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1. If a group becomes too large, more than _____, group interaction breaks down and the clients become a class made up of individuals, rather than a single, cohesive, therapeutic body.
A. 10
B. 15
C. 20
D. 25
2. Therapists should be careful to distinguish treatment groups from AA’s self-help approach, which, having no formal leadership, cannot provide meaningful accountability.
A. True
B. False
3. Retention rates are affected positively by:
A. Client preparation.
B. Maximum client involvement during the early stages of treatment.
C. Prompts to encourage attendance.
D. All of the above.
4. A very successful tactic therapists can use to try to forestall premature termination is by persuading clients who plan to leave group to attend just one more session. This gives other group members the opportunity to persuade the restless member not to drop out.
A. True
B. False
5. The first step toward wraparound services is to:
A. Recognize that wraparound services retain clients in therapy longer.
B. Document the need for them.
C. Recognize that wraparound services seldom flourish in isolation.
D. Search existing community resources that may identify services already in place.
6. A group member’s acceptance of the contract before entering a group has been described as the single most important factor contributing to the success of outpatient therapy groups.
A. True
B. False
7. Group members should know what information about them might be shared and why, how, and when this sharing occurs, so they do not feel betrayed when someone outside the group knows about something said within the group.
A. True
B. False
8. Touch in a group can be positive, negative, or neutral, and the leader should evaluate carefully any circumstances in which physical contact occurs.
A. True
B. False
9. Many clients treated for substance abuse also have histories of emotional and physical abuse, and merely directing attention toward them can trigger feelings of shame, thus, while it is extremely important to make connections between and among group members and to involve them in the process, the sensitive leader will not insist on recitations.
A. True
B. False
10. Termination is a time for:
A. Putting closure on the experience.
B. Examining the impact of the group on each person.
C. Acknowledging the feelings triggered by departure.
D. All of the above.
11. Every group facilitator working with substance abuse should understand and be prepared to deal with clients going through which process?
A. Denial
B. Anger
C. Grief
D. Depression
12. Interventions that work well early in treatment may be ineffective, and even harmful, if applied in the same way later in treatment.
A. True
B. False
13. Which therapeutic factor contributes to healing by liberating clients as they learn how to express feelings and reveal what is bothering them?
A. Catharsis
B. Interpersonal learning
C. Imitative behavior
D. Altruism
14. Each of the following existential factors aid clients in coming to terms with hard truths, except for:
A. Life can be unfair.
B. Life can be painful and death is inevitable.
C. Life isn’t faced alone if you have others you are close with.
D. Each of us is responsible for the ways in which we live.
15. Clinicians should view relapse as all of the following, except:
A. Failure of both the group leader and the client.
B. A clinical opportunity for both group leader and clients to learn from the event.
C. A chance to integrate the new knowledge.
D. A chance to strengthen levels of motivation.
16. During early treatment, the effective leader will focus on immediate, primary concerns, such as all of the following, except for:
A. Achieving abstinence
B. Affect regulation
C. Preventing relapse
D. Learning ways to manage cravings
17. Confrontation, if done too punitively or if motivated by a group leader’s countertransference issues, can severely damage the therapeutic alliance, and inappropriate confrontation may even strengthen the client’s resistance to change, thereby increasing the rigidity of defenses.
A. True
B. False
18. The leader can support the process of change by:
A. Drawing attention to new and positive developments.
B. Pointing out how far clients have traveled.
C. Affirming the possibility of increased connection and new sources of satisfaction.
D. All of the above.
19. All of the following are specific behaviors that group facilitators can emphasize the reality of constancy and security, except for:
A. Group leaders should sit next to a different client at each meeting as to not single out any particular client.
B. Group leaders should maintain specific start and end times.
C. Group leaders should maintain ground rules for speaking.
D. Group leaders should wear the same style of attire at each meeting.
20. One of the feelings that the group leader needs to be able to empathize with is _____, which is common among people with substance abuse histories.
A. Guilt
B. Shame
C. Denial
D. Anger
21. To determine the type of leadership required to support a client in treatment, the clinician should consider the client’s:
A. Capacity to manage affect
B. Level of functioning
C. Social supports
D. All of the above
22. When the group pressures a member to disclose information, the leader should remind the group that members need only reveal information about themselves at levels with which they are comfortable.
A. True
B. False
23. The group members should experience feelings at a level of arousal wherein feelings are undeniable and the group member is overcome.
A. True
B. False
24. A client can be severely damaged by emotional overstimulation.
A. True
B. False
25. If a client obviously is intoxicated at the beginning of the group, that person should be asked to leave and return for the next session in a condition appropriate for participation.
A. True
B. False
26. When physical boundaries are breached in the group, and no one in the group raises the issue, the leader should not call attention to the behavior.
A. True
B. False
27. Which of the following is an appropriate intervention used to help group members engage in meaningful dialog with each other?
A. Praising good communication when it happens.
B. Noticing a member’s body language, and without shaming, asking that person to express the feeling out loud.
C. When someone has difficulty expressing a thought, putting the idea in words and asking, “Have I got it right?”
D. All of the above.
28. Evidence is strong that direct, forceful, aggressive approaches are perhaps the most effective way to help people consider new information and change their perceptions.
A. True
B. False
29. Which form of countertransference is experienced when treating highly resistant populations, and cause leaders to feel powerless, demoralized, or even angry?
A. Feelings of having been there.
B. Feelings of helplessness when the therapist is more invested in the treatment than the client is.
C. Feelings of incompetence due to unfamiliarity with culture and jargon.
D. All of the above.
30. Countertransference is all of the following, except for:
A. Inevitable
B. A way to support the group process
C. Bad
D. Countertransference is all of the above
31. The effective leader will:
A. Ignore resistance.
B. Attempt to override resistance.
C. Welcome resistance as an opportunity to understand something important going on for the client or the group.
D. None of the above.
32. Sometimes resistance can be induced by leaders who are:
A. Passive
B. Guarded
C. Weak
D. Any of the above
33. It is particularly important to make the 12-Step program’s encouragement of “unquestioning acceptance” a focus of analysis in group therapy early in recovery.
A. True
B. False
34. Sponsors of 12-Step members may distrust therapy and discourage group members from continuing in treatment.
A. True
B. False
35. The 12-Step philosophy opposes therapy and medication.
A. True
B. False
36. The pregroup interview for long-term groups should ask what medications group members are taking and names of prescribing physicians so cooperative treatment is possible.
A. True
B. False
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