Counseling Final exam

Issues related to confidentiality and privacy in the college setting have become more complex due to the advent of __________.

online/telehealth counseling

Which of the following accurately depicts the roles of helpers in community settings?

Each answer in this question is accurate:

* They may become involved in community advocacy efforts and direct community intervention.
* They are employed in the widest variety of employment settings relative to other helpers.
* They often conduct psychotherapy with individuals, families, and/or groups

Which of the following characteristics of a helper would enhance the helping process?

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a conscious intent to be helpful

Professional helpers can be distinguished from non-professional helpers by which of the following?

all are possible distinctions:

* identification with a professional organization
* adoption of an ethical code and standards of practice
* existence of an accrediting body that governs training, credentialing, and licensing of practice

Examples of workers who are not generally considered professional helpers, but who may enter the helping network on a *temporary* basis include __________.

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ministers and teachers

Helping professionals working with members of the military deal with a wide range of issues including all of the following EXCEPT:

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employment loss

The four conditions under which helping is most likely to occur include: someone trained and/or capable as a helper, someone willing to offer help, a setting conducive to helping, and

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a client seeking help.

Which of the following is FALSE regarding Robinson’s (1997) concept of multiculturalism?

Multiculturalism is synonymous with the concept of diversity.

In addition to the common core of helper characteristics and skills previously identified in the literature, four important qualities for helping practice in the 21st century are:

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virtue, cultural competence, neural integration, and resilience.

The concept of resiliency is highly salient to professional helping practice because it promotes:

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all of these answers are influenced by resilience:

* coping with everyday stressors.
* preparedness to address global challenges such as racism and terrorism.
* transfer of hope and optimism to clients.

Understanding the client’s perspectives alone is not sufficient. The helper must also

engage in all of the answers in this list:

* express verbally the helper’s sense of understanding of the client.
* mirror the client’s feelings without agreeing, disagreeing, reassuring, or denying.
* reflect on the immediate process in the helping session.

Which of the following statements about client hidden shame is FALSE?

Hidden shame is due to excessive parental empathic attunement.

The concept of core conditions in the therapeutic process refers to

the therapeutic relationship.

The condition of being honest, transparent, open, and real with the client is known as

congruence or genuineness.

Identify the most probable sequence of helping experiences with a new client who has a history of discrimination, oppression, or betrayal.

client guardedness, testing of helper, sense of safety, sense of trust, disclosure by client

The primary focus of person-centered therapy is __________.

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promotion of a therapeutic alliance characterized by empathy, unconditional positive regard, and congruence

Generally, the most productive use of helper disclosure occurs when the focus is on

the helper’s reactions to the client and to the helping relationship.

The demonstration of empathic understanding requires the following of the helper:

empathic rapport and communicative attunement.

When helpers’ unresolved issues get projected onto clients this is referred to as

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countertransference.

In a study conducted by Bedi and colleagues (2005), clients highlighted the contribution of active listening, self-disclosure, encouragement, and validation of feelings to the establishment of a strong helping relationship. These client perceptions underscored the importance of __________ in the helping session.

what the helper says and does

Challenges when working with immigrant and refugee clients include:

all of these possible answers:

* cultural barriers.
* mistrust of the helper.
* language barriers.

Four potential communication barriers in cross-cultural helping that have been identified by Pedersen and Ivey (1993) include: verbal and nonverbal language problems, interference from preconceptions and stereotyping, erroneous evaluation, and

stress

Perpetuation of gender roles has the potential to negatively influence:

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all genders.

Clients often approach helping with thoughts such as, “I know that I need help”, and “I wish I weren’t here”. Given this dual set of motivations, helpers may anticipate that clients will engage in __________ communication at times. 

conflicting and contradictory

Karasu (1992) observed that helpers tend to __________ the power of listening and to __________ the power of speaking.

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underestimate, overestimate

With respect to helper-induced silence, unintentional silence is often used:

as a reflection of his or her tendency to hide, withhold, and self-protect.

Research suggests that many helpers have:

prejudicial beliefs that affect the therapeutic relationship with LGBTQ clients.

Which of the following describes people with disabilities?

there is a wide range of disabilities clients may experience.

When a communication mismatch occurs in the context of a cross-cultural helping dyad, there is an increased risk of

all of these possible answers:

* cultural oppression of the client.
* inability of the helper to establish rapport with the client.
* premature termination of the session by the client.

An important differentiation between immigrant and refugee clients is:

immigrants have migrated voluntarily and refugees have been forced to migrate.

Challenges when working with immigrant and refugee clients include:

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all of these possible answers

* cultural barriers.
* mistrust of the helper.
* language barriers.

Four potential communication barriers in cross-cultural helping that have been identified by Pedersen and Ivey (1993) include: verbal and nonverbal language problems, interference from preconceptions and stereotyping, erroneous evaluation, and

stress

Perpetuation of gender roles has the potential to negatively influence:

all genders

Clients often approach helping with thoughts such as, “I know that I need help”, and “I wish I weren’t here”. Given this dual set of motivations, helpers may anticipate that clients will engage in __________ communication at times. 

conflicting and contradictory

Karasu (1992) observed that helpers tend to __________ the power of listening and to __________ the power of speaking.

underestimate, overestimate

With respect to helper-induced silence, unintentional silence is often used:

as a reflection of his or her tendency to hide, withhold, and self-protect.

Research suggests that many helpers have:

prejudicial beliefs that affect the therapeutic relationship with LGBTQ clients.

Which of the following describes people with disabilities?

there is a wide range of disabilities clients may experience.

When a communication mismatch occurs in the context of a cross-cultural helping dyad, there is an increased risk of

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All of these possible answers.

* Cultural oppression of the client.
* The inability of the helper to establish rapport with the client.
* Premature termination of the session by the client.

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An important differentiation between immigrant and refugee clients is:

immigrants have migrated voluntarily and refugees have been forced to migrate.

Reflecting client feelings at a deeper level requires that the helper

acknowledge the implied admission of the client’s message.

CLIENT:

 *“I hate waiting in line.  I’ve had to wait in so many lines over this past week: To get on the freeway, to get my coffee, to pay my school bill.  I get really frustrated by all the other people who don’t move along smoothly.  You know how these people can’t make a decision, they have to consider every option on the menu, and they have to ask all their friends what they think is best.  These are the people who make the world chaotic and irritating.  This week I’ve “campaigned” with all my friends about including something in the driver’s license process that helps either train or eliminate people who can make good decisions.”* 

 *HELPER:*

 Write a summarization of cognitive content to the above client statements:

You think that many people take too long to make a decision and these people make things go less smoothly.

CLIENT:

 *“I hate waiting in line.  I’ve had to wait in so many lines over this past week: To get on the freeway, to get my coffee, to pay my school bill.  I get really frustrated by all the other people who don’t move along smoothly.  You know how these people can’t make a decision, they have to consider every option on the menu, and they have to ask all their friends what they think is best.  These are the people who make the world chaotic and irritating.  This week I’ve “campaigned” with all my friends about including something in the driver’s license process that helps either train or eliminate people who can make good decisions.”*

HELPER:

Write a paraphrase to one of the above client statements 

You think people take way too long to make a decision.

Clients find value in reflection of feelings because it allows them to

recognize and accept their feelings.

What is often one of the toughest challenges for beginning helpers?

listening.

CLIENT:

 *“I hate waiting in line.  I’ve had to wait in so many lines over this past week: To get on the freeway, to get my coffee, to pay my school bill.  I get really frustrated by all the other people who don’t move along smoothly.  You know how these people can’t make a decision, they have to consider every option on the menu, and they have to ask all their friends what they think is best.  These are the people who make the world chaotic and irritating.  This week I’ve “campaigned” with all my friends about including something in the driver’s license process that helps either train or eliminate people who can make good decisions.”* 

 HELPER:

Write a reflection to the above client statements 

You feel upset with people who take too long to make a decision.

When helpers listen judgmentally, they are engaging in

evaluative listening.

Nichols (2009) describes two purposes for listening, namely to take in information and to

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bear witness to their experience.

Egan (2014) suggests that biases become problematic in

filtered listening.

CLIENT:

 *“I hate waiting in line.  I’ve had to wait in so many lines over this past week: To get on the freeway, to get my coffee, to pay my school bill.  I get really frustrated by all the other people who don’t move along smoothly.  You know how these people can’t make a decision, they have to consider every option on the menu, and they have to ask all their friends what they think is best.  These are the people who make the world chaotic and irritating.  This week I’ve “campaigned” with all my friends about including something in the driver’s license process that helps either train or eliminate people who can make good decisions.”* 

 HELPER:

Write a summarization of feeling/affective content 

You feel irritated and agitated with people taking so long to make a decision that it makes you have to wait.

In the following example, what skill is the helper demonstrating? • CLIENT: I’m sorry I didn’t get my homework done. I hate that it’s not finished! • HELPER: You seem to be feeling disappointed and frustrate\~

reflection of feeling.

Paraphrasing

All of these are possible answers.

* Should use the most important words form the client’s response
* usually picks up on cognitive content.
* Should be interspersed with other strategies to avoid parroting the client.

An issue with using questions is that clients can find them

intrusive.

Stacking questions are problematic because they

don’t allow enough time for client’s to process information and respon

Kinds of discrepancies to challenge include all the following EXCEPT

thinking and feeling

CLIENT:

 *“I hate waiting in line.  I’ve had to wait in so many lines over this past week: To get on the freeway, to get my coffee, to pay my school bill.  I get really frustrated by all the other people who don’t move along smoothly.  You know how these people can’t make a decision, they have to consider every option on the menu, and they have to ask all their friends what they think is best.  These are the people who make the world chaotic and irritating.  This week I’ve “campaigned” with all my friends about including something in the driver’s license process that helps either train or eliminate people who can make good decisions.”*

 HELPER:

Write a reflection of meaning response to the above client 

In the past week, you have been feeling extremely frustrated with the pace at which the world around you is going. This has greatly affected your mood and you have come to the conclusion that people take way too long to make a design.

The key to using challenge responses ethically is to

know your client and carefully tailor the challenge to best help them.

The purpose of using reflection of meaning is to help clients

all of these possible answers.

* confront their core assumptions.
* explore issues.
* recognize that their story is not a fact, but a perception.

CLIENT:

 *“I hate waiting in line.  I’ve had to wait in so many lines over this past week: To get on the freeway, to get my coffee, to pay my school bill.  I get really frustrated by all the other people who don’t move along smoothly.  You know how these people can’t make a decision, they have to consider every option on the menu, and they have to ask all their friends what they think is best.  These are the people who make the world chaotic and irritating.  This week I’ve “campaigned” with all my friends about including something in the driver’s license process that helps either train or eliminate people who can make good decisions.”*

 HELPER:

 Write a clarifying question to the above client 

How often are you encountering waiting in line? Was it those three times or have you noticed more times in the previous weeks?

CLIENT:

 *“I hate waiting in line.  I’ve had to wait in so many lines over this past week: To get on the freeway, to get my coffee, to pay my school bill.  I get really frustrated by all the other people who don’t move along smoothly.  You know how these people can’t make a decision, they have to consider every option on the menu, and they have to ask all their friends what they think is best.  These are the people who make the world chaotic and irritating.  This week I’ve “campaigned” with all my friends about including something in the driver’s license process that helps either train or eliminate people who can make good decisions.”*

 HELPER:

Write a challenging response to the above client 

I wonder if there is something going on in your personal life that is making you more irritated lately which intern is magnifying every other inconvenience that has occurred in the past week?

___________________ questions tend to further the helper’s agenda

Leading

Action skills are used by helpers to

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effect change.

A major decision in using action skills involves

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the timing of use.

CLIENT:

 *“I hate waiting in line.  I’ve had to wait in so many lines over this past week: To get on the freeway, to get my coffee, to pay my school bill.  I get really frustrated by all the other people who don’t move along smoothly.  You know how these people can’t make a decision, they have to consider every option on the menu, and they have to ask all their friends what they think is best.  These are the people who make the world chaotic and irritating.  This week I’ve “campaigned” with all my friends about including something in the driver’s license process that helps either train or eliminate people who can make good decisions.”* 

 HELPER:

Write an open-ended question to the above client 

How often do you notice yourself getting irritated with waiting on people to make a decision?

Subsequent interviews are characterized by the following EXCEPT

changing topics

Confidentiality discussions should take place early on so that clients can

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make an informed decision about consenting to counseling.

The federal government rule called the Health Insurance Portability and Accountability Act (HIPAA) is concerned primarily with which aspect of helping?

confidentiality and privacy

When the helper defines the nature, limits, roles, and goals of helping, this is referred to as __________.

structuring

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Which of the following demonstrates best practice in writing up an intake report?

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Steps are taken to ensure that the report will be viewed only by those to whom the client (or guardian) has granted access.

When encouraging a client to begin to talk in the helping session, it would be LEAST helpful if the helper were to extend

a closed question.

One of the reasons Cormier describes as appropriate for termination is when the client has

accomplished all goals regarding their problems.

Helpers are ethically and legally required to provide clients with information about treatment benefits, risks, and alternatives when establishing a foundation for

informed consent.

Helping sessions with adults are generally limited to __________ minutes in length due to recognition of a saturation point that will detract from productive work for both client and helper

45-50

When a helper opens a session by asking the client, “Where would you like to begin today?” this is an example of __________.

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an unstructured invitation

It is common in the helping process for the sharing of outer, more obvious client concerns to precede the sharing of more subtle, less obvious concerns as a climate of safety and trust is establishe\~ Thus, helping is often referred to as a process of

unfolding.

The spiral pattern associated with the stages of change model (Prochaska, DiClemente, & Norcross, 1992) suggests that most of those individuals who relapse

learn from their mistakes and can try something different the next time around

Clients resist setting goals because

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the behaviour in need of change is also desirable.

Utilizing the stages of change model (Prochaska, DiClemente, & Norcross, 1992), an individual who agrees that she would benefit from implementing a daily walking program, but cannot imagine how to fit it around a busy work day, would likely be identified at which stage of readiness for change?

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contemplation

When outcome goals are structured in an imprecise manner as exemplified by the statement, “I want to feel better about my life”,

assessing progress toward the desired results will be based on subjective inference rather than objective measurement.

An integrative approach to helping incorporates the following dimensions of client issues and concerns:

contextual factors, beliefs, feelings, behavior, interaction and relational patterns, and language patterns

SMART goals help clients set meaningful and attainable goals. Which element of the SMART goal is missing from the following outcome goal? Goal: The client will decrease tardiness.

Relevance.

Complete the following analogy. Process goals are to __________ as outcome goals are to __________.

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universal, tailored

Client resistance is most likely to be triggered when the helper

prescribes a solution or goal.

According to Jourard’s (1963) conceptualization of basic human needs, when the needs for __________ go unmet, individuals lack self-respect and self-confidence, or may compensate with excessive and manufactured self-respect and self-confidence.

status, success, and self-esteem

An adaptive approach that will assist clients in containing difficult feelings and to avoid becoming overwhelmed is to 

regulate affect using self-soothing strategies.

When a helper includes extended family, community elders, and/or spiritual leaders in the treatment of the client, this complementary extension of the role of traditional helper is referred to as

facilitator of indigenous support systems and practices.

Exposure therapy is used with clients who

have a phobia or panic they need to become habituated to.

Narrative therapy

works to help a client re-story their experiences so that they are more accurate.

The third wave of behavior therapy includes Acceptance and Commitment Therapy, or ACT, which focuses on

defusion techniques to help clients look at their thoughts rather than from their thoughts.

When using incomplete sentences to aid in eliciting and expressing feelings, a client completes a sentence stem such as, “If I felt angry, …” by

responding spontaneously with different completions until the client feels that s/he has finished.

To determine the personal meaning of a “slip of the body”, Perls (1973), a Gestalt therapist, suggested that the client

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exaggerate a particular movement of the body.

In a helping session with a cognitively oriented helper, the client’s irrational or illogical beliefs are questioned. This would take place during the __________ phase of A-B-C-D-E Analysis.

disputation and challenging irrational beliefs (D)

Social modeling, rehearsal, feedback, shaping, successive approximation, and in vivo tasks are elements of __________.

behavioral skills training.

__**List and define one**__ (1) of David Burns' __cognitive distortions__ identified in class during lecture and on the PowerPoint

all or nothing thinking: everything is viewed in black and white categories

When considering the possible need to breach confidentiality with a client, you take into account your client’s feelings, your boss’s concerns, the outcome on others if the situation is not disclosed, the possible repercussions on your reputation, and your feelings about the action. This is an example of

considering problem impact.

Beginning helpers often experience _____________________, a form of anxiety related to their insecurities about their knowledge base and skills as they enter the profession.

imposter phenomenon.

The final step in ethical decision making is

documenting.

Effective self-care requires

self-awareness.

The process best described as connecting, communicating, and interaction with professional peers

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networking.

When practicing, professionals are expected to adhere to

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all of these possible answers.

* applicable laws.
* standards of practice.
* codes of ethics.