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Part I Multiple Choice (13 points)6 year old David cannot take no for an answer.


Part I Multiple Choice (13 points)6 year old David cannot take no for an answer. When he doesn’t get his way he throws a temper tantrum until his parents give in. In addition he is often defiant when his parents ask him to do something. David’s teacher says he is a model student in his 1st grade class. The most likely diagnosis is:a.. Oppositional-Defiant Disorder b. Attention-Deficit Hyperactivity Disorder c. Conduct Disorder d. Delinquent Disorder2. Jim (11) has been caught setting cats on fire, shooting birds with his pellet gun, and pulling a knife on a kid at school in order to get lunch money. Most recently he was caught shoplifting at Target. Jim boasted it was the first time he had been caught stealing in three years. When asked why he steals, Jim states, “Because I don’t feel like spending my money on CD’s. I’d rather spend it on pot.” The most likely diagnosis is: a. Kleptomania b. Oppositional-Defiant Disorder c. Conduct Disorder d. Delinquent DisorderJenny who is in the third grade often talks to her friends during class time. She rarely follows directions, often loses her school supplies and forgets to turn in her homework. She is a great kid but is really struggling in school. The most likely diagnosis is:a.. Oppositional-Defiant Disorder b. Attention-Deficit Hyperactivity Disorder c. Conduct Disorder d. Delinquent Disorder4. Larry hears voices telling him that he is the savior of the world and that he needs to assemble a group of followers to ascend French Hill next Saturday to await the coming of the Lord. Larry is most likely experiencing: a. ADHD b. Schizophrenia c. Schizoid Personality Disorder d. Demonization Disorder5. Two weeks ago Bonnie broke up with her boyfriend of four years. Since that time, Bonnie has been feeling miserable. She has been sleeping 14 hours a day, missing work, and socially isolated. She tells her friends that she has no reason to go on living. She says she doesn’t care about anything anymore and just wishes she could go to sleep and never wake up. This is the first time Bonnie has ever felt this way. The most likely disorder is: a. Bipolar disorder b. Major Depression c. Obsessive-compulsive disorder d. Schizophrenia6. Jake decides to take an F on his experimental psychology class project because he is afraid to touch the white rats. The most likely diagnosis is: a. Simple Phobia b. Social Phobia c. Oppositional-Defiant Disorder d. Panic Disorder7. Zach’s dream is to live in the wilderness of Alaska with his dog Homer after he retires from his computer programming job with Hi Tech Industries. Zach, age 50, has never had a romantic relationship with a woman and doesn’t seem to be bothered at all by that fact. He tells you he wants to live off the land and get away from all the crazy people in this world. Zach has been a very productive employee for Hi Tech and has earned lots of bucks designing state of the art software. He gets along relatively well with his coworkers but prefers to communicate through E-Mail rather than in person. The most likely diagnosis is: a. Paranoid Personality Disorder b. Schizotypal Personality Disorder c. Schizoid Personality Disorder d. Avoidant Personality Disorder8. Craig is an eleven year old boy who is very afraid of getting sick. He helps calm his fear by washing his hands whenever they feel contaminated. Lately Craig has been washing so much that his hands have begun to crack and bleed from the dryness. Craig wants to stop washing and worrying so much but he just can’t stop. The most likely diagnosis would be: a. Obsessive-Compulsive Personality Disorder b. Obsessive-Compulsive Disorder c. Obsessive Disorder d. Compulsive DisorderPart II Integration Readings (9 points)According to Dr. Propst, rank order the 3 activities in terms of their importance of providing training for a psychoanalyst with number 1 being the most important. The 3 activities are course work, supervision and personal analysis. (3 points)1.2.3.According to Dr. Mendez the practical integration of Christian faith can be done in an implicit or explicit way. What is the difference? (2 points)For the Christian psychologist there are two sources of truth: What are they? (2 points)Give an example of a pathogenic belief and a scriptural truth that can disconfirm it (2 points)Part III MicroskillsGive an example of the microskill listed after each vignette (16 points)I don’t want to kiss him yet, I’d rather take this relationship slow. I know he wants to kiss me but if he really cares about me then he will just have to wait until I’m ready. I know that may not sound fair but that is the best I can do. And you want to know something really weird. I’m wondering if I really believe myself. A part of me is saying heck go for it. There are a lot worse things that can happen to you in this world besides kissing a guy who looks like a work of art. It’s like I think sometimes I worry too much. Why not just have fun and let whatever happens be okay. Question to elicit meaning: Logical Consequence: Reframe: Interpretation:My assistant manager, Mark, at work is driving me crazy. He always has to be right, never admits a mistake and never apologizes when something is his fault. I think he has a narcissistic personality disorder or something. It just really aggravates me that we work so hard and he takes all the credit. And when something goes wrong then it is obviously our fault. I have no idea why he was even hired. He is such a jerk (client is visibly agitated and upset, her face is turning red and her fists are clenched). I can’t stand working for him, but I’m making good money so I can’t quit. I don’t know what to do. I tried talking to my Dad about it last night after work but he just made his usual remark, “I told you that place wasn’t right for you, maybe now you will listen to me.” Yeah, thanks Dad, that’s really what I needed to hear. The funny thing is that Mark doesn’t seem to bother everyone else as much as me. They just laugh at him behind his back when he acts like a jerk. But really it’s not that big of a deal. Because we have three assistant managers and I really like the other two so I probably shouldn’t worry about it. I’m sure I’ll get used to it. It’s really not that big of a deal. And like I said the money is great. Confrontation: Interpretation using the insight triangleI feel so frustrated with Michael. He is so selfish. He never appreciates anything I do for him. But I can’t handle life without him. I don’t know why but I love him so much. Sometimes I wish I had never met him because then I wouldn’t be going through so much pain. I can’t believe how much I hurt inside when I think of how little he seems to care for me. I mean it seems like he only wants me around when it’s convenient for him. That’s totally not fair. I do so much for him and he gives nothing. I hate that. And he makes fun of me because I go to Church. My faith is very important to me. I wish he would understand that. I wonder if God is punishing me because I’m dating a Non-Christian. What do you think? Logical Consequence: Feedback:Part IV Effective Counseling Diagram (3 points)Reproduce the exploring the internal world section of the Effective Counseling DiagramPart V Control Mastery Theory (19 points)Case #1 MaryMary has been referred to you for counseling by her Pastor. She is an attractive, 28 year-old woman who has been married to Andre for 7 years. They have two daughters, Madison (8) and Brook (5). Mary told her Pastor that she has been having doubts about whether or not Andre still loves her. She has not discussed her fears with Andre because she believes he will react defensively and ignore her even more. During her first session, she tells you that she and Andre have not had sex for over a month. She says she is worried that Andre may be interested in the star player on the USC tennis team which Andre coaches.Mary prays to God that Andre would treasure and cherish her, but no matter how hard she tries to hold in her complaints and acquiesce to Andre’s wishes, nothing seems to change. Mary wonders why God does not respond to her prayers to make her marriage work. Lately, Mary has been having trouble sleeping and she feels exhausted most of the time. Her physician has repeatedly told her that there is nothing medically wrong with her. Mary’s parents were married when Mary’s mother (Joan) was 18. Joan and Mary’s father (Steven) met in college at USC at a Fraternity party. Joan got pregnant with Mary her freshman year. Joan dropped out of USC and gave up her swimming scholarship in order to care for Mary. Joan and Steven married shortly after Steven graduated and they had two more girls in addition to Mary. Steven cheated on Joan when Mary was six and Joan was pregnant with their third child. When Joan discovered Steven’s infidelity, she “fell apart” in Mary’s words. Joan divorced Steven immediately.After the divorce, Mary grew up very fast. She tried to be the perfect child hoping that her mother would recover if she could make her mother happy. Mary rarely played with her friends after school and on weekends often feeling obligated to care for her two younger sisters and her mother. Joan became increasingly dependent on Mary as a confidant she could rely on for comfort and support. Mary recalled one particular occasion where she had to miss her High School Homecoming dance because her mother said she would kill herself if Mary left her side. Mary’s only outlet during her childhood was tennis, which she plunged into full force. She became one of the top junior tennis players in the country. Mary’s father rarely saw Mary after the divorce. He married his secretary and moved out of the state. Mary never understood how her father could leave her when she needed him so much. Mary recounted many painful memories of her father breaking promises to come out and visit her. She recalled his absence at the junior national tennis tournament, which she won. However, the victory felt hollow without her father there. During high school, Mary excelled in academics and sports but never heard her father say he was proud of her. As expected, her father missed her graduation even though he promised to attend. After high school, Mary went to USC on a full ride tennis scholarship. At USC Mary met Andre, who was an assistant coach for the women’s’ tennis team and ten years older than Mary. She was swept off her feet. Andre was very handsome and charismatic, but most importantly he was very interested in Mary. He often told her how beautiful she was which she loved hearing even though it was hard for her to believe. Andre was fun loving, had a great sense of humor, and was always the life of the party. This balanced out Mary, who was reserved and guarded, fearing that if she was open and honest with others they would reject her. Against her better judgment, Mary began a sexual relationship with Andre fearing that if she didn’t comply with his sexual advances he would leave her. This led to a unplanned pregnancy for Mary during her freshman year at USC. She dropped out of school to raise her child Madison. One year later, she married Andre and a year after that Andre took over as the head women’s tennis coach at USC. Although Mary often thought about finishing her degree, she did not go back to school because she felt her children needed her at home. Just last year her best friend talked her into enrolling in a degree completion program at the local private University. Married life has been difficult for Mary. She describes Andre as a “big kid.” She complains that he indulges the children too much and makes her look like the “bad guy.” She says Andre has changed so much since they were dating. She complains that he ignores her unless he needs something from her. Mary feels very alone. She worries that Andre doesn’t seem to be bothered by the fact that they haven’t had sex in over a month. Last week Mary discovered some text messages that Andre had been sending to his star player Veronica. In Mary’s view the text messages were very flirtatious and inappropriate. Mary is very depressed and afraid. She cries throughout most of her sessions as she recounts a lifetime of disappointment, hurt and pain. List a key trauma for Mary (1 point)List a pathogenic belief Mary might have related to survivor guilt (1 point)List a pathogenic belief Mary might have related to omnipotent responsibility (1 point) Give an example a of transference compliance test Mary might enact in therapy and how you would pass the test (2 points)Give an example of a non-compliance transference tests Mary might enact in therapy and how you would pass the test (2 points)Give an example of a passive into active test Mary might enact in therapy that stems from her relationship with her mother and how you would pass the test (2 points)Mary tells you that she was invited by her best friend to play in a tennis tournament next month in Arizona all expenses paid, and is not sure whether to accept the invitation, because she feels selfish for leaving her children behind. What type of guilt is she most likely experiencing? If she tells you she has decided to go to the tournament even though she feels guilty how is she testing you? How would you respond in a way that passes this test? (3 points)How can you respond to Mary’s belief that God has ignored her cries, utilizing the concept of the insight triangle? Hint: the then and there refers to her family of origin. (2 points)Mary tells you that she is thinking about dropping out of her degree completion program so she can focus more on her family. She asks you what you think. What kind of test is this and how will you pass it (2 points)At the end of one of Mary’s sessions she asks to go 10 minutes over so she can tell you something that she forgot to mention. From your history of Mary you know she has had trouble saying no to people who take advantage of her. What type of test is this? How can you pass it? (2 points)List one way Mary has identified with her mother out of loyalty guilt? Be specific (1 point)
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