CADC Counseling Theories and Models 3 — Questions and Answers
Question 1: In Dialectical Behavior Therapy (DBT), the concept of 'dialectics' primarily refers to:
- The balance between confrontation and empathy
- The synthesis of opposing truths, especially acceptance and change (Correct answer)
- A debate technique used in group therapy
- The use of logic to challenge irrational beliefs
Correct answer: The synthesis of opposing truths, especially acceptance and change
DBT's core dialectic is the simultaneous acceptance of the client as they are while also supporting their need to change, resolving the apparent contradiction.
Question 2: A client in early recovery reports that drinking helped them feel 'normal' and reduced anxiety. From a Psychodynamic perspective, this is best understood as:
- Positive reinforcement of substance use
- Ego-syntonic self-medication of unconscious conflict (Correct answer)
- Operant conditioning of avoidance behavior
- A rational coping strategy
Correct answer: Ego-syntonic self-medication of unconscious conflict
The self-medication hypothesis from a psychodynamic lens suggests substance use serves to manage unconscious emotional pain or unresolved internal conflict.
Question 3: Acceptance and Commitment Therapy (ACT) uses the term 'psychological flexibility' to describe:
- The ability to tolerate ambiguity without relapse
- Contacting the present moment and changing or persisting in behavior guided by values (Correct answer)
- Adapting one's personality to meet situational demands
- Shifting between coping strategies as needed
Correct answer: Contacting the present moment and changing or persisting in behavior guided by values
Psychological flexibility in ACT means being fully present, accepting thoughts and feelings without unnecessary defense, and taking value-consistent action.
Question 4: A counselor who uses a solution-focused approach would MOST likely ask a client:
- Tell me about when the drinking started and why.
- What would be different in your life if the problem were solved tomorrow? (Correct answer)
- How does your substance use connect to your childhood experiences?
- What irrational beliefs are driving your behavior?
Correct answer: What would be different in your life if the problem were solved tomorrow?
The Miracle Question is a hallmark solution-focused technique that helps clients envision a desired future, bypassing problem-focused discourse.
Question 5: Which of the following best describes the role of 'reinforcement' in Behavioral theories of addiction?
- Negative early experiences create unconscious compulsions toward substances
- Substance use is maintained by the rewarding effects and relief from discomfort it provides (Correct answer)
- Peer relationships shape identity in ways that promote drug use
- Cultural norms determine which substances are socially acceptable
Correct answer: Substance use is maintained by the rewarding effects and relief from discomfort it provides
Behavioral theory holds that both positive reinforcement (euphoria) and negative reinforcement (relief from withdrawal or anxiety) maintain addictive behavior.
Question 6: In Family Systems Theory, a family member who enables a loved one's substance use while simultaneously complaining about it is demonstrating which dynamic?
- Triangulation
- Enmeshment
- Homeostasis (Correct answer)
- Differentiation
Correct answer: Homeostasis
Homeostasis in family systems refers to the tendency for families to maintain familiar patterns of interaction even when those patterns are dysfunctional.
Question 7: Person-Centered Therapy's concept of 'unconditional positive regard' means the counselor:
- Agrees with everything the client says to build rapport
- Accepts the client fully without judgment, regardless of their behavior or choices (Correct answer)
- Avoids giving direct feedback to preserve the therapeutic relationship
- Prioritizes the client's immediate comfort over long-term goals
Correct answer: Accepts the client fully without judgment, regardless of their behavior or choices
Unconditional positive regard, one of Rogers' core conditions, involves the counselor valuing the client as a person without conditions or evaluative judgment.
CADC Counseling Theories and Models 3
In Dialectical Behavior Therapy (DBT), the concept of 'dialectics' primarily refers to: