NCE Chapter 11 part 1

Counseling Families, Diagnosing, Neurocounseling, & Advanced Concepts

A married couple brings their two children to counseling for behavioral problems. The 14-year-old daughter stays out late and their 17-year-old son is using drugs. According to most marriage and family therapists the identified patient would be

the family.

You are seeing a husband and wife for marriage counseling. During one of the sessions you decide to see them separately. The husband tells you he has seen an attorney because he is filing for divorce. He has not told his wife and indicates that he will not do so. You feel the wife has a right to know this because it will help her plan for the future. You should

only tell his wife if he gives you permission.

You are supervising a licensing candidate who is primarily interested in marriage and family counseling. You are very attracted to her and have sex with her. According to ethics guidelines

this is unethical.

The fastest growing clientele for professional counselors are

persons

experiencing marriage and family problems.

Family counselors generally believe in

circular/reciprocal causality (e.g., dynamics of family

members).

Cybernetics is a concept used by family therapists. It is usually

associated with the work of

Norbert Wiener.

A family that is stable and reaches an equilibrium is in a state of

homeostasis

Adaptability is the ability of the family to balance

stability and change; morphostasis and morphogenesis

A family wants to see you for counseling; however, they have a

very limited income and can’t afford to pay. You therefore agree

to see the family for free (i.e., pro bono). The term that best

describes your actions would be

aspirational ethics.

Experiential conjoint family therapy is closely related to the work of

Virginia Satir.

Virginia Satir felt that a major goal of therapy was to improve

intrafamily communication (i.e., communication between family

members). According to Satir, four basic patterns prevented

good communication under stress. These defensive postures or

stress positions are: placating, blaming, being overly reasonable,

and being irrelevant. Placating means

you try to please everybody out of a fear of rejection.

The placater is a people pleaser under stress while the blamer

all of the above are typical behaviors of the blamer.

The person who becomes overly reasonable

is likely to engage in the defense mechanism of

intellectualization.

According to Virginia Satir, the individual displaying an irrelevant

style

will distract the family from the problem via constantly

talking about irrelevant topics.

Virginia Satir is considered a leading figure in experiential family

therapy. ________ is sometimes called the dean of experiential

family therapy

Carl Whitaker (experiential symbolic family therapy)

Carl Whitaker’s interaction with the family could best be

described as

joining the family and experiencing it as if he were a family

member.

According to Carl Whitaker,

a co-therapist is helpful.

Psychotherapy of the absurd is primarily related to the work of

Carl Whitaker.

A behavioristic marriage and family therapist is counseling the entire family together. She turns to the 18-year-old son who is attending community college and says, “You must complete your sociology essay before you can use the family car and go out with your friends.” strategy?

David Premack’s principle or law.

A behavioristic marriage and family counselor is counseling the

entire family together. She turns to the 18-year-old son who is

attending community college and says, “I know you like to play

golf. Therefore, every time you cut the grass your father will take

you to play golf. I am going to have you and your dad sign a

contract confirming that you agree with this policy.” Which

principle is primarily guiding her strategy?

Quid pro quo.

A male is supervising a female counselor for state licensing. He

tells her that he will continue to supervise her as long as she has

sex with him. This is an example of

quid pro quo.

A behavioristic family counselor suggests that the family chart the number of times that 6-year-old Billy says “no” when he is told to do something. The baseline of the chart would refer to the period

before the behavior modification begins.

The family counselor explains to Mrs. Smith that the next time that 9-year-old Sally hits her little brother she must sit in the family room by herself. The counselor is using

time-out, a procedure that most behaviorists feel is a form

of extinction.

Mrs. Chance tells a family therapist that she pays all the bills,

does all the cleaning, and brings in 90% of the family’s income.

Moreover, Mrs. Chance is convinced that her husband does not

appreciate her or show her affection. According to the

behavioristic principle of family therapy known as reciprocity

there is a good chance that Mrs. Chance will consider

leaving the marriage.

A couple is having sexual problems that stem from anxiety. A

marriage counselor who is a strict behaviorist would most likely

rely on systematic desensitization procedures.

A family counselor notices that the husband in a blended family

is having obsessive sexual thoughts about a woman living down

the street. A strict behaviorist would most likely

practice thought stopping.

You secure a job as the executive director of a family counseling agency. As you go through your files you discover that five years before you took the job the agency selected 100 families and counseled them using a strict behaviorist model. The agency took the next group of 100 families and counseled them using Satir’s experiential conjoint family therapy model. Each family received 12 sessions of therapy and each family took a before and after assessment that accurately depicted how well the family was functioning. You decide to run a t test to examine whether or not a statistically significant difference is evident between the two approaches. This is

causal comparative or ex post facto (i.e., after the fact) research.

All of the techniques listed below would be used by a behavioristic

family therapist except:

Family sculpting.

Which statement is true of families?

Remarriage today is common.

Which statement is true?

Single life is short-lived for divorced persons. About 30%

of all divorced persons are remarried within 12 months of

being divorced.

The theory of psychodynamic family counseling is primarily

associated with

Nathan Ackerman.

In psychoanalytic family therapy the word object means

a significant other with whom a child wishes to bond.

In psychoanalytic family therapy the term introjects really means

that the client

unconsciously internalizes the positive and negative

characteristics of the objects within themselves.

Pick the best example(s) of the psychoanalytic concept of

splitting.

A client who realistically perceives her therapist as only

having good qualities and A client who sees her therapist as all bad.

A 72-year-old woman you are counseling in a family reminds you

of your mother and this is bringing up unresolved childhood

issues for you as the counselor. This is an example of

countertransference

A family actually changes the structure of their family system.

According to Watzlawick, Weakland, and Fisch the family has

achieved

second-order change that is more desirable than first-order

change

A woman sees her husband as all good sometimes and all bad at

others. An analytically trained family therapist who believes in

object relations would see this as

splitting

Nathan Ackerman is considered a famous psychoanalytic family

therapist; so are

James Framo and Robin Skynner.

Cloe Madanes and Jay Haley are associated with the ________

school of family counseling.

strategic

When Jay Haley began investigating psychotherapy he

had a degree in the arts and communication rather than

the helping professions.

Jay Haley believes in giving clients directives. You are counseling a family and during the session the 14-year-old daughter exclaims that she is suicidal. The best example of a directive would be

you turn to the family and say, “If your daughter threatens suicide this week I want the entire family—including your daughter—to stay home and nobody leaves for the day.”

Which of these responses is the best example of the double-bind concept used in Haley’s strategic therapy? You are trying to help a client stop smoking:

Double blind = no-win situation characterized by contradictory messages

You hypnotize her and tell her she will never smoke another cigarette again. After you awaken her you admonish her to smoke as many cigarettes as she can for the first three days.

The directive or prescription given to the smoker in the previous question could best be described as

a paradoxical intervention.

A couple tells a therapist using strategic family therapy that they

have a quarrel at least once every evening. The therapist says,

“Between now and the next time I see you I want you to have a

serious quarrel at least twice every evening.” This is an example of

prescribing the symptom.

Strategic family counselors often rely on relabeling or reframing. A client says his girlfriend yells at him every time he engages in a certain behavior. The best example of reframing or relabeling would be

a counselor who remarks, “Research seems to show that when she yells at you it is because she loves you so much. A woman often feels foolish if she hugs or kisses you in a situation like that.”

In strategic family counseling the person with the power in the

family

has the authority to make rules and enforce them.

Psychoanalytic practitioners do not attack symptoms directly.

Strategic therapy

is pragmatic and often focuses on abating symptoms.

Cloe Madanes insisted that symptoms serve a function. A child,

for example, sees that her mother is depressed. The daughter

throws a glass cup to the floor to break it. This brings her mother

out of the depressed state and makes her mother angry and

powerful. This is known as

incongruous hierarchy.

Madanes advocated pretend techniques that are somewhat

paradoxical. An example might be

a child who has panic attacks pretends to have one during

the session and the parents pretend to help him.

A strategic family therapist says to a family, “I don’t know what

else you can do to stop the bickering and fighting in your house.”

This is an example of

restraining (therapist may warn the family or individual about the negative consequences of change.)

A client remarks that her depression is extremely intense. Her strategic counselor remarks, “It is very possible your depression is hopeless. It is possible you will never get over it.” Her comment is an example of

positioning

occurs when a helper accepts the client’s predicament & then exaggerates the condition

A family counselor treats an Asian American family exactly like he treats the Arab American families in his caseload. He also imposes values from his own culture on them. This counselor has been described in the literature as

lacking cultural sensitivity and culturally encapsulated.

Which statement is true of African American families?

Fewer African Americans are getting married & African Americans are less likely to be concerned about gender roles (e.g., men and women can cook meals or work outside of the home).

When working with an African American family, the best

approach would probably be

Bowen’s family therapy; Minuchin’s structural family

therapy; or Haley’s strategic family therapy.

When counseling Asian American families the best approach

would most likely be

solution-focused/problem-focused modalities.

Which statement is true of Latino/a families?

They have a high unemployment rate, often live in poverty,

and rarely earn high school diplomas or college degrees.

A model by Olson, Sprenkle, and Russell suggests that family functioning can be described in two dimensions—cohesion and adaptability. The family therapy term cohesion refers to the level

how rigid, structured, flexible, or chaotic the family is.

Which statement is true regarding Native American families?

all of the above are true

The statement “Native Americans, also called American Indians in some of the literature, have a problem with alcoholism and suicide” is

true

Murray Bowen is known for his work in intergenerational family therapy. When Bowen refers to triangulation he means

when a dyad (i.e., two individuals) is under stress a third person is recruited to help stabilize the difficulty between the original dyad. This could even be a child placed in the middle of the conflict

One of the primary goals of Bowen’s intergenerational family therapy is differentiation. Differentiation is

the extent that one can separate one’s intellect from one’s emotional self.

Bowen popularized a three-generational pictorial diagram as a therapy tool. This is known as

a genogram

An intergenerational family therapist says she is concerned with the nuclear family emotional system. She is referring to

the fact that although the current family in therapy has an emotional system, this emotional system is influenced by previous generations whether they are alive or dead.

Albert Ellis is to REBT as Salvador Minuchin is to

structural family therapy.

An important technique in structural family therapy is joining. Which statement most accurately depicts this intervention?

The therapist meets, greets, and attempts to bond with the family. The therapist will use language similar to that of the family and mimesis which means that he or she will mimic communication patterns.

A family is seeing a structural family therapist because there is a huge argument every time the subject of the 16-year-old daughter’s boyfriend comes up. The therapist says, “Okay, I want you to play like you are at home and act out precisely what transpires when the subject of your daughter’s boyfriend is mentioned.” The structural family therapist is using a technique called

enactment

strategy that allows a counselor to see an instant replay

When a structural therapist uses the term boundaries he or she really means

the physical and psychological entities that separate

individuals and subsystems from others in the family

In Minuchin’s structural approach, clear boundaries are

ideal—firm yet flexible.

A woman is having difficulties at her place of employment. Her husband turns to her in a session and says, “You’re on your own, I’ve got my own problems.” A structural family therapist would assert that the boundaries between this couple are

rigid

A mother insists on accompanying her 20-year-old daughter on a date. A structural therapist would assume that the family

has diffuse boundaries.

Minuchin would often mimic the family’s style. This is known as

none of the above.

Mimesis (therapist copies family style)

Ackerman is psychodynamic. Haley is strategic. Minuchin is structural. Bowen is intergenerational. Another well-known intergenerational family therapist would be

Ivan Boszormenyi-Nagy (enunciated Naahge)

A family member who is emotionally distant is

disengaged

During the course of a family session you discover that the man and his 14-year-old son are putting pressure on mom to quit her job. Mom very much likes her work. In Haley’s theory this set of dynamics would be called

the perverse triangle.

________ was a pioneer in the early history of family therapy

Alfred Adler

Which therapist could best be described as atheoretical?

Carl Whitaker.

Solution-oriented therapy as practiced by William O’Hanlon,

Insoo Kim Berg, Steve de Shazer, and Michelle Weiner Davis

focuses primarily on

the future.

Narrative therapy (NT), which highlights stories in counseling,

is associated with the work of

Michael White, his wife Cheryl White, and David Epston.

Postmodernist Tom Anderson, a psychiatrist from Norway,

became disenchanted with traditional family therapy. He began

using a radical approach based primarily on

a one-way mirror and a reflecting treatment team.

Feminist therapy criticizes traditional therapies

all of the above.

The term skeleton keys as used in Steve de Shazer’s brief

solution-focused therapy (BSFT) indicates

a standard or stock intervention that will work for numerous problems

One criticism of using cognitive-behavioral methods like REBT

with families or individuals in multicultural counseling would be

that the cognitive disputation could go against cultural

messages

Most experts predict that in the twenty-first century, theories of

counseling and psychotherapy will

become more integrative, since about 30–50% of all

therapists say they are eclectic.

Pick the most accurate statement.

Brief solution-oriented therapy sometimes uses a treatment

team behind a one-way mirror, nevertheless, it is not

required.

A researcher takes a group of clients and gives them a depression

inventory. He then provides each client with two sessions of

brief solution-oriented therapy and gives them the same

depression inventory. A t test is used to compare the two sets of

scores on the same people (i.e., the before and after measures of

depression). This would be

a related measures within-subject design.

A question on the NCE or CPCE regarding a pre-experimental design uses the letters XO. The letters stand fo

treatment (X) and observation, measurement, or score (O).

Another type of pre-experimental design is the one-group only

posttest design. This is best depicted by

XO

A time-series design is a quasi-experimental design

without randomly chosen control and experimental groups,

which relies on multiple observations of the dependent

variable (i.e., the thing you are measuring) before and after

the treatment occurs.

The Solomon four-group is considered a true experimental

design since each group is chosen via a random sample. When

using this design

one control group receives a pretest and one experimental

group receives a pretest; the other control group and

experimental group do not.

John Gottman is known for

creating a paradigm to predict which marriages would

likely end in divorce. (6 predictors)

The newest career theory would be

constructivist and cognitive approaches.

A popular TWA career counseling model by René V. Dawis and

Lloyd Lofquist uses the abbreviation PEC. This stands for

person environment correspondence.

Most experts believe that the number of multigenerational

families with a child, a parent, and a grandparent living together

will

increase

A researcher wants to prove that structural family therapy is the most effective modality. She conducted a study a year ago using a significance level of .05. Several colleagues felt her significance level needed to come down. She thus ran the same basic experiment again with new people using a significance level of .01. Her chances of making a Type I error or so-called alpha error reduced. Now assume you compare her new research to her old research. What could you say about the possibility that her results will indicate that structural family therapy was not significantly different when in reality it truly is significant?

The chance of this occurring increases when compared to

the first experiment.

A question on your comprehensive exam asks you to compute

the coefficient of determination. You are given a correlation

coefficient of .70. How would you mathematically accomplish

this task?

You would square the .70.

A correlation coefficient between variables X and Y is .60. If we square this figure we now have the coefficient of determination or true common variance of 36%. What is the coefficient of nondetermination that shows unique rather than common variance

It would be 64%.

John Krumboltz proposes a ________ model of career

development

social learning behavioristic

Krumboltz’s social learning theory is sometimes referred to as a

cognitive theory because it emphasizes beliefs that clients have

about themselves as well as the world of work. When Krumboltz

speaks of self-observation generalizations he really means

Pavlov’s principle of stimulus generalization.

SCCT stands for

social cognitive career theory.

Career counselors refer to job shadowing and volunteering as

________ activities, while reading the job hunting book What

Color Is Your Parachute? is ________.

interactive; noninteractive