Chapter 18: Quiz
1. The meta-analytic evidence on therapy effectiveness shows:
- A) Therapy doesn't work better than no treatment
- B) Therapy consistently outperforms no treatment for depression, anxiety, PTSD, OCD, and other conditions with medium effect sizes
- C) Only medication works for mental health conditions
- D) All forms of therapy are equally effective for all conditions
Answer: B. Meta-analyses spanning thousands of studies show therapy outperforms no treatment with medium effect sizes (d ≈ 0.5–0.8), comparable to many medical treatments.
2. The "dodo bird verdict" claims that:
- A) Therapy doesn't work
- B) Different therapy approaches produce roughly equivalent outcomes, suggesting common factors matter more than specific techniques
- C) Only one type of therapy works
- D) Birds have better mental health than humans
Answer: B. The dodo bird verdict suggests that what therapies share (therapeutic alliance, hope, structure) matters more than how they differ. This holds for many conditions but breaks down for specific conditions like OCD and PTSD.
3. Therapist effects account for approximately what percentage of therapy outcome variance?
- A) Less than 0.1%
- B) 1%
- C) 5–8%
- D) 50%
Answer: C. Therapist effects (~5–8%) are approximately 5–8 times larger than therapy type effects (~1%), making the specific therapist one of the strongest predictors of outcome.
4. For which condition is CBT with exposure and response prevention (ERP) particularly effective?
- A) Schizophrenia
- B) OCD (Obsessive-Compulsive Disorder)
- C) Autism spectrum disorder
- D) Intellectual disability
Answer: B. CBT with ERP has some of the largest effect sizes in all of psychotherapy (d ≈ 1.0+) for OCD. This is a case where the specific approach matters significantly.
5. The primary difference between TikTok therapy and evidence-based therapy is:
- A) Evidence-based therapy is less warm
- B) TikTok therapy emphasizes validation and insight; evidence-based therapy emphasizes skills, behavior change, and exposure (which involves discomfort)
- C) They are identical in approach
- D) Evidence-based therapy never uses validation
Answer: B. Evidence-based therapy is both warm AND challenging. The discomfort of exposure therapy, cognitive restructuring, and behavior change is part of the mechanism of change — something the TikTok version tends to minimize.
6. Therapy response rates for evidence-based approaches are approximately:
- A) 10–20%
- B) 50–65%
- C) 90–100%
- D) 100% for CBT, 0% for other approaches
Answer: B. Approximately 50–65% of patients show clinically meaningful improvement with evidence-based therapy. This means therapy works for the majority but not for everyone.
7. The therapeutic alliance refers to:
- A) A formal contract between therapist and client
- B) The quality of the relationship between therapist and client — warmth, trust, agreement on goals, and collaboration
- C) An insurance agreement
- D) The alliance between different therapy schools
Answer: B. The therapeutic alliance is one of the strongest predictors of therapy outcome, regardless of the specific therapeutic approach used.
8. If therapy isn't working after 8–12 sessions, the chapter suggests considering all of the following EXCEPT:
- A) The wrong approach for the specific condition
- B) The wrong therapist
- C) Blaming yourself for not trying hard enough
- D) An undiagnosed condition or unaddressed life circumstances
Answer: C. The chapter explicitly states that if therapy isn't working, it's not necessarily the client's fault. The problem may be the approach, the therapist, an undiagnosed condition, or life circumstances.
9. For mild depression, the evidence suggests:
- A) Medication is always the best first-line treatment
- B) Therapy and lifestyle interventions (exercise, sleep, social connection) may be more appropriate first-line treatments than medication
- C) No treatment is needed for mild depression
- D) Only hospitalization is appropriate
Answer: B. For mild depression, the drug-placebo difference is small, and therapy plus lifestyle interventions may be more appropriate first-line approaches.
10. The chapter's overall message about therapy effectiveness is:
- A) Therapy always works perfectly for everyone
- B) Therapy doesn't work at all
- C) Therapy works for many people, but effectiveness depends on the specific approach for the specific condition, the skill of the therapist, and the client-therapist match — and not all therapy approaches have evidence
- D) Only medication works
Answer: C. The chapter supports therapy's overall effectiveness while introducing important nuances about approach-condition matching, therapist skill, and the limits of the dodo bird verdict.