant
C) Restructuring
D) Pavlovian

Question 6

ALL BUT WHICH of the following distinguishes the therapeutic relationship in behavior therapy from that of other therapies?

A) The therapist tends to adopt a more collaborative style.
B) The therapist tends to be slightly less warm or empathic.
C) The therapist may be more accepting of the problem as viewed/presented by the client.
D) The treatment recommended by the therapist may more obviously address the problematic behavior.

Question 7

Joseph Wolpe's name is most closely associated with which of the following?

A) free association
B) systematic desensitization
C) contingency management
D) thought stopping

Question 8

To achieve maximum benefit in exposure therapy,

A) the duration of exposures should be short rather than long.
B) exposures should not provoke anxiety.
C) the client should be directed to attend as little as possible to the feared stimulus.
D) exposure should be graduated, starting with stimuli that evoke low levels of anxiety and moving up.

Question 9

Dr.Olaf and Marcus are proceeding through a systematic desensitization exercise when Marcus signals that he feels anxious.Given what you know about the treatment,what should happen next?

A) Dr. Olaf should halt the treatment entirely, and he and Marcus should spend time trying to identify the origin of Marcus's anxiety.
B) Dr. Olaf should reassure Marcus that the anxiety is normal, but that he must endure it until it subsides naturally.
C) Dr. Olaf should direct Marcus to stop visualizing the scenario and help him to relax, and then they should resume the exercise.
D) Dr. Olaf should direct Marcus to stop visualizing that scenario and they should move to the next one up the hierarchy.

Question 10

Susan is a client with a phobia of airplanes who is seeing Dr.Williams,a behavioral therapist.Which of the following should occur during systematic desensitization?

A) Dr. Williams decides the order of the items that Susan generates for her anxiety hierarchy.
B) Dr. Williams teaches Susan to relax by audiorecording instructions for tensing and relaxing various muscle groups.
C) Dr. Williams has Susan list 20 ways in which her fear of flying has negatively affected her life.
D) Dr. Williams explains to Susan the rationale for the desensitization treatment, using professional jargon.

Question 11

In __________ exposure,the client actually confronts the feared stimulus or anxiety-provoking situation.

A) in vivo
B) simulated
C) experiential
D) in imagino

Question 12

Systematic desensitization

A) was developed by Meichenbaum.
B) has proven similarly efficacious for mood and anxiety disorders.
C) is based upon the principle that one cannot be simultaneously anxious and relaxed.
D) all of the above

Question 13

Relaxation training in systematic desensitization

A) was once an important component of treatment, but no longer is emphasized.
B) typically occupies about 15-20 sessions.
C) involves teaching the client to tense and relax particular muscle groups.
D) all of the above

Question 14

In the 1950s,Rotter theorized that

A) behavior was determined by the value of the reinforcement that followed it.
B) behavior was determined by the expectancy that it would be reinforced.
C) both of the above
D) neither of the above

Question 15

In 1924,Mary Cover Jones worked with a young boy to remove a fear of rabbits and similar objects.Her therapeutic technique

A) involved pairing rabbits with objects that elicited a higher intensity of fear.
B) emphasized the symbolic meaning that the child attached to the rabbits.
C) was similar to Wolpe's later techniques involving reciprocal inhibition.
D) emphasized the replacement of irrational cognitions with more logical cognitions.

Question 16

If a client who has never been taught proper table manners becomes seriously anxious while dining out with others,a behavior therapist's goal should be to

A) employ exposure treatment to help the client overcome his/her anxiety.
B) teach the client proper table manners to overcome his/her behavioral deficit.
C) refer the client to either a client-centered or psychodynamic therapist.
D) teach the client relaxation skills to use when he/she becomes anxious about table manners.

Question 17

It has been hypothesized that systematic desensitization works as a result of

A) counterconditioning.
B) habituation.
C) extinction.
D) all of the above

Question 18

Michael is a client with social phobia who is seeing a behavioral therapist.If the therapist uses exposure therapy,

A) the therapist is using a technique with no empirical support for this disorder.
B) Michael will have to remain in anxiety-provoking situations until his anxiety subsides.
C) he or she cannot use any other treatment interventions concurrently.
D) none of the above

Question 19

In systematic desensitization,who constructs the hierarchy?

A) the client alone
B) the therapist alone
C) the client and therapist together
D) a neutral third party

Question 20

Interoceptive cues

A) are internal physiological stimuli such as rapid breathing and dizziness.
B) are particularly important in specific phobias since the symptoms of this disorder usually come "out of the blue."
C) both of the above
D) neither of the above

Question 21

The belief that life is awful,terrible,horrible,or catastrophic when things don't go the way we'd like them to go

A) is one of the common irrational beliefs identified by Ellis.
B) is the type of belief that, according to cognitive therapists, increases one's risk of psychopathology.
C) would be a target of change for an RET therapist.
D) all of the above

Question 22

A client tells his behavioral therapist that he has a goal of jogging for 30 minutes every other day.The therapist helps the client create a system by which he rewards himself first for putting on jogging clothes and doing any kind of exercise for any length of time,then for jogging for 5 minutes,then for jogging for 15 minutes,and ultimately for jogging for 30 minutes.This technique is best described as

A) shaping.
B) behavioral instruction.
C) time-out.
D) a token economy.

Question 23

Mark is a client who reports anxiety in situations where he's required to interact with his supervisors at work.He reports that he "just doesn't know what to say or do" in such situations.His behavioral therapist should probably employ

A) behavioral rehearsal.
B) rational restructuring.
C) covert sensitization.
D) all of the above

Question 24

Which of the following rules for patients in an inpatient psychiatric facility best illustrates the proper application of a token economy?

A) If you make your bed in the morning, you can watch TV for an extra 15 minutes that night.
B) If you make your bed in the morning, you immediately receive a red poker chip that can be exchanged for 15 extra minutes of TV.
C) If you are a good patient in the morning, you can watch TV for an extra 15 minutes that night.
D) If you are a good patient in the morning, you immediately receive a red poker chip.

Question 25

Which of the following clinical examples best illustrates guided participation?

A) A client with contamination fears is asked to imagine a series of progressively more intense anxiety-producing scenarios.
B) A client with social anxiety watches a videotape of a model interacting at a party.
C) After watching a model exhibit target behaviors, a client with a snake phobia is gradually encouraged by the therapist to try out similar behaviors.
D) The therapist of a client with sexual dysfunction challenges the irrational beliefs that underlie the problem and tries to replace them with more rational beliefs.

Question 26

Vince and his therapist are using behavioral rehearsal to help him reduce his interpersonal aggression.What form is this rehearsal likely to take?

A) Vince's therapist acts as his coach during a role-play exercise.
B) Vince and his therapist do a role play, and his therapist gives him feedback as they review the video recording of the performance.
C) Vince and his therapist do a role play, and then he and his therapist swap roles so the therapist can model appropriate behavior.
D) any of the above

Question 27

Aversion therapy is typically applied when a client has

A) an aversion to a food or other stimulus and the goal is to overcome it.
B) a desired response in his/her repertoire and the goal is to increase its frequency.
C) an unwanted response in his/her repertoire and the goal is to decrease its frequency.
D) a behavioral deficit and the goal is to expand his/her behavioral repertoire.

Question 28

A client and therapist agree upon the following rule regarding the client's behavior by signing a document which states,"If I study my most boring textbook for 5 hours this week,I can see the movie of my choice on Sunday." Which of the following contingency management techniques is illustrated by this example?

A) "Grandma's rule" (i.e., the Premack principle)
B) contingency contracting
C) both of the above
D) neither of the above

Question 29

If lack of assertiveness stems from __________,then __________ might be the treatment of choice.

A) lack of information; education
B) behavioral deficits; behavioral rehearsal
C) unrealistically negative expectations; desensitization
D) more than one of the above

Question 30

A child who has been playing outside in the dirt comes inside,refuses to wash his hands,and gets the refrigerator dirty.His parents force him to clean not only the refrigerator,but the kitchen floor and countertops as well.Behavioral therapists would label this technique as

A) overcorrection.
B) "Grandma's rule."
C) response cost.
D) negative reinforcement.

Question 31

Deena and her therapist are using behavioral rehearsal to address her difficulties with social anxiety,and currently they are drawing up a hierarchy of social situations where Deena has been having problems.This suggests that they are in the __________ stage of the behavioral rehearsal.

A) first
B) second
C) third
D) fourth

Question 32

In the ABC model of RET,

A) "A" represents the "actions," or target behaviors, that the client wants to change.
B) the fundamental goal is to alter "C" by increasing the extent to which "B" is logical.
C) both of the above
D) neither of the above

Question 33

Ethan,who is in the third grade,has not been doing his homework.The counselor at school suggests that his parents institute a token economy where Ethan receives a poker chip each time he completes his homework,and every time he accumulates 5 chips and turns them in to his parents,they buy him a comic book.In this case,what is considered the "backup reinforcer"?

A) the comic book
B) the poker chip
C) the parents' praise
D) the homework

Question 34

A therapist who is working with a client diagnosed with generalized anxiety disorder decides to use stress inoculation training.Which of the following is likely to take place during this treatment?

A) First, the client is taught how certain thought patterns lead to anxiety, and is also taught how to cope with potential threats. Next, the client rehearses these coping skills and then applies them in various stressful conditions.
B) The client is "flooded" or "imploded" with anxiety by being forced to remain in the most anxiety-provoking situation imaginable, thus decreasing the anxiety experienced in similar but less extreme situations.
C) Unconscious conflicts that underlie the anxiety are explored in order to neutralize the anxiety at the most fundamental psychological level.
D) more than one of the above

Question 35

Aversion therapy is quite controversial.ALL BUT WHICH of the following is a common criticism of this type of treatment?

A) Punishment may not be the most effective way to influence behavior in the long term.
B) This type of treatment shows little appreciation for human dignity.
C) The range of practicable aversive agents is somewhat limited.
D) All of the above are common criticisms.

Question 36

A child is punished for lying to her parents by having her allowance reduced.Behavioral therapists would label this technique as

A) response cost.
B) token economy.
C) thought stopping.
D) overcorrection.

Question 37

The role of self-efficacy in cognitive-behavioral therapy was most clearly emphasized by

A) Watson.
B) Bandura.
C) Wolpe.
D) Meichenbaum.

Question 38

Which of the following is NOT an example of a behavioral therapy technique based upon contingency management principles?

A) "Grandma's rule" (i.e., the Premack principle)
B) shaping
C) time-out
D) systematic desensitization

Question 39

Trisha is a client who wants to reduce her cigarette smoking behaviors.Her behavioral therapist instructs her to imagine that while she is smoking,her lungs are impaired and she is desperately but unsuccessfully trying to catch her breath.This technique is best described as

A) behavioral rehearsal.
B) covert sensitization.
C) shaping.
D) overcorrection.

Question 40

According to Ellis,

A) the unconscious origins of irrational thought are the key elements to be examined during therapy.
B) therapists should focus exclusively upon stimuli and responses, and should not focus upon any intervening cognitive processes.
C) our interpretations of events, rather than the events themselves, determine our behavioral reactions.
D) none of the above

Question 41

Dialectical Behavior Therapy

A) lasts about six months.
B) involves both individual and group therapy components.
C) has not been well-supported by research to date.
D) more than one of the above

Question 42

Provide a brief fictional example of a therapist using systematic desensitization with a client for whom this type of treatment is appropriate.

Question 43

Which of the following is true regarding behavioral and cognitive-behavioral therapy?

A) They require a few more sessions, on average, than most psychodynamic treatments.
B) Several meta-analytic studies have found that they are slightly more effective than other forms of therapy.
C) They seem to be consistent with the values and activities of scientist-practitioners and clinical scientists.
D) more than one of the above

Question 44

Which of the following is NOT a routine part of a cognitive therapy session,as outlined by Beck?

A) eliciting emotional expression
B) setting an agenda
C) checking mood symptoms
D) assigning homework

Question 45

Propose a token economy for a director of an inpatient psychiatric unit who would like to increase the frequency of patients making their beds.

Question 46

The empirical evidence supporting Beck's cognitive therapy suggests that it is effective for

A) depression.
B) personality disorders.
C) eating disorders.
D) all of the above

Question 47

The diagnosis most closely associated with Dialectical Behavior Therapy is

A) antisocial personality disorder.
B) major depression.
C) obsessive-compulsive disorder.
D) borderline personality disorder.

Question 48

Explain the ABC model of RET,including the fundamental goal of this approach to therapy.

Question 49

Many people have criticized aversion therapy over the years.Defend the use of this type of treatment with at least three distinct arguments.

Question 50

For what type of diagnosis is exposure and response prevention the treatment of choice? Illustrate with a fictional example the important elements of this treatment.

Question 51

According to Aaron Beck,depressed individuals are characterized by negative beliefs about

A) others' views of them.
B) their work and their relationships.
C) their safety and security.
D) themselves, their world, and their future.

Question 52

In what type of clinical situation is participant modeling an appropriate form of treatment? What factors can increase the effectiveness of the model?

Question 53

Which of the following is NOT one of the skills training areas outlined by Dialectical Behavior Therapy?

A) mindfulness
B) time management
C) distress tolerance
D) interpersonal effectiveness

Question 54

Which form of therapy has developed more manualized approaches to psychotherapy than any other?

A) behavioral
B) humanistic
C) group therapy
D) psychodynamic

Question 55

Critics of behavior therapy argue that

A) behavioral therapy techniques can be mechanistic and dehumanizing.
B) behavioral therapy may relieve symptoms but does not promote inner growth or fulfillment.
C) behavioral treatment seems to lack a unifying theory.
D) all of the above

Question 56

In what type of clinical situation is behavior rehearsal an appropriate form of treatment? What are the four stages of this type of treatment?

Question 57

A depressed client is seeing a therapist who uses Beck's cognitive therapy.Which of the following is the therapist LEAST likely to do during treatment?

A) Identify automatic thoughts that precede a depressed mood and challenge their validity.
B) Schedule activities to counteract the periods of inactivity that may cause one to focus on depressive feelings.
C) Help the client search for alternative solutions to problems rather than resigning to defeat.
D) Teach the client relaxation skills and move through a hierarchy of symptoms of physical tension.

Question 58

Identify and describe briefly at least four distinct techniques used in Beck's cognitive therapy for depression.Also,comment on the effectiveness of this treatment.

Question 59

Summarize the rationale of exposure therapy and identify at least three features that enhance its effectiveness.