Title: Etiology and Treatment
Course: Question bank check

Q: Beatriz went to see her nurse practitioner because she was feeling poorly. He told her he thought she had depression. Beatriz asked him, “So that is caused by a chemical imbalance in my brain, right?” What is the most accurate reply the nurse practitioner could give?
- Yes, that’s right. Your brain is not producing enough of a neurotransmitter, so that led to depression. (Incorrect. This is a common “myth” regarding etiology; mental disorders are systemic outcomes of multiple parts that interact with each other and the environment.)
- No, that’s incorrect. Usually mental disorders result from some psychological issues in your childhood. (Incorrect. This explanation is unidimensional (only psychological). Mental disorders are systemic outcomes of multiple parts that interact with each other and the environment.)
- That is pretty close. You inherited some traits that have thrown your brain chemistry out of balance. (Incorrect. This is a unidimensional explanation, only considering biology; mental disorders are systemic outcomes of multiple parts that interact with each other and the environment.)
- Not exactly. Mental disorders result from many different factors interacting, including the environment. (Correct! Mental disorders are not caused by any single factors; they are systemic outcomes of multiple parts that interact with each other and the environment.)
A: Not exactly. Mental disorders result from many different factors interacting, including the environment.

Q: Which of the following is the most accurate definition of a system?
- It is a group of parts that are connected to each other in an additive fashion like: A + B + C. (Incorrect. Systems are not simply additive; the parts are interdependent, so how one part or element functions affects other parts or elements. Mental disorders are the result of a system.)
- It is a group of elements that are hierarchically nested with parts at the top dominating functioning. (Incorrect. Systems can be nested inside other systems (your breathing system is part of your body’s overall system), but within a system itself, the parts are interdependent, each one affecting usually many others. Mental disorders are the result of a system.)
- It is a group of elements that happen to occupy a similar space and that mimic each other's roles. (Incorrect. System parts each usually have their own specific functions; they rarely mimic each other. The parts are interdependent, each affecting others. Mental disorders are the result of a system.)
- It is a group of interdependent parts that, together, contribute to a unified whole or purpose. (Correct! Examples of systems include mechanical (car), biological (body), social (school or church), and environmental (weather, ecosystems). Mental disorders are the result of a system.)
A: It is a group of interdependent parts that, together, contribute to a unified whole or purpose.

Q: Leo just came out of class where the professor was explaining how mental disorders are the result of a system of elements. He says to you that he doesn’t understand why it has to be so complicated. “Why can’t we just say that this one illness is due to one thing and another illness is due to something else?” he asks you. What is the most accurate response you can give him?
- You have a good point. Most mental disorders are caused by a single major event or situation. (Incorrect. No mental disorder is caused by any single event or situation; using simplistic explanations interferes with our ability to understand interactions and come up with better solutions.)
- More complicated answers are just due to the way science works; don’t worry too much about it.
- ~Incorrect. Science doesn’t pursue complex answers just for the sake of it; systems are naturally complex, and improving our ability to understand interactions helps us come up with better solutions.
- Etiology of an illness based on cause and effect relationships, so just focus on key aspects. (Incorrect. Simple cause and effect explanations do not work with most of the major issues we struggle with today. Using simplistic explanations interferes with our ability to understand interactions and come up with better solutions.)
- Simplistic answers don’t help us understand what is happening or how to find better treatments. (Correct! Simplistic answers often miss important interactions and can lead us to wrong conclusions; better understanding of systems lead to more effective treatments.)
A: Simplistic answers don’t help us understand what is happening or how to find better treatments.

Q: When Lisa was pregnant, she became ill with influenza that was passed on to her baby, Max. As a young adult, Max was diagnosed with schizophrenia. Lisa’s uncle and a cousin had also been diagnosed with schizophrenia in their 20s. It appears that developing the flu while early in his development may have increased Max’s chances of developing schizophrenia. What is the term used to describe this type of interaction?
- biological dominance (Incorrect. This is not a term used in the module; epigenetics refers to how the environment may trigger specific genes, changing the risk for developing the disorder.)
- triggered illness (Incorrect. This is not a term used in the module; epigenetics refers to how the environment may trigger specific genes, changing the risk for developing the disorder.)
- envirogenomics (Incorrect. This fictional term is similar, but the correct term is “epigenetics” which refers to how the environment may trigger specific genes, changing the risk for developing the disorder.)
- epigenetics (Correct! Epigenetics refers to the interaction where environmental influences may activate or deactivate specific genes that increase or decrease the risk for specific disorders.)
A: epigenetics

Q: While he is giving a presentation at a community center on depression, Israel hosts a Q&A session. One of the participants asks Israel a question: “So is depression caused by nature or by nurture?” What would be the most accurate answer that Israel could give?
- Nature. Depression is a good example of how genetic inheritance produces a significant disorder. (Incorrect. This is a unidimensional explanation (biological); the biopsychosocial model is the best explanation.)
- Nurture. The impact of early childhood experiences have lasting effects that can lead to depression. (Incorrect. This is a unidimensional explanation (biological); the biopsychosocial model is the best explanation.)
- Neither. The nature/nurture debate ignores the complexity of how chemical imbalances create disorder. (Incorrect. This answer includes the disputed “chemical imbalance” explanation and ignores the role of the biopsychosocial model in understanding etiology.)
- Both. We use a biopsychosocial model to understand the many factors contributing to a disorder. (Correct! The biopsychosocial is the best overall description of how biological, psychological, and social/cultural aspects interact in producing mental disorders.)
A: Both. We use a biopsychosocial model to understand the many factors contributing to a disorder.

Q: Erin’s mother and sister have phobias, and her grandfather experiences panic attacks. Erin’s parents were extremely protective while she was growing up and frequently warned her that the world was dangerous and that one had to be on guard. She has also developed some thought patterns that intensify her emotional reactions to stressors, and she was teased and rejected while growing up because her family was poor. Which of the following is the best explanation for why Erin has developed an anxiety disorder?
- Epigenetic model. (Incorrect. The epigenetic model describes how environmental interactions with genes may activate or deactivate specific genes in a person’s genome. The BPS is the best explanation.)
- Biogenic model. (Incorrect. The Biogenic approach or model emphasized mental illness as a physical disease and used a primarily biological/medical explanation, so it is unidimensional. The BPS is the best explanation.)
- Mind-Body Dualism model. (Incorrect. Mind-body dualism is an idea that is centuries old and that describes the mind and body as totally separate from each other; it is not supported at all by our current understanding of how brain and body interact. The BPS model is the best explanation.)
- Biopsychosocial model. (Correct! The BPS is the best model that explains the major aspects of interacting factors that lead to mental disorders.)
A: Biopsychosocial model.

Q: Andi grew up in a family with multiple characteristics. Her father has social phobia and so tends to be quiet and reserved while her mother is gregarious and outgoing. One of her sisters experiences panic attacks, but the other is a cheerleader, and her brother is the captain of the high school debate team. Is Andi likely to develop an anxiety disorder?
- Yes; there are strong family markers for anxiety disorders, so she is at high risk for a disorder. (Incorrect. There does appear to be some diathesis in the family, but her mother and two of her siblings appear to be low risk; the diathesis-stress model would say it depends on her specific genetic inheritance and how much stress she experiences in life.)
- No; overall, the family is doing well and has not experienced a lot of stress, so she is probably safe. (Incorrect. According to the diathesis-stress model, her father and one sister have experienced enough stress to develop a disorder, but others have not. It is likely that Andi has diathesis for anxiety, so she has risk, but we don’t know how strong that diathesis is.)
- We can’t tell since disorders can just pop up without warning, and her family shows signs of anxiety. (Incorrect. Disorders do not just pop up out of nowhere. According to the diathesis-stress model, Andi does have a diathesis for anxiety, so she is at some risk for it, but there may also be some protective genetics in her family (from her mother), and a lot may depend on how much stress she experiences.)
- It depends on the specific genes she inherited and how much stress she experiences in her life. (Correct! In the diathesis-stress model, Andi appears to have a diathesis for anxiety disorders, and whether that is expressed depends on how much stress she experiences.)
A: It depends on the specific genes she inherited and how much stress she experiences in her life.

Q: Jamal’s family all drink alcohol. As he grew up, his father frequently returned home late after becoming intoxicated, and his mother drank at home, usually alone. His siblings also “party” with friends on weekends and often during the week. Jamal also tends to have a hot temper, is suspicious of authority figures, and doesn’t care much what others think of him. He is currently in the middle of divorce proceedings. What model best predicts his likelihood of developing alcohol dependence (alcoholism)?
- Diathesis-Stress (Incorrect. Jamal’s situation is not a simple additive situation of diathesis + stress; his personality traits and behaviors may actually create situations where he drinks to cope and reduce stress which fits with the rGE model.)
- Epigenetics (Incorrect. Epigenetics specifically describes how environmental influences may activate or deactivate genes; although epigenetics effects may contribute to Jamal’s situation, they do not specifically predict or describe why he might develop alcoholism.)
- Multicausal Genetics (Incorrect. This term is not part of the module. Jamal’s personality traits and behaviors (and family environment) increase the chances that he will drink to cope, triggering his underlying diathesis for alcoholism, consistent with the rGE model.)
- Gene-Environment Correlation (rGE) (Correct! Jamal’s personality traits and behaviors (and family environment) increase the chances that he will feel isolated and angry and will drink to cope, triggering his underlying diathesis for alcoholism.)
A: Gene-Environment Correlation (rGE)

Q: Laura and her friend Selena are studying together. They are trying to figure out the difference between the diathesis-stress (DS) and rGE models of mental disorders. They email you as their professor to ask for clarification. What is the most accurate answer you could give?
- rGE and DS models are basically the same, but one model was developed in the U.S. and the other was developed in Europe as explanations for etiology. (Incorrect. This description is inaccurate; rGE is a more modern explanation that emphasizes that genetic/biological factors may actually create the stressful environment that triggers illness.)
- DS emphasizes a threshold situation which leads to activation of the diathesis while rGE does not include the concept of a threshold. (Incorrect. Both DS and rGE use the threshold concept; rGE differs because it emphasizes that genes/biology interact with the environment to create or push the person into stressful situations.)
- rGE emphasizes biopsychosocial elements that all interact together while the DS model is focused only on genetic inheritance level increasing the risk. (Incorrect. Both DS and rGE are versions of the biopsychosocial model; rGE differs because it emphasizes that genes/biology interact with the environment to create or push the person into stressful situations.)
- DS is a simpler model of simple additive effects while rGE recognizes how genetics and behaviors may interact to generate stress and trigger the diathesis. (Correct! rGE is a newer model that acknowledges how genetic and biological elements may actually either create or drive a person towards a stressful environment that triggers the diathesis.)
A: DS is a simpler model of simple additive effects while rGE recognizes how genetics and behaviors may interact to generate stress and trigger the diathesis.

Q: What is the main difference between the diathesis-stress model and the gene-environment correlation model (rGE)?
- rGE and DS models are basically the same, but one model was developed in the U.S. and the other was developed in Europe as explanations for etiology.
- DS emphasizes a threshold situation which leads to activation of the diathesis while rGE does not include the concept of a threshold. (Incorrect. Both DS and rGE use the threshold concept; rGE differs because it emphasizes that genes/biology interact with the environment to create or push the person into stressful situations.)
- rGE emphasizes biopsychosocial elements that all interact together while the DS model is focused only on genetic inheritance of increasing the risk for a mental disorder.
- DS is a simpler model of explaining how stress can trigger a disorder while rGE recognizes how genetics either create or drive a person towards a stressful environment that triggers the diathesis.
A: DS is a simpler model of explaining how stress can trigger a disorder while rGE recognizes how genetics either create or drive a person towards a stressful environment that triggers the diathesis.

Q: Shannel’s friend comes to her for support. Her brother was recently hospitalized after a suicide attempt, and she is trying to grapple with this. She says to Shannel, “This cursed gene runs in my family, and this probably means I’m going to kill myself, too, right?” What is an accurate response that Shannel could give to her friend?
- Yes, if it runs in your family, you will get depressed; the best thing is to prepare and prevent it if you can. (Incorrect. Because all mental disorders are polygenic with multiple genes interacting, it depends on how many and which genes a person inherits. There is no certainty in etiology.)
- No, depression is mostly psychological, not genetic, so keep your hopes up and manage your stress. (Incorrect. All mental disorders result from biopsychosocial interactions; depression, like all other disorders, involves biological as well as other influences and transmission is polygenic.)
- Depression comes from a chemical imbalance in neurotransmitters, so it is different for everyone. (Incorrect. The “chemical imbalance” explanation is an oversimplified myth; biological disruptions of neurotransmitter systems are polygenic and etiology involves other interactions from the biopsychosocial model.)
- There is no one gene that causes depression; all mental illness results from multiple genes interacting. (Correct! All mental disorder etiology involves polygenic transmission, or multiple genes contributing to the outcome.)
A: There is no one gene that causes depression; all mental illness results from multiple genes interacting.

Q: After class, Andy is reviewing an article that states that the heritability ratio for intelligence is .65 while the heritability ratio for kindness is .40. What does this mean?
- Intelligence is more randomly distributed in the population than kindness. (Incorrect. The correct answer is the opposite. A higher heritability ratio means that genetics play a larger role in the variation of that trait in the population; a lower ratio means genetics have less impact.)
- Environmental influences are more likely to shape intelligence than kindness. (Incorrect. The correct answer is the opposite. A higher heritability ratio means that genetics play a larger role in the variation of that trait in the population; a lower ratio means genetics have less impact.)
- The number of genes involved in intelligence is greater than the number involved in kindness. (Incorrect. The heritability ratio is not a measure of the number of genes, but of the overall impact of genetics on the described trait, so higher ratio equals more genetic influence on the trait in the population.)
- Genetics have more influence on intelligence in the population than on kindness. (Correct! A higher heritability ratio means that genetics play a larger role in the variation of that trait in the population; a lower ratio means genetics have less impact.)
A: Genetics have more influence on intelligence in the population than on kindness.

Q: Acacia inherits a variety of genes from both of her parents. These genes combine and interact with each other, some increasing her chance of developing Bipolar disorder, some possibly reducing her chances. This overall pattern of genetic inheritance for the mental disorder is called what?
- Interdependent (Incorrect. Although the genetic interactions are interdependent, this is not the correct name for this form of inheritance which is polygenic.)
- Mendalian (Incorrect. Mendalian inheritance accounts for some aspects of human functioning and is known for terms like “dominant” and “recessive” genes, but this does not apply to mental illness which is polygenic.)
- Multiplistic (Incorrect. Multiple genes are involved in mental illness, but the correct term is polygenic.)
- Polygenic (Correct! This is the term describing that inheritance for mental disorders is the result of multiple interacting genes.)
A: Polygenic

Q: I am a neurotransmitter created in the nucleus of a neuron. I have been packed into a bubble-shaped vesicle and pushed down the axon. We have now arrived at the terminal button and the walls of our vesicle are merging with the cell membrane. What is going to happen next?
- I will merge with the myelin sheath and improve the quality of the next signal from my neuron. (Incorrect. The myelin sheath is created by glial cells, but neurotransmitters are not involved. The NT will go into the synapse and bind with a receptor on the postsynaptic neuron.)
- I will help push Potassium ions out of the cell, changing the membrane potential for the signal. (Incorrect. The changes in membrane potential occur as a result of previous bindings on the dendrites and are part of the action potential; when a vesicle binds with the membrane, NTs are pushed into the synapse and bind with receptor cells on the postsynaptic neuron.)
- I will decrease my neuron’s threshold of excitation, increasing the chance of a future action potential. (Incorrect. Releasing NTs does not increase the signaling neuron’s threshold; that has already happened previously. When a vesicle binds with the membrane, NTs are pushed into the synapse and bind with receptor cells on the postsynaptic neuron.)
- I will float into the synapse and then hopefully bind with a receptor on the postsynaptic neuron. (Correct! Neurotransmitters float into the synapse and bind with receptors on the postsynaptic neuron to carry the signal onto the next cell.)
A: I will float into the synapse and then hopefully bind with a receptor on the postsynaptic neuron.

Q: Regina is working on a short essay for her Abnormal Psychology class. She writes, “If the neuron’s dendrites receive a few signals or mixed excitatory and inhibitory signals, then it will send a weak signal to the postsynaptic neuron, but if it receives many receptor binding signals, then it will send a strong signal to the next neuron.” Is Regina correct?
- No; the description is inaccurate; strong signals at the dendrites will be moderated to an average signal. (Incorrect. There is no moderation of incoming signals; it is an additive process, and if sufficient depolarization occurs to exceed the threshold, the neuron will launch a new signal.)
- Yes; the strength of the incoming signal determines the strength of the signal the neuron sends. (Incorrect. There is no partial or weak signal. The All-or-None principle means if the threshold is crossed, an action potential will occur.)
- Partially; too many strong incoming signals create disruptions in the membrane, confusing the signal. (Incorrect. If many excitatory signals come in (more than inhibitory signals) and the threshold is exceeded, the neuron will launch an action potential; this is the All-or-None principle.)
- No; the neuron will either launch an action potential or it will not; there are no weak or strong signals. (Correct! The All-or-None principle means if the threshold is crossed, an action potential will occur.)
A: No; the neuron will either launch an action potential or it will not; there are no weak or strong signals.

Q: Out with his friends on Friday, Gerry raises his glass and says, “I love going out with you guys for a drink after a long week. Here’s to beer and relaxing!” In his brain, the neurotransmitter GABA may be having a significant influence at this time. This is because GABA is what type of neurotransmitter?
- excitatory (Incorrect. GABA is an inhibitory neurotransmitter. Glutamate is a good example of an excitatory neurotransmitter.)
- Neuromodulator (Incorrect. Serotonin is an example of a neuromodulator that influences how other systems work. GABA is an inhibitory neurotransmitter.)
- Neuro-replicator (Incorrect. This is not a term used in the readings. GABA is an inhibitory neurotransmitter linked to reducing anxiety and feelings of relaxation.)
- inhibitory (Correct. GABA is an inhibitory neurotransmitter, and its action may be to reduce anxiety and stress, leading to a sense of relaxation.)
A: inhibitory

Q: Efraín is hiking along a path in the mountains when he comes around a corner and suddenly sees the path has eroded and there is a 30-foot drop in front of him. His heart begins to pound, his breathing speeds up, and his muscles get tense. What is this reaction called and where is it located in the nervous system?
- autonomic fixation; somatic nervous system (Incorrect. The somatic nervous system manages intentional movement and sensory inputs; “autonomic fixation” is not a correct term; this is an example of the fight or flight response.)
- feed and breed; autonomic nervous system (Incorrect. Feed and breed is a term used to describe functions of the parasympathetic nervous system while the example describes the fight or flight response.)
- survivor syndrome; parasympathetic nervous system (Incorrect. “Survivor syndrome” describes an entirely different situation; Efraín’s reaction is fight or flight - preparing his body to manage the situation.)
- fight or flight; sympathetic nervous system (Correct! The Fight or Flight response which is a survival mechanism, is managed by the sympathetic nervous system.)
A: fight or flight; sympathetic nervous system

Q: Jin Kyong’s mother was killed in a vehicle accident when she was a young girl, just starting school. This event had a significant impact on Jin Kyong’s life, including damage to a major neural pathway that has made her more likely to overreact to stress in her life and increasing her chances of experiencing a mental illness. What is this pathway called?
- The sensory-cortical-neuroadronergic sheath (Incorrect. There is no pathway with this name; the HPA Axis plays a major role in our fight or flight response and stress reactions and ability to adapt to negative events.)
- The central emotive-behavioral pathway (Incorrect. There is no pathway with this name; the HPA Axis plays a major role in our fight or flight response and stress reactions and ability to adapt to negative events.)
- The endocrine-midbrain-processing axis (While the endocrine system is involved as well as the hypothalamus from the midbrain, this is not the correct name; it is called the HPA Axis: Hypothalamic-Pituitary-Adrenocortical Axis.)
- The hypothalamic-pituitary-adrenocortical axis (Correct! The HPA Axis plays a major role in our fight or flight response and stress reactions and ability to adapt to negative events.)
A: The hypothalamic-pituitary-adrenocortical axis

Q: Devin opens his notebook and one of the pages slices across his fingertip. He processes the pain of this injury using what part of this brain?
- motor cortex (Incorrect. His motor cortex coordinated his muscles in opening the notebook, but processing the injury and pain occurs in the somatosensory cortex.)
- frontal lobes (Incorrect. The frontal lobes are the part of the cerebral cortex involved in reasoning, motor control, emotion, and language and contains the motor cortex. The processing of the injury is done in Devin’s somatosensory cortex.)
- occipital lobe (Incorrect. The occipital lobe is associated with visual processing and contains the primary visual cortex; the injury would be processed in Devin’s somatosensory cortex.)
- somatosensory cortex (Correct. The somatosensory cortex is responsible for processing sensory information from across the body, including pain.)
A: somatosensory cortex

Q: It is 1942, and Jabarah has been put into an asylum for her severe mental illness. She sometimes yells at persons who are not there and becomes agitated, pacing back and forth for hours. She has sometimes refused to eat, accusing the nurses of trying to poison her. Her doctor decides they need to try a lobotomy to calm her down. What does this involve?
- Severing the corpus callosum that connects the left and right hemispheres of the brain. (Incorrect. This type of surgery is used in cases of severe epilepsy, but it is not considered a lobotomy.)
- Surgery that removes the thalamus and other elements of the midbrain. (Incorrect. Lobotomies usually severed the connections between the prefrontal cortex and the thalamus, but also often did damage to other parts of the frontal lobe.)
- Cutting the major pathways between the parietal lobe and the frontal and temporal lobes. (Incorrect. Lobotomies usually severed the connections between the prefrontal cortex and the thalamus, but also often did damage to other parts of the frontal lobe.)
- Severing the connections between parts of the frontal lobe and other parts of the brain. (Correct! Lobotomies usually severed the connections between the prefrontal cortex and the thalamus, but also often did damage to other parts of the frontal lobe.)
A: Severing the connections between parts of the frontal lobe and other parts of the brain.

Q: Jamie was hospitalized for his schizophrenia during an active psychotic episode. While he was in the hospital, the psychiatrist prescribed an antipsychotic medication to help reduce his symptoms, especially the hallucinations and delusions. The drug that he was given could be classified as what kind of agent?
- agonist (Incorrect. Agonist agents mimic a neurotransmitter; in this case, the antipsychotic decreases the effect of the neurotransmitter so it is an antagonist agent.)
- inhibitor (Incorrect. Inhibitor is a broad term that applies to several situations; in this case, the antipsychotic reduces the effect of dopamine, so it is an antagonist.)
- eliminator (Incorrect. This is not a correct term. In this case, the antipsychotic reduces the effect of dopamine, so it is an antagonist.)
- antagonist (Correct! Because excessive dopamine in some locations can trigger psychotic symptoms, antipsychotics usually bind to dopamine receptors, reducing the effect of the neurotransmitter.)
A: antagonist

Q: Electroconvulsive therapy can be most effective and is most often used in alleviating symptoms for people with what type of mental disorder?
- severe forms of eating disorders such as anorexia nervosa or bulimia (Incorrect. Electroconvulsive therapy has not been demonstrated to be effective at treating eating disorders.)
- attention deficit hyperactivity disorder (ADHD) with comorbid (co-existing) anxiety (Incorrect. Electroconvulsive therapy has not been shown to be effective at treating ADHD and anxiety.)
- schizophrenia or other psychotic disorders (Incorrect. Electroconvulsive therapy is generally not considered as a regular treatment for schizophrenia or other psychotic conditions, although it can sometimes be useful as a last resort.)
- severe depression who have not responded to traditional drug therapy (Correct. Though highly invasive, electroconvulsive therapy has shown some effectiveness in severe forms of depression that have not responded to drug therapy.)
A: severe depression who have not responded to traditional drug therapy

Q: Matt is starting to get into an argument with his wife. At one point, he calls her by the name of his old girlfriend, which doesn’t help the situation. Although modern research does not support his strong interpretation of such behaviors, Freud believed that these types of slips revealed what?
- hidden forms of hysteria (Incorrect. At the time, Freud believed that hysteria was mostly a female type of mental disorder resulting from significant repression of traumatic events.)
- secret longings by the superego (Incorrect. Freud believed the superego was a major part of personality traits, but it represented socially sanctioned and “correct” or moral behaviors. A “freudian slip” results from supposed unconscious desires.)
- neurotic psychological imbalances (Incorrect. Freud believed that imbalances between the aspects of the personality produced neurosis which was related to anxiety or depression; a “freudian slip” results from supposed unconscious desires.)
- unconscious thoughts or desires (Correct! Freud believed that most of the mind was unconscious and that repressed ideas could break through into conscious behavior.)
A: unconscious thoughts or desires

Q: Maggie is sitting in the back of the class. Part of her really wants to try and beat her latest score at Candy Crush, but she feels guilty for thinking of that rather than paying attention to the professor. She finally decides that she will get on her phone during a short class break and see if she can get ahead in the game. What part of her personality led her to reach this resolution?
- id (Incorrect. Freud believed the id was the part of personality governed by primitive drives towards sex and aggression. In this case, Maggie’s ego found a practical middle ground.)
- superego (Incorrect. Freud believed the superego represented cultural and social norms and expectations and strives for perfection. Maggie’s ego found a practical middle ground.)
- drives (Incorrect. Freud believed that primitive drives primarily focused on aggression or sexuality were a core part of the id; Maggie’s ego was able to find a practical middle ground between the id and superego.)
- ego (Correct! Maggie’s ego was able to find a way to satisfy both the id and the superego in a way that balanced both and was socially acceptable.)
A: ego

Q: In a meeting of her department at work, Raina hears her boss praise a colleague for the tremendous work he did in completing a major task; her boss does not mention Raina at all even though she worked side-by-side with her colleague for weeks on the project. She bites her lip, and rushing back into her office, she kicks her trashcan across the room and utters a brief yell of anger. In Freud’s model of personality, what aspect was driving her behaviors?
- a biological drive for pleasure-seeking (Incorrect. Freud did believe that this was one of the primitive biological drives present at birth, but this was more about aggression than pleasure-seeking.)
- a psychological drive for recognition (Incorrect. Freud’s concept of drives was that they were mostly *biological* in nature and present from birth; these make up a major part of personality.)
- a psychological drive for self-actualization (Incorrect. Freud’s concept of drives was that they were mostly *biological* in nature and present from birth; these make up a major part of personality.)
- a biological drive for aggression (Correct! Freud believed that primitive biological drives were present at birth and included a drive for aggressive behavior; this is part of what makes up the id.)
A: a biological drive for aggression

Q: As he goes through a normal day, Mario often makes use of defense mechanisms. What part of the personality did Freud think used defense mechanisms and what was the purpose of using them?
- The id to defend against the accusations and guilt feelings produced by the superego. (Incorrect. According to Freud, when the demands of the id or superego may overwhelm the ego, anxiety results. The Ego uses defense mechanisms to reduce anxiety by distorting thoughts or perceptions of reality.)
- The superego to prevent expression of sexual and aggressive drives. (Incorrect. According to Freud, when the demands of the id or superego may overwhelm the ego, anxiety results. The Ego uses defense mechanisms to reduce anxiety by distorting thoughts or perceptions of reality.)
- The id to help us disconnect from, and not have to face, reality. (Incorrect. The Id operates on the pleasure principle, so it is the job of the ego and its defense mechanisms to curb the desires of the id and keep these impulses from being realized.)
- The ego to prevent threatening impulses from being consciously recognized. (Correct! According to Freud, when the demands of the id or superego may overwhelm the ego, anxiety results. If a realistic compromise is not possible, the ego may reduce anxiety by distorting thoughts or perceptions through defense mechanisms.)
A: The ego to prevent threatening impulses from being consciously recognized.

Q: Chantelle has aggressive tendencies and gets in fights often in high school. She later decides to join the military. Which defense mechanism does this exemplify?
- displacement (Incorrect. Displacement involves transferring aggression to a safer target; instead of transferring her aggression to a sibling or pet Chantelle uses Sublimation to channel her energy to a more noble pursuit.)
- projection (Incorrect. Chantelle is not attributing her aggression to anyone or anything else; instead she’s using Sublimation to transfer her energy to a more socially acceptable pursuit in the military.)
- repression (Incorrect. Chantelle has chosen Sublimation to channel her aggressive tendencies into a more acceptable pursuit than fighting by joining the military, so it is unlikely she’s repressed her aggression.)
- sublimation (Correct. Chantelle is channelling her aggression into a socially acceptable and noble pursuit by joining the military.)
A: sublimation

Q: When he was growing up, Booker’s parents were harsh and punishing much of the time. Freud would say that as a result of this, that Booker has become perfectionistic and neat, very careful and cautious, rarely giving much to others, and stubborn. Freud would say that Booker was fixed in which psychosexual stage?
- oral (Incorrect. Freud believed fixation in the Oral stage would result in a person who is anxious and needy, seeking oral pleasures; Booker is fixated in the anal stage.)
- phallic (Incorrect. Freud believed fixation in the Phallic stage would fail to resolve the Oedipal/Electra complex and be angry or vain and highly ambitious; Booker is fixated in the anal stage.)
- genital (Incorrect. Freud believed that a person who developed without fixations in the previous stages and arrived in the Genital stage would be a healthy adult with normal sexual interests; Booker is fixated in the anal stage.)
- anal (Correct. Freud would say that Booker was anal-retentive due to his fear of soiling himself when he was being potty trained due to the harsh treatment by his parents for mistakes.)
A: anal

Q: Denise’s psychoanalyst asks her to lay on a couch in her office, to relax and close her eyes, and begin to spontaneously speak whatever thoughts come to her mind without editing them. The goal is to identify unconscious patterns or conflicts that Denise is struggling with that can then be addressed in treatment. This form of treatment is described as what?
- dream analysis (Incorrect. Dream analysis is another key aspect of psychoanalytic treatment to uncover unconscious patterns, but this example is a here-and-now, present report of thoughts called free association.)
- unconscious discovery (Incorrect. This is not a term used in psychoanalysis; Denise’s analyst is asking her to engage in free association.)
- ego evasion (Incorrect. Although the goal of this technique is to avoid ego suppression of unconscious material, the correct description is free association.)
- free association (Correct! This is the term that Freud used to describe attempts to avoid Ego suppression of unconscious motives, emotions, and thoughts.)
A: free association

Q: Over time, as Guang becomes accustomed to psychodynamic therapy and his relationship with his therapist deepens, he begins to experience some rebelliousness and related behaviors towards his therapist during sessions that reflect his previous relationship with his step-father who raised him after his father died. What is this process of repeating patterns from previous relationships called in therapy?
- echoism (Incorrect. This is not a term used in psychoanalysis or psychodynamic therapy; Guang is experiencing transference.)
- psychodynamics (Incorrect. This is the term used for a model and broad approach to therapy that emphasizes childhood experiences and unconscious processes; Guang is experiencing transference.)
- relational reflection (Incorrect. This is not a term used in psychoanalysis or psychodynamic therapy; Guang is experiencing transference.)
- transference (Correct! This is the term that describes the transfer of previous relationship patterns into the therapeutic relationship.)
A: transference

Q: Brigette is participating in psychotherapy. Her therapist’s major approach is to seek to understand how Brigette understands and relates to significant others in her life with the goal of promoting her own independence and healthy relationships. Which school of psychodynamic therapy does Brigette’s therapist belong to?
- psychoanalysis (Incorrect. Brigette’s therapist is mostly concerned with Brigette’s internalized representations of her relationships or object relations therapy.)
- ego psychology (Incorrect. Ego psychology is concerned with strengthening the ego to enable better functioning and use of more adaptive defense mechanisms.)
- self psychology (Incorrect. Self psychology is mostly concerned with the client’s sense of self and issues of self-esteem and relationship boundaries. Brigette is engaged in object relations therapy.)
- object relations therapy (Correct! This form of therapy is concerned with a person’s internal representations of others, relationship boundaries and independence, and issues of transference.)
A: object relations therapy

Q: Which of the following statements most closely aligns with the humanistic approach?
- Each person can be negatively affected by unconscious thoughts, feelings, and memories. (Incorrect. This answer reflects the psychoanalytic approach which maintained that unconscious thoughts affect an individual’s emotions and behavior.)
- Each person seeks after power, and therapy is needed to fully develop a healthy personality. (Incorrect. This answer does not reflect any of the psychogenic approaches.)
- Each person’s thought processes can be understood by directly observing his or her behavior. (Incorrect. This reflects the behaviorist view.)
- Each person is inherently good and motivated to be a healthy functioning individual. (Correct! Humanism emphasized that each person is inherently good, self-motivated, and strives to become a healthy, effectively functioning individual.)
A: Each person is inherently good and motivated to be a healthy functioning individual.

Q: When Bill visits his therapist for a session, the therapist mostly lets Bill direct the session and talk about what is important to him and what is on his mind. There are no discussions about unconscious motives, and the focus tends to be on the here-and-now and sometimes on future goals and desires. His therapist is very warm and empathic, accepting whatever Bill describes and never criticizing. What type of therapy is Bill participating in?
- self psychology therapy (Incorrect. Self Psychology is a form of psychodynamic therapy that focuses on how past experience shape one’s understanding of the self and how a person relates to others as a result.)
- brief psychodynamic therapy (Incorrect. As per its name, brief psychodynamic therapy is a modern version of psychodynamic treatment that still focuses on unconscious processes and therapist interpretations.)
- cognitive behavioral therapy (Incorrect. CBT developed as an integration of behavioral and cognitive approaches and is very interactive; while it does involve empathy and understanding of the client.)
- person centered therapy (Correct! This form of therapy was developed Carl Rogers and is marked by unconditional positive regard, empathy, and allowing the client to describe their wishes and goals and resolve discrepancies.)
A: person centered therapy

Q: Kayla is a psychologist and therapist who believes that there is no background purpose or meaning in life; she believes that human beings need to create their own sense of meaning or purpose and that one of the goals of therapy is to help clients come to grips to the anxiety of making their own choices and living an authentic life. What approach is Kayla taking in her work?
- person centered therapy (Incorrect. PCT is another humanistic therapeutic approach, although its emphasis is more on empathy, genuineness, and helping the client explore their own sense of identity.)
- ego psychology therapy (Incorrect. This is a form of psychodynamic therapy focused primarily on strengthening the ego (in Freud’s personality structure), working with defense mechanisms, and helping the client adapt to life’s demands.)
- unconditional therapy (Incorrect. Unconditional positive regard is not a type of therapy, although it is a principle that runs through most forms of therapy, especially humanistic approaches. It emphasizes accepting the humanity of the client and not judging their thoughts or reactions.)
- existential therapy (Correct! Existential therapy is a humanistic approach to therapy that emphasizes self-determination, purpose, and authenticity.)
A: existential therapy

Q: Which person was most interested in studying how new behaviors are learned?
- Abraham Maslow (Incorrect. Abraham Maslow was most interested in the process by which individuals meet their needs in a hierarchical manner that begins with basic needs and ends with self-actualization.)
- Carl Rogers (Incorrect. Carl Rogers was a humanist interested in the use of client-centered therapy.)
- Sigmund Freud (Incorrect. Sigmund Freud was primarily focused on the unconscious and his ideas concerning personality structure and human development.)
- B.F. Skinner (Correct! B.F. Skinner was known for his study of operant conditioning, which facilitates learning through the consequences that follow an organism’s behavior.)
A: B.F. Skinner

Q: Aaron and his roommate are studying for an exam in their abnormal psychology course. The roommate looks at Aaron and says, “What is the difference, again, between classical and operant conditioning?” What is the most accurate answer that Aaron can give?
- Classical conditioning is about conscious behaviors where choice has an impact and operant is about unconscious behaviors that drive interactions with the environment. (Incorrect. Conscious vs. unconscious are not used in behaviorism which is focused on observable behaviors; operant behaviors are voluntary and the consequences of the behavior shape learning.)
- Classical conditioning is about when an organism’s behavior is rewarded and learning occurs whereas operant is about when the organism’s behavior is punished and learning is extinguished. (Incorrect. Operant conditioning involves both reinforcement and punishment while classical conditioning is related to reflective behaviors.)
- Classical conditioning is focused on a single organism’s interaction with the environment while operant is focused on how the organism learns from social engagement with others. (Incorrect. Both of these forms of learning may occur alone or in groups; social/observational learning was a later development in behaviorism and does not fit either classical or operant conditioning.)
- Classical conditioning is about reflexive behaviors linked to an unlearned stimulus while operant is about an organism’s voluntary behaviors and what happens afterwards. (Correct! An organism’s voluntary behaviors were called “operant” behaviors and new behaviors are learned based on the consequences of the behavior (reinforcement or punishment).)
A: Classical conditioning is about reflexive behaviors linked to an unlearned stimulus while operant is about an organism’s voluntary behaviors and what happens afterwards.

Q: Lydia has cancer and has been going to chemotherapy. Her nurses are very supportive and helpful, but during treatment, Lydia feels dizzy and becomes nauseated, even throwing up sometimes during treatment. One day, at the store, she sees one of her nurses and after saying hello, feels nauseated and dizzy. This means that as a result of Lydia’s experience, the nurse has become:
- an unconditioned response (Incorrect. Lydia’s reaction to the chemotherapy (vomiting and dizziness) were unconditioned responses and the nurse was a neutral stimulus, but after being paired with her reaction, she is now a conditioned stimulus.)
- a neutral stimulus (Incorrect. The nurse was originally a neutral stimulus, but after being paired several times with Lydia’s dizziness and nausea, she has become a conditioned stimulus that triggers the reaction even without chemotherapy.)
- a conditioned response (Incorrect. Lydia’s dizziness and vomiting due to the chemotherapy was an unconditioned response and the nurse was an unlearned stimulus; but after pairing these together, the nurse has become a learned stimulus.)
- a conditioned stimulus (Correct. The nurse was originally a neutral stimulus, but after being paired several times with Lydia’s nausea, she has now become a conditioned stimulus.)
A: a conditioned stimulus

Q: Marlena’s child is aggressive with siblings and other children on the playground. She is working with a behavior therapist to try and reduce the frequency of these aggressive incidents and increase her child’s use of more socially engaging behaviors that will help improve her relationship with others. What is the first step in this process of therapy?
- Work with Marlena to enhance the child’s superego functioning. (Incorrect. This answer utilizes elements of psychoanalytic theory, not behavioral theory. You need a baseline before you make changes.)
- Develop a hierarchy of punishers to reduce the aggression. (Incorrect. While use of some punishers may be appropriate at some stage, you first need to establish a baseline to measure results.)
- Use a stepwise teaching method to encourage prosocial behavior. (Incorrect. You do want to teach prosocial behaviors and use reward systems for them to take hold, but you first need baseline assessments of target behaviors to know if treatment is working.)
- Establish a baseline for the frequency of the aggression. (Correct! You need a baseline in order to know if the treatment is having an effect or if changes need to be made.)
A: Establish a baseline for the frequency of the aggression.

Q: On the advice of his therapist, Ellis decides to treat his fear of heights by exposing himself to heights gradually, following a hierarchy they created starting with relaxing while imagining small movements upward that get progressively more anxiety-provoking and eventually moving to real-life situations. Which therapeutic method is Ellis using?
- aversion therapy (Incorrect. Though Ellis finds heights quite aversive, he’s using a behavioral technique that increases his exposure to unsettling events gradually while maintaining the ability to relax and feel comfortable in the setting.)
- free association (Incorrect. Ellis is not speaking about whatever comes to mind in a psychotherapeutic setting; this is a psychoanalytic method.)
- flooding (Incorrect. Flooding is a more intense form of exposure therapy during which the client is exposed to the most fear-inducing event first and asked to stay in that situation until the anxiety decreases.)
- systematic desensitization (Correct. By gradually increasing his exposure to anxiety-provoking events and learning to maintain a sense of calm and relaxation, Ellis is utilizing systematic desensitization.)
A: systematic desensitization

Q: Mary Cover Jones, the mother of behavioral therapy, helped three-year old Peter overcome his fear of rabbits by giving him a snack while having the rabbit in the room and gradually moving it closer to him and then having him interact with it while he ate his snack. This form of exposure therapy relies on which learning principle?
- operant conditioning (Incorrect. This method did not rely on Peter engaging in any behavior and receiving a consequence, so it was not operant conditioning.)
- aversive therapy (Incorrect. Aversive therapy involves pairing a behavior with an unpleasant stimulus; the opposite occurred in this case with Peter.)
- social learning (Incorrect. Social learning occurs through interactions and observations of others’ behaviors; in this case, it was just Peter and the rabbit.)
- classical conditioning (Correct! Jones gradually disconnected the rabbit as a conditioned stimulus for fear and linked it to a new unconditioned stimulus (snack) that produced positive emotion and pleasure.)
A: classical conditioning

Q: The cognitive revolution turned the emphasis in psychology away from the behavioral focus on only observable behavior. At the time, this new emphasis in psychology had a focus on
- the role of emotion in behavioral motivation. (Incorrect. Although behavior was still seen as important in the cognitive revolution, the focus was on thoughts and cognitive processes.)
- the value of introspection and human value. (Incorrect. Introspection was not an emphasis of the cognitive revolution and value was an emphasis in humanism.)
- the role of dreams in shaping consciousness. (Incorrect. Dreams were not a key topic of the cognitive revolution although they were a major focus of Freud’s earlier work and theories.)
- the scientific study of internal mental states. (Correct! The cognitive revolution expanded the study of the mind to include the internal mental states that behaviorism left out including cognition and emotion.)
A: the scientific study of internal mental states.

Q: I believe that humans have innate worth, but also that we naturally engage in both rational and irrational patterns of thinking and behavior. Thus, much of human suffering is caused by our own irrational thinking, exaggerated emotional reactions, and unproductive behaviors. We can improve our ability to function well by adopting a healthier acceptance of ourselves and others and working to develop more rational thought processes. Who am I?
- Aaron Beck (Incorrect. Beck believed in “automatic thoughts” and cognitive distortions that could negatively impact functioning, but he didn’t refer to them as irrational. His approach was also less philosophical than that of Ellis.)
- Albert Bandura (Incorrect. Bandura was important in beginning to integrate cognitive and social aspects into behaviorism, but he did not have a model or explicit thinking concerning how thinking connected to emotions.)
- Abraham Maslow (Incorrect. Maslow was a humanist, focused on what motivated human beings; his work did not focus explicitly on thought patterns.)
- Albert Ellis (Correct! These beliefs and ideas form the basis of Ellis’s REBT form of therapy.)
A: Albert Ellis

Q: Porsche just did a presentation at work; however, she had a few mistakes that were pointed out by her co-workers and her boss. She returns to her office in tears and when a friend asks what is going on, she says that she is stupid and incompetent, that her boss hates her, and that she is thinking of quitting. What aspect of this scenario fits the “C” of REBT’s “A-B-C” model?
- her presentation and the several mistakes that she made (Incorrect. This situation, including her mistakes, is part of the Activating Event or “A” of the REBT model.)
- her comments that she is stupid and her boss hates her (Incorrect. These statements reflect her irrational thinking or beliefs which is the “B” part of the REBT model.)
- her experience of the high pressures present in the workplace (Incorrect. High pressure in the workplace to be successful or not make mistakes can contribute to the Activating Event or “A” of the model.)
- her feelings of incompetence, inability, and hopelessness (Correct! These exaggerated or intensified feelings are the result of her irrational thinking and represent the consequences or “C” part of the REBT model.)
A: her feelings of incompetence, inability, and hopelessness

Q: Neo struggles with social anxiety and agoraphobia. He avoids social interactions with others if he can, and is afraid that if he goes outside or to the store, that something terrible will happen. Which of the following approaches fits with CBT principles?
- In sessions, Neo explores how he was treated by his father and how this shaped his current fears of others. (Incorrect. This description fits psychodynamic therapy such as Object Relations Therapy, not CBT.)
- In sessions, Neo works to accept responsibility for his own choices and to accept the reality of isolation. (Incorrect. This description fits humanistic therapy such as existential forms of treatment, not CBT.)
- In sessions, Neo describes his dreams and seeks to understand his unconscious patterns and conflicts. (Incorrect. Dream analysis is part of psychoanalysis and is not part of CBT.)
- In sessions, Neo identifies negative thoughts that impact his view of himself, and practices exposure methods. (Correct! Combining work to disrupt cognitive distortions and using behavioral methods fits with CBT.)
A: In sessions, Neo identifies negative thoughts that impact his view of himself, and practices exposure methods.

Q: Claire is writing a paper about different forms of psychotherapy. She wants to explain how CBT is different from older forms of therapy. Which of the following statements would be most accurate?
- CBT spends significant time in understanding how previous relationships shape current behaviors. (Incorrect. Although CBT therapists do want to understand the context of thoughts and behaviors and events that shaped them, this is not a major focus.)
- CBT is grounded in evaluating previous situations of classical conditioning that impact self-esteem. (Incorrect. Sometimes, classical conditioning of behaviors can have an influence on current behaviors, but CBT therapists focus more on interactions of thinking and behavior.)
- CBT therapists use financial and food incentives to reward client’s development of new behaviors. (Incorrect. CBT therapists do not use reinforcers in sessions to shape client behaviors, but they do provide support and assistance to clients in exposure situations and other contexts.)
- CBT is focused on the here-and-now and includes practice of new behaviors through homework. (Correct! CBT is present-focused and uses homework for clients to practice and learn new ways of thinking and behaving outside of sessions.)
A: CBT is focused on the here-and-now and includes practice of new behaviors through homework.

Q: After having some relatively ineffective experiences in counseling before, Min-Jun is concerned about starting CBT. Which of the following is an accurate statement about some of the benefits of CBT compared to other forms of treatment?
- CBT is more comprehensive than other treatments, focusing on personality development and emotional growth. (Incorrect. Ego psychology and analysis aim to resolve developmental crises and promote personality development over the long-term.)
- CBT is a therapy where the client decides the goals and directs the sessions, creating increased independence. (Incorrect. While most forms of CBT encourage collaboration, this description of client-directed sessions is more characteristic of humanistic therapies.)
- CBT only focuses on those problems that can be fixed quickly, creating greater satisfaction in clients. (Incorrect. This description could apply to some forms of brief therapy approaches, but CBT in general aims to identify core thought patterns and behaviors that can be changed to enhance adaptive functioning.)
- CBT achieves significant results in fewer sessions than older therapies and is more cost-effective as a result. (Correct! CBT is an interactive, practical approach that achieves results in shorter time than many olde therapies, reducing cost; it also shows lower relapse rates than many other treatments and medications.)
A: CBT achieves significant results in fewer sessions than older therapies and is more cost-effective as a result.

Q: In trying to decide what therapist to see for her schizoaffective disorder, Angie decided to visit with three different therapists in order to make a decision. Following the reasoning of the American Psychological Association about what elements are most likely to produce successful outcomes, which of the following would be a good thing for Angie to ask questions about and evaluate during her visits?
- The gender of the therapist, what graduate program they went to and how well they were in the program. (Incorrect. Gender has little relation to effectiveness and merely attending a program does not mean the therapist will be effective.)
- The number of clients currently being seen by the therapist and how nice their office looks. (Incorrect. These may be markers of financial success, but they do not necessarily indicate the therapy will be effective; these are also not part of the APA conclusions.)
- Whether the therapist has a sense of humor, is confident, and has a good payment policy. (Incorrect. Some of this may be part of being able to relate to the client, but this is not one of the APA’s conclusions and not all of this is relevant to effectiveness.)
- Whether the therapist is using an evidence-based treatment that is effective for her condition. (Correct! This is one of the APA’s conclusions about the basis for effective therapy.)
A: Whether the therapist is using an evidence-based treatment that is effective for her condition.

Q: Guido and Marcello are seeing different therapists for different conditions. One therapist is using CBT while the other therapist is using IPT. However, both men seem to be making progress with their concerns, and their lives are improving. Which of the following is a common factor across therapies that may help to explain this result?
- The symptoms both men are experiencing are mostly mild, so improvement occurs quickly. (Incorrect. Even if symptoms were mild, this does not mean two therapies would work as effectively as each other.)
- Both of these therapies use basically the same methods and just have different names. (Incorrect. These therapies are built on different models and use different methods and techniques.)
- The placebo effect accounts for why both therapies appear to have roughly the same results. (Incorrect. Studies of therapies take placebo effects into account and have demonstrated that therapy performs better than placebo.)
- Both therapists have done well in creating a sense of hope and that the future will improve. (Correct! This is one of the core common factors that is believed to underlie successful therapy, regardless of the type of therapy used.)
A: Both therapists have done well in creating a sense of hope and that the future will improve.

Q: Li-Jing has been in practice for many years using psychodynamic therapy. However, she thinks she can improve the results of her work by adding in some CBT elements. She goes to a CBT workshop and picks and chooses the methods she thinks would fit best with her perspective and tries them out. Later on, after a webinar on IPT, she also adds in a couple of methods she learned there into her new form of therapy. Li-Jing is using what type of approach now in her treatments?
- brief psychodynamic therapy (Incorrect. BPT is a specific form of psychodynamic therapy with a goal towards being more interactive and focusing on a core problem to work on.)
- theoretical integration (Incorrect. Li-Jing is not combining theories and integrating the parts. She has not changed her overall theory or model of therapy, she has just incorporated methods from other approaches.)
- common factors therapy (Incorrect. While Li-Jing, if she is effective, is making use of core features of most psychotherapies, this is not a specific type of therapeutic approach. She is maintaining her overall perspective, but using methods from various therapies.)
- technical eclecticism (Correct! Li-Jing is “choosing from many...and applying the parts” as she adapts her approach to treatment.)
A: technical eclecticism

Q: Oscar is being treated for depression. His therapist, Annalise, encourages him to notice his unpleasant thoughts and feelings without trying to avoid them, but to recognize that they are spur of the moment ideas that Oscar does not really believe. She then encourages him to meditate daily to reduce and lower stress. This is likely an example of
- client-centered therapy. (Incorrect. Although client-centered therapy is focused on self-acceptance and on unconditional positive regard, it does not involve medication or attentive recognition of one’s present state.)
- cognitive behavioral therapy. (Incorrect. Cognitive therapy focuses on identifying and replacing maladaptive thoughts.)
- behavioral therapy. (Incorrect. Behavioral therapy focuses on changing behavior through use of things like punishment and reinforcement.)
- mindfulness-based therapy. (Correct. Mindfulness focuses on being able to identify and accept thoughts and feelings without attaching judgement to them and to not get caught up in them.)
A: mindfulness-based therapy.

Q: Due to advances in technology, Sarah has been able to connect with her therapist much more often than before, using her smartphone. Which of the following is likely another benefit of this form of treatment?
- Online therapy provides immediate contact with her therapist. (Incorrect. Therapists are not on call so this is not accurate, but emergency situations may be handled this way.)
- Online therapy billing is per minute, allowing customized session duration. (Incorrect. This is not considered one of the elements that contribute to effectiveness of online therapy.)
- She is able to show her therapist her living conditions and stressors. (Incorrect. While this might be useful in specific situations, this is not one of the major reasons why online therapy might be effective.)
- She is able to participate in therapy despite living in a rural area. (Correct! Online therapy allows connection for those who may not have been able to participate before due to distance or socioeconomic constraints.)
A: She is able to participate in therapy despite living in a rural area.

Q: Although further research is needed on its effectiveness, Trevor is using an app on his phone to play a video game to help him train his mind to focus on positive images and thoughts in order to reduce stress and anxiety. What form of treatment is he using?
- virtual reality therapy (Incorrect. Virtual reality therapy usually involves more immersive exposure to virtual environments to practice specific responses (usually with virtual headsets and other technology).)
- attention retraining
- ~Incorrect. This approach does involve training the brain to focus attention on more positive stimuli, but this is not the correct name.
- positive commitment therapy (Incorrect. Although this treatment does require a type of commitment to enhance positive emotions, it is more about retraining how your brain focuses on environmental stimuli.)
- cognitive bias modification (Correct! CBM is the term for this type of experimental treatment.)
A: cognitive bias modification

Q: Which type of therapy is most economical in terms of cost?
- individual therapy (Incorrect. Individual therapy is not the most cost-effective form of therapy.)
- humanistic therapy (Incorrect. Though a therapist may use humanistic approaches in therapy, this is usually individual therapy and is not considered to be the most cost-effective.)
- psychoanalysis (Incorrect. There are a number of limitations to using psychoanalysis in a group setting; in addition, this form of therapy can take years to work through making it one of the more expensive forms of therapy.)
- group therapy (Correct. Group therapy is often most cost effective.)
A: group therapy

Q: Horacio has decided to participate in group therapy. What is one of the ways that this participation may benefit him and others in the group?
- Members can learn from personality clashes and conflict with group members. (Incorrect. Therapists and facilitators are present to help minimize conflict between group members.)
- Members can share what happens to others outside the group and bring back feedback to share. (Incorrect. Confidentiality is a key aspect of all forms of therapy including group therapy.)
- Shy members are able to passively listen to others and learn from them rather than actively engaging. (Incorrect. Though members are able to learn from each other, it is important that all group members are engaged.)
- Members can point out each other’s problematic behavioral patterns. (Correct. Sometimes hearing feedback from others can be more effective than hearing it from the therapist.)
A: Members can point out each other’s problematic behavioral patterns.

Q: ShaNae and Felipe are going to marriage counseling, because they have had a difficult time getting along and supporting each other in the year since their daughter was born. Which therapeutic approach is likely to be used for their treatment?
- humanistic therapy (Incorrect. Focusing on humanistic aspects will not help them resolve the current conflicts they are experiencing.)
- strategic family planning (Incorrect. Family planning is about decisions regarding having children. ShaNae and Felipe will not be engaging in strategic family planning to help with their conflict resolution.)
- behavioral therapy (Incorrect. In addition to behaviors toward each other, a therapist must also help them address current thoughts and emotions that are contributing to the conflict.)
- cognitive-behavioral therapy (Correct. CBT will help them to address the various problematic thoughts and feelings they have toward each other and address their expectations.)
A: cognitive-behavioral therapy

Q: If Jalen, who is an immigrant from Indonesia, undergoes counseling for a family problem, his therapist should be aware of Jalen’s cultural background, the important role of cultural identity, role his family and community play in his life, and the importance of addressing issues of stigma and his own potential cultural biases in the therapeutic relationship. This level of awareness is known as what?
- cultural compassion. (Incorrect. Though it is important to approach our clients with compassion, understanding their cultural background and social barriers is referred to as something else.)
- cognitive-cultural theory. (Incorrect. Multicultural counseling helps to integrate life experience and values of the client with therapeutic goals.)
- therapeutic relevance. (Incorrect. While this information is important and highly relevant to the course of therapy and intervention, this awareness is referred to as something else.)
- cultural competence. (Correct. Understanding a client’s culture and background and your own cultural identity helps you to be more competent in your approach and when making treatment decisions.)
A: cultural competence.

Q: Recent studies have shown that even when income and insurance issues are taken into account, ethnic minorities access and utilize mental health treatments at significantly lower rates. Which are the following are both likely reasons for this pattern?
- Inadequate access to insurance and conflicts with time away from work (Incorrect. The question notes that already accounting for insurance has been done in the studies; all persons seeking treatment may experience conflicts with work demands.)
- Lack of desire to improve their lives and acceptance of the status quo (Incorrect. People who are suffering desire to improve their lives, but there may be systemic obstacles in place that make it difficult to access care.)
- Increased sense of hopelessness and anger against health care providers (Incorrect. Some hopelessness may be present depending on available services, but neither of these aspects has been reported in the studies.)
- Lack of access to bilingual services and fear concerning additional stigma (Correct! Lack of access to language services is related to feeling unsafe and misunderstood, and existing stigma linked to fear of additional stigmatization beyond existing social patterns also can play a role.)
A: Lack of access to bilingual services and fear concerning additional stigma

Q: Shanza is studying to be a psychologist, and in their class they have been having extended discussions concerning the development of cultural competence. Which of the following is a critical aspect of developing this set of skills?
- adoption of a collectivist worldview in order to work effectively with clients (Incorrect. Cultural competence does not mean that one must give up one’s own identity or adopt the identity of another culture or group.)
- completing a semester-long immersion in an immigrant community (Incorrect. Although such activities may be useful as part of developing cultural competence, they are not required to do so and a person could perform this activity without developing competence.)
- signing an ethics agreement to avoid biased language with regard to gender and culture (Incorrect. Although cultural competence is increasingly becoming part of the ethical principles of many disciplines, you are not required to sign any agreement; cultural competence is also much more complex and integrated than signing a form.)
- acceptance of one’s own cultural identity, assumptions, beliefs, and behaviors (Correct. Known as “cultural humility” one must be able to understand one’s own cultural identity and assumptions while also learning to accept and work with those from other backgrounds.)
A: acceptance of one’s own cultural identity, assumptions, beliefs, and behaviors