NBCC Counseling Theories & Helping Relationships 4 ā Questions and Answers
Question 1: Dialectical Behavior Therapy (DBT), developed by Marsha Linehan, was originally designed to treat which population?
- Individuals with schizophrenia spectrum disorders
- Adolescents with conduct disorder
- Individuals with borderline personality disorder and chronic suicidality (Correct answer)
- Adults with obsessive-compulsive disorder unresponsive to CBT
Correct answer: Individuals with borderline personality disorder and chronic suicidality
Linehan developed DBT specifically for chronically suicidal individuals diagnosed with borderline personality disorder, integrating CBT with acceptance strategies and dialectical philosophy.
Question 2: In narrative therapy, 'externalizing the problem' involves:
- Projecting blame onto external circumstances to reduce client shame
- Linguistically separating the problem from the person's identity (Correct answer)
- Exploring how family members externalize their anxiety onto the client
- Identifying external reinforcers that maintain the problem behavior
Correct answer: Linguistically separating the problem from the person's identity
Externalizing separates the person from the problem through language (e.g., 'depression visits you' rather than 'you are depressed'), allowing clients to relate to and resist the problem rather than identify with it.
Question 3: According to Carl Rogers, which of the three core conditions is most foundational, as without it the other two conditions cannot be genuine?
- Empathic understanding
- Congruence (genuineness) (Correct answer)
- Unconditional positive regard
- Accurate emotional reflection
Correct answer: Congruence (genuineness)
Rogers considered congruence (genuineness/authenticity) the most fundamental condition because a counselor who is not genuine cannot truly offer real empathy or unconditional positive regard.
Question 4: A counselor uses a genogram in session. Which theoretical orientation most commonly employs this tool?
- Cognitive-behavioral therapy
- Bowen's multigenerational family therapy (Correct answer)
- Solution-focused brief therapy
- Behavioral family therapy
Correct answer: Bowen's multigenerational family therapy
Genogramsāmultigenerational family maps tracking relationship patterns, triangles, and emotional cutoffs across generationsāare a primary assessment and intervention tool in Bowenian therapy.
Question 5: Reality therapy's focus on current behavior rather than past events aligns most directly with which foundational concept developed by William Glasser?
- The importance of catharsis in releasing suppressed emotions
- Choice theory: all behavior is chosen to satisfy basic needs (Correct answer)
- The reinforcement history that shaped current behavioral patterns
- Unconscious motivation derived from unresolved developmental conflicts
Correct answer: Choice theory: all behavior is chosen to satisfy basic needs
Glasser's choice theory holds that all behavior (acting, thinking, feeling, physiology) is chosen in an attempt to satisfy five basic needs: survival, love/belonging, power, freedom, and fun.
Question 6: In Acceptance and Commitment Therapy (ACT), 'psychological flexibility' is achieved primarily through:
- Challenging and disputing irrational beliefs until they are replaced with rational ones
- Accepting private experiences while committing to values-based action (Correct answer)
- Systematic exposure to feared stimuli until anxiety habituates
- Restructuring dysfunctional family roles and communication patterns
Correct answer: Accepting private experiences while committing to values-based action
ACT aims for psychological flexibility by helping clients accept difficult thoughts and feelings without struggle while committing to actions aligned with personal values, rather than eliminating unwanted internal experiences.
Question 7: Which of the following best characterizes the 'identified patient' concept in family systems therapy?
- The family member with the most severe psychological diagnosis
- The family member who first initiated contact with the counselor
- The symptomatic member who carries the family system's dysfunction (Correct answer)
- The family member most resistant to therapeutic change
Correct answer: The symptomatic member who carries the family system's dysfunction
The identified patient is the family member whose symptoms express the broader family system's dysfunction; family therapists treat the whole system rather than 'fixing' this individual.
NBCC Counseling Theories & Helping Relationships 4
Dialectical Behavior Therapy (DBT), developed by Marsha Linehan, was originally designed to treat which population?