Quiz #10: Issues in Theory, Practice, and Research

1. Contemporary theories of counseling:

a. are grounded on assumptions that are a part of Eastern culture.
b. emphasize the uniqueness of the individual, self-assertion, and ego strength.
c. Focus on interdependence, and losing self in the totality of the cosmos.
d. Emphasizes the social and cultural facts of human existence.

2. _______________ is based on a negotiation between the client and therapist to define the therapeutic relationship including specifying the goals of therapy and methods likely to be used to obtain these goals.

a. An agreement
b. A contract
c. A covenant
d. A legally enforceable arrangement.

3. When a counselor works in a managed care system, client’s goals need to be:

a. long term and all encompassing.
b. Educational and therapeutic.
c. Geared towards the client gaining insight into his or her problems and movement towards self-actualization.
d. Highly specific, limited to reduction of problematic symptoms, and often aimed at teaching coping skills.

4. _______________ is a general term covering the process of identifying an emotional or behavioral problem and making a statement about the current status of a client.

a. Medical diagnosis
b. Differential diagnosis
c. Psychodiagnosis
d. Individual diagnosis

5. Practitioners who argue against diagnosis:

a. claim that DSM labels and stigmatizes people.
b. are likely to be psychoanalytically oriented therapists.
c. usually have a behavioristic orientation.
d. are likely to work for a managed care system.

6. Therapists who fall into the category of clinicians who see diagnosis as being restrictive or who oppose diagnosis are likely to be:

a. directive therapists.
b. existential or relationship-oriented therapists.
c. psychoanalytic therapists.
d. Those who practice from a multicultural framework.

7. The following is NOT true concerning therapeutic use of the DSM-IV to diagnose clients:

a. Emphasis is on pathology, deficits, limitations, problems , and symptoms.
b. It deals largely with culture-bound syndromes.
c. It is based on the assumption that distress in a family or social context is the result of individual pathology.
d. It is based on a systemic approach that views the source of distress as being within the entire system, rather than on the individual.

8. Mary is seeking counseling for relationship problems from her managed care facility. Her issues revolve around caretaking and the counselor is sure Mary can be helped through some assertiveness training. Since Mary does not fit into a DSM-IV category, the ethical therapist would most likely:

a. Submit a claim using DSM-IV category that is acceptable to the insurance company but is not what Mary is suffering from.
b. Inform Mary that insurance will likely not cover her services and she may be responsible for charges
c. Refuse to treat Mary and send her to another provider on the network
d. Submit a comprehensive report to the insurance company detailing the impact of the problem on Mary.

9. It would be appropriate to use the diagnostic category of “Dependent Personality Disorder” of:

a. Asian clients who tend to let their parents make important decisions for them.
b. a Native American client who quit his job to go back to the reservation because his parent was dying.
c. a Mexican-American client who is highly involved with her family even though she is married.
d. Caucasian college students who need to check with their parents before making any decisions, no matter how minor.

10. According to professional ethical principles on testing, it would be unethical for a counselor to:

a. perform testing and assessment services for which they have not been adequately trained.
b. develop, administer, score, interpret, or use assessment procedures that are appropriate for the situation.
c. test within the client’s socialized behavioral or cognitive patterns.
d. consider the validity of a given test and interpret data in the context of the cultural characteristics of the client.

11. John is seeking counseling through his managed care provider and he needs to be informed that:

a. the managed care company may request the entire clinical record of a client.
b. he has the right to expect unlimited sessions.
c. his insurance provider will not have access to his records.
d. no referrals will be made upon termination of therapy.

12. The managed care model:

a. allows practitioners to decide what clients need, how and when to treat them, and how long therapy will last.
b. stresses time-limited interventions, cost-effective methods, and a focus on preventive strategies.
c. has grown out of demands by practitioners for quality control and stabilizing escalating costs of mental-health care.
d. encourages curative interventions, accurate diagnosis and hospital admissions when needed.
e. Assumes that practitioners will set therapeutic goals of personal growth and self-actualization for their clients.

13. Most who write about managed care seem to agree that the system is here to stay and that therapists will need to:

a. open their own private practice to accommodate those who resist using their managed care resources.
b. become trained or retrained in a body of knowledge and skills applicable to time-efficient and cost-effective therapies.
c. Concentrate on using psychoanalytic therapy with clients who need long-term care.
d. Avoid any family-of-origin issues when working with clients on a short-term basis.

14. What critical ethical issue(s) is(are) associated with managed care?

a. informed consent
b. confidentiality
c. abandonment
d. all of the above

15. Therapists cannot use the limitations of the managed care plan as a shield for failing to:

a. render crisis intervention.
b. make appropriate referrals.
c. request additional services from the managed care plan.
d. all of the above