MRCPsych Psychological Treatments and Psychotherapy 2 — Questions and Answers
Question 1: In psychodynamic psychotherapy, 'transference' refers to:
- The therapist's emotional reaction to the patient
- The patient displacing feelings from past relationships onto the therapist (Correct answer)
- The transfer of therapeutic gains to everyday life
- Projecting one's own feelings onto another person
Correct answer: The patient displacing feelings from past relationships onto the therapist
Transference is the unconscious redirection of feelings and expectations from significant past relationships (usually parental figures) onto the therapist.
Question 2: Mentalisation-Based Treatment (MBT) was developed primarily by:
- Marsha Linehan and colleagues
- Peter Fonagy and Anthony Bateman (Correct answer)
- Aaron Beck and colleagues
- Jeffrey Young
Correct answer: Peter Fonagy and Anthony Bateman
MBT was developed by Peter Fonagy and Anthony Bateman, grounded in attachment theory and the concept of mentalisation (understanding mental states in self and others).
Question 3: Schema Therapy, developed by Jeffrey Young, primarily targets:
- Maladaptive early schemas and coping modes rooted in unmet childhood needs (Correct answer)
- Cognitive distortions in the here-and-now
- Behavioural avoidance patterns in anxiety disorders
- Interpersonal deficits in social functioning
Correct answer: Maladaptive early schemas and coping modes rooted in unmet childhood needs
Schema Therapy addresses early maladaptive schemas (deep-rooted patterns from unmet childhood needs) and the coping modes used to manage them.
Question 4: Acceptance and Commitment Therapy (ACT) belongs to which 'wave' of cognitive-behavioural therapies?
- First wave
- Second wave
- Third wave (Correct answer)
- Fourth wave
Correct answer: Third wave
ACT is a third-wave CBT that emphasises psychological flexibility, values-based action, and acceptance of thoughts/feelings rather than direct cognitive restructuring.
Question 5: The therapeutic alliance has been shown in research to be:
- Irrelevant to therapy outcome if the technique is delivered correctly
- One of the strongest predictors of therapy outcome across all modalities (Correct answer)
- Only important in psychodynamic therapies
- Primarily determined by the patient's diagnosis
Correct answer: One of the strongest predictors of therapy outcome across all modalities
Meta-analyses consistently show that the therapeutic alliance (bond, goals, tasks) is one of the strongest predictors of therapy outcome, across different therapy modalities.
Question 6: Mindfulness-Based Cognitive Therapy (MBCT) is specifically recommended by NICE for:
- First-episode depression
- Prevention of relapse in recurrent depression (three or more episodes) (Correct answer)
- Acute psychosis
- Generalised anxiety disorder as first-line treatment
Correct answer: Prevention of relapse in recurrent depression (three or more episodes)
NICE recommends MBCT for prevention of depressive relapse, with strongest evidence for those with three or more previous depressive episodes.
Question 7: Cognitive Analytical Therapy (CAT) uses 'procedural sequences' and which key diagram to map reciprocal roles?
- The formulation triangle
- The sequential diagrammatic reformulation (SDR) (Correct answer)
- The vicious cycle diagram
- The cognitive conceptualisation diagram
Correct answer: The sequential diagrammatic reformulation (SDR)
CAT uses the Sequential Diagrammatic Reformulation (SDR) to map self-to-other reciprocal role patterns and the procedures (including traps, dilemmas, and snags) that maintain them.
MRCPsych Psychological Treatments and Psychotherapy 2
In psychodynamic psychotherapy, 'transference' refers to: