Friday, August 8, 2014

Direct and Indirect Practice Questions (11)

   
1. All of the following are associated with Gestalt therapy except: 

A. Here and Now
B. Awareness
C. Figure and Ground
D. Congruence 


2. Client idealized and romanticized about social worker and is borderline. The social worker wants to discuss this with client. What should the social worker do FIRST? 
A.Explain that feelings are incompatible with treatment goals
B. Explain feelings can only be discussed in the therapeutic context. 
C. Explore clients intimate feelings
D. Have client re-evaluated 


3.  A Social worker suspects her client's mother is battered. Presenting problem is addressing daughter’s school difficulties? However, when the social worker attempts to explore the mother's possible domestic violence history, the mother avoids answering the social workers questions. The social worker SHOULD: 
A. Force the mother to go to a shelter
B. Assist client with daughters school
C. File a police report 
D. Continue exploring domestic violence mother. 

  
 4. What psychotherapy is Most Appropriate for a delusional client:
A. Dialectical Behavioral Therapy
B. Problem Solving Therapy
C. Supportive Therapy
D. psychoanalysis

5. Structural family therapy maintains that there is an overall organization or structure that produces a family’s dysfunctional interactions. Salvador Minuchin believes boundaries can be too closed or too open. A structural family therapist would use all the following interventions except:
A. Mimesis
B. Manipulation
C. Problem Solving 
D. Enactments and Restructuing

 6. In Structural Family Therapy, parenting, spousal and sibling are all : 
A. Subsystems
B. Family structure
C. Closed System
D. Open System 

7. During a first session with a client in crisis, you should focus on which of the following FIRST:
A. Personality issues
B. Client's immediate or stated presenting problem.
C. General day-to-day problems in functioning
D. Client's possible substance use.


8.As a rational Emotive Therapist you would be most interested in therapeutic techniques, which help to modify which of the following :
A. Behaviors
B. Emotions
C. Beliefs
D.  Events

9. You have been assigned a gay teen-age client. Of the many roles you play as therapist, which one is the MOST important role for you in this situation?
A. Helping client Disclose to his family that he is gay.
B. Helping client unlearn maladaptive self-protective behaviors.
C. Exposing client to gay role models.
D. Providing the client with relevant information and resources.

10. As a psychodynamic social worker you view your clients addiction to cigarette smoking as a behavioral fixation, designed to recreate the needs of which Developmental phase in Freudian theory?

A. Anal
B. Phallic
C . Latency
D. Oral

11. "Life Script" is associated with which of the following theorist?
A. Transactional Analysis
B. Gestalt Therapy
C. Adlerian Psychotherapy
D. Reality Therapy


  ANSWERS (11)

1.      D. Congruence is associated with client centered therapy. Gestalt therapy is a type of therapy used to deepen our awareness of ourselves and our feelings in a less intellectual manner than the more traditional forms of therapy.  "Gestalt" means the whole; it implies wholeness.  In any experience or interaction there are feelings in the foreground and in the background. The individual perceives the environment as a total unit;  he/she responds to the whole of what is seen and this whole is composed of the stimuli of which the person is aware or to which he/she attends, the "spontaneous concentration" of contact (the figure) and those of which the person is not aware or does not attend (the ground).  The figure/ground process is perceptual and changes momentarily.

2.     
2.  B  Its essential to clarify boundaries with all clients.  Many borderline personality disorder clients are starving for parental nurturing and affection. ... For example, to nurture a child without boundaries of security and safety.

3.  C  the best answer is to focus on the presenting problem. We must respect the Clint's right to privacy and given clients response she doesn't seem ready to address the possible domestic violence.

4. C In spite of successful antipsychotic drug treatment, many people with schizophrenia have difficulty with motivation, activities of daily living, relationships, and communication. Also, since the illness typically begins during the years critical to education and professional training, people with schizophrenia often lack social and work skills and experience. In these cases, the psychosocial treatments can be especially important. Many useful therapies have been developed to assist people suffering from schizophrenia and include: Supportive therapy.  Rehabilitation, family education, self help groups

5.  C Mimesis: The paralleling of a family’s mood or behavior, which solidifies a therapeutic alliance. For example, a therapist may talk slowly with a slow-talking family or be animated with an animated family.
Joining: An accommodating maneuver in which the therapist establishes rapport with family members and temporarily becomes part of the family system. The family accepts the therapist more openly, thus enhancing the therapist’s ability to being about change.
Enactment: The acting out of dysfunctional transactional patterns within the family therapy session, encouraged by the therapist. Through setting up these transactions in the present, the therapist learns much about the family’s structure and interactional patterns. The therapist is then able to intervene in the process by increasing its intensity, indicating alternative transactions, marking boundaries, and so forth. The therapist may also have the family enact more positive transactional patterns within the therapy session, which will serve as a template for more positive interactions outside therapy.
Restructuring: Any therapeutic intervention that confronts and challenges a family and facilitates structural changes. Examples of restructuring maneuvers include assigning tasks, shifting power systems, escalating stress, and marking boundaries.
All these interventions are manipulative in nature. It's meant to    Unbalance the family  thus interfering with the homeostasis of the family system.

6. A  Stemming from the concept of structure is the concept of boundaries. Boundaries describe the patterned transactions between members of a system to the exclusion of others. The SFT therapist posits that a functional organization within the family must have appropriate boundaries between subsystems: the parental, the siblings, the family unit as a whole, and the individual.
Assessment  of structure are gauged against developmental norms. Enmeshment is the inappropriate closeness of family members against a backdrop, of course, of developmental appropriateness. The term disengaged is used when there is too much distance between family members.


7.  B. The client's presenting problem is the most important issue for the client. You should always start where client is and allow the client's needs to drive the intervention. If you respond to something that is not important to the client the client can perceive you as not interested I. Their concerns and may not continue to seek help.

8.  C. Albert Ellis' approach to cognitive therapy, sees disturbances as a result of irrational beliefs that guide people's interpretation of events.

9. D. Though several answers appears good, we are provided with limited information. The only thing we know is that the client is a gay teenager.  There is no listing of problems and we have no way of knowing what this client needs.  However, A,B,C are incorrect because there were no problems or maladaptive behaviors noted in the question.


10. D. Oral stage is from 0-2 years old. Newborn babies are initially limited to sucking and drinking. Their sexual instinctual drive is therefore focused around the mouth, initially in passive sucking and chewing. Later, pleasure is derived from more aggressive biting and chewing. Fixations, which persist beyond each developmental stage are manifested through the oral stage as thumb sucking or cigarette smoking.
A is incorrect because A child 2-4 years old is in the Anal stage and the primary task is toilet training. Fixation at the anal stage leads to anal retentive (person who pays such attention to detail that the obsession becomes an annoyance to others, potentially to the detriment of the anal-retentive person. The term derives from Freudian psychoanalysis.) or "anal expressive , the expressive period, in which the child derives pleasure in expelling feces, and the retentive period, in which they derive pleasure from storing it. The anal stage coincides with toilet training in the child, and is marked by ‘conflicts with parents about compliance and defiance’


11. A The heart of TA is the idea that our behaviour is governed by a life-script, a set of rules that govern the way we behave in different situations. In extreme cases the life-script may run to a final scene: it will include a set of circumstances that would cause us to want to die. Scripts also include positive components about situations that make us feel loved and valued. We each write our own life-script during our early childhood. It is largely complete by the time we are seven years old.




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