Principles of Psychotherapy — MCQs
Which of the following scientists propagated the 'therapeutic community concept'?
A 24-year-old female with emotionally unstable personality disorder develops strong feelings for her therapist, believing he understands her emotions. This scenario is an example of:
Therapeutic exposure is a form of_______ therapy.
McNaughton's rule relates to?
Wrong statement about psychoanalysis is:
Best therapy suited to teach daily life skill to a mentally challenged child:
In which of the following scenarios is supportive therapy LEAST likely to be given?
Who coined the term "Id" in psychology?
Systematic desensitization is a therapeutic technique used in which of the following conditions?
What are the indications for Electroconvulsive Therapy (ECT)?
Principles of Psychotherapy Indian Medical PG Practice Questions and MCQs
Question 1: Which of the following scientists propagated the 'therapeutic community concept'?
- A. Freud
- B. Maxwell Jones (Correct Answer)
- C. JB Watson
- D. Adler
Explanation: ***Maxwell Jones*** - **Maxwell Jones**, a British psychiatrist, is widely credited with developing and promoting the **therapeutic community concept** during the mid-20th century. - He implemented this approach in psychiatric hospitals, emphasizing patient participation, shared responsibility, and a democratic structure to facilitate recovery. *Freud* - **Sigmund Freud** is the father of **psychoanalysis**, focusing on unconscious processes, childhood experiences, and individual therapy rather than a communal treatment model. - His work involved concepts like the **id, ego, and superego**, dream analysis, and transference in a one-on-one therapeutic setting. *JB Watson* - **John B. Watson** was a pioneering psychologist who established the school of **behaviorism**, emphasizing observable behavior and classical conditioning. - His contributions are related to learning theory and the study of environmental influences on behavior, not community-based psychiatric treatment. *Adler* - **Alfred Adler** developed **individual psychology**, focusing on feelings of inferiority, striving for superiority, and social interest. - While he emphasized social connections, his approach involved individual counseling and understanding personality dynamics, distinct from the communal living and treatment model of a therapeutic community.
Question 2: A 24-year-old female with emotionally unstable personality disorder develops strong feelings for her therapist, believing he understands her emotions. This scenario is an example of:
- A. Therapist's positive feelings
- B. Positive transference (Correct Answer)
- C. Negative transference
- D. Countertransference
Explanation: ***Positive transference*** - **Positive transference** occurs when a patient develops feelings of admiration, love, or attachment towards their therapist, often projecting past positive relationships onto them. - In this scenario, the patient's strong feelings and belief that the therapist understands her emotions, stemming from her **emotionally unstable personality disorder**, align with the characteristics of positive transference. *Negative transference* - **Negative transference** involves the patient projecting negative feelings, such as anger, hostility, or distrust, onto the therapist. - The patient's feelings for the therapist are described as strong and positive, indicating a connection rather than animosity or resentment. *Countertransference* - **Countertransference** refers to the therapist's emotional reactions or feelings toward the patient, which might be influenced by their own past experiences or unresolved conflicts. - This option focuses on the patient's feelings and perceptions, not the therapist's, making it an inappropriate fit for the described scenario. *Therapist's positive feelings* - This option describes the **therapist's feelings**, not the patient's, making it a mismatch for the question's focus on the patient's emotional response. - While a therapist might develop positive feelings toward a patient, the scenario explicitly details the patient's perspective and her strong feelings for the therapist.
Question 3: Therapeutic exposure is a form of_______ therapy.
- A. Behavioural (Correct Answer)
- B. Supportive
- C. Cognitive
- D. Psychoanalytical
Explanation: ***Behavioural*** - **Therapeutic exposure** is a core technique in **behavioral therapy**, particularly in the treatment of anxiety disorders, phobias, and PTSD. - It involves **gradually confronting feared objects, situations, or thoughts** to reduce anxiety and avoidance behaviors through processes like **habituation** and **extinction**. *Supportive* - **Supportive therapy** focuses on providing **empathy, encouragement, and practical advice** to help individuals cope with stressors and improve their functioning. - While it can involve discussing difficult situations, it does not typically involve **direct, structured exposure** to feared stimuli. *Cognitive* - **Cognitive therapy** primarily targets **maladaptive thought patterns** and beliefs, aiming to identify and restructure them. - While insights gained in cognitive therapy can support exposure work, **exposure itself is a behavioral technique**, not a cognitive one. *Psychoanalytical* - **Psychoanalytical therapy** explores **unconscious conflicts, early childhood experiences, and defense mechanisms** to gain insight into present psychological difficulties. - This approach relies heavily on **free association, dream analysis, and transference**, rather than direct exposure methods.
Question 4: McNaughton's rule relates to?
- A. Medical negligence
- B. Criminal responsibility of insane (Correct Answer)
- C. Inquest
- D. Professional secrecy
Explanation: ***Criminal responsibility of insane*** - **McNaughton's rule** (also spelled M'Naghten rule) is a legal test for criminal insanity, stating that a defendant is not guilty by reason of insanity if, at the time of committing the act, they were suffering from a **defect of reason, from disease of the mind**, as not to know the nature and quality of the act they were doing, or if they did know it, that they did not know what they were doing was wrong. - This rule establishes the criteria for determining whether an individual's mental state at the time of a crime exempts them from **criminal responsibility**. *Medical negligence* - **Medical negligence** involves a healthcare professional's failure to provide care that meets the accepted standard, resulting in harm to a patient. - This concept is governed by principles such as the **Bolam test** or the **Bolitho test** in various jurisdictions, not McNaughton's rule. *Inquest* - An **inquest** is a judicial inquiry to ascertain the facts concerning an incident, especially a death, often conducted by a coroner. - It focuses on determining the **cause of death** and the circumstances surrounding it, not on the criminal responsibility of an accused. *Professional secrecy* - **Professional secrecy** (or confidentiality) refers to the ethical and legal obligation of professionals, including medical practitioners, to protect sensitive information shared by their clients or patients. - This principle is governed by **ethical codes** and **data protection laws**, not by McNaughton's rule.
Question 5: Wrong statement about psychoanalysis is:
- A. Transference is patient's feeling for therapist
- B. Counter transference is clinician's feelings for patient
- C. Parapraxis has meaning
- D. Unguided communication has no meaning (Correct Answer)
Explanation: ***Unguided communication has no meaning*** - In **psychoanalysis**, every form of communication, including **unguided communication**, is believed to carry significant meaning, often reflecting unconscious thoughts or conflicts. - This statement is incorrect because the core tenet of psychoanalysis involves interpreting seemingly random or unguided expressions to uncover deeper psychological truths. *Transference is patient's feeling for therapist* - **Transference** is a central concept in psychoanalysis where a **patient's unconscious feelings and attitudes** from past relationships are redirected and expressed towards the therapist. - These feelings can be positive or negative and are crucial for understanding the patient's relational patterns. *Counter transference is clinician's feelings for patient* - **Countertransference** refers to the **therapist's emotional reactions** and unconscious feelings towards the patient, often triggered by the patient's transference. - Recognizing and managing countertransference is essential for maintaining objectivity and therapeutic effectiveness. *Parapraxis has meaning* - **Parapraxis**, also known as a **Freudian slip**, refers to an error in speech, memory, or action that is believed to reveal **unconscious thoughts or desires**. - Psychoanalysis posits that these slips are not random but instead carry hidden meaning, providing insight into the individual's unconscious mind.
Question 6: Best therapy suited to teach daily life skill to a mentally challenged child:
- A. Contingency management (Correct Answer)
- B. Cognitive reconstruction
- C. Self instruction
- D. CBT (Cognitive behavior therapy)
Explanation: ***Contingency management*** - This therapy involves consistently **rewarding desired behaviors** and withholding rewards for undesirable ones, which is highly effective for teaching new skills to individuals with intellectual disabilities. - It uses principles of **operant conditioning** to shape behavior through positive reinforcement, making it suitable for acquiring daily living skills. *Cognitive reconstruction* - This technique focuses on identifying and changing **maladaptive thought patterns**, which typically requires a higher level of cognitive function. - It is generally not the primary or most effective approach for teaching concrete daily life skills to individuals with significant **cognitive limitations**. *Self instruction* - This involves teaching individuals to guide their own behavior using **internal verbal cues** or self-talk. - While beneficial for some, it often requires a certain degree of **abstract thinking** and memory, making it less suitable as a standalone method for those with profound cognitive challenges in acquiring basic skills. *CBT (Cognitive behavior therapy)* - CBT integrates cognitive and behavioral strategies to address emotional and behavioral problems by modifying **thoughts, feelings, and behaviors**. - While beneficial for a range of psychological issues, its emphasis on **cognitive restructuring** makes it less directly applicable or the most effective first-line therapy for teaching concrete, functional daily living skills to mentally challenged children.
Question 7: In which of the following scenarios is supportive therapy LEAST likely to be given?
- A. Patient who is severely ill and not cooperative.
- B. Person who is motivated and has control over their emotions. (Correct Answer)
- C. Person with cognitive and functional abilities.
- D. Patient who is severely ill and has significant psychological impairment.
Explanation: ***Person who is motivated and has control over their emotions.*** - Patients who are **highly motivated** and have **good emotional control** are ideal candidates for **insight-oriented psychotherapy** (such as psychodynamic therapy or psychoanalysis), NOT basic supportive therapy. - Supportive therapy is a **less intensive** form of treatment that focuses on symptom relief, maintaining functioning, and strengthening existing defenses rather than developing insight. - Using supportive therapy for such motivated patients would be **underutilizing their therapeutic potential** and capacity for deeper psychological work. - These patients can engage in more challenging therapeutic work that requires introspection, emotional processing, and behavioral change. *Patient who is severely ill and not cooperative.* - **Supportive therapy is specifically indicated** for severely ill and uncooperative patients who cannot engage in insight-oriented work. - This approach requires **minimal patient cooperation** and focuses on maintaining stability rather than achieving insight. - Non-directive, empathic support can still benefit patients with limited engagement capacity. *Person with cognitive and functional abilities.* - While such patients could benefit from more intensive therapies, supportive therapy can still be appropriate in certain contexts. - Cognitive and functional abilities alone don't preclude the use of supportive interventions. *Patient who is severely ill and has significant psychological impairment.* - These patients are **prime candidates for supportive therapy**, which is designed for individuals with limited psychological resources. - Supportive therapy aims to strengthen existing defenses, provide reassurance, and maintain functioning without requiring deep insight or emotional processing. - This is one of the **main indications** for supportive psychotherapy.
Question 8: Who coined the term "Id" in psychology?
- A. Walker
- B. Bleuler
- C. Freud (Correct Answer)
- D. Skinner
Explanation: ***Correct: Freud*** - The concept of the **"Id"** is a cornerstone of **Freudian psychoanalytic theory**, representing the primitive and instinctual component of the personality - Sigmund Freud introduced the id, ego, and superego to describe the **three parts of the human personality** and how they interact to influence behavior - The term "Id" is derived from the Latin word meaning "it," translated from Freud's German term "Es" *Incorrect: Skinner* - **B.F. Skinner** was a prominent figure in **behaviorism**, focusing on **operant conditioning** and the role of reinforcement and punishment in shaping behavior - His theories did not involve the psychoanalytic constructs of id, ego, or superego *Incorrect: Walker* - The name "Walker" is not commonly associated with foundational theories of personality psychology - There is no well-known psychologist named Walker who coined major psychological terms like the "Id" *Incorrect: Bleuler* - **Eugen Bleuler** is known for his work on **schizophrenia**, a term he coined, and for identifying its core symptoms - His contributions were primarily in descriptive psychiatry, not in the psychodynamic theory of personality structures like the id
Question 9: Systematic desensitization is a therapeutic technique used in which of the following conditions?
- A. Dissociation
- B. Phobia (Correct Answer)
- C. Schizoid personality
- D. Psychosis
Explanation: **Explanation:** **Systematic Desensitization** is a behavioral therapy technique developed by **Joseph Wolpe**, based on the principle of **Classical Conditioning** (specifically **Reciprocal Inhibition**). The core concept is that a person cannot be anxious and relaxed at the same time. It involves three steps: training in deep muscle relaxation (Jacobson’s Progressive Muscle Relaxation), constructing a hierarchy of anxiety-provoking stimuli, and gradual exposure to these stimuli while maintaining a relaxed state. * **Why Phobia is Correct:** Systematic desensitization is the treatment of choice for **Specific Phobias** (e.g., fear of heights, spiders). By pairing the feared object with relaxation, the "anxiety response" is replaced by a "relaxation response" (Counter-conditioning). **Analysis of Incorrect Options:** * **Dissociation:** Managed primarily through supportive psychotherapy, hypnosis, or "Amobarbital interviews" to recover repressed memories, rather than behavioral conditioning. * **Schizoid Personality:** This is a personality disorder characterized by social detachment. Treatment focuses on social skills training or supportive therapy; desensitization is ineffective as there is no specific phobic stimulus. * **Psychosis:** Conditions like Schizophrenia require pharmacotherapy (Antipsychotics). Behavioral therapies are used only for social rehabilitation, not for treating core psychotic symptoms. **High-Yield Clinical Pearls for NEET-PG:** * **Founder:** Joseph Wolpe. * **Basis:** Reciprocal Inhibition / Counter-conditioning. * **Hierarchy:** Uses the **SUD scale** (Subjective Units of Distress) to rank fears. * **In-vivo vs. Imaginal:** While Wolpe used imaginal exposure, **In-vivo exposure** (real-life) is now considered more effective for most phobias. * **Flooding:** A related technique where the patient is exposed to the maximum intensity of the feared stimulus immediately (preventing the avoidance response).
Question 10: What are the indications for Electroconvulsive Therapy (ECT)?
- A. Paranoid schizophrenia
- B. Depression with suicidal tendency (Correct Answer)
- C. Neurotic depression
- D. All of the above
Explanation: **Explanation:** Electroconvulsive Therapy (ECT) is a biological treatment involving the induction of a generalized seizure through electrical stimulation. In modern psychiatry, the primary indication for ECT is when a **rapid clinical response** is required or when pharmacological treatments have failed. **Why Option B is Correct:** Severe **Depression with suicidal tendency** is the absolute first-line indication for ECT. When a patient is actively suicidal, the 2–4 week lag period of antidepressants is too risky. ECT provides the fastest reduction in depressive symptoms and suicidal ideation, making it a life-saving intervention in emergency psychiatry. Other major indications include severe catatonia and treatment-resistant mania. **Why Other Options are Incorrect:** * **A. Paranoid Schizophrenia:** While ECT can be used as an adjunct in schizophrenia (especially if catatonic or affective symptoms are present), it is not the primary or first-line treatment. Antipsychotics remain the mainstay. * **C. Neurotic Depression:** Also known as Dysthymia or Persistent Depressive Disorder, this condition is characterized by low-grade, chronic symptoms often linked to personality and psychosocial stressors. It responds better to psychotherapy and SSRIs; ECT is generally ineffective for non-psychotic, neurotic-level depression. **High-Yield Clinical Pearls for NEET-PG:** * **Most common side effect:** Retrograde amnesia (usually resolves). * **Absolute Contraindication:** There are no absolute contraindications, but **Increased Intracranial Pressure (ICP)** is the most significant relative contraindication due to the risk of brain herniation. * **Modified ECT:** Involves the use of an anesthetic (Thiopental/Propofol) and a muscle relaxant (**Succinylcholine**) to prevent bone fractures. * **Electrode Placement:** Bilateral (Gold standard for efficacy) vs. Unilateral (Lower cognitive side effects).
Want unlimited practice?
Get full access to all questions, explanations, and performance tracking.
Start For Free