NCMHCE Counseling Theories and Theoretical Orientations — Questions and Answers
Question 1: Albert Ellis's Rational Emotive Behavior Therapy (REBT) uses the A-B-C model. What does 'B' represent in this framework?
- The behavioral response that follows an activating event
- The client's beliefs about the activating event that drive emotional consequences (Correct answer)
- The biological predisposition toward irrational thinking
- The balanced perspective the counselor helps the client achieve
Correct answer: The client's beliefs about the activating event that drive emotional consequences
In Ellis's A-B-C model, A = Activating event, B = Beliefs (rational or irrational) the client holds about the event, and C = Consequential emotions and behaviors. REBT holds that it is B, not A, that primarily causes emotional disturbance — making disputing irrational beliefs the core therapeutic task.
Question 2: A counselor using Solution-Focused Brief Therapy (SFBT) asks a client: 'Suppose tonight while you were asleep a miracle occurred and your problem was solved — what would be different when you woke up?' This technique is called:
- The empty chair technique
- Systematic desensitization
- The miracle question (Correct answer)
- Socratic questioning
Correct answer: The miracle question
The miracle question is a signature SFBT technique developed by Steve de Shazer and Insoo Kim Berg. It bypasses problem-focused thinking by inviting clients to imagine life post-solution, which helps identify goals and exceptions that can be built upon in treatment.
Question 3: Dialectical Behavior Therapy (DBT) was originally developed by Marsha Linehan to treat which primary population?
- Adults with obsessive-compulsive disorder
- Adolescents with conduct disorder
- Clients with borderline personality disorder (Correct answer)
- Veterans with post-traumatic stress disorder
Correct answer: Clients with borderline personality disorder
Linehan developed DBT in the late 1980s specifically for chronically suicidal individuals meeting criteria for borderline personality disorder. DBT combines behavioral science with acceptance and mindfulness (Zen) strategies and has since been adapted for eating disorders, SUD, and adolescents.
Question 4: In psychoanalytic theory, the defense mechanism in which unacceptable impulses are redirected toward a more acceptable or less threatening target is called:
- Projection
- Displacement (Correct answer)
- Reaction formation
- Sublimation
Correct answer: Displacement
Displacement shifts an emotion or impulse from its original target (often threatening) to a safer substitute — for example, a person who is angry at their boss comes home and yells at a family member. Projection attributes one's own unacceptable feelings to others; sublimation channels unacceptable impulses into socially acceptable behavior.
Question 5: Carl Rogers identified three core counselor conditions necessary and sufficient for therapeutic change. Which of the following correctly lists all three?
- Empathy, unconditional positive regard, and congruence (genuineness) (Correct answer)
- Warmth, active listening, and positive reinforcement
- Neutrality, reflection, and free association
- Acceptance, confrontation, and immediacy
Correct answer: Empathy, unconditional positive regard, and congruence (genuineness)
Rogers's person-centered theory holds that empathy (accurate understanding of the client's subjective world), unconditional positive regard (non-judgmental acceptance), and congruence (the counselor being authentic) are the necessary and sufficient conditions for therapeutic personality change.
Question 6: Narrative therapy, developed by Michael White and David Epston, primarily helps clients by:
- Analyzing how unconscious conflicts from early childhood drive current behavior
- Teaching clients to identify and restructure cognitive distortions
- Externalizing problems so clients can reauthor their life stories with preferred identities (Correct answer)
- Using behavioral experiments to test the validity of negative automatic thoughts
Correct answer: Externalizing problems so clients can reauthor their life stories with preferred identities
Narrative therapy holds that people make meaning through stories and that problems arise when dominant 'problem-saturated' stories define a person's identity. Externalizing ('the problem is the problem, not the person') and identifying 'unique outcomes' allows clients to co-author alternative, preferred narratives.
NCMHCE Counseling Theories and Theoretical Orientations
Albert Ellis's Rational Emotive Behavior Therapy (REBT) uses the A-B-C model.
What does 'B' represent in this framework?