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Mastering Competencies in Family Therapy
Chapter 8: Cognitive-Behavioral and Mindfulness-Based Couple and Family Therapies
1. Of the behavioral and cognitive-behavioral couple and family therapies, which one is a
scientifically-based approach to couple therapy based on 30 years of research on the key
differences between happy and unhappy marriages?
a. Cognitive-behavioral family therapy
b. Integrative behavioral couples therapy
c. Gottman method couple therapy
d. Functional family therapy
2. In general in the mental health field, which therapies are some of the most commonly
used therapeutic approaches?
a. Systemic therapies
b. Cognitive-behavioral therapies
c. Experiential therapies
d. Psychoanalytic family therapies
3. Cognitive-behavioral family therapies have had the greatest influence in which area?
a. Parenting
b. Couples dynamics
c. Individual pathology
d. Attachment
4. Reinforcement refers to which of the following?
a. Implementing boundaries
b. Rewarding a client to make the therapeutic process more enjoyable and easy for
the therapist
c. Using punishment to force clients to adapt to the way the therapist thinks they
should be living their lives
d. How positive or negative responses from the environment shape future behaviors
5. Reinforcement is typically only effective if parents are __________.
a. cordial
b. authoritarian
c. consistent
d. emotionally involved
6. Rather than use a general goal such as “improve communication,” cognitive-behavioral
family therapists identify which behaviors and thoughts for interventions?
a. All
b. Specific
c. Problematic
d. Easy
7. What is the role of the therapist in CBFT?
a. Friend
b. Equal
c. Expert
d. Advisor
8. Why do cognitive-behavioral family therapists use empathy to build the therapeutic
alliance?
a. To create rapport, allowing therapists to get to the “real” interventions of therapy
b. Because empathy is a curative process in and of itself
c. To “integrate” experiential concepts to make better therapy
d. To manipulate clients into feeling more comfortable with the therapy process
9. What is the primary reason CBFT therapists use contracts?
a. To make sure the client comes to therapy consistently and pays on time
b. To trick the client into thinking that something is required so they will work
harder and take therapy seriously
c. To force the client to work on the behaviors they want to target
d. To give the client a sense of commitment to the process as well as motivate them
10. The CBFT therapist’s problem analysis focuses on present day __________,
__________, and __________ that make the situation a problem.
a. behaviors; emotions; thoughts
b. actions; reactivity; rationale
c. behaviors; actions; thoughts
d. actions; emotions; rationale
11. Which type of assessment do CBFT therapists conduct at the beginning of therapy as a
starting point for measuring change?
a. Target
b. Antecedent
c. Baseline
d. In-depth
12. Tess is working with a couple who has reported marital problems. She is working from a
CBFT perspective and thinks that it would be helpful to have a detailed and accurate
account of the problems the couple wants to work on. Tess asks the couple to log the
frequency, duration, and severity of specific behavioral symptoms, such as their anger,
outbursts, conflict, and social withdrawal. This is known as what type of assessment?
a. Necessary intake procedures
b. Baseline functioning
c. Creating a contingent environment
d. Arbitrary inference
13. In CBFT, a __________ allows the therapist to look for mutually reinforcing behaviors
between family members and examines how these patterns are maintaining the symptom.
a. baseline assessment
b. interactional sequencing
c. functional analysis
d. family life chronology
14. Albert Ellis’ A-B-C theory has been applied to working with families. In this model, what
does the A-B-C stand for?
a. Action, behavior, and cognition
b. Activating event, behavioral reaction, and cognitive response
c. Action, belief, and cause
d. Activating event, belief, and consequence
15. The concept of personalization is a cognitive distortion defined by which of the
following?
a. External events are attributed to oneself; it is especially common in intimate
relationships.
b. It is a belief based on little evidence.
c. It is a belief based on one or two incidents used to make a broad, sweeping
judgment about another’s essential character.
d. It is the assigning of a personality trait to someone based on a handful of
incidents, often ignoring exceptions.
16. The concept of dichotomous thinking is a cognitive distortion defined by which of the
following?
a. Going to extreme of either overemphasizing or underemphasizing based on the
facts
b. Generalizing one or two incidents to make a broad, sweeping judgment about
another’s essential character
c. Focusing on one detail while ignoring the context and other obvious details
d. An all-or-nothing mentality: always/never, success/failure, or good/bad
17. All of the following would be considered examples of late-phase treatment goals in
cognitive-behavioral family therapy EXCEPT?
a. Develop positive mutual reinforcement cycle to reduce negativity and labeling
b. Replace perfectionist beliefs about child school performance with more realistic
expectations
c. Redefine family schemas to increase tolerance of difference between members
d. Redefine couple schemas to reduce pressure for perfection and increase tolerance
of weaknesses in the other
18. Pavlov was able to train dogs to salivate at the sound of a bell by pairing the dog’s natural
response to salivate at the sight of food with a bell. When the bell was rung each time
food was presented, the dog learned that the bell signaled food was coming and began
salivating. After enough repetition, the dog began to salivate with just the sound of the
bell. What is this called?
a. Classical conditioning
b. Operant conditioning
c. Reinforcement training
d. Punishment training
19. In operant conditioning, desired behaviors can be positively or negatively reinforced or
punished, depending on desired behaviors. What techniques are designed to do this?
a. Positive reinforcement or reward
b. Negative reinforcement
c. Positive punishment and negative punishment
d. All the above
20. There are four options for shaping behavior in operant conditioning. Which of the
following is the best definition for positive reinforcement or reward?
a. Rewards desired behaviors by adding something desirable (e.g., a treat)
b. Rewards desired behaviors by removing something undesirable (e.g., relaxing
curfew)
c. Reduces undesirable behavior by adding something undesirable (e.g., assigning
extra chores)
d. Reduces undesirable behavior by removing something desirable (e.g., grounding)
21. In operant conditioning, positive punishment is defined as which of the following?
a. Rewards desired behaviors by adding something desirable (e.g., a treat)
b. Rewards desired behaviors by removing something undesirable (e.g., relaxing
curfew)
c. Reduces undesirable behavior by adding something undesirable (e.g., assigning
extra chores)
d. Reduces undesirable behavior by removing something desirable (e.g., grounding)
22. Positive reinforcement is strongly encouraged to increase desired behavior with children.
Which of the following is NOT a good example of positive reinforcement?
a. A toy or treat
b. A chore
c. A compliment
d. Expressions of appreciation
23. If a teen’s grade point average is above 3.0, the parents agree to an 11:00 p.m. curfew on
Friday and Saturday. This is an example of which of the following?
a. Behavior exchange
b. Quid pro quo
c. Contingency contract
d. Token economy
24. When working with couples, mutual behavior exchanges can be useful to help partners
negotiate relational rules. This is also known as which of the following?
a. Behavior exchange
b. Quid pro quo
c. Contingency contract
d. Token economy
25. Which intervention — considered a hallmark of CBFT — involves teaching clients
psychological and relational principles about their problems and how best to handle
them?
a. Psychoeducation
b. Psychoanalysis
c. Psychopharmacology
d. Psychology
26. When a therapist must decide whether or not to challenge a client’s irrational beliefs, the
therapist should consider each of the following EXCEPT?
a. The therapeutic relationship
b. The therapist’s style
c. The client’s culture and/or gender
d. The frequency of sessions
27. A CBFT therapist can challenge a client’s irrational beliefs in many ways. Which of the
following would NOT be considered appropriate for confrontation?
a. For the therapist to explicitly tell the client their belief is irrational
b. For the therapist to ask the client a series of questions to help them see their belief
is irrational
c. For the therapist to replace the irrational beliefs with realistic ones
d. All of the above
28. A therapist might work with a client to help them understand their beliefs are illogical or
dysfunctional using which of the following methods?
a. Guided discovery
b. Inductive reasoning
c. Neither A nor B
d. Both A and B
29. To help clients confront their own irrational beliefs, a CBFT therapist might ask a client
to keep a thought record. What kind of information is NOT generally kept in a thought
record?
a. The trigger situation
b. The emotional response
c. The cognitive distortion
d. The homework task
30. CBFT homework tasks are described as which of the following?
a. Linear and literal
b. Metaphorically making the covert overt
c. Interrupting the problem interaction
d. Enacting the solution
31. One of the key factors in CBFT case conceptualization is which of the following?
a. To describe the relationship between the family and the symptom
b. To define the problem in concrete, measurable terms
c. To describe each person’s role in the interaction sequence
d. To define the parts patterns between people
32. In this paradoxical approach to cognitive-behavioral approaches, the client is guided to
accept difficult thoughts and emotions in order to transform them. What is the name of
this therapy?
a. Pure behavioral therapy
b. Cognitive-behavioral family therapy
c. Mindfulness-based therapy
d. Dialectical-behavioral therapy
33. In order for a therapist to lead a client in mindfulness practices, a therapist must do which
of the following?
a. Be fully congruent with him or herself
b. Be free of any mental difficulties
c. Be fully differentiated from their family of origin
d. Be engaged in their own mindfulness practices
34. Mindfulness has been integrated into two therapy approaches that have shown great
promise in treating a wide range of clinical conditions. What are they?
a. Humanistic therapy and acceptance and commitment therapy
b. Dialectical behavioral therapy and acceptance and commitment therapy
c. Humanistic therapy and existential therapy
d. Dialectical behavioral therapy and existential therapy
35. In mindfulness-based stress reduction and mindfulness-based cognitive therapy, clients
learn to do all of the following EXCEPT?
a. Deliberately distract their attention and thereby better control their thoughts.
b. Become curious, open, and accepting of their thoughts and feelings (even those
that are unpleasant).
c. Develop greater acceptance of self, other, and things as they are.
d. Live in and experience themselves in the present moment.
36. The process of dialectical behavioral therapy involves helping clients learn to increase
balance in their lives by better managing the inherent dialect tensions in life including all
of the following EXCEPT?
a. Being able to seek to improve oneself as well as accept oneself
b. Being able to accept life as it is and also seek to solve problems
c. Taking care of one’s own needs and putting them before the needs of others
d. Balancing independence and interdependence
37. What therapy is based on the postmodern premise that we construct our realities through
language — which shapes our thoughts, feelings, and behaviors?
a. Dialectical behavioral therapy
b. Cognitive-behavioral family therapy
c. Acceptance and commitment therapy
d. Mindfulness-based therapy
38. In which approach is it psychologically healthy to feel bad feelings as well as good
feelings?
a. Acceptance and commitment therapy
b. Cognitive-behavioral family therapy
c. Mindfulness-based therapy
d. Dialectical-behavioral therapy
39. Which of the following statements about the Gottman method couples therapy approach
is NOT true?
a. The therapist coaches couples to develop the interaction patterns that distinguish
successful marriages from marriages that end in breakup.
b. This model is grounded entirely in research results rather than theory.
c. Improving communication helps couples stay together.
d. Better communication produces short-term gains but does not significantly affect
whether or not couples stay together.
40. In the Gottman method of couples therapy, what role does the therapist have with his or
her clients?
a. Coach
b. Observer
c. Peer
d. Partner
41. In Gottman’s studies, the presence of four behaviors during a couple’s argument
predicted divorce with 85% accuracy. Criticism, one of the four horsemen, is best
described as which of the following?
a. Seeing oneself as superior to one’s partner
b. A statement that implies something is globally wrong with the partner
c. When the listener withdraws from interaction, either physically or mentally
d. Used to ward off attack and defensiveness claims
42. Which of the following statements about the Four Horsemen of the Apocalypse in
Gottman’s studies is TRUE?
a. Men tend to criticize more than women.
b. Happy marriages have many instances of contempt.
c. Women are more likely to stonewall than men.
d. Most couples criticize, defend, and stonewall to a certain extent.
43. According to Gottman’s research, which of the following statements is NOT true?
a. When failed repair attempts are combined with the Four Horsemen, Gottman can
predict whether a couple will divorce in the next five years with 97.5% accuracy.
b. Marriages in which men are willing to accept influence from their wives are 80%
more likely to end in divorce.
c. For 96% of couples, only the first minute of data is necessary to predict divorce or
stability; harsh startup is one of several key variables in predicting divorce in that
first minute.
d. Stable couples have five times as many positive interactions as negative
interactions during conflict; distressed couples may have a 1:1 ratio.
44. In the Gottman method of couples therapy, what are love maps??
a. A series of questions to help the couple understand what helps their partner feel
loved
b. An outline of things that are hurtful to each partner in the couple
c. A series of questions to help the couple become more aware of the issues that are
important to their partner
d. An outline of the ways each partner expresses love in the relationship
45. Gottman teaches couples a series of rules to help soften startup. Which of the following is
NOT a soft startup rule?
a. Complain but don’t blame.
b. Avoid sharing negative feelings.
c. Ask for what you need.
d. Be polite and appreciative.
46. By design, cognitive-behavioral therapies aim to help clients conform to dominant
cultural values, because that is equated with “functional” within a given society.
Therefore, therapists need to carefully consider which of the following when using
CBFT?
a. Ensuring treatment goals do not clash with cultural values of the client
b. Whether or not the expert stance of the therapist is in conflict with a client’s
cultural values or beliefs
c. Both A and B
d. Neither A nor B
47. When using CBFT with a diverse population, which of the following is important to keep
in mind?
a. CBFT is a good fit with any cultural group because it focuses on thoughts and
behaviors rather than emotion.
b. CBFT goals inherently conform to dominant cultural values; therefore, it is
necessary to be culturally sensitive.
c. CBFT treatment goals outweigh religious, cultural, or socio-economic values.
d. CBFT therapists should not take an expert stance if the family is of a different
cultural background.
48. Which of the following statements about CBFT research and the evidence base is most
accurate?
a. CBFT therapies are some of the best-researched approaches in family therapy.
b. CBFT is the panacea of mental health termagant.
c. CBFT is superior to other approaches in family therapy.
d. None of the above.