SPEX SPEX Exam 5 — Questions and Answers
Question 1: A psychologist receives a subpoena for a client's psychotherapy notes. The most appropriate initial response is to:
- Consult with an attorney and notify the client before releasing any records (Correct answer)
- Immediately comply since a subpoena is a court order
- Destroy the notes to protect the client's confidentiality
- Release only a summary and retain the original notes
Correct answer: Consult with an attorney and notify the client before releasing any records
A subpoena is not a court order requiring immediate compliance; the psychologist should consult legal counsel and notify the client, who may seek to quash the subpoena.
Question 2: Which of the following best describes the concept of 'therapeutic alliance' and its relationship to treatment outcome?
- Therapeutic alliance is one of the strongest predictors of outcome across therapy modalities (Correct answer)
- Therapeutic alliance only predicts outcome in psychodynamic therapy
- Alliance is less important than specific techniques in determining outcome
- Alliance quality does not predict dropout rates
Correct answer: Therapeutic alliance is one of the strongest predictors of outcome across therapy modalities
Meta-analytic research consistently shows that therapeutic alliance—the collaborative bond and agreement on goals and tasks—is a robust predictor of positive outcome across diverse therapy types.
Question 3: Under the Americans with Disabilities Act (ADA), a psychologist in private practice with 15 or more employees is required to:
- Provide reasonable accommodations for employees with disabilities unless it causes undue hardship (Correct answer)
- Hire a specific percentage of employees with disabilities
- Provide free psychological services to clients with disabilities
- Waive copayments for clients covered by Medicare
Correct answer: Provide reasonable accommodations for employees with disabilities unless it causes undue hardship
The ADA requires employers with 15 or more employees to provide reasonable accommodations for qualified individuals with disabilities unless doing so creates undue hardship.
Question 4: Which of the following scenarios represents a dual relationship that most clearly violates APA ethical standards?
- Providing individual therapy to a client whom the psychologist also supervises professionally (Correct answer)
- Co-authoring research with a former supervisee after supervision has ended
- Serving as an expert witness in a case involving a defendant the psychologist has never met
- Attending the same community event as a former therapy client
Correct answer: Providing individual therapy to a client whom the psychologist also supervises professionally
Simultaneously serving as both therapist and supervisor to the same individual creates an exploitative power differential and a clear dual relationship that is ethically prohibited.
Question 5: In behavioral medicine, motivational interviewing (MI) is best characterized by which therapeutic stance?
- Collaborative, evocative, and autonomy-supportive (Correct answer)
- Directive, confrontational, and prescriptive
- Nondirective and purely reflective without guiding change
- Psychoeducational with structured homework assignments
Correct answer: Collaborative, evocative, and autonomy-supportive
MI is defined by its Spirit: collaboration (partnership), evocation (drawing out client's own motivation), and honoring autonomy, distinguishing it from both directive and purely nondirective approaches.
Question 6: A psychologist discovers that a colleague is practicing while impaired by alcohol, placing clients at risk. According to APA ethics, the psychologist should FIRST:
- Attempt to informally address the situation with the colleague directly if feasible (Correct answer)
- Immediately file a formal complaint with the state licensing board
- Report the colleague anonymously to their employer
- Do nothing unless a client formally complains
Correct answer: Attempt to informally address the situation with the colleague directly if feasible
APA's Ethics Code indicates that psychologists should first attempt to resolve ethics concerns informally with the colleague when feasible, escalating to formal reporting if the informal approach is unsuccessful or inappropriate.
Question 7: Which of the following best describes the role of 'effect size' in psychological research?
- It quantifies the practical magnitude of a difference or relationship, independent of sample size (Correct answer)
- It determines whether a finding reaches statistical significance
- It measures the probability that results occurred by chance
- It indicates the internal consistency of a measurement tool
Correct answer: It quantifies the practical magnitude of a difference or relationship, independent of sample size
Effect size (e.g., Cohen's d, r) indicates the practical or clinical magnitude of a finding and does not depend on sample size, making it essential for evaluating real-world significance beyond statistical significance.
SPEX SPEX Exam 5
A psychologist receives a subpoena for a client's psychotherapy notes.
The most appropriate initial response is to: