ASPPB Intervention Strategies & Treatment Planning 5 — Questions and Answers
Question 1: A psychologist using Schema Therapy would MOST directly target which aspect of a client's presentation?
- Current automatic negative thoughts causing daily distress
- Deeply held maladaptive beliefs about self and others that developed in childhood (Correct answer)
- Behavioral avoidance patterns reinforced in adolescence
- Neurochemical imbalances underlying mood dysregulation
Correct answer: Deeply held maladaptive beliefs about self and others that developed in childhood
Schema Therapy targets early maladaptive schemas — deeply ingrained core beliefs about self and relationships that originated in unmet childhood needs.
Question 2: A client reports drinking heavily every weekend to cope with social anxiety. When planning treatment, the psychologist should address:
- Only the alcohol use, since it is the most dangerous presenting problem
- Only the social anxiety, since it is the root cause
- Both conditions concurrently using an integrated treatment approach (Correct answer)
- Refer the client to addiction services and defer anxiety treatment indefinitely
Correct answer: Both conditions concurrently using an integrated treatment approach
Comorbid anxiety and substance use disorders are most effectively addressed with integrated treatment that targets both simultaneously to avoid relapse driven by the untreated condition.
Question 3: In cognitive processing therapy (CPT) for PTSD, 'stuck points' refer to:
- Moments in session when the client dissociates and cannot continue
- Maladaptive cognitions about the trauma that impede natural emotional processing and recovery (Correct answer)
- Trauma memories that the client refuses to disclose
- Avoidance behaviors that block full symptom assessment
Correct answer: Maladaptive cognitions about the trauma that impede natural emotional processing and recovery
Stuck points are problematic thoughts — often about safety, trust, power, esteem, and intimacy — that conflict with prior beliefs and prevent emotional recovery.
Question 4: Which treatment approach has the STRONGEST evidence base for anorexia nervosa in adolescents?
- Cognitive behavioral therapy focused on weight and shape concerns
- Family-Based Treatment (Maudsley approach) (Correct answer)
- Dialectical behavior therapy adapted for eating disorders
- Interpersonal therapy targeting social role disputes
Correct answer: Family-Based Treatment (Maudsley approach)
Family-Based Treatment (FBT/Maudsley) has the most robust empirical support for adolescent anorexia nervosa, externalizing the illness and empowering parents in re-nourishment.
Question 5: A psychologist decides to implement 'homework' between sessions. Evidence indicates this practice:
- Is generally resisted by clients and reduces therapeutic alliance
- Significantly enhances treatment outcomes across multiple therapies when completed (Correct answer)
- Is only effective in behavioral therapies, not cognitive or insight-oriented ones
- Should be avoided with clients who have low motivation
Correct answer: Significantly enhances treatment outcomes across multiple therapies when completed
Meta-analytic research consistently shows that homework compliance is associated with better outcomes across CBT and other therapeutic modalities.
Question 6: A client with generalized anxiety disorder (GAD) presents with chronic worry and muscular tension. Which intervention specifically targets the intolerance of uncertainty that maintains GAD?
- Applied relaxation training to reduce physiological arousal
- Worry postponement experiments and uncertainty-exposure exercises (Correct answer)
- Mindfulness-based stress reduction only
- Systematic desensitization to anxiety-provoking stimuli
Correct answer: Worry postponement experiments and uncertainty-exposure exercises
Dugas's cognitive model of GAD emphasizes that intolerance of uncertainty drives worry, so treatment directly targets this through behavioral experiments that increase tolerance of uncertain outcomes.
Question 7: When a psychologist terminates treatment, ethical practice requires which of the following regarding the treatment plan?
- Destroying all treatment records to protect client confidentiality
- Documenting goal progress, reason for termination, and a plan for relapse prevention or follow-up care (Correct answer)
- Obtaining written consent from the client that all goals were fully met
- Providing a minimum of 90 days' notice before ending services
Correct answer: Documenting goal progress, reason for termination, and a plan for relapse prevention or follow-up care
Ethical termination includes documentation of treatment progress, the rationale for ending services, and provisions for continued care or relapse prevention to avoid client abandonment.
ASPPB Intervention Strategies & Treatment Planning 5
A psychologist using Schema Therapy would MOST directly target which aspect of a client's presentation?