Introduction to Clinical Psychology 8th Edition by Geoffrey P. Kramer Douglas A. Bernstein Vicky Phares test bank

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Introduction to Clinical Psychology 8th Edition by Geoffrey P. Kramer Douglas A. Bernstein Vicky Phares test bank

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CHAPTER SEVEN
Psychodynamic and Humanistic Psychotherapies

LEARNING OBJECTIVES

1. How did psychoanalysis develop?
2. What is the structural model of personality in psychoanalytic theory?
3. What is meant by psychic determinism?
4. What roles do anxiety and defense mechanisms play in the production of psychological
problems?
5. What are transference and countertransference? How are they viewed by the various
psychodynamic approaches?
6. How do psychodynamic psychotherapies attempt to help clients stop repeating the past?
7. What role do the following play in psychoanalysis: resistance, interpretation, and insight?
8. What major changes or variations in psychoanalytic thought have occurred after Freud?
9. How does the practice of contemporary psychodynamic therapists differ from the
practice of psychoanalysts?
10. How do humanistic psychologists view personality and psychological problems?
11. What special role does the self have in humanistic psychotherapy?
12. What are unconditional positive regard, empathy, and congruence, and why are they
important in person-centered psychotherapy?
13. What role does the therapeutic relationship play in person-centered and other humanistic
psychotherapies?
14. How does Gestalt therapy differ from person-centered therapy?
15. What is the major focus of the existential humanistic psychotherapies?
16. Compared with other major approaches to psychotherapy, how prevalent are the
humanistic approaches among practicing clinical and counseling psychologists?

CHAPTER OUTLINE

PSYCHOANALYSIS
Theoretical Foundations
Goals of Psychoanalysis
Clinical Applications

PSYCHODYNAMIC PSYCHOTHERAPY
Psychoanalytically Oriented Psychotherapy
Early Alternatives to Classical Psychoanalysis
Ego Psychology
Object Relations and Self-Psychology
Relational Psychodynamic Psychotherapy
Short-Term Psychodynamic Psychotherapy
Common Features and Variations Is Psychodynamic Therapies
The Current Status of Psychodynamic Psychotherapy

HUMANISTIC PSYCHOTHERAPY
Person-Centered Therapy
The Goals of Person-Centered Therapy

OTHER HUMANISTIC APPROACHES
Gestalt Therapy
Existential and Other Humanistic Approaches
The Current Status of Humanistic Psychotherapy

IDENTIFICATION / KEY TERMS

psychoanalysis (p. 176)
hypnosis (p. 176)
cathartic method (p. 176)
free association (p. 177)
topographical model (p. 177)
id, ego, superego (p. 177)
structural model (p. 178)
defense mechanisms (p. 179)
transference (p. 179)
countertransference (p. 179)
psychic determinism (p. 181)
resistance (p. 181)
interpretation (p. 181)
insight (p. 182)
working through (p. 182)
dream work (p. 185)
transference neurosis (p. 185)
resistance (p. 185)
Alfred Adler (p. 189)
Carl Jung (p. 189)
ego analysts (p. 189)
ego strengths (p. 189)
object relations (p. 189)
self-psychology (p. 190)
Harry Stack Sullivan (p. 190)
intersubjectivism (p. 190)
constructivism (p. 190)
postmodernism (p. 190)
short-term dynamic psychotherapy (p. 191)
interpersonal psychotherapy (p. 250)
supportive/expressive continuum (p. 192)
corrective emotional experience (p. 192)
humanistic psychotherapy (p. 193)
person-centered psychotherapy (p. 193)
actualizing tendency (p. 193)
self-actualization (p. 193)
Carl Rogers (p. 193)
unconditional positive regard (p. 194)
real vs. ideal self (p. 195)
empathic understanding (p. 196)
external frame of reference (p. 196)
congruence (p. 197)
Gestalt therapy (p. 200)
Fritz and Laura Perls (p. 200)
role-playing (p. 201)
existential psychotherapy (p. 202)
Rollo May (p. 265)
Viktor Frankl (p. 265)
motivational interviewing (p. 202)
emotion-focused therapy (p. 203)

DISCUSSION QUESTIONS / CLASS ACTIVITIES

PSYCHOANALYSIS

1. Have the students look for stereotypical portrayals of psychoanalysis (bearded therapist taking notes, client laying on couch, word association tests, inkblots, etc.). They should be able to find them easily in the comics, as postcards, in magazines and, of course, online. Use this to discuss how psychoanalysis has shaped the public perceptions of what psychotherapy is.

2. Ask students to keep track of their dreams for a week. This should demonstrate three things: that there are common themes to most individuals dreams, that each individual will have dreams that repeat themselves, and that by being encouraged to remember their dreams, they should begin to recall more of their dreams.

PSYCHODYNAMIC PSYCHOTHERAPY

3. In groups, have the students stage two types of interviews. In one, the therapist should sit out of visual range during the interview (as in traditional psychoanalysis). In the other condition, the therapist should be sitting where he or she can maintain eye-contact (as in psychodyanamic and ego-analytic styles). What are the client perceptions in these two situations? Does one feel more engaging? How about for the therapist? Is one situation more comfortable than the other?

4. Consider the Victorian era during which Freud developed his libidinal-based theory. Is it surprising that Adler, Erikson, and even daughter, Anna, sought other driving forces? Do the students think that Freud would have been such a sensation in another era?

5. Have students discuss the basic concepts of brief psychodynamic therapy (BPT). How do therapists decide to use BPT instead of longer-term or more open-ended approaches? Which style do the students feel they would be more comfortable with in their work?

HUMANISTIC PSYCHOTHERAPY

6. This is a good time to use the classic Who are you? interview. The students pair up and one asks the other the question repeatedly for ten minutes. The students then switch roles. Rogers used this exercise to explore how complicated the self is, how it is reliant on social feedback, and how powerful it is to contemplate the vagaries of how we experience our self.

7. Have the students practice empathic responding with one another. This would be a good time to discuss some of the new findings on mirror neurons and how our brains seem to be wired for empathy. (See Additional Resources section.)

OTHER HUMANISTIC APPROACHES

8. Gestalt therapy fell into decline after research indicated that the direct expression of anger (such as hitting pillows, shoving bobo dolls, etc.) actually led to increased anger, rather than a dissipation of anger. However, many therapists still use Gestalt techniques in their practices. What information might a therapist seek when including such techniques in their treatment approach? Where would they find this information?

9. Invite a therapist who uses Gestalt techniques to demonstrate some of these to the class. Alternatively, have the students try the empty chair technique with one another, or the unmailed letter technique.

WEB EXERCISES

1. Explore the sections of the APA website that address psychoanalysis. Start at apa.org/about/division/div39 and follow the links to the subsections and research divisions. Does the amount of information on this site reflect clinical psychologys early relationship with psychoanalysis?

2. APA Division 32 is dedicated to humanistic psychology. Explore these pages starting at apa.org/about/division/div32. Compare this material to that presented on the website for the Association for Humanistic Psychology at ahpweb.org. How do these sites compare?

3. Visit guidetopsychology.com/brieftx.htm for information about brief psychodynamic therapy and case examples. What impact do you foresee brief therapeutic approaches having on the practice of clinical psychology?

4. Information about Viktor Frankl is available at psychnet-uk.com/psychotherapy/psychotherapy_existential_therapyl.htm. What impact do you think his early life experiences had on the development of his theoretical orientation?

5. Visit the website for the Association for the Advancement of Gestalt Therapy at aagt.org, and the Gestalt therapy section of behavior.net. Do you think Gestalt therapy will regain a prominent role in clinical work? Why or why not?

ADDITIONAL RESOURCES

A video segment about mirror neurons is available at pbs.org/wgbh/nova/sciencenow/3204/01.html. This 14-minute clip was aired on FrontlineNow in January 2008.

The APA videotape series Systems of psychotherapy includes videos and DVDs illustrating Adlerian therapy, brief dynamic therapy, client-centered therapy, existential therapy, Gestalt therapy, psychoanalytic therapy and short-term dynamic therapy. They are available from the APA website at apa.org/videos/4310335.html. Each video is approx. 100 minutes long.

Epstein, M. (1995). Thoughts without a thinker: Psychotherapy from a Buddhist perspective. New York: Basic Books. Presents a discussion of the working through phase in psychoanalysis as assisted by meditative processes.

Stern, D. (2004). The present moment in psychotherapy and everyday life. New York: W.W. Norton & Co.

Wallin, D. (2007). Attachment in Psychotherapy. New York: Guilford. A detailed discussion that integrates John Bowlbys and Mary Mains work with psychodynamic psychotherapy.

TEST BANK

MULTIPLE CHOICE

1. Which of the following is NOT an essential proposition of the psychoanalytic approach?

a. Mental life is best understood as a dynamic interaction of competing forces.
b. Mental life occurs mainly at an unconscious level.
c. There is a relationship between a clients developmental history and current problems.
d. Most learning is observational.

Answer: d Page: 178

2. Defense mechanisms

a. are conscious strategies that the ego employs to contain anxiety.
b. are always successful and adaptive.
c. can be at the root of behaviors that cause client distress.
d. are always problematic and must be eradicated as a goal of treatment.

Answer: c Page: 179

3. _________________ is the process of bringing maladaptive patterns of relating into the therapy, whereby typical patterns of relationships are re-enacted with the therapist.

a. Dynamic conflict
b. Catharsis
c. Transference
d. Countertransference

Answer: c Page: 179

4. Which of the following are listed in the correct order of occurrence in psychoanalysis?

a. transference, resistance, interpretation, working through
b. defensiveness, resistance, working through, transference
c. interpretation, defensiveness, psychic determinism, working through
d. none of the above, there is no predictable course of therapy in psychoanalysis

Answer: a Page: 182

5. Which of the following is NOT a goal of psychoanalysis?

a. repairing the mother-child rupture
b. intellectual and emotional insight into the causes of problems
c. strengthening the egos control over the id and superego
d. working through the implications of insights into causes of problems

Answer: a Page: 182

6. Which of the following are sources of unconscious material that psychoanalysts utilize?

a. free association material
b. slips of the tongue, body language
c. accidents, memory lapses, humor
d. all of the above would be material that would interest an analyst

Answer: d Page: 182

7. After a trip to New York City, a client shares a dream in which she fell off the Empire State Building. In analyzing this dream, the Empire State Building would be considered the ______________ and the falling off would be the __________________.

a. manifest content; latent content
b. latent content; manifest content
c. phallic symbol; dream work
d. structural dimension; transference fear

Answer: a Page: 185

8. What was a significant characteristic of Alfred Adlers approach to psychotherapy?

a. Adler focused on exploring and altering maladaptive lifestyles.
b. Adler used homework and modeling as ways to help clients become aware of their lifestyle.
c. Adler focused more on the social and relational aspects of psychopathology and less on intrapsychic conflicts.
d. all of the above

Answer: d Page: 189

9. The theorists who sought to use psychoanalytic techniques to understand and explore clients strengths and adaptive ego functions are collectively called

a. individual psychologists.
b. object-relations therapists.
c. ego analysts.
d. reverse psychoanalysts.

Answer: c Page: 189

10. In object relations therapy, object relations refer to

a. the importance placed on things the client owns.
b. how individuals relate to the social world and things around them.
c. relationships that develop from the earliest infant-caregiver interactions.
d. all of the above

Answer: c Page: 189

11. A similarity between Kohuts self-psychology practitioners and the object relations therapists is that they both

a. remain relatively passive in the therapeutic relationship.
b. attempt to provide remedial nurturing and attachment experiences.
c. view therapy as a short-term endeavor.
d. all of the above

Answer: b Page: 190

12. Relational psychodynamic psychotherapies

a. stress the importance of early relationships.
b. borrow heavily from psychoanalysis, ego-analysis, person-centered, and humanistic approaches.
c. are often referred to as two-person theories.
d. all of the above

Answer: d Page: 190

13. Which of the following approaches stress pragmatic goals, establishing a therapeutic alliance as quickly as possible, and focusing on a current crisis or problem?

a. relational psychodynamic psychotherapy
b. object relations psychotherapy
c. ego psychoanalytic therapy
d. short-term psychodynamic psychotherapy

Answer: d Page: 191

14. Which of the following is true about psychodynamic psychotherapy?

a. It is practiced by only 2% of clinicians.
b. Its foundations have been largely challenged and discredited.
c. It has failed to evolve to keep up with the demands of modern clinical practice.
d. It is the second most popular approach to therapy among faculty at accredited graduate programs.

Answer: d Page: 192

15. Humanistic approaches to psychotherapy emphasize _________________, while psychodynamic therapies emphasize__________________.

a. immediate experience; unconscious conflict
b. mans inherent goodness; mans tendency towards evil
c. childhood experiences; adult trauma
d. all of the above

Answer: a Page: 193

16. Which of the following statements would NOT be supported by a humanistic therapist?

a. Humans are naturally good and able to make choices about their lives.
b. Humans are creative and will guide their own behavior towards their full potential.
c. The therapeutic relationship is not very important because growth towards potential is inevitable.
d. Clients are equal partners in the therapeutic endeavor.

Answer: c Page: 193

17. Which of the following would be a likely goal a person-centered therapist would set for his or her client?

a. improving interpersonal communication
b. increased satisfaction with work and play
c. the ability to love unconditionally
d. none of the above, person-centered therapists dont set goals for their clients

Answer: d Page: 195

18. When an empathic therapist tries to understand what it would be like to be his client, Rogers would say he is using a(n)

a. internal frame of reference.
b. external frame of reference.
c. empathic congruence.
d. reflective stance.

Answer: a Page: 195

19. The person-centered therapists primary responsibility is to

a. encourage the client to explore positive directions for growth.
b. provide an atmosphere in which the client is comfortable exploring thoughts and feelings.
c. truly like the client.
d. plan homework assignments that will encourage growth activities between sessions.

Answer: b Page: 196

20. Congruence in person-centered therapy means

a. that the therapist must say whatever is on her mind.
b. that the therapist must maintain a professional facade, so as not in influence the clients understanding of his own feelings.
c. the therapist is genuine; his or her feelings and actions are consistent with one another.
d. going with the gut in reacting to the material the client brings up.

Answer: c Page: 197

21. A primary goal of Gestalt therapy is to

a. help clients become aware of genuine feelings they have disowned.
b. recognize the feelings and values that they have borrowed from other people.
c. both a and b
d. neither a nor b

Answer: c Page: 201

22. A Gestalt therapist is likely to be _________________ and _________________that a person-centered therapist.

a. more directive; less confrontative
b. less confrontative; less directive
c. more directive; more confrontative
d. more empathic; less concerned about avoidance

Answer: c Page: 201

23. The therapeutic approach developed in Europe following the World Wars than helps clients explore fully what it means to be alive is called

a. existential psychotherapy.
b. Gestalt therapy.
c. humanistic determinism.
d. postmodern humanism.

Answer: a Page: 202

24. The therapeutic approach that is often used with resistant clients, such as substance abusers, is called

a. Gestalt therapy.
b. existential psychotherapy.
c. postmodern humanism.
d. motivational interviewing.

Answer: d Page: 202

25. Relative to psychodynamic approaches, humanistic approaches

a. were among the earliest at attempting empirical research on the therapeutic endeavor.
b. are more likely to be utilized in counseling psychology programs than clinical psychology programs.
c. are less appealing to practitioners who seek a more active role in therapy.
d. all of the above

Answer: d Page: 203

TRUE/FALSE

26. By developing psychoanalysis, Freud can be considered the founder of psychotherapy as we know it today.

Answer: True Page: 176

27. The psychoanalytic continuum from unconscious to preconscious, to conscious thought is called the structural model of the mind.

Answer: False Page: 177

28. Transference is useful in therapy because of the fact that to the extent that a new relationship is similar to an old one, reactions based on the old relationship are likely to occur.

Answer: True Page: 179

29. A transference neurosis occurs when the client unconsciously replicates other relationships with the therapist.

Answer: True Page: 179

30. Short-term psychodynamic therapy emphasizes pragmatic goals and attempts to meet them in less than 10 sessions.

Answer: False Page: 191

31. In order to express unconditional positive regard, the therapist must approve of all the things the client says.

Answer: False Page: 194

32. Gestalt therapists tend to be much more dogmatic and active than person-centered or psychoanalytic therapists.

Answer: True Page: 200

33. Existential therapists encourage clients to develop a sense of meaning and purpose in their lives.

Answer: True Page: 202

34. Emotion-focused therapy helps clients avoid feelings of vulnerability.

Answer: False Page: 203

35. Carl Rogers was the first to recognize the need for scientific research to substantiate the effectiveness of psychotherapeutic interventions.

Answer: True Page: 203

ESSAY

36. Discuss the ways in which psychoanalytic theory continues to influence most approaches to psychotherapy today. (Page: 177)

37. What are some reasons why therapists might gravitate away from strict psychoanalytic approaches toward object relations or ego-analytic approaches? (Pages: 189-192)

38. Discuss the interaction between the level of disturbance a client is exhibiting and the therapists decision to use supportive or expressive approaches. (Page: 192)

39. Discuss the dual role of reflection in person-centered therapy. (Page: 196)

40. What could be considered the main contribution of humanistic therapies to the larger field of psychotherapy? (Page: 204)

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