AMFTRB Practice Questions Flashcards
When a Solution-Focused therapist working with a client presenting with issues around alcohol abuse asks “What needs to be different with your drinking?”, they are beginning to negotiate the:
a. exceptions to the problem.
b. solution talk of the therapy.
c. first-formula session task.
d. miracle question.
exceptions to the problem.
Discussion: Solution-Focused therapists use questions that often center around making distinctions. Here the therapist is beginning to look for when the drinking is or is not a problem and to tease out what is working in the client’s life.
An MFT in a 3-person group practice keeps her client PHI on her office computer. She uses clinical practice management software that keeps most information she needs conveniently organized. In addition to all insurance information, the software does her billing via direct internet connection to a payer clearinghouse, resulting in quick turn-around of payments, and also allows for email communications with the client, keeping the emails organized and associated with the client record. The software also provides a text entry area to record the session information. However, during her original clinical training, she developed the habit of scribbling a few notes on a pad next to her as she conducted her therapy sessions, which she still does. Her computer is password protected, she uses an encryption technology for all client and insurance company electronic/email transactions and her handwritten session notes are kept on paper and filed in a locked cabinet in her office. Two of the clinicians in the practice described above share the same family therapy case. One sees the parents in couples therapy, the other works with their 16 year old daughter individually, also offering occasional family meetings. The daughter often tells her therapist that there is information that she does not want disclosed to her parents.
Which of the following statements is correct?
a. In states where the ‘age of majority’, also called, ‘age of consent’ is 16, HIPAA PHI protection and access guidelines apply to the daughter’s request.
b. The therapists can exchange HIPAA protected PHI without authorization from either parent because they are within the same covered entity.
c. The therapists can exchange psychotherapy notes and other experiences without written authorization because they are in the same covered entity.
d. HIPAA Privacy Rules allow for the exchange of psychotherapy notes and counseling content without authorization, and also even when opposed by the client, for the purposes of normal healthcare operations.
The therapists can exchange HIPAA protected PHI without authorization from either parent because they are within the same covered entity.
Discussion: The normal healthcare operations access is strictly limited to PHI, and does not apply to notes or counseling content.
Olson’s Circumplex Model refers to specific levels of flexibility which include all of the following except:
a. chaotic.
b. disengaged.
c. structured.
d. rigid.
disengaged.
Discussion: In Olson’s Circumplex Model, the concept of disengaged is a level of cohesion, not flexibility.
A behavioral family therapist working with a wife who is having trouble getting her husband’s attention when she talks, offers the following instruction: “This time when he turns his head away, I want you to squeeze his hand gently and tell him you really want him to listen.” These verbal instructions are called:
A. coercion.
B. classical conditioning.
C. coaching.
D. discriminitive stimulus (cue).
coaching.
Discussion: Classical conditioning is pure stimulus-response, as in Pavlov’s dogs. Discriminitive stimulus is part of an elaborate process of training a subject to distinguish among very similar stimuli.
A couple comes to a therapy session with their 2, 3, and 4 year old children and the therapist gets down on the floor and begins playing with the children. The therapist’s stance is:
a. attached and proximate.
b. close but distant.
c. detached and playful.
d. coach.
attached and proximate.
Discussion: This stance is most often associated with Whitaker. Whitaker believed that personal involvement was a critical factor in the successes of experiential family therapy. The therapist must have the courage to be involved in a real caring way with the client family. According to Whitaker, if the therapist is not personally involved there is no real learning.
Oldest children tend to gravitate to leadership positions and youngest children often prefer to be followers. The characteristics of one position are not “better” than those of another position, but are complementary. This concept comes from the works of:
a. Bowen
b. Haley
c. Toman
d. Erickson
Toman
While Bowen incorporates the concept of sibling position into his theory, he found Tolman’s work so thorough and consistent with his ideas that he incorporated it into his theory. The basic idea is that people who grow up in the same sibling position predictably have important common characteristics.
Multi-ethnic and multi-racial families often present with rich and complex histories and dynamics. The best assessment tool for outlining the complexities of a multiracial family is a:
a. DSM-5’s GARF Ethnicity Relational Scales.
b. FACES III: Diversity Matrix.
c. Timberlawn Racial Dichotomy Scales.A genogram is useful for increasing understanding of family relationships and dynamics. Further identifying and exploring the multiracial heritages across the family generations can provide insight into isolation, bonds, beliefs, roles and societal micro aggressions.
d. cultural genogram.
cultural genogram.
Discussion: A genogram is useful for increasing understanding of family relationships and dynamics. Further identifying and exploring the multiracial heritages across the family generations can provide insight into isolation, bonds, beliefs, roles and societal micro aggressions.
In Adlerian parenting models, it is important for parents to pay attention to and monitor their own emotional reactions because:
a. They can use their emotional reaction to better understand their children’s mistaken goals.
b. They can avoid disciplining when they are emotionally triggered.
c. They can model congruent communication to their children.
d. They can identify unresolved family of origin triggers.
They can use their emotional reaction to better understand their children’s mistaken goals.
Discussion: Parents emotional reactions to their children’s problematic behaviors provide clues to children’s mistaken beliefs below the behaviors. Parents are taught to monitor their own emotions so they can identify the possible beliefs and identify and a connected response.
An agency wants to apply for a grant to set up a program to treat delinquent youths. An MFT is assigned to review available models and make recommendations for the clinical component of the program. After a thorough literature review, the MFT identifies “Multi-Systemic Therapy” (MST) as the one with the greatest effectiveness results and although it is expensive, finds that it is also most cost-effective.
a. MST is not appropriate for this agency because it’s “eco-systemic” component requires training in ecology which is beyond the scope of the agency’s mission.
b. The agancy’s client base includes multiple ethnic and cultural groups. The MFT notes that MST has not been fully tested with these diverse groups, but can still recommend the model with the qualification that diversity concerns be built in to delivery and outcome monitoring.
c. Because Multi-systemic Therapy was unfamiliar to the MFT, he cannot recommend it. However, he finds that Structural Family Therapy is a component of MST. His initial training and continuing education both emphasized Structural and he therefore is very familiar with it. Because he knows the methods of Structural and the benefits, he recommends it, not MST, as the core of the agency’s program.
d. The agancy’s client base includes multiple ethnic and cultural groups. The MFT notes that MST has been fully tested with diverse ethnic groups and would require no special attention in this area.
The agancy’s client base includes multiple ethnic and cultural groups. The MFT notes that MST has not been fully tested with these diverse groups, but can still recommend the model with the qualification that diversity concerns be built in to delivery and outcome monitoring.
Discussion: The MST model has not been fully tested with a wide range of cultural groups (as of 2012). Therefore it is not correct to say that it will need no special attention in this area.
Mr. & Mrs. Doherty present for family therapy complaining that their son Jon will not listen to them and is acting out.
In designing a treatment plan, a Contextual family therapist would:
A. track disabling sequences.
B. assess the credits and debits.
C. establish long and short term goals.
D. map the system.
establish long and short term goals.
Discussion: The Contextual model does focus on goals, both long and short term. The overall goal of this therapy is to address injustices and distrust which are the causes of dysfunction (Boszormenyi-Nagy & Ulrich, 1981, “Contextual Family Therapy”, in Gurman & Kniskern’s, “Handbook of Family Therapy”). The other answers can be eliminated as follows: “track disabling sequences” - Strategic; “assess the credits and debits” - Contextual, but an aspect of assessment, not part of treatment planning; “map the system” - Structural.
Rational/scientific, approval, worrier, protective all describe parts of:
a. Nagy’s relational determinants.
b. Hoffman’s level of congruence.
c. Satir’s levels of communication.
d. Schwartz’s parts of the therapist.
Schwartz’s parts of the therapist.
Discussion: Schwartz identifies these as parts of the therapist in his Internal Family Systems Model.
A family therapist has in-session goals to accentuate the client’s expression of attachment needs. Such emotional expression might be termed:
a. Secondary Emotions.
b. Catharsis.
c. Primary Emotions.
d. Battle for Initiative.
Primary Emotions.
Discussion: This question is a good example of how a generalized notion of a family therapist actually refers to a model; in this case, Emotionally Focused Therapy. You are being tested on your knowledge that attachment needs are the basis of primary emotions.
All of the following are considered communication theorists EXCEPT:
A. Satir.
B. White.
C. Watzlawick.
D. Haley.
White.
Discussion: This question requires some serious hair-splitting. All family therapists might be thought of as being “communication theorists” in one form or another. To answer the question, you must find the best answer, not necessarily the answer that is strictly “right”. White’s Narrative approach is a process for helping people create renewed descriptions of their lives. In contrast, the goal of the communications therapist (primarily the MRI school) is to look at the pattern of behavioral sequences that is maintained by language. This model disregards the internal structure of individuals in order to concentrate on their interaction and communication. Focus is limited to what goes on between, rather within individual, family members. White focuses on meaning whereas communication theorists focus on behavior. Communication theorists disregard the past, whereas White asks how the individual or family “story” establishes meaning in relation to the broader stories of gender, community, class, culture, etc.
Which of the following theorists, a pioneer in cognitive psychology, strongly influenced the narrative model with his work “The Narrative Construction of Reality”?
A. Ellis.
B. Maturano.
C. Bateson.
D. Bruner.
Bruner.
Discussion: In an article from the journal Critical Inquiry, Bruner argued that the mind structures its sense of reality through mediation through “cultural products, like language and other symbolic systems”. He specifically focused on the idea of narrative as one of these cultural products.
A couple comes to therapy because they feel their sex life is not satisfying. The female reports that she is always anxious and is unable to reach orgasm and feels that her husband thinks she is an inadequate sex partner.
The female partner feels that her male partner is more experienced about sex, therefore, the therapist would:
A. send them both to a sex educator.
B. teach her Behavioral sex therapy skills.
C. assess where she feels that she has a deficit about sexuality.
D. have him teach her about sex techniques.
assess where she feels that she has a deficit about sexuality.
Discussion: Avoid assumptions. Only through questioning the client about what she perceives her deficit around sexuality to be, can the next intervention be determined. The other answers might be interventions derived from information received after focused questioning about perceived deficits.
What does “tickling the defenses” mean?
a. a Psychodynamic concept for assessing the defense mechanisms of the family.
b. a Minuchin term for joining and accommodating with the family.
c. making the family laugh.
d. provoking people to open up and say what’s really on their mind.
provoking people to open up and say what’s really on their mind.
Discussion: Ackerman’s phrase for provoking people to open up and say what’s really on their mind. Ackerman consistently urged therapists to become emotionally engaged with families and to use confrontation to transform dormant conflicts into open discussion.
Questions that provide information about how a problem has managed to disrupt a family versus how much they have been able to control it are referred to as:
a. the First Formular Task questions.
b. Relative Influence questions.
c. Mapping the System questions.
d. Scaling Questions.
Relative Influence questions.
Discussion: The task of mapping the relative influence of the problem is a Narrative task that looks to establish how the problem has exercised control over the family and individual family members.
