Counseling theories, founder to technique

According to Beck, depression is maintained by a cognitive triad of negative views about which three things?

1. self, world, and future
   Beck's cognitive triad is a negative view of the self (defective), the world (hostile or demanding) and the future (hopeless); it is his model of depressive thinking.
2. thoughts, feelings, and behaviors
   Thoughts, feelings and behaviors are the three parts of the general CBT model; the trap is confusing that model with the content of depressive beliefs.
3. past, present, and future
   Past, present and future is a time line, not Beck's triad; it keeps 'future' but drops the self and the world, which is why it feels close.

A client who was criticized by a supervisor comes home and yells at their children over a minor mess. Which defense mechanism is the client MOST likely using?

1. Displacement
   Displacement moves feelings from a threatening target (the supervisor) onto a safer one (the children); the anger is real but redirected.
2. Reaction formation
   Reaction formation turns an unacceptable feeling into its opposite, such as excessive kindness toward someone resented; the client here shows the anger openly.
3. Sublimation
   Sublimation channels an impulse into a socially valued activity, such as exercise or art; yelling at children is not a constructive outlet.

According to Yalom, which set lists the four ultimate concerns of existential psychotherapy?

1. Anxiety, guilt, responsibility, and choice
   Anxiety, guilt, responsibility and choice are themes existential writers discuss, but they are reactions to or parts of the givens, not Yalom's four concerns.
2. Being, nonbeing, and self-transcendence
   Being, nonbeing and self-transcendence borrow the vocabulary of other existential thinkers (Tillich, Frankl); the list sounds existential but is not Yalom's set.
3. Death, freedom, isolation, and meaninglessness
   Yalom's four ultimate concerns, the givens of existence that existential therapy works with, are death, freedom (with responsibility), existential isolation and meaninglessness.

Why does a classical psychoanalyst maintain relative anonymity, often called a 'blank screen', with the client?

1. To satisfy the legal requirements of confidentiality
   Confidentiality is about protecting what the client says, not about the analyst withholding personal information; the two are unrelated.
2. To model emotional neutrality
   The blank screen is not a model of neutrality for the client to copy; modeling belongs to social learning approaches, not to psychoanalytic technique.
3. To allow the client's transference to develop clearly
   A relatively anonymous analyst gives the client little real information, so the feelings the client projects onto the analyst can emerge and be examined as transference.

According to Freud, which structure of personality operates on the reality principle and mediates between impulses and moral demands?

1. The id
   The id runs on the pleasure principle and seeks immediate gratification; it supplies the impulses the ego has to manage.
2. The ego
   Freud's ego follows the reality principle and mediates between the id's impulses, the superego's moral demands and the outside world.
3. The superego
   The superego holds internalized moral standards and pushes for perfection; it is one of the forces the ego mediates, not the mediator.

According to Ellis's ABC model, what is the direct cause of a client's emotional and behavioral consequences?

1. The client's beliefs about the event
   In Ellis's ABC model, the activating event (A) does not cause the consequence (C) directly; the belief (B) about it does, especially irrational beliefs.
2. The disputing of irrational beliefs
   Disputing (D) is the intervention that changes beliefs, not the cause of the emotional consequence.
3. The client's childhood experiences
   REBT does not look to childhood as the direct cause; Ellis held that people keep re-indoctrinating themselves with beliefs in the present.

Wolpe's systematic desensitization is based on which principle?

1. Stimulus generalization
   Stimulus generalization explains how a fear spreads to similar situations; it describes how phobias grow, not how desensitization works.
2. Reciprocal inhibition
   Wolpe's reciprocal inhibition holds that anxiety cannot coexist with an incompatible response such as relaxation, so pairing relaxation with a graded hierarchy weakens anxiety.
3. Negative reinforcement
   Negative reinforcement strengthens behavior by removing something aversive; it explains why avoidance persists, not why desensitization reduces fear.

A client says, 'If I fail this exam, my life is over.' The counselor asks what would realistically happen next and how the client would cope. Which cognitive technique is this?

1. Paradoxical intention
   Paradoxical intention asks the client to intend the feared symptom (Frankl); the counselor here explores consequences instead.
2. Thought stopping
   Thought stopping interrupts an unwanted thought (for example by saying 'stop'); it does not examine realistic outcomes.
3. Decatastrophizing
   Decatastrophizing, the 'what if' technique, asks the client to look at what would realistically happen and how he would cope, testing the catastrophic prediction.

According to Rogers, what is the inborn motivation that moves every person toward growth and fulfillment of potential?

1. Actualizing tendency
   Rogers held that every organism has an inborn actualizing tendency toward growth and fulfilling its potential; therapy frees it.
2. Striving for superiority
   Striving for superiority (or perfection) is Adler's master motive, a push to overcome felt inferiority, not Rogers' concept.
3. Will to meaning
   The will to meaning is Frankl's primary human motive in logotherapy; it is about finding meaning, not organismic growth.

According to Glasser's choice theory, which set lists the five basic needs?

1. Work, love, friendship, self, and spirituality
   These are Adlerian life tasks (Adler's work, love and friendship, with self and spirituality added by later Adlerians); the list mixes in 'love' to look like Glasser's.
2. Physiological, safety, belonging, esteem, and self-actualization
   These are Maslow's hierarchy levels; the shared 'belonging' makes it look close, but Maslow's model is hierarchical and Glasser's is not.
3. Survival, love and belonging, power, freedom, and fun
   Glasser's choice theory names five basic needs: survival, love and belonging, power, freedom and fun; behavior is the person's best attempt to meet them.

A narrative counselor asks, 'Tell me about a time when the Anger tried to take over but you didn't let it.' What is the counselor searching for?

1. A cognitive distortion
   Cognitive distortions are a Beck concept to be challenged; narrative therapy does not search for faulty thinking.
2. A unique outcome
   A unique outcome is a moment when the problem did not get its way; narrative counselors search for these to build an alternative story.
3. A problem-saturated story
   The problem-saturated story is what the client brings in; the question here looks for exceptions to it.

A counselor exposes a client who fears elevators to a long elevator ride right away, without a graded hierarchy, until anxiety subsides. Which technique is this?

1. Shaping
   Shaping reinforces successive approximations of a target behavior; it is gradual by design, which is exactly what this exposure skips.
2. Flooding
   Flooding exposes the client to the feared situation at full intensity, without a graded hierarchy, until anxiety subsides.
3. Systematic desensitization
   Systematic desensitization works up a graded hierarchy while the client stays relaxed; the stem rules this out with 'without a graded hierarchy'.

A feminist counselor helps a client see how her husband's larger income and higher social standing give him more control over family decisions, and what kinds of influence she can draw on herself. Which intervention is this?

1. Reframing
   Reframing offers a new meaning for the same facts; it is a general technique, not the feminist analysis of who holds control.
2. Power analysis
   Power analysis examines differences in access to power and resources, such as income and status, and the kinds of power the client can use; it is a core feminist intervention.
3. Gender-role analysis
   Gender-role analysis explores the messages the client learned about how women and men should behave; it focuses on socialized roles, not on income and status.
4. Assertiveness training
   Assertiveness training builds skills for stating needs directly; it may follow the analysis but is not the examination of who holds control.

Which characteristic did Carl Rogers attribute to the fully functioning person?

1. Steady self-sacrifice
   Steady self-sacrifice fits conditions of worth, living for others' approval, the opposite of Rogers' ideal.
2. Strict inner standards
   Strict inner standards sound like a harsh superego; Rogers' fully functioning person trusts experience rather than rigid rules.
3. Openness to experience
   Rogers' fully functioning person is open to experience, lives in the present and trusts her own organism.
4. Freedom from anxiety
   Rogers did not describe the fully functioning person as free of anxiety; openness means feeling all feelings, including anxiety.

A client has agreed to work on her drinking, and the counselor now draws out her own reasons and desire for change. Which of the four motivational interviewing processes (called tasks in the 2023 edition) is this?

1. Engaging
   Engaging is building the working relationship; it comes first and is not specifically about eliciting reasons for change.
2. Focusing
   Focusing is agreeing on what to work on; the stem says the client has already agreed, so focusing is done.
3. Planning
   Planning develops a concrete change plan after motivation is strong; drawing out reasons comes before that.
4. Evoking
   Evoking draws out the client's own motivation, her reasons and desire for change, once the focus has been agreed.

A client repeatedly arrives late and "forgets" sessions whenever painful topics come close. In psychoanalytic terms, what is this?

1. Abreaction
   Abreaction is the emotional release when repressed material is relived; the client here is avoiding that material.
2. Transference
   Transference is feelings about early figures directed onto the analyst; resistance can show up within transference, but avoiding sessions is resistance itself.
3. Working through
   Working through is the later, repeated exploration of insight until it changes behavior; it is progress, not avoidance.
4. Resistance
   In psychoanalytic terms, lateness and 'forgetting' sessions as painful material approaches is resistance, unconscious opposition to facing that material.

A psychoanalytic counselor asks a client to say whatever comes to mind, however trivial or embarrassing. What is the purpose of this technique?

1. To strengthen the client's defenses against anxiety
   Free association works the other way: suspending censorship loosens defenses so warded-off material can emerge; shoring up defenses is the aim of supportive therapy.
2. To give the analyst grounds for direct advice
   Classical analysts avoid direct advice; the associations are material for interpretation, not a basis for telling the client what to do.
3. To replace interpretation with emotional release
   Catharsis may happen along the way, but release alone does not resolve the conflict; the analyst still interprets the associations.
4. To let repressed material surface into awareness
   Free association suspends the usual censoring of thoughts so repressed wishes and conflicts can surface into awareness, where analyst and client can interpret them.

Which counselor statement BEST reflects the collaborative empiricism of Beck's cognitive therapy?

1. "What might that thought say about your childhood?"
   Tracing the thought to childhood is a psychodynamic move; Beck's method checks the thought against present evidence.
2. "That belief is irrational, and you must stop thinking it."
   Labeling a belief irrational and demanding change is closer to directive REBT disputing; it is neither collaborative nor a test.
3. "It sounds like you feel hopeless about all of this."
   "It sounds like you feel hopeless" is an empathic person-centered reflection; it acknowledges the feeling but does not test the thought.
4. "Let's treat that thought as a hunch and test it together."
   Collaborative empiricism treats the client's beliefs as hypotheses that counselor and client test together against evidence.

A client says, "Starting this Friday, I will not drink on weeknights." In motivational interviewing, this statement is which type of change talk?

1. Activation
   Activation signals willingness or readiness ('I'm ready to', 'I'm willing') without stating that the client will do it.
2. Taking steps
   Taking steps describes something already done ('I poured out the bottles'); the client here states a future intention.
3. Commitment
   'I will' with a start date is commitment language, the strongest form of mobilizing change talk.
4. Desire
   Desire is preparatory change talk ('I want to cut back'); it expresses a wish, not a commitment.

A client tells a counselor, "I know I should quit, but smoking is the only thing that calms me down." In current motivational interviewing terms, the second half of this statement is:

1. Discord
   Discord is friction in the relationship with the counselor, not the client's arguments about the behavior.
2. A double-sided reflection
   A double-sided reflection is something the counselor says, reflecting both sides of ambivalence; the stem asks about the client's own words.
3. Change talk
   Change talk is the first half ('I know I should quit'); the stem asks about the part that argues for staying the same.
4. Sustain talk
   Sustain talk is the client's own speech in favor of keeping the status quo; 'it's the only thing that calms me' argues for smoking.

A client who has relapsed says she almost canceled today. The counselor responds, "Coming in today, when part of you wanted to stay home, took real determination." In MI's OARS skills, this is:

1. A reflection
   A reflection mirrors what the client said or meant; the counselor here adds a recognition of strength, which makes it an affirmation.
2. An open question
   An open question invites the client to elaborate; this response is a statement, not a question.
3. A summary
   A summary gathers several things the client has said; this is one statement about one effort.
4. An affirmation
   An affirmation recognizes a client's strengths and efforts, here the determination it took to come in.

As a client begins to cry about her divorce, she quickly changes the subject. Her Gestalt counselor gently asks her to remain with the sadness and notice what it is like. Which technique is this?

1. Staying with the feeling
   Staying with the feeling asks the client to remain with an uncomfortable emotion she wants to escape, so she can experience it fully.
2. Empty chair
   The empty chair sets up a dialogue with an absent person or a part of the self; there is no dialogue in this stem.
3. Exaggerating the gesture
   Exaggeration has the client amplify a movement or gesture to make its meaning clear; nothing physical is being exaggerated here.
4. Making the rounds
   Making the rounds is a group exercise in which a member speaks to each person in turn; it is not an individual technique.

A person-centered counselor tries to grasp a client's situation exactly as the client perceives it, assuming that this private, subjective reality, not objective facts, guides his behavior. Rogers called this subjective reality the

1. private logic
   Private logic is Adler's term for a person's idiosyncratic reasoning behind the lifestyle; it is not Rogers' term.
2. conditions of worth
   Conditions of worth are the internalized conditions for being valued; they shape the self but are not the whole perceived world.
3. ideal self
   The ideal self is who the person thinks she should be; it is one part of experience, not the subjective reality as a whole.
4. phenomenal field
   Rogers called the person's subjective, private world of experience the phenomenal field; behavior follows from this perceived reality.

A DBT client prepares to ask her roommate to pay his share of the rent: she will describe the facts, express how she feels, assert what she wants, and point out how it benefits him. Which DBT skills module teaches this sequence?

1. Emotion regulation
   Emotion regulation skills change emotional responses over time (checking the facts, opposite action); they do not script a request to another person.
2. Distress tolerance
   Distress tolerance skills get a person through a crisis without making it worse (TIPP, self-soothing); they are not about negotiating with others.
3. Walking the middle path
   Walking the Middle Path is the adolescent DBT module (Miller and Rathus) on dialectics and validation in families; it does not teach this request sequence.
4. Interpersonal effectiveness
   Describe, express, assert and reinforce are the first steps of DEAR MAN, the interpersonal effectiveness skill for asking for what one wants.

A Gestalt counselor asks a client to end each statement about her feelings with "...and I take responsibility for it." What is the main purpose of this exercise?

1. To rehearse what she will say to another person
   Rehearsal is a different Gestalt exercise: saying aloud what one plans to tell someone; this exercise is about how she speaks of her own emotions.
2. To stop attributing her emotions to other people
   Adding 'and I take responsibility for it' turns 'he makes me angry' into ownership: she stops attributing her emotions to others and treats them as her own.
3. To treat each part of a dream as part of herself
   Gestalt dream work has the client speak as each part of a dream; nothing in this exercise involves a dream.
4. To act out the opposite of how she usually behaves
   The reversal technique has the client act out the opposite of a habitual behavior to reach a denied side; this exercise keeps her behavior and adds ownership.

A client lives by her parents' rule that 'crying is weakness' without ever examining whether she agrees with it. In Gestalt terms, which contact-boundary disturbance is this?

1. Retroflection
   Retroflection turns back onto oneself what one would like to do to others, for example self-blame instead of anger; it is not about accepting a rule.
2. Introjection
   Introjection is uncritically swallowing others' rules and values, here 'crying is weakness', without examining whether they fit.
3. Projection
   Projection attributes one's own disowned feelings to others; the client here takes in a rule rather than putting out a feeling.

A client says nothing ever gets better. A solution-focused counselor asks, 'With all that going on, how have you managed to keep going?' Which technique is this?

1. Coping question
   A coping question asks how the client has managed to keep going despite difficulties, drawing out resources even when nothing seems better.
2. Exception question
   An exception question asks about times the problem was absent or less severe; this client says there are none, and the counselor asks about coping instead.
3. Miracle question
   The miracle question asks the client to imagine life after the problem is solved overnight; it is about the future, not current coping.

Beisser's paradoxical theory of change is central to Gestalt therapy. According to this theory, when does change occur?

1. When a person strives to become who they should be
   Striving for who one should be is exactly what the theory says does not produce change; it is the 'should' that Gestalt treats as an obstacle.
2. When insight into past conflicts is achieved
   Insight into past conflicts is the psychoanalytic route; Gestalt works with present awareness.
3. When a person fully becomes what they are
   Beisser's paradoxical theory of change says change occurs when a person becomes what she is, not when she tries to become what she is not.

In Hayes's acceptance and commitment therapy, what is the unwillingness to stay in contact with painful thoughts, feelings, and bodily sensations called?

1. Lack of values clarity
   Lack of values clarity means not knowing what matters to the person; it is unrelated to avoiding painful sensations.
2. Attachment to the conceptualized self
   Attachment to the conceptualized self is clinging to a fixed self-story; it is another inflexibility process, not avoidance of feelings.
3. Experiential avoidance
   In ACT, experiential avoidance is the unwillingness to stay in contact with painful private experiences; the hexaflex targets it through acceptance.

An REBT counselor assigns a client to ask loudly for a glass of milk in a hardware store so he learns that others' disapproval is tolerable. What is this technique called?

1. Shame-attacking exercise
   Ellis's shame-attacking exercises have the client do something harmlessly embarrassing in public to learn that disapproval is tolerable.
2. Rational emotive imagery
   Rational emotive imagery is done in imagination, practicing a healthier emotion in a vividly imagined scene; this task is carried out in public.
3. Paradoxical intention
   Paradoxical intention (Frankl) asks the client to intend the feared symptom itself; here the client does a socially odd act to test beliefs about disapproval.

A client concludes, 'My supervisor didn't smile at me, so she must be planning to fire me.' According to Beck, which cognitive distortion is this?

1. Dichotomous thinking
   Dichotomous thinking sorts experience into all-or-nothing categories; the client's leap from one cue to a firing is not an either/or judgment.
2. Arbitrary inference
   Arbitrary inference is drawing a conclusion without supporting evidence; a missing smile does not show a plan to fire anyone.
3. Overgeneralization
   Overgeneralization builds a broad rule from one incident ('nobody likes me'); this client draws one specific conclusion about one event.

Miller and Rollnick (2013) named the counselor's natural urge to fix the client's problem and argue for change. What did they call it?

1. The premature focus trap
   The premature focus trap is pushing toward the counselor's topic before the client is ready; it is about agenda, not the urge to fix.
2. The righting reflex
   The righting reflex is the counselor's urge to correct and argue for change, which tends to provoke sustain talk; the 2023 fourth edition calls it the fixing reflex.
3. The expert trap
   The expert trap is the counselor assuming she has all the answers; it is a related pitfall, but not the reflex to argue for change.

In a narrative therapy group, the leader asks members how depression has been trying to talk them out of attending. Which technique is this?

1. Externalizing the problem
   Externalizing speaks of the problem as an outside agent with its own tactics (how depression 'talks them out of' coming), separating the person from the problem so members can stand against it.
2. Definitional ceremony
   A definitional ceremony has outsider witnesses retell what moved them in a person's story; it is a narrative group practice, but it does not ask how the problem operates.
3. Re-membering conversation
   Re-membering conversations revise who belongs in a person's 'club of life'; they concern relationships, not the problem's tactics.

An Adlerian group leader highlights members' strengths and efforts to build their confidence and belief in themselves. Which technique is this?

1. Spitting in the soup
   Spitting in the soup exposes the hidden payoff of a behavior; it spoils a pattern rather than building confidence.
2. Positive reinforcement
   Positive reinforcement is a behavioral contingency that strengthens a specific behavior; Adlerian encouragement targets the person's courage, not a response rate.
3. Encouragement
   Encouragement is Adler's core technique: highlighting strengths and effort to build courage and counter discouragement.

In a Gestalt group, a member speaks to an empty chair as if her late father were sitting in it. What is this technique MOST intended to address?

1. Group confluence
   Confluence is a blurred boundary between self and others, such as merging with the group; the dialogue here is with one absent person, not about merging.
2. Unfinished business
   Speaking to the late father in an empty chair brings unfinished business, feelings never expressed to him, into the present so it can be completed.
3. Deflection of contact
   Deflection is avoiding direct contact through vagueness, humor or changing the subject; the exercise's target is the unresolved relationship with the father, not a habit of deflecting.

According to Adler, which birth position is MOST often described as feeling 'dethroned' by the arrival of a sibling?

1. The oldest child
   Adler described the oldest child as dethroned when a sibling arrives and loses the position of only child.
2. The youngest child
   The youngest child is never displaced and is often described as pampered.
3. The second child
   The second child is born with a pacesetter ahead and is often described as competitive, not dethroned.

A counselor asks a client what he already knows about how alcohol affects sleep, shares brief information with his permission, and then asks what he makes of it. What is this MI strategy called?

1. Decisional balance
   Decisional balance weighs the pros and cons of change; no pros and cons are being listed here.
2. Developing discrepancy
   Developing discrepancy highlights the gap between current behavior and the client's values; the stem describes a way of sharing information.
3. Affirming strengths
   Affirming recognizes the client's strengths or efforts; the counselor here exchanges information instead.
4. Elicit-provide-elicit
   Elicit-provide-elicit asks what the client knows, offers information with permission, then asks what the client makes of it.

In a behavioral group, a member signs an agreement specifying a target behavior and the reinforcement she will earn for performing it. What is this called?

1. Token economy
   A token economy uses points or tokens exchanged for rewards across a setting; there is no individual written agreement.
2. Contingency contract
   A contingency contract is a written agreement that names a target behavior and the consequence or reward for doing it.
3. Successive approximation
   Successive approximation (shaping) reinforces steps toward a behavior; it is not a signed agreement.

A client deliberately decides not to think about a stressful exam until after the weekend. How does this differ from repression?

1. it is a conscious choice, whereas repression is unconscious
   Deliberately putting a worry aside is suppression, a conscious act; repression pushes material out of awareness unconsciously.
2. it is a psychotic defense, whereas repression is mature
   Suppression is classed as a mature defense; neither suppression nor repression is a psychotic defense.
3. it is unconscious, whereas repression is a conscious choice
   This reverses the two: suppression is the conscious one and repression the unconscious one.

A client says, "My drinking isn't a problem at all." The counselor responds calmly, "So there's absolutely nothing about your drinking that worries you or anyone else." Which MI skill is the counselor using?

1. Simple reflection
   A simple reflection repeats or lightly rephrases what the client said; this response adds intensity he did not express ('absolutely nothing… or anyone else').
2. Confronting the denial
   MI avoids confrontation; the counselor's calm tone and reflective wording are not a challenge to denial.
3. Amplified reflection
   An amplified reflection states the client's position in a slightly stronger form ('absolutely nothing'), which often prompts the client to argue the other side.
4. Shifting focus
   Shifting focus moves the conversation away from a stuck topic; the counselor here stays on the drinking and restates it more strongly.