National Counselor Examination Study Guide, Exams of Nursing

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National Counselor Examination Study

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Using motivation from 'within' is known as ______________ A. Inside motivation B. Interior motivation C. Intrinsic motivation D. Idealistic motivation - ans C. Intrinsic motivation Which of the following is not an example of extrinsic motivation? A. Employee performance improves when wages are increased B. A sleep apnea patient follows a strict sleep hygiene plan C. Children finish a task more quickly if they are promised candy D. A student studies more on a test to make the highest grade in the class - ans B. A sleep apnea patient follows a strict sleep hygiene plan Which of the following socioeconomic factor could affect the outcome of therapeutic counseling? Choose all that apply. A. Lack of transportation B. Lack of intrinsic motivation C. Lack of positive cultural norms for entering therapy D. None of the above - ans A. Lack of transportation C. Lack of positive cultural norms for entering therapy What is the meaning of transference/countertransference relationships? Choose all that apply. A. A client transferring their relationship with another onto the therapist B. The therapist transferring their relationship with another onto the client C. Transferring the blame or outcome of behavior onto someone else D. None of the above - ans A. A client transferring their relationship with another onto the therapist B. The therapist transferring their relationship with another onto the client What is one instance that might cause a clinician to break the strong code of client confidentiality? A. Feeling the need to talk B. Duty to warn C. When the therapist is going on vacation D. All of the above - ans B. Duty to warn Behavior Theory - ans comes from the idea that all behaviors are learned and acquired through a process known as conditioning

What theory is most often associated with the psychologists B.F. Skinner and John B. Watson? - ans behavior theory Behavior Therapy - ans concentrates on the observable behaviors of a person or group, and dismisses internal mental states Key components of Behavior theory: - ans conditioning, reinforcement, and punishment What does behavioral theory NOT take into count? - ans the concepts of emotion or even the unconscious or subconscious, as these states are subjective rather than objective Behaviorists believe that all behavior can be what? - ans Trained Classical Conditioning - ans a process in which a subject comes to respond to a stimulus that was previously considered neutral, continued exposure to the stimulus will elicit a desired response Operant Conditioning - ans a process in which a subject engages in the correct behavior through the use of both rewards and punishments for a response. The subject learns to associate the behavior with the outcome Who created the behavioral psychology theory based on the idea that human beings respond to their environment; external stimuli, not internal stimuli? - ans Watson - he believed that all human beings could change their behavior through classical or operant conditioning. Who developed the following schedules of reinforcement: Continuous reinforcement, partial reinforcement (fixed ratio, variable ratio, fixed interval, variable interval) - ans B.F. Skinner - behavioral theorist Continuous reinforcement schedule - ans reinforcing the desired response every time it occurs Partial reinforcement schedule - ans reinforcing a response only part of the time; results in slower acquisition of a response but much greater resistance to extinction than does continuous reinforcement fixed ratio schedule - ans a reinforcement schedule that reinforces a response only after a predetermined number of responses What strength of reinforcement does fixed ratio schedule produce? - ans a high, steady rate of responses. What schedule of reinforcement is: giving a subject a piece of candy after they answer five questions correctly - ans Fixed ratio

Delirium, Parkinson's disease, and Alzheimer's disease are all what type of disorder? - ans Neurocognitive A family counselor who consciously joins with the family during sessions, observes what he experiences during those sessions, and then makes interpretations to family members is most likely operating from what perspective? A. Bowen B. Humanistic C. Experiential D. Narrative - ans C. Experiential A counselor works closely with clients from a culture different from hers in an attempt to understand their perspectives - is an example of what type of worldview? - ans Emic Facts about social justice counseling: - ans - it seeks a balance of power and resources

• it addresses issues of unequal power
• it has led to ACA identifying advocacy competencies for counselors what is shaping in operant conditioning? - ans a way of adding behaviors to a persons repertoire -used when target behavior does not yet exist -what is reinforced is an approximation of the target behavior, the behavior you want to shape. Thorndike is best known for what theory? - ans law of effect - responses that are immediately positively reinforced are more likely to occur again in the future. -also, responses that are immediately negatively reinforced are are less likely to occur in the future. Cognitive theories of psychology focus on what? - ans a persons thought processes, such as motivation, problem solving, decision-making, thinking, and attention. Aaron Beck is what kind of theorist?? - ans Cognitive -believed people had automatic thoughts which are spontaneous negative cognitive distortions. -negative thoughts affect a persons behavior. -regardless of disorder a person is experiencing - he believed if negative thoughts could be identified, they could be evaluated and replaced - which would then change the response or behavior Filtering, Polarized thinking, Overgeneralization, Catastrophizing, Personalization, Control Fallacies, Blaming, Shoulds, Emotional Reasoning, and Always being right - are examples of what? - ans Cognitive Distortions Filtering - ans negative details of a situation are magnified and all positive details of the situation are deleted. The person then dwells on the negative of the situation.

Polarized thinking - ans Situations, People or places are either "all or nothing". For example, a person either loves or hates others, or perceives situations as "the best ever" or "the worst ever" Overgeneralization - ans Based on one experience or little information, a person draws a conclusion. For example if a person got into a car accident at a store parking lot, they might come to view the store as dangerous and refuse to return Catastrophizing - ans A person expects the worst, even when there is evidence to suggest otherwise. For example, a person might not apply for a job, thinking they won't get it anyway - so why bother? Personalization - ans The belief that every response is directed at the person and that they are the cause of external events or feelings. For example, a victim may blame themselves for leaving their house for work late, perceiving that their own lateness was the cause of the car accident. Control Fallacies - ans A person sees himself or herself as a victim and believes that the external world has an inordinate amount of control over him or her. For example "I wouldn't have forgotten my work assignment if my boss didn't give me so much work". There are also internal control fallacies where a person views themselves as responsible. For example, "My boss is mad at me because he didn't greet me today". There are also fallacies of control, which is a belief that life in general is not fair. Blaming - ans A person blames others for their situation, such as attributing the cause of negative behaviors to others actions. Shoulds - ans A belief in the "should and should nots" For example someone might think, "I should eat healthier. I should not eat all these chips. If i was stronger, I wouldn't be so fat" Emotional Reasoning - ans A belief that emotions are thoughts, or the thought that because one thinks or feels something, it might be true. For example, a thought might be, " I don't feel like working today, so I must be depressed" Always being right - ans A person's need to go to all lengths to prove themselves right, even when evidence suggests otherwise Mindfulness cognitive therapy is mostly used for what? - ans medical and emotional issues Piaget's Theory of Cognitive Development - ans sensorimotor stage, preoperational stage, concrete operations, and formal operations

Freud's Psychosexual Stages - ans oral stage, anal stage, phallic stage, latency stage, genital stage oral stage - ans Freud's first stage of psychosexual development, (birth to about age 1 or 2) during which the instincts of infants are focused on the mouth as the primary pleasure center. Oral stage fixation - ans If child is neglected, or when the child has to wean from the breast or bottle, they become upset. fixation in adulthood is a smoking habit Anal stage - ans Freud's second stage of psychosexual development (1 to 3 years) pleasure focuses on bowel and bladder elimination; gratification from the ability to independently control physical elimination Anal stage fixation - ans Conflict occurs if the child is excessively punished for their inability to control their bowels, or if they are exposed to rigid scheduling. Fixation would be someone who is compulsively clean or neat, in which case they would be known as "anal retentive" phallic/yonic stage - ans Freud's third stage of psychosexual development (3 - 6 years) A child focuses on their own genitalia. The child realizes there are differences between males and females. phallic/yonic stage fixation - ans Freud believed that conflict that occurs in this stage that he called the oedipus complex, where he felt that a child subconsciously longs for the attention of their parent of the opposite sex. This stage is still considered controversial in the psychological world. Latent Stage - ans Freud's fourth stage of psychosexual development (6 years - puberty) This is a time where a child may continue to work towards resolution of the previous stages, or is fairly dormant. Genital Stage - ans Freud's 5th and last stage of personality development (puberty through adulthood - 12+) a person can identify their sexual urges but is able to delay gratification. A person is working on or has established the ability to obtain and maintain relationships that are outside sexual desires as well as friendships. Freud's theory of the human psyche includes: - ans id, ego, superego Id - ans Based on instinct, impulsivity and pleasure. The id demands immediate gratification. The id is not in touch with reality or logic. Ego - ans This part of the psyche attempts to balance the needs of the id and the needs of the superego. The ego is reality-based.

Superego - ans This part of the psyche is based on morals and ethics. The superego strives to always do the right thing or not act at all. Freuds thoughts about conscious mind, subconscious mind, and the unconscious mind

• ans conscious mind - very aware of your thoughts, memories, and actions subconscious - just below the conscious mind, info should be able to be retrieved at this level but there's something blocking it unconscious mind - where thoughts, feelings or information goes when your conscious can not cope with the information, this can be because it is too traumatic for the psyche to recall Erik Erikson's focus - ans on conflicts that take place within the ego, while freud focused on conflict between the id and ego Erikson's Theory of Psychosocial Development - ans Eight stages in which a healthy developing individual should pass through from infancy to late adulthood. In each stage the person confronts and hopefully masters new challenges. Each stage builds on the successful completion of earlier stages (Trust vs Mistrust, Autonomy vs. Shame, Initiative vs. Guilt, Ego Identity vs Role Confusion, Intimacy vs. Isolation, Generativity vs Stagnation, Ego Integrity vs Despair) Hope: Trust vs. Mistrust - ans (Infants, 0 - 1 year) The first stage of Erik Erikson's Theory of Psychosocial Development centers around the infants basic needs being met by the parents. If warmth, regularity, affection - trust If parents fail to provide a secure environment and to meet the child's basic need - mistrust Major developmental task in infancy is to learn whether or not other people especially primary caregivers regularly satisfy basic needs. Will: Autonomy vs. Shame and Doubt - ans (Toddlers, 2 - 3 years) The second stage of Erik Erikson's Theory of Psychosocial Development where as the child gains control over eliminative functions and motor abilities, they begin to explore their surroundings. Parents who provide patience and and encouragement - autonomy Restrictive parents instill doubt and reluctance to attempt new challenges - shame and doubt

The eighth stage of Erik Erikson's Theory of Psychosocial Development - Main Question: "Have I lived a full life?" Humanistic Psychology - ans focuses on the overall good of human beings instead of the negativity or mental illness of the individual. Believes that all people are innately good. Stresses the importance of an individuals potential. Believes that negative behavior, mental illness and social problems occur when a person responds to the environment in a negative way that deviates from the natural tendency to do good. Maslow's Hierarchy of Needs - ans physiological - basic needs food, water, & shelter safety love/belonging - social needs esteem - self esteem, achievement self-actualization - morality, meeting potential Who are two well known personality theorists? - ans Henry Murray and Karen Horney Henry Murray and Psychogenic Needs - ans developed a theory of personality that suggests personality is influenced by our needs (psychogenic needs) These are at an unconscious level, but have a great impact on our personality. Two types of needs: Primary - biological needs such as the need for food water and shelter Secondary - psychological or emotional needs, such as the need to be cared for or nurtured, need for independence, and success. Murray identified 24 needs that each person has. Ambition needs, Materialistic needs, Power needs, Affection needs, Information needs. Horneys List of Neurotic Needs - ans Believed neurosis was a result of anxiety caused by interpersonal relationships 10 neurotic needs classed into three broad categories -needs that move you towards others -needs that move you away from others -needs that move you against others Big Five Dimensions of Personality - ans The proposed five basic dimensions of personality Openness to experience Conscientiousness - thoughtfulness, good impulse control, goal-directed behaviors Extraversion Agreeableness - altruism

Neuroticism - those high in this trait tend to experience emotional instability, anxiety, moodiness, irritability and sadness Borderline Personality Theory - ans Marsha Linehan - Dialectical Behavioral Therapy (DBT) - believes disorder is developed due to environmental situations that occur through childhood - called this the Invalidating Environment - person who is emotionally vulnerable has an excessive autonomic nervous system response to stress - level of distress causes an irrational behavioral and emotional response "emotional dysregulation" 4 key skills trained in DBT: - ans -core mindfulness skills -interpersonal effectiveness skills -emotion modulation skills -distress tolerance skills David Kolb - ans has one of best known models of learning styles - he believed that individual learning styles evolve from personal genetics, as well as the environment. David Kolbys identified 4 learning styles: - ans The converger - high ability in abstract conceptualization and active experimentation the diverger - high ability in concrete experience and reflective observation the assimilator - high ability in abstract conceptualization and reflective observation the accommodator - high ability in concrete experience and active experimentation Charles Spearman - ans creator of "g-factor", or general intelligence, belief that intelligence could be measured and scored Louis L. Thurstone - ans seven primary mental abilities: verbal comprehension, reasoning, perceptual speed, numerical ability, word fluency, associative memory, spatial visualization. Howard Gardner - ans Multiple Intelligences - believed that identifying a person's intelligence by a score was not the best way to measure intelligence. 8 intelligences Robert Sternberg - ans triarchic theory of intelligence- [1] analytical - problem-solving [2] practical [3] creative Social learning theory is associated with who? - ans Bandura - he believed that there was a social element to learning, which included that people learn behaviors by watching other people interact. This is known as modeling. Three core concepts of social learning: - ans 1. People can learn through observation - Three models: Live, verbal instructional, symbolic

Problems: lack of secure attachment can lead to many mental health issues including Oppositional defiant disorder (ODD), conduct disorder (CD), or borderline personality disorder Research suggests children adopted after 6 mo have higher risk of attachment problems 3 approaches to Abnormal Psychology - ans Behavioral - observable behaviors Medical - biological causes on mental illness Cognitive - internal thoughts, perceptions and reasoning contribute to psychological disorders. Categories of Psychological Disorders: - ans -adjustment disorders -mood disorders -anxiety disorders -developmental disorders DSM V uses what kind of approach to diagnosing? - ans multiaxial Axis I: Clinical Syndromes Axis II: Developmental Disorders and Personality Disorders Axis III: Physical Conditions Axis IV: Severity of Psychosocial Stressors Axis V: Global Assessment of Functioning (GAF) Mood Disorders - ans characterized by disturbance of mood as a predominant feature ex. depression, bi-polar, mania Depression - ans most commonly associated with feeling of deep sadness, lack of energy, marked tearfulness or crying in some cases, suicidal thoughts or actions. Bipolar Disorder - ans Three types: 1 - primary symptom presentation is manic, or rapid (daily) cycling episodes of mania and depression 2 - primary symptom presentation is recurrent depression accompanied by hypomanic episodes (milder state of mania where symptoms may not impair social or occupational functioning or need for hospitalization, but can be observed by others cyclothymic disorder - chronic state of cycling between hypomanic and depressive episodes that do not reach the diagnostic standard Manic episodes are characterized by: - ans -distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is needed)

-during period of mood disturbance, three (or more) of the following symptoms have persisted (4 if mood is only irritable) -increased self-esteem, decreased need for sleep, more talkative than usual, flight of ideas, increase in goal-directed activity, psychomotor agitation, excessive involvement in pleasurable activities that have high potential for painful consequences Suicide - ans myth that talking to a person about suicidal thoughts causes person to think about or act on suicidal thoughts - NOT TRUE. A person who is thinking or planning suicide will not be persuaded to act by discussing the topic - they may use the opportunity to be talked OUT of planning the attempt Anxiety Disorders - ans presence of fears or phobias, constant worry and nervousness, can also have physical complaints without medical reasoning, and can interfere with daily living. Ex. Panic attack, agoraphobia, obsessive-compulsive, and PTSD According to DSM V diagnostic criteria for anxiety disorders includes: - ans 1 - distress that is marked and excessive for what would be expected from the stressor 2 - creates significant impairment in school, work, or social environments. symptoms must also occur within 3 months of exposure to the stressor and must not last longer than 6 months after exposure to the stressor Adjustment Disorders - ans Key symptoms of adjustment disorders is the development of symptoms due to a known stressor. There is a known environmental, situational, or even medical reason for the change in feelings and/or behavior. Psychotic disorders - ans symptoms of delusions, hallucinations, disorganized behavior, and impairment in reality testing. Ex. schizophrenia, schizoaffective disorder, schizophreniform Developmental Disorders - ans mental or physical impairment or combination of mental and physical impairments; manifested before the individual attains age 22 Impulse-control Disorders - ans involves an inability to control impulses, resulting in harm to oneself or others. Types of impulse-control disorders: - ans Intermittent Explosive Disorder Kleptomania - stealing Pathological Gambling Pyromania - fire starting Trichotillomania - hair pulling dermatillomania - skin picking

8. Continued use despite the consequences of danger
9. recognizing there is a physical or psychological addiction, but continuing use anyway
10. Need for more to get desired effect
11. Use of substances to eliminate withdrawal symptoms Individual Therapy - ans A therapy modality in which an individual client is treated by a single therapist Group Therapy - ans Therapy that involves the therapist and two or more clients at the same time Marital/Couples Therapy - ans Therapy that has a therapist and either both spouses or significant others Family Therapy - ans Therapy with the therapist and either a child and parent/guardian or children and parent(s)/guardian(s). Support Groups - ans Not run by therapist. where persons with a similar issue meet together at a certain place and time to support each other through the crisis or issue. Examples are 12 step programs or grief and loss group. Peer to peer counseling - ans relies on nonprofessionals assisting others who share the same issues. often used with kids or adolescents in school or therapeutic schools or residential settings Play therapy - ans Can be used with adults, but mostly with kids or clients with autism. This approach uses items such as puppets, dolls, doll houses, and games to work with the client on expression Art Therapy - ans Uses expressive arts such as painting, drawing, sculpting to help a person express their emotions and thoughts through forms and not words. utilizes a persons creative faculties in the area of art to develop their physical and emotional health. It assists in increasing well-being. Often used for those who are young or have difficulty with expressive language (autism). Music Therapy - ans uses sound or use of instruments to promote a sense of self- awareness, feeling of over-all well-being and ability to express themselves Psychoanalysis - ans Developed by Freud, this approach uses analysis of word association, dream interpretation and fantasy interpretation. The process of seeks to identify how the mind and its thought processes effect behavior Behavioral Therapy - ans Therapy that focuses on changing behavior through classical conditioning and operant conditioning

Cognitive Behavioral (CBT) - ans Approach that focuses on teaching a person how to identify their thinking effort and replace them with positive thinking. This change will produce an improved outcome (consequence) and thus alter a person's mood positively. Person Centered (Rogerian) - ans This approach is non-directive, and often uses reflection from the therapist to assist the person in increasing awareness and to promote self-actualization Dialectical Behavior Therapy (DBT) - ans Approach most associated for treatment for persons with Borderline Personality Disorder. Approach teaches 4 core skills to help a person to obtain emotional regulation Humanistic Therapy - ans Therapeutic approach that looks at the uniqueness and positive attributes of an individual. Adlerian - ans The focus is to assist a person in adapting their feelings of inferiority. Believes that a persons behavioral patterns and beliefs stem from their childhood Solution Focused Brief Therapy - ans Therapy based on a client's personal current goals versus past issues. Past is referenced when there has been history of success. The goal is future focused. Mindfulness - ans This approach uses a combination of techniques to assist the person in releasing the psychological anxiety or negative feeling and to be in the moment. Techniques used are breathing, meditation, and yoga movements. Often used with other therapies such as cognitive therapy, MBCT, mindfulness-based stress reductions (MBSR) and most often in dialectical behavior therapy (DBT) Synonym to Treatment Plan - ans Individual Plan Synonym to strength based - ans client focused Career Counseling - ans career development is a lifelong process of developmental experiences that focus on seeking, obtaining, and processing information about self, occupational and educational alternatives, lifestyles and role options. four categories:

• differential psychology - interest in occupation option - Trait Factor (Frank Parsons)
• personality - individual characteristics (Holland)
• sociology - occupational goals on movement lateral or upward (Bandura)
• developmental psychology - where a person is at developmentally effects their current and future goals Holland - ans believed that career choice is based on behavioral or personality style. Believed choice of occupation is expression of personality. People in certain jobs have

Banduras theory has Triadic Reciprocal Model of Causality, they are: - ans -personal attributes -external environmental factors -overt behaviors Super's Developmental Self-Concept Theory - ans vocational development is the process of developing a self-perception over time. Stages: Growth (Birth - Mid teens) - task: develop self-perception: shift from play to work orientation

• Fantasy (4 - 10 yrs) career fantasies
• interest (11 - 12 yrs) identifies personal interests as a basis for career choices
• capacity (13 - 14) becomes more focused on skills that meet requirements of jon Exploration (Mid teens - early 20's) - task:to develop and implement self perception through trials at different jobs. Begin to develop preferences in roles.
• Tentative (15 - 17 yrs) trials at part time jobs, volunteer work or classes in career field
• Crystallization of Preference (18 - 21 yrs) - choosing a college or career path Establishment (mid 20's - mid 40's) - task: to find a secure field of choice,/professional preference
• trial and stabilization (25 - 30 yrs) - May make a few moves during this time, but attempting to find the right job to stabilize
• advancement (30 - 40 yrs) - continued effort to remain in the job or set up for promotions Maintenance (40's - early 60's) - task: to preserve one's position in the company or the field. little to no change may occur in career path or in company Disengagement or Decline (Late 60's - retirement) - task: decrease in activity at work and preparation to decrease time in workforce or retire Super's life career rainbow - ans illustration which each color represents a life role, used to help find balance of work and life suited for them Life roles: child, student, leisure, citizen, worker, homemaker or parent Lifestyle Factors: -personal determinants: psychological, biological -situation determinants: historical, socioeconomic -environmental determinants: labor market, employment practices Parson's theory of career development: Trait and Factor theory - ans - person will preform best if their career fits both their personality and abilities
• wrote book "choosing a vocation" - says that personal counsel is fundamental to career search

• 7 stages for career counselor to work through with clients:

1. Personal data
2. self-analysis
3. the client's own choice and decision
4. counselors analysis
5. outlook on the vocational field
6. induction and advice: reasonable and objective
7. general helpfulness Krumboltz's Learning Theory of Career Counseling (LTCC) - ans - based on social learning model and emphasizes the importance of learning experiences and their effect on occupational selection

• believed that individuals unique learning experiences over their life is what influences career choice influences: -from meeting learned standard in one's experiences and performance -to cope with the environment -career entry behavior -career decision making -from multiple factors that include cognitive processes, influences from the environment, and one's own individualized inherited personal characteristics and traits. Krumboltz theory believes positive and negative experiences both impact a persons career beliefs. In addition, unpredictable social and environmental conditions also have an influence. Because of these influences, the career counselor should focus on what 5 skills: - ans -curiosity -persistence -flexibility -optimism -risk-taking Tiedeman Decision Making Theory for Career - ans believes that a person is accountable for ones own choice and behavior. believes that when a person view the situation as possibly having a negative outcome, it has impact on their decision to engage in behavior.
• in terms of career, if a person believes they may fail, they will not try. In contest, if they believe they can be successful, they will often attempt Tiedeman believed there were 7 stages in decision making: - ans 1. Exploration

2. Crystallization
3. Choice
4. Clarification
5. Induction
6. Reformation
7. Integration