PSTH Exam Revision:

Question 2:
You will be given multiple cases at the end of the document, answer the below
6 questions with each case: Remember to make applicable
deductions/linking/examples with each case
1. You are working from a psychoanalytical drive structure approach, a cognitive
behavioural approach and a Gestalt theory approach. Comment on the
following:
1.1] What are some assumptions we hold in this modality? (4)
1.2] How you make sense of his symptoms (4)
1.3] Your goals of therapy (2)
1.4] The therapeutic relationship (any idea of the nature/ dynamics thereof) (1)
1.5] The techniques in your therapy (8)
1.6] Any 2 limitations + strengths you will face in working with him (4)

Question 3:
The Moyo family, consisting of Mr. Moyo (45), Mrs. Moyo (42), and their three
children, Nkosi (19), Thembi (16), and Sibusiso (12), presented with significant
conflict and tension. Mr. Moyo's authoritarian parenting style had created a
hierarchical structure which resulted in problems of open communication among
family members. Mrs. Moyo's emotional withdrawal and lack of involvement had
further worsen the issue. Nkosi, the eldest, rebelled against his father's strict rules,
while Thembi struggled with self-esteem and body image issues which led her stop
pursuing her love for art, because her parents thought that being an artist is not a
stable career. Sibusiso, the youngest, acted out at school to garner attention. The
family's dynamics were characterized by defined roles: Mr. Moyo as provider and
disciplinarian, Mrs. Moyo as caregiver and mediator, Nkosi as rebel and scapegoat,
Thembi as peacemaker and people-pleaser, and Sibusiso as attention-seeker.
3.1. Use the two sub-therapies of family therapy to make sense of the Moyo family
problems/ symptoms. (4)
3.2. Which therapeutic techniques will you use to help this family? Clearly state in
which of the two sub-therapies do these techniques fall under. (2)
3.3. Which of the two-family therapies is most effective? Use the goals of the
therapies to motivate your answer. (2)

Question 4:
Describe the basic assumptions of these theories:
 Community counselling
 Behavioural Therapy
 Discursive Therapy
 Social Interest Therapy
  Family Counselling
 Relational Structure
 Employment counselling
 Indigenous therapy

Question 5:
5.1. List any 3 behavioural styles and provide an example for each (6).
5.2. Discuss the step three and four of the employment counselling process (4)
5.3. Differentiate between the educational role and social advocacy role techniques
and make example for each (4).
5.3. Discuss Super’ theory (2)
5.4. Define the self-advocacy and career adaptation theory and list the types of
adaptation that people need counselling for (4)
5.5. What are the symptoms, goals, techniques, counsellor relationship and
strengths of Employment and vocational therapy? (10)
5.6. Name and explain any five of Holland’s personal and environmental categories.
(10)

Question 6:
Thembi was later diagnosed with depression and had to take medication. The
therapist helped Thembi to change the way she sees herself, her low self-esteem
and body image issues. She decided to take charge of her own life and not be a
people pleaser or a peace maker in her family which often led to her supressing her
feelings and avoiding confrontations. This made her realize her capabilities and led
her towards having a sense of control over her life and ultimately towards recovery.
The therapist then introduced Thembi to community art schools that she can attend,
youth development programmes that will her publish her art which will help her
develop opportunities for future employment.
6.1. Define the three types of changes and clearly show examples from the cases
study. (6)
6.2. What are some of the challenges and benefits that Thembi could face while
making changes to her life situation? (3)
6.2. Thembi’s therapist later decided to include her family after a couple of sessions
with her. Which counsellor orientation that is illustrated and how can it benefit
Thembi (2)

Question 7:
7.1. Identify which ethical dilemmas are illustrated in the following case vignettes.
7.1.1. Thembisa, a 17-year-old, shares her pregnancy with her school counsellor,
Ms. Nkosi. Thembisa's parents are unaware of the pregnancy. The school's policy
requires notifying parents about sensitive issues.
7.1.2. During a session, Mr. Khumalo, a counsellor, shares his personal struggles
with addiction to help his client, Sibusiso, feel more comfortable opening up.
7.1.3. A therapist found out that his client is a black male and unconsciously
assumed that he is in therapy because of problems associated with poverty,
discrimination and historic marginalisation.
7.1.4. A counsellor assumes her Asian client's cultural background contributes to
their mental health issues without exploring individual circumstances.
7.1.5. A counsellor, Mr. Moyo, is unsure about treating a client with a complex issue
beyond his expertise, but still continues treatment.
7.1.6. Ms. Patel, an elderly client with dementia, wants to make her own financial
decisions. However, her cognitive decline raises concerns about her ability to do so.
7.1.7. Ms. Nel’s client showed physical symptoms and stated that she hears voices
and see people in her room after a couple of counselling sessions. Ms. Nel had to
communicate with a psychiatrist about her client. She later included a nurse and a
social worker so that they can communication as a team to help her client.
7.1.8. A clinician uses outdated and stigmatizing language in a client's diagnosis.
7.1.9. Linda, a psychologist who just landed her first job offered to counsel her friend
after she showed symptoms of depression due to miscarriage.
7.1.10. John, a counsellor, refused to interact with a client because he felt like he is
different from him, he kept on steering their conversation towards what suits him.
7.1.11. A counsellor failed to recognize and include community-level problems into
the counselling process that might influence her client’s depression and anxiety such
as unemployment.
7.1.12. Ms linda, a counsellor, recently found out about her client’s suicidal attempt,
she is also concerned about how her client make ‘jokes’ about harming her ex-
boyfriend.
7.1.13. Percy believes that his knowledge as a counsellor is enough to know what is
important for his client, he has never considered his client’s family as potentially
contributing to his client’s problems.

Question 8:
 8.1. Considering the case of Nobuhle, illustrate how and why you will use this
specific technique (7)
8.1.1. aversion therapy
8.1.2. Naming
8.1.3. Diagnostic formulations
8.1.4. Health-for-all by all
8.1.5. asking the question
8.1.6. empathetic understanding
8.1.7. cleansing and scarification
8.2. Considering the case of Johannes, illustrate how and why you will use this
specific technique (7)
8.2.1. Making use of and relying on critical consequences
8.2.2. Reflective questions
8.2.3. Expectation
8.2.4. spitting in the soup
8.2.5. Externalisation
8.2.6. genuineness
8.2.7. systematic desensitisation
8.3. Considering the case of Sipho, illustrate how and why you will use this specific
technique (7)
8.3.1. token economics
8.3.2. pleasing someone
8.3.3. enactment
8.3.4. Spiritual Techniques
8.3.5. Extreme-formulation
8.3.6. homework
8.3.7 Development of allies

Question 9:
A counsellor went all out for her client making sure that evaluates and apply her
authenticity in all the steps of the counselling process.
9.1. Identify and give brief explanations of the skills and attitudes that a counsellor
should have (6)
9.2. Describe the process that this counsellor used to help her client (10)
9.3. What are the goals to achieve or the skills to possess in order to show healthy
scepticism as a counsellor? (3)
9.5. Define multiculturalism and explain why it is important for a counsellor to be
aware of his/her own cultural and social identities and values, beliefs and biases (7)
9.4. This counsellor further empowered her client to stand up for herself and
advocate for social issues she faces in the community. List and explain the three
levels of changes under this orientation and describe how this counsellor could use
social justice orientation to even further help her client (8).

Test yourself Tip: choose one case from Q2 & answer the 5
q’s + 3 modalities assumptions + 2 techniques each with
Nobuhlle/Sipho/Johannes and the rest of the questions needed
and time yourself for 2 hours. Basically, only do what is
expected of us as per the exam scope, then time yourself.

You are one step closer to walking on that Callie Human

Stage. Remember to pray at ALL times, and treat this like a
regular semester test that just happens to be 2 hours (to
reduce anxiety). Goodluck!!
In case of self-doubt: Read Philippians 4 verse 13, and
remember that you have exactly what it takes, otherwise, how
would you have made it this far (final year)? Lamaphupho
awakho ngeke afezeke if you doubt yourself now will they?
Bangene!!!

Question 2 Case Studies:

1. Bonolo is a 56-year-old, married black woman presenting with fibromyalgia,
difficulty sleeping, and a history of anxiety and depression. She reports feeling
stress and isolation in her job and is having a difficult time managing her
multiple roles. Bonolo is the oldest of five children, and after her parents'
 divorce, she took on the responsibility of caring for her younger siblings.
Bonolo, an accountant, has been married to Mehlo, a schoolteacher, for 31
years. She states they have ups and downs but basically their relationship is
supportive. Because Bonolo is the only person speaking up for issues of
diversity and racial equality at her workplace, she often feels isolated and
tired. She does not have enough time to spend with friends or to do the things
she once enjoyed because of her long work hours. Bonolo also helps her
adult children with their bills when needed and is the primary caretaker of her
mother, who lives with her and is in the advanced stages of dementia. This is
Bonolo's first time in formal counselling. She reports having gone to her pastor
when she was feeling 'down' in the past. Bonolo also reports times of being
sexually molested by an older cousin. She seeks counselling because she is
having difficulty staying focused at work and is generally feeling sad and
overwhelmed. Bonolo also reports experiencing a great deal of anxiety. She
states she is not suicidal but is "sick and tired of feeling sick and tired". Bonolo
summarises her current situation saying, "I realised the other day that I am
tired of just existing and surviving. So here I am". Bonolo was referred to Dr
Kirksey by the pastor of her church. Despite the many challenges in her life,
Bonolo says that her faith in God is strong and church has always been her
place of refuge.

2. Meet Maya, a 35-year-old single mother who has been struggling to cope with
the loss of her partner two years ago. She has been feeling overwhelmed by
grief, guilt, and anxiety, which has affected her relationship with her 7-year-old
daughter, Sophia. Maya finds it hard to manage Sophia's behavioural issues
at school like bullying other kids, and this often makes her feel like she's
failing as a parent. She also struggles with social anxiety, avoiding social
gatherings and feeling disconnected from friends and family. Maya has a hard
time opening up about her emotions and feels stuck in her grief, unsure of
how to move forward and find meaning in her life again.

3. George is a 35-year-old high school teacher who was recently hospitalized

due to depression and anxiety symptoms. George has a traumatic childhood –
mainly due to an absent mother figure who left the family when George was
still a baby. George often dreams about how he strangles his mother due to
his anger towards her. Furthermore, he reports that his current job demands
long hours, which negatively affects his marriage. His wife complains that
George often ‘overworks’ his work because he lacks self-confidence. She
mentions that he involves himself with every possible extra mural school
activity in an attempt to prove himself. When the psychologist asks George
about his lack of self-confidence, he totally denies it and says, “there is
nothing wrong with his ego”. George believes that he was not good enough of
a child for his mother to love him; therefore, he needs to prove his worthiness
through his achievements as a teacher.