False: Bion developed the idea of basic assumptions as primitive states of mind automatically generated when people combine in a group. The basic assumptions include pairing (the hope that coupling of individuals could lead to the birth of an individual or idea providing salvation), dependence (expecting the leader to provide solutions) and fight/flight (fleeing or engaging in a battle with others). He suggested that fantasies and emotional drives associated with the basic assumptions interfere with the explicit work task, preventing change and development (Brown & Pedder 1991, p. 122).

True: Interpersonal psychotherapy reduces psychiatric symptoms by improving the quality of the patient’s current interpersonal relations and social functioning. It is indicated in the treatment of depressive disorders, bulimia, binge eating disorder and for individuals facing conflict with significant others or having difficulty adjusting to life transitions. Interpersonal therapy assumes that the social and interpersonal context plays a role in the development and maintenance of some psychiatric disorders. Moreover, the patient’s relationships with others influence the response to treatment as well as the overall outcome (Sadock & Sadock 2005, p. 2617).

True: Compared to waiting list or routine treatment, interpersonal, supportive, cognitive behavioural and experiential therapies in both individual and group settings are more effective in the treatment of depression, anxiety, anger and distress and in improving quality of life in the context of HIV infection. Moreover, medication plus psychotherapy is more effective than either treatment alone (Sadock & Sadock 2005, p. 435).

True: The use of CBT techniques in the context of a collaborative therapeutic relationship can reduce the intensity with which delusions are held. Patients are encouraged to test the plausibility of their beliefs through guided discovery, thus enabling them to arrive at their own conclusion regarding the need to revise delusional beliefs (Sadock & Sadock 2005, p. 2603).

False: In a randomized controlled study comparing operant behavioural treatment and cognitive behavioural treatment with a waiting list control for the treatment of chronic low back pain, Turner & Clancy (1988) showed that both active treatments reduced physical and psychosocial disability as well as self reports of pain.

True: In cognitive therapy the therapist actively interacts with the patient, making it a collaborative venture in contrast to some other forms of psychotherapy. The therapy is structured in order to engage the participation of the patient in the empirical investigation of their thoughts, inferences, conclusions and assumptions (Beck et al 1979; Gelder et al 2006, p. 589; Johnstone et al 2004, p. 315).

True: In cognitive therapy, empirical investigation of the patient’s automatic thoughts, inferences, conclusions and assumptions is emphasized. The therapist does not accept the patient’s conclusions and inferences at face value and instead seeks to determine their validity by looking with the patient at the available evidence (Beck et al 1979; Johnstone et al 2004, p. 315; Sadock & Sadock 2005, p. 2599).

True: In cognitive therapy the therapist asks questions in order to elicit the idiosyncratic meanings that cause distress and to look for evidence in favour of or against such thoughts and beliefs. The use of questions to reveal the self-defeating nature of the client’s negative automatic thoughts has been termed ‘Socratic questioning’ (Johnstone et al 2004, p. 315).

False: Enmeshment is a term used in family therapy. In structural family therapy the family is viewed as a system with interacting subsystems. Clarity of boundaries between interacting subsystems is thought to be a good indicator of family functioning and should allow individuals to function without undue interference and also allow contact with other subsystems or individuals within the family. In some families there is a lack of contact (disengaged), whereas in others there is an extreme form of proximity and intensity referred to as ‘enmeshment’. In enmeshed families the individual gets lost in the system and the capacity to function independently is impaired (Minuchin 1974, p. 54; Sadock & Sadock 2005, p. 2586).

True: Linehan developed dialectic behavioural therapy for patients who repeatedly harm themselves, and who have borderline personality disorder. Patients learn problem-solving techniques for dealing with stressful events, including ways of improving social skills and controlling anger and other emotions (Bateman & Tyrer 2004; Gelder et al 2006, p. 599).

True: The therapist encourages symptomatic behaviours or other undesirable behaviours in an attempt to lessen such behaviours or bring them under control. Such tasks may result in the individual discovering that they do have some control or influence over things which they may have deemed beyond their influence resulting in a sense of helplessness (Dallos & Draper 2000, p. 50; Gelder et al 2006, p. 610).

False: Freud originally described introjection as a process of narcissistic identification in which the lost object is introjected and retained as part of the internal psyche. Freud later described it as the primary internalizing mechanism by which parental values are internalized at the resolution of the oedipal phase leading to the origin of the superego (Sadock & Sadock 2005, p. 720).

True: Strategic therapy uses interventions to reduce the power of symptoms over the family and to bring about change. It does not use a normative model of healthy family functioning but aims to enable the family to move towards a healthier way of relating. The therapist uses reframing, direct interventions and paradoxical injunctions to interrupt repetitive unproductive patterns (Stein et al 1999, p. 279).

False: ‘Group analysis’ refers to the theory and practice of group psychotherapy based on the work of S. H. Foulkes. In group analysis, man is viewed as a social animal born and brought up in a social situation in the context of which the individual’s personality develops. The individual is considered as a nodal point in a network of relationships in the group – the matrix. Group analysis attends to the individual’s current life situation more directly than in individual analytical therapy, emphasizing the ‘here and now’ and focusing less on the individual’s developmental history. Communication within the group is considered to be central and the group focuses not only on what is said but also on when, how and why. This allows for a deeper and richer understanding of the hidden communication (Aveline & Dryden 1988, p. 19).

True: In group psychotherapy the intensity of the transference towards the therapist is less as the group tends to absorb some of the transference feelings. Some of the roles of the therapist, e.g. providing support to struggling members, are taken on by group members, which reduces the intensity of the transference towards the therapist. The diluted transference is worked through in the interactions between group members (Aveline & Dryden 1988, p. 21).

False: In dynamic group psychotherapy, the therapist generally avoids giving direct instructions to the group or group members. Even though vicarious learning inevitably occurs in dynamic group psychotherapy, the therapist does not explicitly encourage this process (Aveline & Dryden 1988, p. 297).

False: The individual in the large group faces a particular dilemma between the wish to lose oneself in the group and maintaining one’s identity. This is partly due to the size of the large group, which means that the individual cannot have a relationship with all group members at an individual level, as is perhaps possible in a small group. It is the sense of individual identity acquired in relation to other people (through a process of recognizing one’s separateness from others and the separateness of others from oneself) that is under threat in the context of the large group (Kreeger 1975, p. 53).

True: An interpretation is a tentative hypothesis, a suggestion rather than a dogmatic assertion. According to psychodynamic therapists, the tentative hypothesis is offered as an invitation to a mutual exploration as opposed to a statement of fact (Brown & Pedder 1991, p. 78).

True: The term ‘negative therapeutic reaction’ refers to the worsening or reappearance of symptoms following some progress in analysis. Initially, it was thought of as an act of defiance but was later conceptualized as a paradoxical reaction to the accuracy of the interpretation. The negative therapeutic reaction is thought to be determined by aggressive and destructive instincts (Bateman & Holmes 1995, p. 165).

True: Patients with a reasonable level of personality integration (having the capacity to face emotions and continue to function independently), motivation for change, psychological mindedness, average intelligence, realistic expectations of therapy and the absence of psychosis, substance misuse and irresolvable life crisis have favourable outcomes in long-term insight-oriented psychotherapy. A good response to a trial interpretation is helpful in assessing the psychological mindedness of the individual (Mace 1995, pp. 18, 165; Sadock & Sadock 2005, p. 2486).

False: Supportive therapy is a long-term psychotherapy aimed at maximizing the patient’s strengths, restoring and maintaining psychological equilibrium and acknowledging but attempting to minimize dependence on the therapist. This is achieved by supporting their defences without attempting to restructure their personality, enlarging their behavioural repertoire, alleviating anxiety, and providing a secure and trusting relationship with the therapist. Supportive psychotherapy focuses on fostering and maintaining a positive transference at all times and minimizing the effects of negative transference, should it arise. The therapists need supervision to manage transference and countertransference issues (Sadock & Sadock 2005, p. 2494).

False: The four themes that characterize therapeutic communities include:

Other features of therapeutic communities include: Informality, Mutual help, Directness and honesty, Shared decisions, Shared activities, and Group meetings (Aveline & Dryden 1988, p. 163; Gelder et al 2006, p. 607).

False: In a therapeutic community, staff members are also members of the therapeutic community. They participate in informal social activities and relationships, e.g. preparing meals, etc. This helps break down the patient–staff barriers. However, such democratization has its limits and it is important to remember that the staff are there for the therapeutic benefit of patients and not for the gratification of their own personal needs (Aveline & Dryden 1988, p. 168).

False: Transference is an unconscious process in which the individual transfers onto the therapist and others experiences, attitudes and feelings experienced in the past in relation to significant others in early life. Inevitably, it affects the therapist and provides important information regarding the patient’s internal world.

False: If a patient becomes distressed in a session, the therapist should attend to the individual’s distress sensitively. It is important to allow the patient to be upset and express their distress. The therapist should also try to establish why the person became upset; cognitive therapists may choose to focus on the thoughts (hot cognitions) whereas a dynamic therapist may focus on the feelings. Generally speaking, the therapist should not extend the length of the session and should attempt to contain the distress within the boundary of the session. On occasions, patients may become extremely distressed and if there is a concern regarding their own safety or the safety of others then the assessment and management of risk should be the priority.