Test Bank for Family Therapy Concepts and Methods 12th Edition by Michael Nichols, Sean Davis

Test Bank Questions

Contents Chapter 1: The Evolution of Family Therapy

1

Chapter 2: The Fundamental Concepts of Family Therapy

7

Chapter 3: Basic Techniques of Family Therapy

11

Chapter 4: Bowen Family Systems Therapy

13

Chapter 5: Strategic Family Therapy

18

Chapter 6: Structural Family Therapy

23

Chapter 7: Experiential Family Therapy

27

Chapter 8: Psychoanalytic Family Therapy

32

Chapter 9: Cognitive-Behavioral Family Therapy

36

Chapter 10: Family Therapy in the Twenty-First Century

39

Chapter 11: Tailoring Treatment to Specific Populations and Problems

43

Chapter 12: Solution-Focused Therapy

46

Chapter 13: Narrative Therapy

48

Chapter 14: Comparative Analysis

51

Chapter 15: Research on Family Intervention

59

Answer Keys

60

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Chapter 1: The Evolution of Family Therapy

Chapter 1: The Evolution of Family Therapy 1.1 Multiple-Choice Questions 1)

Lyman Wynne’s term for the facade of family harmony that characterized many schizophrenic families is A) B) C) D)

2)

Hospital clinicians began to acknowledge and include the family in an individual’s treatment when A) B) C) D) E)

3)

Murray Bowen John Elderkin Bell Virginia Satir Carl Whitaker

Frieda Fromm-Reichmann’s concept, ―________ mother,‖ described a domineering, aggressive, rejecting, and insecure mother who was thought to provide the pathological parenting that produced schizophrenia.

A) B) C) D)

6)

unfreezing social equilibrium group process field theory

The first to apply group concepts to family treatment was A) B) C) D)

5)

they noticed when the patient got better, someone in the family got worse they realized the family was footing the bill for treatment they realized the family continued to influence the course of treatment anyway A and C none of these choices

Kurt Lewin’s idea of ________ can be seen in action in Minuchin’s promotion of crises in family lunch sessions, Norman Paul’s use of cross-confrontations, and Peggy Papp’s family choreography.

A) B) C) D)

4)

pseudocomplementarity pseudomutuality pseudoharmony pseudohostility

undifferentiated schizophrenogenic reactive symbiotic

Gregory Bateson and his colleagues at Palo Alto introduced this concept to describe the patterns of disturbed family communication which cause schizophrenia.

A) schizophrenogenesis 1 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 1: The Evolution of Family Therapy

B) double bind C) pseudohostility D) none of these choices 7)

The only means to effectively escape a double bind is to A) B) C) D)

8)

According to Theodore Lidz, marital schism occurs when A) B) C) D)

9)

withdraw from the relationship metacommunicate quid pro quo A and B

one spouse with serious psychopathology dominates the other there is a chronic failure of spouses to achieve role reciprocity one spouse consistently engages in double-binding communication there is a loss of autonomy due to a blurring of psychological boundaries between spouses

Jackson’s concept, ________, that families are units that resist change, became the defining metaphor of family therapy’s first three decades.

A) B) C) D)

emotional reactivity quid pro quo family homeostasis A and C

10) This family therapist’s personal resolution of emotional reactivity in his family was as significant for his approach to family therapy as Freud’s self-analysis was for psychoanalysis.

A) B) C) D)

Salvador Minuchin Jay Haley Murray Bowen Carl Whitaker

11) This family therapist believed in the existence of an interpersonal unconscious in every family.

A) B) C) D)

Murray Bowen Nathan Ackerman Ivan Boszormenyi-Nagy Virginia Satir

12) The group therapy model was not entirely appropriate for families for what reason?

A) family members are peers B) families have a shared history C) A and C 2 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 1: The Evolution of Family Therapy

D) none of these choices 13) The Bateson group may be best remembered for the concepts of the double bind and A) B) C) D)

triangles family structure group process metacommunication

14) The tendency of families to resist change in order to maintain a steady state is known as A) B) C) D)

homeostasis the black box concept paradox complementarity

15) According to the text, one problem with treating families as though they were groups like any other group is that A) B) C) D)

it fails to consider the intrapsychic components of family problems it fails to appreciate the need for hierarchy and structure family members are released from their inhibitions there is no problem with treating families like any other group

16) A conflict created when a person receives contradictory messages on different levels of abstraction in an important relationship, and cannot leave or comment is known as a A) B) C) D)

reframe complementarity quid pro quo double bind

17) The goal of family group therapy was to A) B) C) D)

promote verbalization and understanding of unmet needs promote individuation of family members improve family relationships all of these choices

18) Group-oriented therapists promoted communication by concentrating on ________ rather than ________.

A) B) C) D)

process/content solutions/problems the system/the individual positive feedback loops/negative feedback loops

19) The family theory of the etiology of schizophrenia which focused on disturbed patterns of communication was founded by Gregory Bateson, Theodore Lidz, and 3 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 1: The Evolution of Family Therapy

A) B) C) D)

Carl Whitaker Lyman Wynne Virginia Satir Mara Selvini-Palazzoli

20) A relationship in which husband and wife both pursue careers and share housekeeping and childrearing responsibilities is A) B) C) D)

complementary unrealistic competitive symmetrical

21) Communications family therapists hypothesized that normal families can maintain integrity in the face of environmental vagaries through A) B) C) D)

positive feedback negative feedback metacommunication therapeutic double-binds

22) According to communications theory, healthy families are able to adapt to changing circumstances through use of A) B) C) D)

positive feedback negative feedback homeostasis therapeutic double-binds

23) One of the major propositions put forth in Watzlawick et al. ’s (1967) Pragmatics of Human Communication, was that all messages have a report and a ________ function.

A) B) C) D)

semantic pragmatic paradoxical command

1.2 Short Answer 1)

Explain ―homeostasis.‖

2)

Discuss the advantages and disadvantages of using a systems metaphor to understand and treat families.

3)

In communications family therapy, resistance and symptoms were treated with a variety of paradoxical techniques, known as therapeutic double-binds. Define and give an illustration of a therapeutic double-bind. Why were they considered so powerful?

4)

Some argue that paradoxical instructions are insulting and should not be used. Others insist 4 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 1: The Evolution of Family Therapy

their use is necessary in order to successfully treat families. Take a position for or against the use of paradox and defend your perspective.

5)

Explain the etiology of schizophrenia from a communications theory perspective.

6)

What is the ―black box‖ concept? How does it inform the goals for therapy according to the communications perspective?

7)

Discuss family group therapy’s major contributions to the family therapy field. What were the major limitations that led to its eventual demise?

8)

Describe the double-bind theory of schizophrenia. Historically, why was the theory important? (How might the methods of operationalizing the double-bind phenomenon have affected its lack of empirical support? What methods of measurement could be used to capture the complexity in double bind communication and thus adequately test the validity of the phenomenon?)

9)

Listed below are a number of concepts and methods that have endured and continue to shape the field of family therapy. Choose any three; describe and give an example of each.

How can each concept be used to enrich our understanding of families and guide our treatment interventions? (a) (b) (c) (d) (e)

double bind theory family homeostasis metacommunication complementarity process/content distinction

10) What is a negative feedback loop and how or why is it initiated? Provide an example of a negative feedback loop based on a personal observation of a family interaction.

11) How are family systems therapies different from traditional individual therapies?

12) Some would argue that there is a radical divergence between family systems therapies and the more traditional psychotherapeutic approaches. Others would challenge this view, arguing that there are many points of similarity and that the differences are exaggerated.

Take one position or the other and defend your stand.

13) Choose two of the individuals below and describe how they helped to launch the family therapy movement. Be specific in discussing their contributions to the field. (a) (b) (c) (d) (e) (f) (g)

Gregory Bateson Theodore Lidz Milton Erickson Nathan Ackerman Murray Bowen Don Jackson Jay Haley 5 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 1: The Evolution of Family Therapy

(h) Salvador Minuchin (i) Virginia Satir (j) Carl Whitaker 14) How is group therapy similar to and different from family therapy?

15) What was the positive impact of research on family dynamics and schizophrenia? What was its negative impact?

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Chapter 2: The Fundamental Concepts of Family Therapy

Chapter 2: The Fundamental Concepts of Family Therapy 2.1 Multiple-Choice Questions 1)

Which is not a concept of von Bertalanffy’s general systems theory?

A) B) C) D)

2)

sequences of interaction family hierarchy family rules negative feedback

Constructivism first found its way into psychotherapy in the work of A) B) C) D)

6)

family structure homeostasis function of the system family life cycle

Which phenomena are not a focus of cybernetics, as applied to families?

A) B) C) D)

5)

systems theory cybernetics constructivism general systems theory

The stages of a family’s life from separation from one’s parents to marriage, having children, growing older, retirement, and finally death, are known as the A) B) C) D)

4)

a system is more than the sum of its parts equifinality homeostatic reactivity

A biological model of living systems as whole entities which maintain themselves through continuous input and output from the environment, developed by Ludwig von Bertalanffy is known as A) B) C) D)

3)

―black box‖ metaphor

Paul Watzlawick Kenneth Gergen George Kelly Michael White

A balanced steady state of equilibrium is known as A) B) C) D)

metacommunication homeostasis morphogenesis equifinality 7 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 2: The Fundamental Concepts of Family Therapy

7)

The study of control processes in systems, particularly the analysis of the flow of information in closed systems, is known as A) B) C) D)

8)

Narrative therapy differs from solution-focused therapy in being more focused on ________ than ________.

A) B) C) D)

9)

functional analysis of behavior cybernetics existentialism general systems theory

exceptions; problems cognitions; interactions attitudes; behavior individuals; families

With the exception of the feminist critique, what has been largely missing in family therapy has been an examination of A) B) C) D)

cultural biases the society we are helping people fit into value systems all of these choices

10) General systems theory, cybernetics, and social constructionism are ________ concepts.

A) B) C) D)

epistemological metapsychological clinical metaphysical

11) The greatest conceptual influence on the early development of family therapy was A) B) C) D)

the family life cycle constructivism feminism systems theory

12) The concept of the family life cycle was introduced to the field by A) B) C) D)

Salvador Minuchin Betty Carter and Monica McGoldrick Jay Haley Don Jackson

13) The notions of complementarity, structuralism, and general systems theory are all embraced by which family theory?

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Chapter 2: The Fundamental Concepts of Family Therapy

A) B) C) D)

behavioral family therapy experiential family therapy communications family therapy structural family therapy

14) Boundaries around the executive subsystem in the family are of particular importance because the family ________ is seen by structural therapists as crucial to the family’s wellbeing.

A) B) C) D)

network hierarchy life cycle quid pro quo

2.2 Short Answer 1)

Why should a family’s ethnic background be considered in assessment?

2)

List the stages of the family life cycle (Carter & McGoldrick, 1999) and describe the primary task(s) of each stage. Consider how the therapist would intervene with the family at each of these stages.

3)

List and describe at least three contextual influences on the evolution of family therapy.

4)

What are positive and negative feedback and how do they operate in families?

5)

Listed below are a number of concepts and methods that have endured and continue to shape the field of family therapy. Choose any three and describe them. How can each concept be used to enrich our understanding of families and guide our treatment interventions? a) b) c) d) e) f) g)

6)

importance of family context triadic models family structure psychopathology serving a function in families circular sequences of interaction family life cycle multigenerational patterns

How can general systems theory revitalize family therapy and bridge the chasm between the narrative approaches of the twenty-first century and the traditional schools (i.e., structural, Bowenian, communications, and/or strategic) of family therapy?

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Chapter 3: Basic Techniques of Family Therapy

Chapter 3: Basic Techniques of Family Therapy 3.1 Multiple-Choice Questions 1)

The goal of a first interview with a family is to develop an alliance with the family and: A) B) C) D)

2)

Challenging linearity means: A) B) C) D)

3)

To have therapists with similar backgrounds to clients To ask questions To study cultural and ethnic traditions To accept how clients wish to relate within their own families

To treat couples together To treat them separately To see them together and separately To refer the case to a systemic couples therapist

According to the authors a therapist should focus on -------A) B) C) D)

7)

_

In cases of common couple violence most feminist therapists think it best A) B) C) D)

6)

Subsystems Boundaries Family rules Triangles

According to the authors, the best way to develop cultural sensitivity is A) B) C) D)

5)

Asking how others are involved in the presenting problem Asking for a chronology of the presenting problem Asking for a family history Asking family members for a circular explanation of the presenting problem

All but which of the following is not part of exploring a family's structure?

A) B) C) D)

4)

To determine if medication is indicated To get a detailed picture of the identified patient To develop a tentative hypothesis about the what is maintaining the problem To consider whether or not to take the case

A family’s strengths and weaknesses The presenting problem The family life cycle stage of the family The bio-psycho-social milieu

The authors suggest developing a tentative hypothesis about a family's problem: A) After exploring the presenting complain B) After the first session C) After the initial phone call 10 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 3: Basic Techniques of Family Therapy

D) During the first few sessions 8)

At termination a family therapist should A) B) C) D)

9)

_

Explore the therapeutic relationship Resolve the therapeutic relationship Focus on the things the family has learned Focus on what the family has been doing

The authors recommend.

A) B) C) D)

_

A brief follow-up a few weeks after termination Asking family members how they will handle challenges in the future Allowing families to determine when therapy should end All of the above

3.2 Short Answer 1)

What are the pros and cons of insisting that the entire family attend the initial consultation?

2)

What is the ―problem-determined system‖? Give a couple of examples.

3)

What is essential to accomplish in the first session in order to establish a productive therapeutic alliance with a family?

4)

How can a therapist effectively challenge linear attributions of blame? Give a couple of examples.

5)

Why is it important for a clinician to develop a therapeutic hypothesis, and what are some of the elements that such a formulation should include?

6)

What is the danger of a therapist taking too active and directive a role in the middle stages of a family’s treatment?

7)

Why is traditional couples considered potentially dangerous in the treatment of cases involving marital violence?

8)

What are some of the arguments in favor of treating violent partners together in couples therapy?

9)

What are the first priorities in treating cases involving child sexual abuse?

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Chapter 4: Bowen Family Systems Therapy

Chapter 4: Bowen Family Systems Therapy 4.1 Multiple-Choice Questions 1)

A Bowen therapist working with an individual family member in treatment is most likely to do which of the following?

A) B) C) D) E)

2)

The primary goal of Bowen family therapy is to A) B) C) D)

3)

avoid the expression of intense emotions avoid contact with dysfunctional family members have parents who are well differentiated be firstborn children A and C

An increase in chronic anxiety in the nuclear family system will tend to ________ less differentiated families, while it will ________ more highly differentiated families.

A) B) C) D)

6)

can extricate themselves from all emotional triangles can balance their needs for closeness and autonomy avoid contact with their parents approach life in a purely rational fashion

According to Bowen theory, more highly differentiated individuals will likely A) B) C) D) E)

5)

heighten emotional experiencing in family members increase the family’s repertoire of problem-solving skills improve communication between family members increase the level of self-focus in family members

―Differentiated‖ individuals

A) B) C) D) 4)

create a therapeutic triangle use displacement stories model how to take an ―I‖ position work with a genogram C and D

be absorbed by/promote growth in promote growth in/be absorbed by cause an increase in symptoms in/be absorbed by cause a decrease in symptoms in/promote growth in

Murray Bowen developed his ideas about family therapy while at the NIMH, studying ________ families. Based on his observations of these families’ intense clinging interdependence, he concluded that a lack of differentiation was responsible for all family pathology.

A) alcoholic B) depressed 12 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 4: Bowen Family Systems Therapy

C) neurotic D) psychotic 7)

By training family members in 3 areas--teaching differentiation, avoiding triangulation, and ________, Bowen therapists can enable a single individual to transform the whole network of his or her family system.

A) B) C) D)

8)

In Bowen theory, the flight from a conflictual emotional attachment to one’s parents is known as A) B) C) D)

9)

avoiding expression of intense emotions reopening cut-off family relationships increasing contact with dysfunctional family members all of these choices

emotional cutoff enmeshment disengagement fusion

In Bowen theory, this is a process wherein the projection of varying degrees of immaturity to different children in the same family occurs. The child who is most involved in the family emerges with the lowest level of differentiation, and passes on problems to succeeding generations.

A) B) C) D)

societal emotional process family projection process nuclear family emotional process multigenerational transmission process

10) This Bowenian concept describes the level of emotional ―stuck-togetherness‖ or fusion in the family.

A) B) C) D)

unconscious need complementarity lack of differentiation of self triangling A and C

11) According to Bowen, ________ are the smallest stable unit of human relations.

A) B) C) D)

dyads triangles foursomes none of these choices

12) The central premise of Bowen theory is that unresolved ________ must be resolved before one can differentiate a mature, healthy personality.

A) oedipal conflicts B) emotional experiencing 13 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 4: Bowen Family Systems Therapy

C) emotional reactivity to one’s family of origin D) attachment deficits 13) From a Bowenian perspective, optimal development in the family occurs when all members are relatively differentiated, anxiety is low, and parents A) B) C) D)

form an executive subsystem cut-off from dysfunctional family members avoid heightened emotionality remain in emotional contact with their families of origin

14) People tend to marry spouses at ________ levels of differentiation.

A) B) C) D)

varying similar complementary opposite

15) Unlike experiential therapists, Bowenians seek to ________ levels of anxiety in order to increase levels of differentiation of self in the family.

A) B) C) D)

increase identify monitor decrease

16) ________ is a prominent technique in Bowen therapy designed to clarify emotional processes involved in altering key triangles. The technique is used in order to help family members become aware of systems processes and recognize their own roles in them--it was first developed for use with emotional pursuers and distancers.

A) B) C) D)

relationship experiments coaching use of genograms use of displacement stories

17) According to feminist Bowenians, ________ causes the most problems in American families.

A) B) C) D)

patriarchy domestic violence emotional fusion A and C

18) According to the principles of which Bowenian construct, simply teaching a mother better techniques for disciplining her son will fail, because the intervention ignores the problem that she is overinvolved with the boy as a result of her husband’s emotional distance.

A) enmeshment 14 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 4: Bowen Family Systems Therapy

B) multigenerational transmission process C) emotional cutoff D) triangles 19) Bowen’s concept ―differentiation of self‖ is most like, which of the following?

A) B) C) D)

independence disengagement self-actualization ego strength

4.2 Short Answer 1)

What are emotional triangles? How and why are they formed?

2)

Explain differentiation of self.

3)

What are the multigenerational emotional processes? Give an example that illustrates these processes.

4)

Compare and contrast emotional fusion and enmeshment. How are they alike; how are they different?

5)

According to Bowen theory, a lack of differentiation in the nuclear family will tend to be expressed in one of three ways. List and give an example of each.

6)

A 25-year-old, single man seeks consultation. He is depressed and anxious, and his selfesteem is low. His father expected him to be an attorney like himself, but the client has been unsuccessful in his repeated applications to law school. He lives with his parents, and there is much tension in the home whenever his career plans are discussed. At present he is working as a therapy aide in a state psychiatric center. He enjoys his work but is embarrassed that he is employed beneath the level one would expect for a college graduate.

Discuss the case from a Bowenian perspective. Be specific when applying Bowen’s theoretical constructs. Second, indicate how, for this client, the Bowenian approach would differ from a more traditional theoretical approach (individual therapy or vocational counseling).

7)

List the stages of the family life cycle (Carter and McGoldrick, 1988) and describe the primary tasks of each stage. Consider how the therapist would intervene from a Bowenian perspective with the family at each of these stages.

8)

What is the basic procedure Bowenian therapists use with couples and how does this differ from, say, structural family therapy (or narrative, etc.) with couples?

9)

What are the primary (concrete) things to accomplish in working to improve relationships in one’s original family?

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Chapter 4: Bowen Family Systems Therapy

10) To what extent is ―differentiation of self‖ more than just a synonym for ―maturity‖?

11) What is the difference between Guerin’s focus in family therapy versus Bowen’s?

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Chapter 5: Strategic Family Therapy

Chapter 5: Strategic Family Therapy 5.1 Multiple-Choice Questions 1)

Both strategic and Milan systemic therapies aim to achieve personality change through A) B) C) D) E)

2)

The strategic and systemic therapies have been most directly influenced by the ideas of A) B) C) D) E)

3)

foster insight negatively reinforce symptoms promote individuation of family members interrupt dysfunctional feedback loops

Relabeling a family’s description of behavior to make it more amenable to therapeutic change is called A) B) C) D)

6)

a positive connotation scapegoating an ordeal prescribing the symptom

A primary goal of communications family therapy was to A) B) C) D)

5)

Gregory Bateson Carl Rogers Virginia Satir Milton Erickson A and D

A paradoxical technique that forces a patient to either give up a symptom or admit that it is under voluntary control is known as A) B) C) D)

4)

use of reframing use of circular questioning hierarchical restructuring use of various paradoxical techniques none of these choices

reframing prescribing the symptom reinforcement reciprocity a double-bind

Basic change in the structure and functioning of a system is known in general systems theory as A) B) C) D)

first-order change second-order change quid pro quo change paradoxical change 17 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 5: Strategic Family Therapy

7)

The development and use of ―pretend techniques,‖ paradoxical interventions in which family members are asked to pretend to engage in symptomatic behavior, is associated with which strategic/systemic therapist?

A) B) C) D)

8)

The Bateson group may be best remembered for the concepts of the double bind and A) B) C) D)

9)

Mara Selvini Palazzoli Virginia Satir Cloe Madanes all of these choices

metacommunication family structure group processes triangles

MRI therapists identify 3 categories of client solutions which tend to perpetuate or exacerbate their problems. They include attempting to solve something which isn’t really a problem, taking action to solve a problem but doing so at the wrong level, and A) B) C) D) E)

complying with a paradoxical directive failing to take action, though action is necessary denying that a problem exists B and C none of these choices

10) Though many schools of family therapy believe that the real problem in families is some form of underlying family pathology, ________ family therapists deny that underlying dynamics are the cause of symptomatic behavior.

A) B) C) D)

strategic structural Bowenian all of these choices

11) The idea that because the mind is so complex, it’s better to study people’s input and output (e.g., behavior and communication) than to speculate about what goes on in their minds is known as A) B) C) D)

black box concept general systems theory paradox metacommunication

12) All of these choices schools have for their goals of therapy both symptom resolution and transformation in the whole family system, except which?

A) MRI B) experiential C) Bowenian 18 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 5: Strategic Family Therapy

D) structural 13) A method of interviewing developed by the Milan associates in which questions are asked to highlight differences among family members, is known as A) B) C) D)

a therapeutic double-bind circular questioning positive connotation a family ritual

14) A technique used by the Milan group that prescribes a specific act for family members to perform--it is designed to change the family system’s rules.

A) B) C) D)

circular questioning pretend technique positive connotation family ritual

15) Action and insight are the primary vehicles of change in family therapy. The ________ school emphasizes behavioral change and eschews insight as a medium for change.

A) B) C) D)

structural strategic psychodynamic experiential

16) The strategic technique of providing a new label for a family’s description of behavior, in order to make it more amenable to therapeutic change; for example, describing someone as ―lonely‖ rather than ―depressed.‖ A) B) C) D)

interpretation restraining reframing A and C

17) Selvini Palazzoli’s technique of ascribing helpful motives to family behavior in order to promote family cohesion and avoid resistance to therapy is known as A) B) C) D)

ordeal therapy mystification pretend technique positive connotation

18) Jay Haley’s approach incorporates a functionalist viewpoint with his Ericksonian and cybernetic influences, thus combining aspects of the ________ and ________ approaches into his style of treating families.

A) structural/behavioral B) Bowenian/behavioral C) strategic/experiential 19 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 5: Strategic Family Therapy

D) structural/strategic 19) Madanes categorizes family problems according to 4 basic intentions of family members involved in them. They are the desire to dominate and control, the desire to love and protect others, the desire to repent and forgive, and the desire to A) B) C) D)

create a family be loved be secure none of these choices

20) A conflict created when a person receives contradictory messages on different levels of abstraction is known as a A) B) C) D)

reframe double bind complementary message quid pro quo

21) The use of ________ is designed to block or change dysfunctional behavior using indirect, seemingly illogical means.

A) B) C) D)

therapeutic double-binds paradox directives all of these choices

22) The current form of Haley/Madanes therapy is called ________, and still involves giving directives based on therapist hypotheses, though shifting the focus away from the power elements of family hierarchy.

A) B) C) D)

post-modern strategism positive strategism strategic humanism none of these choices

23) The central intervention within the original Milan model consisted of either a ritual or a A) B) C) D)

family sculpting positive connotation therapeutic double bind A and C

5.2 Short Answer 1)

What is the purpose of ―circular questioning‖?

2)

Explain compliance-based and defiance-based directives, and give an example of each.

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Chapter 5: Strategic Family Therapy

How would a strategic therapist decide which type of directive to use with a family in treatment?

3)

In communications family therapy, resistance and symptoms were treated with a variety of paradoxical techniques known as therapeutic double binds. Define and give an illustration of a double bind. Why were they considered to be so powerful?

4)

Describe the invariant prescription.

5)

What is the ―black box‖ concept? How is it used in the communications approach?

6)

Compare and contrast the strategic and Milan systemic theories. Consider theoretical adequacy; specificity of constructs, strategy, and technique; role of the therapist; and types of client problems best suited for each approach.

7)

How does the therapist’s role differ in Milan systemic versus solution-focused therapy?

8)

What is a negative feedback loop and how or why is it initiated? Give an example. What is a positive feedback loop and how or why is it initiated? Give an example.

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Chapter 6: Structural Family Therapy

Chapter 6: Structural Family Therapy 6.1 Multiple-Choice Questions 1)

A family therapist who begins a session by greeting individual family members by name and asking for each person’s view of the problem is demonstrating which strategy?

A) B) C) D)

2)

Structural therapists attempt to alter the family’s view of reality by A) B) C) D)

3)

genograms paradoxical directives double-binds enactments

―Unbalancing‖ involves

A) B) C) D) 7)

rigid, enmeshed, diffuse executive, rigid, enmeshed rigid, executive, diffuse rigid, diffuse, enmeshed

Structural family therapists use ________ to observe and then change transactions that make up family structure.

A) B) C) D)

6)

teach the family problem-solving strategies alter the family structure strengthen boundaries around rigid family subsystems heighten emotional experiencing

Disengaged subsystems are surrounded by ________ boundaries while ________ subsystems have ________ boundaries.

A) B) C) D)

5)

heightening emotional experiencing challenging cognitive constructions realigning boundaries between individuals and subsystems accommodating to the viewpoint of the most powerful family member

The primary treatment goal of structural family therapy is to A) B) C) D)

4)

boundary making highlighting the interactions accommodating joining

realigning relationships between subsystems therapeutic neutrality restorying the family’s narrative taking sides

In order to discern a family’s structure two things are necessary: a theoretical system that 22 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 6: Structural Family Therapy

explains structure and A) B) C) D) 8)

Minuchin’s term for psychological isolation that results from overly rigid boundaries around individuals and subsystems in a family is A) B) C) D)

9)

family members’ self-reports live observation a structured assessment interview none of these choices

enmeshment differentiation emotional cutoff disengagement

When two people marry, they must learn to negotiate the nature of the boundary between them, as well as the boundary separating them from the outside. This structural requirement is known as A) B) C) D)

accommodation complementarity disengagement differentiation

10) The goal in structural family therapy when working with enmeshed families is to A) B) C) D)

establish reinforcement reciprocity by teaching methods of positive control differentiate individuals and subsystems by strengthening the boundaries around them increase interaction by making boundaries more permeable all of these choices

11) Structuralists believe the family must first accept the therapist, in a process called ________, which allows the therapist to increase stress and unbalance the family homeostasis, thus opening the way for structural transformation in the family.

A) B) C) D)

detouring taking an ―I‖ position restructuring joining

12) When parents are unable to resolve the conflicts between them, a common pattern is to continue to argue through the children. When father says mother is too permissive, she says he’s too strict. He may in turn withdraw, and she responds to the child with excessive concern and devotion. The structural term which best describes the resulting family structure is A) diffuse boundaries between husband and wife B) a cross-generational coalition between mother and child C) overinvolvement between father and child 23 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 6: Structural Family Therapy

D) a pathological triangle 13) An interaction stimulated in structural family therapy in order to observe and then change transactions which make up family structure is called A) B) C) D)

a positive connotation a spontaneous behavior exchange a reframing an enactment

14) During which phase of structural family therapy does assessment occur?

A) B) C) D)

opening mapping underlying structure transformation of family structure structural therapists do not use assessments

15) In order to highlight and modify interactions in the family, structural therapists use intensity to A) interrupt rigid patterns of conflict-avoidance B) break families loose from their patterns of equilibrium C) extend interactional sequences beyond the point where dysfunctional homeostasis is reinstated D) all of these choices 16) ________ is another method of modifying interactions, which structural therapists use to help family members employ more functional alternatives already in their repertoire of skills.

A) B) C) D)

Positive connotations Shaping competence Detriangling Operant conditioning

17) Minuchin, Rosman, and Baker (1978) reported a 90% improvement rate in the results of their treatment study of structural family therapy in treating A) B) C) D)

drug addiction anxiety disorders depression anorexia

6.2 Short Answer 1)

Why are ―enactments‖ used in structural therapy?

2)

Discuss the pros and cons of the argument that structural family therapy (as practiced by Minuchin) is not a collaborative model.

24 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 6: Structural Family Therapy

3)

A child from enmeshed family is brought into treatment for school phobia. Demonstrate your knowledge of family structure by describing how this presenting problem may be understood as the sign of an enmeshed family. How might members of an enmeshed family system contribute to the maintenance of such a problem?

4)

List and describe the three overlapping phases in the process of structural family therapy.

Describe the specific strategies that structural therapists employ in each phase. Use a case example for illustration.

5)

Compare and contrast structural family therapy to the early communications therapy practiced by Don Jackson and colleagues. Consider theoretical adequacy, specificity of constructs, strategies and techniques, roles of the therapist, and types of client problems best suited for each approach.

6)

What are ―boundaries‖ and why are they important in understanding the problems of a newly married couple?

7)

What is family structure and how do families become structured?

8)

Describe and explain the four steps in the Minuchin, Nichols, and Lee assessment model.

25 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 7: Experiential Family Therapy

Chapter 7: Experiential Family Therapy 7.1 Multiple-Choice Questions 1)

Experiential family therapists believe ________ is/are the primary cause of dysfunction in families.

A) B) C) D)

2)

Experiential therapy differs from most systems approaches with respect to its emphasis on ________ versus techniques that specifically facilitate interaction.

A) B) C) D)

3)

increased personal integrity greater freedom of choice restructuring of the family system increased sensitivity to one’s needs and feelings

Carl Whitaker, like Murray Bowen, believes that personal growth (i.e., individuation) also requires A) B) C) D)

6)

introjection metacommunication reframing mystification

The goals of experiential family therapy would not include A) B) C) D)

5)

expanding experience improving problem solving restructuring the family hierarchy metacommunication

Laing’s concept that many families distort their children’s experience by denying or relabeling it is known as A) B) C) D)

4)

interlocking triangles unexpressed emotion cross-generational coalitions poor problem-solving

rational thinking family connectedness problem-solving abilities none of these choices

A collection of beliefs based on a distortion of historical reality and shared by all family members, which help shape the rules governing family functioning are known as A) family rules B) invisible loyalties C) family myths 26 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 7: Experiential Family Therapy

D) none of these choices 7)

Within experiential therapy, the ________ is believed to be the essential healing force in the psychotherapeutic process, whereby the therapist establishes caring, person-to-person relationships with each family member while modeling openness, honesty, and spontaneity.

A) B) C) D)

8)

A non-verbal experiential technique, in which family members position themselves in a tableau that reveals significant aspects of their perceptions and feelings, is known as A) B) C) D)

9)

interpretation of unconscious conflict existential encounter therapeutic double-bind paradoxical intervention

existential encounter family sculpting family ritual conjoint family drawing

An important concept in experiential family therapy--defined as the process of developing and fulfilling one’s innate, positive potentialities.

A) B) C) D)

differentiation of self alienation from experience constructivism self-actualization

10) Experiential family therapy is designed to A) B) C) D)

interpret and work through unconscious conflicts increase family members’ levels of differentiation of self facilitate emotional experiencing in family members none of these choices

11) ________ is considered more important by experiential therapists for healthy family functioning than either problem-solving skills or functional family structure.

A) B) C) D)

open, spontaneous experiencing insight symptom relief none of these choices

12) The primary goals of family therapy included all except which of the following?

A) B) C) D)

enhanced sensitivity greater freedom of choice expanded emotional experiencing symptom relief

13) Unlike Bowenians, experiential therapists will ________ then behave in alternately 27 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 7: Experiential Family Therapy

provocative and supportive ways in order to help families learn to express honest emotion.

A) B) C) D)

encourage development of transference discourage development of transference raise the level of anxiety in the family lower the level of anxiety in the family

14) Experiential therapists typically use ________ to help minimize countertransference responses to family members in session.

A) B) C) D)

live observation co-therapists reflecting teams their own therapy

15) Among experientialists, families are typically conceived of and treated as A) B) C) D)

groups of individuals systems parent and child subsystems none of these choices

16) Johnson and Greenberg have found that emotionally-focused couples therapy is more successful when the therapist first ________ and then ________, in that order.

A) B) C) D)

softens the attacking spouse’s stance; engages the withdrawn spouse engages the withdrawn spouse; softens the attacking spouse’s stance facilitates an enactment; encourages expression of secondary emotions encourages expression of secondary emotions; facilitates an enactment

17) The goal of internal family systems therapy is to A) B) C) D)

experience unique outcomes achieve self-leadership de-triangulate B and C

18) Internal family systems theorists use techniques such as ________ from structural family therapy to help people get their polarized parts to deal with each other while blocking the interference of other parts.

A) B) C) D)

joining mapping interactions boundary making increasing intensity

19) An essential role of an internal family systems therapist is to 28 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 7: Experiential Family Therapy

A) B) C) D)

educate family members about internal positive feedback loops help family members notice when their parts have taken over solve the family’s presenting problem reposition the family hierarchy

20) The internal family systems therapist uses ________ or sense of when people are and are not leading with their Selves, to help family members maintain Self-leadership as they interact.

A) B) C) D)

an analytic third ear a parts detector a quid pro quo metacommunication

7.2 Short Answer 1)

Experiential therapists have downplayed the role of theory in psychotherapy. Describe the rationale offered by such people as Whitaker and Keith for using an atheoretical approach to treating families.

2)

What is an ―existential encounter?‖

3)

Describe the technique of ―family sculpting.‖

4)

Experiential therapy derives from existential, humanistic, and phenomenological thought.

Explain the general essence of these lines of thinking, and their implications for treatment.

Contrast these existential ideas with the determinism inherent in psychoanalytic thinking.

5)

What evidence is there for the effectiveness of emotionally-focused couples therapy?

Discuss the types of couple presenting problems that may be most amenable to change through use of an emotion-focused approach? For which types of presenting problems might it be least effective? How could you test your hypotheses regarding differential effectiveness?

Compare and contrast Schwartz’s notion of ―Self leadership‖ and Bowen’s construct, ―differentiation of self.‖

6) 7)

Schwartz’s study of internal family systems (IFS) led him to group the roles that parts commonly adopt when a person has been hurt into 3 categories exiles, managers, and firefighters. Describe and give an example of each. How would an IFS therapist explain the notion of resistance?

29 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 8: Psychoanalytic Family Therapy

Chapter 8: Psychoanalytic Family Therapy 8.1 Multiple-Choice Questions 1)

The outcome of good object relations in infancy is the emergence of A) B) C) D)

2)

________ is an interactive process in which a subject perceives an object as containing elements of the subject’s personality and evokes certain behaviors and feelings from the object that conform to these perceptions.

A) B) C) D)

3)

within between within and between none of these choices

An emotional reaction, usually unconscious and often distorted, on the part of the therapist to a patient or family member in treatment is known as A) B) C) D)

6)

inadequate separation-individuation; introjection of pathological objects repression of aggressive and libidinal impulses; inadequate separation-individuation introjection of pathological objects; enmeshment with family of origin enmeshment with family of origin; repression of aggressive and libidinal impulses inadequate separation-individuation; repression of aggressive and libidinal impulses

Non-psychoanalytic family therapists locate problems between people; psychoanalytic family therapists identify problems ________ people.

A) B) C) D)

5)

Separation-individuation Transference-countertransference Reciprocal introjection Projective identification

According to object relations theory, both ________ and ________ will likely result in poor adult adjustment.

A) B) C) D) E)

4)

anaclitic object constancy ambivalent attachment libidinal object constancy ego idealism

transference countertransference projective identification introjection

A process whereby an infant begins to draw apart from the symbiotic bond with mother and develop autonomous functioning is known as A) introjection 30 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 8: Psychoanalytic Family Therapy

B) separation-individuation C) projective identification D) identification 7)

According to psychoanalytic perspectives, one’s choice of marital partner is based on A) the desire to maximize ―rewards‖ and minimize ―costs‖ of the relationship B) one’s level of differentiation of self, and similar levels of differentiation in the families of origin C) complementary styles of communication D) one’s desire to find someone with complementary needs who will fulfill one’s unconscious fantasies

8)

According to psychoanalytic theory, marital choice is affected in part by the ________ phenomenon, in which the insecurely attached child grows up learning to hide their real needs and feelings to win approval.

A) B) C) D)

9)

false self invisible loyalty introjective double-bind

A process in psychoanalytic family therapy, by which insights are translated into new and more productive ways of behaving and interacting is known as A) B) C) D)

projective identification working through metacommunication interpretation

10) Psychoanalytic family therapists use the technique of interpretation when confronted with ________ in family therapy, because it often takes the form of acting-out.

A) B) C) D)

sublimation introjection resistance libidinal impulses

11) Psychoanalytic clinicians identify pathology in families as the result of ________, while structural family therapists locate dysfunction in the boundaries between subsystems.

A) B) C) D)

conflict intrapsychic rigidity developmental arrest all of these choices

12) Psychoanalytic family therapists pay particular interest to childhood memories when A) they feel family members’ need reassurance and direction B) family members’ associations and spontaneous interactions cease 31 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 8: Psychoanalytic Family Therapy

C) they are re-enacted in the present, manifested as transference D) none of these choices 13) Unlike ________, psychoanalytic clinicians may not complete their assessment or arrive at a final diagnosis until the end of treatment.

A) B) C) D)

experientialists behaviorists structuralists B and C

14) Psychoanalytic family therapy consists of four basic techniques listening, empathy, interpretation, and A) B) C) D)

maintaining analytic neutrality facilitating emotional expression paradoxical directives re-storying

15) According to self psychology, children are more likely to develop a secure and cohesive sense of self when parents provide sufficient opportunities for A) B) C) D)

anaclitic introjection ego splits projective identification idealization

16) Along with the achievement of insight, the processes of ―working through‖ and ________ are considered three specific processes that facilitate change in psychodynamic therapy.

A) B) C) D)

reintegrating split-off parts of the ego sublimation reciprocal introjection warding off of libidinal and aggressive impulses

17) The general goals of psychoanalytic family therapy include all except A) B) C) D)

resolution of unconscious conflict anaclitic object constancy differentiation separation-individuation

8.2 Short Answer 1)

Explain ―projective identification.‖

2)

What is resistance? Give an example of how it is manifested in family therapy. How should the therapist work with resistance in treatment?

32 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 8: Psychoanalytic Family Therapy

3)

Explain the difference between the psychoanalytic techniques of confrontation and interpretation.

4)

Transference occurs in all forms of therapy. What is the general psychoanalytic point of view regarding its significance in treatment? How does the occurrence and use of transference differ in psychoanalytic family therapy and individual psychoanalytic therapy.

5)

Four basic techniques used in psychoanalytic family therapy are: listening, empathy, interpretation, and maintaining analytic neutrality. Define and give an example of how each technique may be used in a treatment session with a couple experiencing marital difficulties.

6)

According to Freud what are the primary human motivations? According to Kohut what are the primary human motivations? Give an example of each and explain how they differ.

7)

What is the difference between Nagy’s concept of ―invisible loyalty‖ and the more familiar and simpler term ―loyalty‖?

8)

What is the difference in impact on the patient between a therapist’s mirroring versus expressing praise and reassurance?

33 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 9: Cognitive-Behavioral Family Therapy

Chapter 9: Cognitive-Behavioral Family Therapy 9.1 Multiple-Choice Questions 1)

The use of high-probability behavior to reinforce low-probability behavior is known as A) B) C) D)

2)

A behavioral technique using to eliminate behavior by not reinforcing it is known as A) B) C) D)

3)

contingency contracting token economy aversion therapy shaping

Systematic desensitization and assertive training are both examples of ________ techniques.

A) B) C) D)

7)

operant conditioning respondent conditioning cognitive/affective techniques none of these choices

This behavioral technique uses a system of points or stars to reward children for successful behavior A) B) C) D)

6)

focuses on triadic constructions of the identified problem aims to restructure the family hierarchy and generational boundaries requires that the entire family to attend therapy supports the parents’ view that the child is the problem

The most commonly used techniques in behavior therapy fall into which category?

A) B) C) D)

5)

punishment assertive training contingency contracting extinction

The behavioral parent training model A) B) C) D)

4)

aversive control Premack principle shaping modeling

operant conditioning cognitive/affective respondent conditioning aversion

Behavioral assessment methods fall into each of the following categories except which?

A) clinical interview 34 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 9: Cognitive-Behavioral Family Therapy

B) observation C) objective testing D) projective testing 8)

Assessments conducted in behavioral marriage therapy are designed to evaluate couples on all except which of the following: A) B) C) D)

9)

their ability to discuss relationship problems the manner in which reward and punishment are exchanged their capacity for whole object relationships skill at pinpointing relevant reinforcers in the relationship

Behavioral marital therapists prefer to use ________ to identify problems and understand their etiology.

A) B) C) D) E)

interviews written questionnaires direct observation B and C none of these choices

10) According to behaviorists, disturbed marital interactions result from A) B) C) D)

low rates of positive reinforcement exchange positive expectancies low rates of aversive control none of these choices

11) A major treatment strategy in behavioral couples therapy is to A) B) C) D)

increase the rate of aversive control improve communication skills decrease positive control all of these choices

12) The major intent of behavioral exchange procedures is to help couples A) B) C) D)

with severe marital problems establish reinforcement reciprocity resolve sexual arousal disorders evaluate treatment outcome

13) Three types of sexual dysfunction identified by Helen Singer Kaplan, which correspond to three stages of the sexual response include arousal disorders, orgasm disorders, and A) B) C) D)

premature ejaculation organic disorders disorders of desire none of these choices 35 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 9: Cognitive-Behavioral Family Therapy

14) The assessment stage in the behavioral treatment of sexual dysfunction involves A) B) C) D)

scheduling a medical examination to rule out organic problems establishing goals for treatment conducting extensive interviews to determine the nature of the dysfunction all of these choices

15) Masters and Johnson tend to lump sexual problems into which category of problem A) B) C) D)

anxiety lack of motivation poor technique lack of information

9.2 Short Answer 1)

What is a ―functional analysis of behavior?‖

2)

Describe the essential components of behavioral family assessment using Kanfer and Phillips’ SORKC model of behavior. Provide a case illustration of how this assessment model is applied.

3)

What is a ―quid pro quo‖ contract?

4)

Describe the principle components of behavioral parent training. Use a case example to illustrate your answer. How does the approach differ when applied to families with young children versus families with adolescents?

5)

Explain the cognitive-behavioral view of resistance. How does it differ from the family systemic view of resistance?

6)

Within the field of family therapy, behaviorists place the greatest emphasis on assessment and use the most formal and standardized procedures. List and discuss at least three advantages and three disadvantages of the behavioral emphasis on and techniques of assessment.

7)

How is systematic desensitization used in the treatment of sexual dysfunction?

8)

Explain how problems develop in a family from a cognitive-behavioral perspective.

9)

What is the difference between automatic thoughts and schemas?

36 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 10: Family Therapy in the Twenty-first Century

Chapter 10: Family Therapy in the Twenty-first Century 10.1 Multiple-Choice Questions 1)

Which of the following are prominent African American family therapists?

A) B) C) D) E)

2)

What percent of people in sex addiction programs are women?

A) B) C) D)

3)

pluralism constructivism feminism ethnocentrism

The feminist revolution in family therapy differs from the Milan or constructivist revolutions because it A) B) C) D)

6)

structural theory experiential theory systems theory feminist theory

A relativistic perspective that emphasizes the subjective construction of reality, and implies that what we see in families is based as much on our preconceptions as on what is actually going on, is known as A) B) C) D)

5)

10% 25% 40% less than 1%

Which of the following played a major part in the deconstruction of family therapy’s philosophical roots?

A) B) C) D)

4)

Laura Markowitz Nancy Boyd-Franklin Ken Hardy B and C All of the above

advocates a non-collaborative model of treatment is a more systemically-based approach has had a relatively minor impact on the field is theoretical and personal

In which of the following states are non-Hispanic whites in the minority?

A) Nevada B) New York 37 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 10: Family Therapy in the Twenty-first Century

C) Florida D) B and C E) all of the above 7)

Which of the following is not used in the study of brain functioning?

A) B) C) D)

8)

Which of the following did not identify himself or herself a collaborative, conversational therapist?

A) B) C) D)

9)

fMRI PET scan ERP EKG

Harlene Anderson Kenneth Gergen Lynn Hoffman Harry Goolishian

While the ________ influence in family therapy has led to increased humility about our theoretical models and less urgency to change or control people, some fear that its valueless relativism may lead therapists to collude with troubled families to deny their problems.

A) B) C) D)

constructivist feminist psychodynamic multicultural

10) The dysfunctional family constellation which has been most commonly cited by family therapists typically blames the ________’s relationship with the children for family symptoms.

A) B) C) D)

mother father grandmother grandfather

11) The archetypal family case of the overinvolved mother and peripheral father is best understood as the product of A) B) C) D)

intrapsychic issues in women societal forces men’s disillusionment with their careers all of these choices

12) Feminist and constructivist styles of therapy differ with respect to which notion?

A) constructivists don’t advocate collaboration with the family B) feminists don’t advocate neutrality in their work with families C) feminists believe that all realities are created equal 38 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 10: Family Therapy in the Twenty-first Century

D) all of these choices 13) Another trend of the 1980s, in which many authors discussed how to do family therapy with specific types of problems and family constellations, was the trend toward A) B) C) D)

ethnic diversity increased specialization constructivism medical models of treatment

14) The ________ family therapists have expressed the greatest opposition to functionalism.

A) B) C) D)

experiential constructivist Bowenian structural

15) Primary resources for many African American families are A) B) C) D)

the extended kinship system the church community A and B the Democratic party

16) Reflecting teams are used by which family therapists?

A) B) C) D)

Bowen family therapists narrative constructive therapists structural family therapists Jay Haley and Cloe Madanes

17) What percent of people in sex addiction programs are women?

A) B) C) D)

10% 25% 40% less than 1%

10.2 Short Answer 1)

What is a reflecting team? How does it work? What are the benefits to using a reflecting team in family therapy?

2)

Under what category does DSM-V diagnose addiction to gaming?

3)

Give one example of a presenting problem that should be viewed (conceptualized) differently if expressed by a middle-income white family versus a low-income minority family (African American, Latino, Asian, or Native American). Explain your reasoning.

39 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 10: Family Therapy in the Twenty-first Century

4)

What is constructivism? Some would argue that constructivism’s profound impact on clinical theory and practice has been positive (e.g., therapists have become collaborators with the family in a kinder, gentler therapy). Others would argue that serious problems exist with using constructivism as a clinical foundation, that it leads therapists astray. Take one position or the other and defend your stand.

5)

What is ―functionalism‖? Is the functionalist influence in family therapy now dead? Take one position or the other and defend your stand.

6)

What factors are relevant in determining whether a therapist is equipped to treat a homosexual couple?

7)

Why should a family’s ethnic culture be considered in assessment?

8)

What’s wrong with saying that neurological events cause certain human actions?

9)

What is wrong with the DSM-IV diagnosis: ―gender identity disorder‖?

40 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 11: Tailoring Treatment to Specific Populations and Problems

Chapter 11: Tailoring Treatment to Specific Populations and Problems 11.1 1)

Multiple-Choice Questions The primary goal of the psychoeducational approach to treatment of schizophrenia is A) B) C) D)

2)

In the section on relationship enrichment programs with of the following was not described as a critical skill for effective functioning as a couple?

A) B) C) D) E)

3)

structural psychoeducational psychodynamic behavioral

In addition to its use with families with schizophrenia, the psychoeducational model is purportedly applicable to the treatment of ________ as well.

A) B) C) D)

6)

internal family systems therapy medical family therapy solution-focused therapy psychoeducation

While the focus on problem resolution or cure has been family therapy’s trademark, these family therapists are advocating coping with serious psychopathology as a worthy goal.

A) B) C) D)

5)

Accommodation Boundary making Sexual compatibility Fun None of the above

The one-day ―survival-skills workshop‖ conducted with groups of family members is used in which treatment approach?

A) B) C) D)

4)

to cure the patient of schizophrenia to determine the family’s contribution to the illness to remove the patient from their family environment to maximize functioning and minimize relapse

family violence eating disorders bipolar disorder all of these choices

Medical family therapists believe that the field of family therapy has ignored the impact of ________ on family functioning.

A) gender inequalities B) race relations 41 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 11: Tailoring Treatment to Specific Populations and Problems

C) transitions in the family life cycle D) chronic illness 7)

The primary structural problem in most single-parent families is A) B) C) D)

8)

According to the ________ approach to treatment, family stress is thought to cause problems for schizophrenic members, but families don’t cause schizophrenia.

A) B) C) D)

9)

an enmeshed mother failure to accommodate rigid boundaries emotional cutoff from extended families

psychoeducation psychodynamic strategic structural

Primary resources for many African American families are A) B) C) D)

the extended kinship system the church community A and B the Democratic party

10) ________ family approaches have demonstrated considerable success in preventing the rehospitalization of schizophrenics.

A) B) C) D)

psychoeducational experiential structural none of these choices

11) Research which focuses on the ________ family therapy is scarce.

A) B) C) D)

effectiveness of process of therapeutic relationship in outcome of

12) Medical family therapists help families reorganize their resources and prepare to deal with a family illness by relying on their assessment of A) B) C) D) 11.2

onset and course of the illness stage in the family life cycle the family’s resources and degree of isolation all of these choices

Short Answer 42 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 11: Tailoring Treatment to Specific Populations and Problems

1.

According to the authors, what is the most common structural problem in single-parent families?

2)

What is a ―survival-skills workshop?‖

3)

According to Henggler and Boruin, what should be the number one focus of home-based family therapy?

4)

What is expressed emotion and what role does it play in mental illness?

5)

What is discernment counseling?

8)

What is problematic about the DSM-IV diagnosis: ―gender identity disorder‖?

43 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 12: Solution-Focused Therapy

Chapter 12: Solution-Focused Therapy 12.1 Multiple-Choice Questions 1)

Early in the development of solution focused therapy, all clients were given the same assignment, ________, in which clients are asked to observe what happens in their life/relationships that they want to continue.

A) B) C) D)

2)

The goal-setting process in solution-focused therapy emphasizes A) B) C) D)

3)

long enough to make clients feel understood not at all long enough to define specific problems to be resolved as long as clients want to

Compliments are an example of A) B) C) D)

6)

exception question miracle question scaling question none of these choices

Solution-focused therapists engage in problem talk A) B) C) D)

5)

defining problems concretely defining simple problems not what clients want to stop doing but what they want to start doing exceptions

This question, used by solution focused therapists, is intended to circumvent clients’ global and unremitting perceptions of the problems and directs their attention to times in the past or present when they didn’t have the problem.

A) B) C) D)

4)

re-storying task invariant prescription family ritual formula first-session task

empathy positive reinforcement negative reinforcement alliance building

Solution-focused therapy focuses primarily on A) B) C) D)

cognition reinforcement history linguistics behavior

44 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 12: Solution-Focused Therapy

7)

Steve de Shazer’s term for someone who isn’t willing to work at changing is A) B) C) D)

8)

Solution-focused therapy draws heavily on A) B) C) D)

9)

customer client patient complainant

systems theory constructivism social constructionism social learning theory

Solution-focused therapists use ―scaling questions‖ to A) B) C) D)

quantify outcomes evaluate the success of sessions break change into small steps compare clients

10) Solution-focused therapy was adapted from A) B) C) D)

narrative therapy narrative solutions therapy emotionally focused therapy the MRI model

12.2 Short Answer 1)

List and describe three types of questions used in solution-focused therapy. Give an example of each. According to solution-focused theory, discuss how each facilitates client improvement.

2)

What types of clients and client problems are best suited for solution-focused therapy and the MRI model of treatment? Are these approaches effective only with high functioning clients, or can they be used effectively to treat more serious problems (e.g., substance abuse, sexual abuse, personality disorders, or severe mental illness)?

3)

How does the therapist’s role differ in a variety of different approaches (name or have students pick one or two) versus solution-focused therapy?

4)

Does solution-oriented therapy ignore people’s pain (as some critics of the approach suggest) or does it facilitate clients’ positive experiences, which in turn empower them to change what is painful in their lives?

45 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 13: Narrative Therapy

Chapter 13: Narrative Therapy 13.1 Multiple-Choice Questions 1)

In narrative therapy, families are asked about ________, times when they have had some control over the problem that have been obscured by their problem-saturated story.

A) B) C) D)

2)

The narrative technique of ________ enables family members to distance from their problem by externalizing it, and thus experiencing their control over the problem.

A) B) C) D)

3)

Bowen family therapists narrative therapists structural family therapists Jay Haley and Cloe Madanes

Unlike the cybernetic metaphor, which focuses on self-defeating patterns of ________, the narrative metaphor focuses on self-defeating ________.

A) B) C) D)

6)

identify the locus of the problem assess the function the problem serves for the family clarify the family’s power over the problem all of these choices

Reflecting teams are used by which family therapists?

A) B) C) D)

5)

creating self-leadership family rituals reauthoring the invariant prescription

Narrative therapy consists of a series of questions designed to A) B) C) D)

4)

unique outcomes examples of self-leadership exceptions invisible loyalties

culture(s); emotion(s) cognition(s); behavior(s) emotion(s); cognition(s) behavior(s); cognition(s)

The narrative approach first founds its way into psychotherapy in the hermeneutic traditions in A) B) C) D)

psychoanalysis gestalt therapy feminism client-centered therapy 46 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 13: Narrative Therapy

7)

According to narrative theory, therapists should not A) B) C) D)

8)

Narrative therapists ________ problems in order to free the family and individual family members from blame.

A) B) C) D)

9)

take a collaborative, listening position with clients help people separate from the dominant cultural narratives consider the larger historical and political context search for flaws in the family system

re-story externalize prescribe reframe

According to narrative therapy, by maintaining a dominant story of their problems, family members fail to see ________ their problems.

A) B) C) D)

the paradox in their contributions to exceptions to underlying causes of

10) The narrative school applied Michel Foucault’s ________ analysis of societies to an understanding of individuals and families as dominated by oppressive, internalized narratives.

A) B) C) D)

political social psychological gender-based cultural

11) Narrative therapists search the family’s history for ________, in their efforts to separate them from their problems.

A) B) C) D)

multigenerational patterns miracle outcomes sparking outcomes none of these choices

12) In order to fortify gains made in narrative treatment, ________ are organized to discuss how to facilitate the client’s success in countering the effects of their problem story.

A) B) C) D)

nurturing teams reflecting teams multiple family groups none of these choices

13) In order to externalize a problem, whether it’s an internal experience, a syndrome, or a 47 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 13: Narrative Therapy

relationship pattern, the narrative therapist must A) B) C) D)

prescribe it personify it ignore it and focus on unique outcomes ask the miracle question

13.2 Short Answer 1)

What is a ―reflecting team?‖ What are the benefits to using a reflecting team in family therapy?

2)

What types of clients and client problems are best suited for narrative models of treatment?

Is this approach effective only with high functioning clients, or can it be used effectively to treat more serious problems (e.g., substance abuse, sexual abuse, or severe mental illness)?

3)

Describe the technique of ―externalizing‖ and illustrate using a clinical example.

4)

Is it necessary to reject systems thinking in order to practice a narrative approach? What might be some advantages and disadvantages of trying to incorporate systemic thinking into narrative therapy?

5)

What is a ―unique outcome?‖

6)

Define and give an example of each of the following narrative questions: deconstruction questions, open space questions, preference questions, story development questions, and meaning questions.

48 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 14: Comparative Analysis

Chapter 14: Comparative Analysis 14.1 Multiple-Choice Questions 1)

The practice of family therapy has generally preceded ________; thereafter progress in the field typically proceeds in leapfrog fashion.

A) B) C) D)

2)

While theories may serve a political purpose and bias observations, they also A) B) C) D)

3)

communications group behavioral structural

Which school tends not to incorporate systems thinking into their practice?

A) B) C) D)

6)

structural; experiential communications; Bowenian Bowenian; structural experiential; constructivist

Which school introduced the idea that families are systems--more than the sum of their parts?

A) B) C) D)

5)

prevent the artistic component of therapy from being expressed hamper beginning therapists from mastering the proven techniques in the field generally are developed before therapy can be practiced provide conceptual categories to organize observations in therapy

Cognitive-behavioral and strategic therapists tend to emphasize the technical role of the therapist, while ________ and ________ therapists stress the artistic side of the person.

A) B) C) D)

4)

politics theory technique science

Milan Bowenian behavioral structural

During the 1970s, most family therapists tended to overestimate the homeostatic forces in families and underestimate their flexibility and resourcefulness--except whom?

A) B) C) D)

Salvador Minuchin Virginia Satir Mara Selvini Palazzoli Don Jackson 49 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 14: Comparative Analysis

7)

Though many schools of family therapy believe that the real problem in many families is some form of underlying family pathology, ________ family therapists deny that underlying dynamics are the cause of symptomatic behavior.

A) B) C) D)

8)

While intrapsychic conflict is an inferred psychological concept, ________ is an observed interactional concept.

A) B) C) D)

9)

strategic structural Bowenian all of these choices

mystification developmental arrest structural pathology none of these choices

The ________ model of mental disorder, which proposes that an individual develops a disorder when a genetic weakness is sufficiently stressed by an event in the environment, is supported by Bowen theorists and psychoeducational therapists.

A) B) C) D)

diathesis-stress general systems object relations none of these choices

10) The concept of ________ describes how when two people are in conflict, the one who experiences the most anxiety will triangle in another person.

A) B) C) D)

cross-generational coalitions pathological need complementarity pathological triangles all of these choices

11) Action and insight are the primary vehicles of change in family therapy. The ________ school emphasizes behavioral change and eschews insight as a medium for change.

A) B) C) D)

behavioral strategic psychodynamic experiential

12) A primary goal of communications family therapy is to A) B) C) D)

interrupt dysfunctional feedback loops promote individuation of family members reinforce symptoms foster insight

13) These family therapists believe that supervised change during therapy sessions seems more 50 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 14: Comparative Analysis

effective for families than unsupervised change at home.

A) B) C) D)

Bowenian structural strategic A and B

14) While most schools of family therapy believe that families are notoriously resistant to change, ________ therapists minimize the importance of resistance.

A) B) C) D)

strategic experiential narrative structural

15) One variation of the patient-therapist relationship is exemplified by this model which instructs its therapists to empathize with a family’s predicament while also empowering them to use their own strengths to find solutions, from a position of partnership.

A) B) C) D)

solution focused Milan communications A and B

16) The use of ________ is designed to block or change dysfunctional behavior using indirect, seemingly illogical means.

A) B) C) D)

therapeutic double-binds paradox directives all of these choices

17) Though most family therapists invite everyone living under the same roof to the first session, members of this school do not insist on seeing the entire family.

A) B) C) D)

MRI structural behavioral A and C

18) Teams of observers positioned behind a one-way mirror are most commonly used by ________ family therapists.

A) B) C) D)

experiential behavioral Bowenian strategic

19) Which family therapy model incorporates intrapsychic concepts into their description of behavior disorders?

51 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 14: Comparative Analysis

A) B) C) D)

structural Bowenian solution-focused MRI strategic

20) While the broad goals of many family therapy schools are to solve presenting problems and to reorganize families, the primary aim of ________ therapists is to reorganize families.

A) B) C) D)

experiential strategic behaviorists structural

21) The only integrative approach to explore intrapsychic processes is the A) B) C) D)

externalization model solution-focused model integrative problem-centered metaframeworks therapy narrative-constructive model

22) Bowen’s notion of triangles, Haley’s focus on hierarchical control, and Minuchin’s concept of boundaries represent examples of the metaframework, A) B) C) D)

sequences internal processes development organization

23) The clinical application of metaframeworks is centered around the practice of ________ rather than finding deficits.

A) B) C) D)

externalizing the problem detriangling releasing constraints shifting cognitive constructions

24) Integrative problem-centered metaframework therapists A) B) C) D) E)

have conversations with families about potential constraints collaborate with family members to form hypotheses use a reflecting team to help re-story the family problem B and C A and B

25) ________ therapists take the position that the simplest and least expensive intervention should be tried before using more complex and expensive treatments.

A) integrative problem-centered metaframeworks therapy B) narrative solutions therapy C) integrative couple therapy 52 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 14: Comparative Analysis

D) none of these choices 26) The narrative solutions approach combines the insights of ________ with narrative techniques.

A) B) C) D)

experiential therapy structural therapy Bowenian theory MRI’s model

27) The narrative solutions approach revolves around the concept of ________, which assumes that people have strong preferences for how they would like to see themselves, and be seen by others.

A) B) C) D)

externalizing the problem preferred views emotional reactivity Self leadership

28) Jacobson and Christensen’s integrative couples therapy adds what element to traditional behavioral couples therapy?

A) B) C) D)

a functional analysis of behavior narrative reconstruction acceptance communications training

29) In contrast to traditional behavioral therapy, integrative behavioral couple therapy emphasizes A) B) C) D)

insight emotional experiencing accountability support and empathy

14.2 Short Answer 1)

How does the therapist’s role differ in narrative versus structural therapy?

2)

Choose a client with whom you have worked individually whose family history and situation you know fairly well. Briefly describe the presenting concern(s), your original case conceptualization, and the general therapeutic approach you took with this person. Then, discuss in some detail how you could conceptualize the client’s problem and situation from a family systems perspective. Include your assessment of life-cycle stage and of important family dynamics. Finally, describe the family systems approach that you could have taken with this client, how your role, strategy, and techniques would have differed, and what differences in outcome could be expected.

3)

Imagine that the following information has been provided to you about the ―Sanders‖ 53 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 14: Comparative Analysis

family, whom you will be seeing for the first time today.

Sue, 36, and Tom, 39, present for an initial consultation along with their two children-- Alice, 15, and Ted, 7. Sue does most of the talking, while Alice sits slumped in her chair with a sullen look on her face. Ted looks anxious and stays close to his mother. They have come because Sue is concerned about her children. Alice’s school performance has been deteriorating over the past year; she has gone from a ―B‖ student to a ―C‖ student. She also stays out late many school nights and fights constantly with her parents. Ted has refused to attend school for the past two weeks because, according to Sue, he is afraid of the other children. Tom is not very involved in the raising of the children. He travels frequently on business, and when he’s home, he goes out at night by himself.

A.

How might the Sanders’ problems be conceptualized from a family life cycle perspective (i.e., Carter & McGoldrick, 1999)? Feel free to speculate about the possible causes of the problems presented by the family. (1/3 of total points)

B.

Take any one of the theoretical perspectives discussed in the text and describe, from that orientation, how you would work with members of the Sanders family and why. Include expected goals and time frame for treatment, and the strategy and techniques you would employ in treating them. Be specific about how your plan could be suited to the needs of this family. Use only one theoretical approach (even though, of course, many are possible), and support your approach as the treatment of choice. (2/3 points)

4)

Some would argue that there is a radical divergence between the family systems therapies and the more traditional individual psychotherapy approaches. Others would challenge this view, arguing that there are many points of similarity and that the differences are exaggerated. Take one position or the other and defend your stand.

5)

Compare and contrast the strategic and structural approaches. Consider theoretical elegance; specificity of constructs, strategy, and technique; role of the therapist; and types of client problems best suited for each approach.

6)

Compare and contrast the Bowenian and experiential approaches. Consider theoretical adequacy; specificity of constructs, strategy, and technique; role of the therapist; and types of client problems best suited for each approach.

7)

A 37-year old woman who is unhappy with her marriage of 5 years is considering divorce and seeks consultation with you. She has lost 3 pregnancies in the past 3 years. Her 45-yearold husband avoids sex, even though he states he is ―not unwilling‖ to have a child. He is not interested in psychotherapy but might be willing to come in once or twice to see what it’s like.

Discuss how you would approach this case from a systems framework. Be specific about your rationale, the theoretical constructs you would employ, and the recommendation you would give her. Recommend only one approach (even though of course many are possible), and support your approach as the treatment of choice.

54 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 14: Comparative Analysis

8)

Which schools of family therapy rely most heavily on paradox. Describe two types of paradoxical techniques. What type of families and family problems might best be treated with these techniques? Discuss the problems associated with the use of paradoxical techniques in treating families.

9)

Explain the goals for an initial telephone contact with a family member, from a family therapy perspective. How might a family therapist attempt to convert a request for individual therapy into a family case?

10) Why and how should a family’s ethnic culture be considered in assessment and treatment?

(Pick at least one ethnic minority culture discussed in class and use the Sanders case--#3 above--on which to base your answers.) Be specific and thorough in your answer.

11) Give three examples of presenting problems that should be viewed (i.e., conceptualized) differently if expressed by a middle-income heterosexual couple and their family versus a middle-income gay or lesbian couple and their family. Explain your reasoning. Be specific and provide examples to support your answer.

12) Choose one family therapy approach studied this quarter and critique it from a feminist perspective. Discuss theoretical constructs, strategies and techniques, and role of the therapist.

13) List and give an example of at least four of Eron and Lund’s guidelines for managing helpful conversations within their narrative solutions approach.

14) What’s new about Jacobson and Christensen’s integrative couple therapy? How does the approach differ from traditional behavioral couples therapy?

15) Discuss at least three similarities between integrative couple therapy and Bowen family systems therapy.

16) Describe and give examples of how communication training is used in integrative couple therapy.

55 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Chapter 15: Research on Family Intervention

Chapter 15: Research on Family Intervention Short Answer/Essay 1.

Discuss some of the difficulties encountered in researching the process and outcome of family therapy. Consider samples, instruments, designs, ethics, etc.

2.

Choose one of the following theoretical concepts. Define the concept, then describe an original research program (one or more studies) that you believe would confirm or disconfirm the validity of the concept for understanding families or family therapy. (For example: ―If x is correct, then one should expect x to predict y in the following situations and x to be independent of y in the following situations.‖) Include: rationale for the study, operational definitions/measurement of variables, description of the sample. hypotheses, and limitations. a. b. c. d. e. f. g. h.

differentiation of self therapeutic double bind enmeshment/disengagement triangles homeostatis functionalism pseudomutuality multigenerational transmission of psychopathology

3.

Does family therapy work? Take a position for or against and cite empirical support for your position.

4.

What do we know about the process of family therapy? Base your answer on the available empirical evidence regarding the process of family therapy. Discuss what is not yet understood about the mechanisms of change in family treatment and suggest 2 or 3 directions for future research.

5.

Discuss the empirical evidence supporting the effectiveness of family treatment. For which family problems has it been shown most effective? For which problems is it less effective?

Cite relevant research in your responses.

6.

Explain the goals for an initial telephone contact with a family member, from a family therapy perspective. How might a family therapist attempt to convert a request for individual therapy into a family case? Cite relevant research and theory to support your answer.

7.

Discuss three types of empirically-supported family treatments for child behavioral disorders.

8.

Describe an empirically-validated treatment for adolescent drug abuse.

9.

Which types of couples generally do best in couples therapy?

10. What factors bias outcome studies in favor of certain models?

56 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Answer Keys

57 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Answers Keys

Multiple Choice Answer Key Chapter 1.

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B D A B B B D B C C B B D A B D D A B D B A D

Chapter 2.

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A D D B C B B C D B D C D B

Chapter 3.

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C A 58 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Answers Keys

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C B B A C D D

Chapter 4.

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E D B C C D B A D B B C D B D A D D D

Chapter 5.

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E E D D A B C A D A A A B D B C 59 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Answers Keys

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D D B B D C B

Chapter 6.

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D B B A D D B D A B D B D A D B D

Chapter 7.

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B A D C B C B B D C A D C B A A B C 60 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Answers Keys

19. B 20. B Chapter 8.

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C D A C B B D A B C D C D A D A B

Chapter 9.

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B D D A B C D C D A B B C D A

Chapter 10.

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D B D B 61 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.

Answers Keys

5. D 6. A 7. D 8. B 9. A 10. A 11. B 12. B 13. B 14. B 15. C 16. B 17. B Chapter 11.

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D C D B C D A A C A B D

Chapter 12 1.

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D C A A B A D B C D

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Answers Keys

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C B D A D B C A D A B

Chapter 14.

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B D D A C B A C A D B A B C A D D D B D C D C E A D B C D

63 Copyright © 2021, 2017, 2013 Pearson Education, Inc. All Rights Reserved.