AMFTRB Practice Questions Pt 5

Question 1

In a practice that includes over 50 active client families, a licensed marriage & family therapist bills only one client’s insurance company through a billing service. All the rest of his clients are billed directly or pay at the time of the therapy. Some of the self-pay clients obtain insurance reimbursement using claim forms and/or billing statements signed by the therapist. In his disclosure statement at the beginning of treatment, the therapist would be wrong in stating:

a. The ethical and legal guidelines for my practice come from my state’s confidentiality and ethics laws and the federal HIPAA Privacy Rule.
b. There are exceptions to confidentiality that permit me to disclose your PHI under certain circumstances.
c. I will not be transmitting any of your confidential information electronically for any reason. Therefore, the HIPAA Privacy Rules will not apply to our therapeutic relationship.
d. If a therapist is not a ‘covered entity’ under the HIPAA rules, then only the state ethics and confidentiality laws, together with our standards of practice, govern my use of confidential information.

Answer 1

c. I will not be transmitting any of your confidential information electronically for any reason. Therefore, the HIPAA Privacy Rules will not apply to our therapeutic relationship.

Question 2

All of the following are considered communication theorists EXCEPT:

A. Satir.
B. Haley.
C. Watzlawick.
D. White.

Answer 2

D. White.

Question 3

Some research has demonstrated that there are certain ‘common factors’ in successful psychotherapy. Which of the following statements is correct?

a. Common factors have been validated for general psychotherapy, but not for couples and family therapy as yet (2012).
b. It has been demonstrated that the common factor of “systemic/dyadic reformulation of the presenting problem,” can be as important or more important that ideal choice of treatment model.
c. A common factor of at least .65 is necessary before we can conclude that an element of treatment is effective.
d. Common factors in couple and family therapy are valuable, but not as valuable as selecting the best research supported treatment model.

Answer 3

b. It has been demonstrated that the common factor of “systemic/dyadic reformulation of the presenting problem,” can be as important or more important that ideal choice of treatment model.

Question 4

Structural and MRI Strategic differ in their orientation to all of the following EXCEPT:

A. emphasis on process over content.
B. therapist use of confrontation.
C. negative- and positive- feedback view of symptom dysfunction.
D. the punctuation of sequences.

Answer 4

A. emphasis on process over content.

Question 5

Wynne labeled the strangely unreal qualities of both positive and negative emotions of disturbed families pseudomutuality and pseudohostility, and the nature of the boundaries around them as:

a. rubber fences.
b. conflicting loyalties.
c. allignments and splits.
d. chaotic

Answer 5

a. rubber fences.

Question 6

Mr. & Mrs. Doherty present for family therapy complaining that their son Jon will not listen to them and is acting out. Whenever they take Jon with them outside the house he creates a scene, not listening and often having a tantrum. The parents are besides themselves feeling that they little patience and the mother states this is very similar to how she saw her parents deal with her younger brother who is now incarcerated. Specific techniques used by a Strategic therapist would include all of the following EXCEPT:

A. an authoritarian approach that returns parents to the appropriate position in the hierarchy.
B. treating the child first and then attending to the couple and any relationship difficulties between the parents.
C. ordeals which make it difficult for the symptom to be maintained.
D. reinforcing of gradual behavioral changes that will ultimately lead to the goal of therapy.

Answer 6

D. reinforcing of gradual behavioral changes that will ultimately lead to the goal of therapy.

Question 7

A study of family therapy, rated outcomes in two different ways. The first way was a self-report in which family members were asked to rate their improvement on a scale of 1 – 5. The second rating was by trained observers watching for changes in specific behaviors on video playback of the families in their sessions. They also rated improvements on a scale of 1 – 5. Which of the following statements is correct?

a. The mean of the findings can be found by adding up all the ratings and dividing by 2.5 (half of 5, which is the highest rating).
b. Trained observers are likely to be more reliable then family members who are expected to offer more subjective judgments.
c. We can be more confident in the findings to the extent that the self-reports and observer ratings correlate.
d. This must be a qualitative study which can give us information about the specific individuals being studied, but cannot generate more general conclusions, which can only come from a quantitative study with robust statistical outcomes.

Answer 7

c. We can be more confident in the findings to the extent that the self-reports and observer ratings correlate.

Question 8

The role of a Strategic therapist is:

a. being objective, detached from family emotional system.
b. conducting a structured initial interview.
c. close tracking of self reports.
Close tracking of self reports - brief therapy model
Objectivity and Genograms - Bowen model.
d. to use genogram to organize data.

Answer 8

b. conducting a structured initial interview.

Question 9

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. miracle question.
b. solution talk of the therapy.
c. first-formula session task.
d. exceptions to the problem.

Answer 9

d. exceptions to the problem.

Question 10

An assessment tool used by Structural therapists is:

A. a genogram.
B. FACES III.
C. a family map.
D. MBTI.

Answer 10

C. a family map.

Question 11

Co-therapists serve a variety of functions in family systems therapy as does the use of teams. Use of co-therapy is an important component of which of the following MFT models?

A. Milan Systemic, Solution-Focused and Structural.
B. Experiential, Network and Contextual.
C. Experiential, Milan Systemic and Internal Family Systems
D. Narrative, Feminist and Internal Family Systems.

Answer 11

C. Experiential, Milan Systemic and Internal Family Systems

Question 12

The MRI model does not focus on:

A. examining the sequences of behavior involved in the attempted solution.
B. the continued application of the wrong solution is seen as maintaining the problem.
C. functional nature of the problem.
D. interactional level.

Answer 12

C. functional nature of the problem.

Question 13

A family comes to therapy presenting with what they state is a problem with their middle daughter. After speaking with the parents in the first session, the therapist assesses that this is actually a marital problem. The theorist least likely to focus on the marital problem early on in therapy is:

a. Insoo Kim Berg.
b. Bowen.
c. Haley.
d. DeShazer.

Answer 13

c. Haley.

Question 14

One of the defining characteristics of the therapist’s techniques in Narrative Therapy is its emphasis on:

a. circular questioning.
b. mapping the relative influence of the problem.
c. Neutrality.
d. creating social justice and a voice for all.

Answer 14

b. mapping the relative influence of the problem.

Question 15

Which of the following are similarities between strategic and structural models?

a. The treatment is symptom oriented.
b. They use in-session interactions to assess the family and emphasize process over content.
c. All of the above.
d. They both consider the impact of the life-cycle stage.

Answer 15

c. All of the above.

Question 16

Which of the following therapists believe that when treating alcoholics, the goal of reduced drinking is only an appropriate goal, if it is also a goal of the clients? This therapist may also state that the more traditional concepts of the disease model may, in fact, be counterproductive for many alcoholic clients.

A. T. J. O’Farrell
B. David Treadway
C. Insoo Berg
D. Michael Elkin

Answer 16

C. Insoo Berg

Question 17

All of the following are similarities between Structural and Strategic except:

a. consideration of the family life cycle.
b. utilization of therapeutic contracts and behavioral tasks.
c. concern with the subsequent organizational structure of the family system.
d. view of families as rule-governing systems.

Answer 17

c. concern with the subsequent organizational structure of the family system.

Question 18

A technique developed by the Milan Model that utilizes a third person’s perspective on a subsystem or other dyads within the system is known as:

a. externalizing.
b. joining.
c. circular questioning.
d. highlighting.

Answer 18

c. circular questioning.

Question 19

A strategic therapist response to a woman whose spouse has had multiple affairs but wants to stay married would be:

a. I understand why you want to stay with him.
b. How many affairs will you tolerate before leaving him?
c. How can you ever trust him?
d. What is your role in the marital dissatisfaction?

Answer 19

a. I understand why you want to stay with him.

Question 20

A same sex couple comes to therapy because they are having problems regarding their parenting of their ten year old son. In the course of the first interview, it is clear that each parent has very different expectations for their son’s behavior. A family therapist should treat the couple:

a. the same as a heterosexuaul couple.
b. different than a heterosexual couple.
c. the same as a heterosexual couples if the couple are both women, but differently if the couple are both men.
d. according to the problem being presented.

Answer 20

d. according to the problem being presented.

Question 21

The stance of the therapist is that of coach for all of the following models EXCEPT:

a. Psychodynamic.
b. Psychoeducational.
c. Intergenerational.
d. Behavioral.

Answer 21

a. Psychodynamic.

Question 22

In a therapy session a husband implies that his wife appears to get her own way most of the time. The therapist then suggests that the husband say ‘no’ to the wife once during the following week. In initially assessing this client, a Strategic therapist would do all of the following except:

A. define the problem.
B. take a family history.
C. develop a plan for the problem.
D. think of the problem that simultaneously offers a solution to the problem and is a problem itself.

Answer 22

B. take a family history.

Question 23

An MFT is using a differentiation approach in treating an internet affair. After completing an assessment of the couple and the circumstances of the affair the therapist will

a. confront the distressed spouse about his/her sense of betrayal.
b. ask the adulterer to apologize.
c. ask both partners to define the boundaries of monogamy for their relationship.
d. focus on the healing and safety of the distressed spouse.

Answer 23

a. confront the distressed spouse about his/her sense of betrayal.

Question 24

Pick the answer that describes the relationship that the following symbol would denote:
Mother -| |Father-
\ Daughter /
a. Conflictual triangle.
b. Diffused Dyad.
c. Rigidly bound triangle.
d. None of the above.

Answer 24

c. Rigidly bound triangle.

Question 25

Mr. & Mrs. Doherty present for family therapy complaining that their son Jon will not listen to them and is acting out.

In assessing this family a Structural therapist would:

A. assess information about each person’s willingness to be part of the therapeutic joining process.
B. listen to each family member’s story of the problem, casting it into a framework of obligations and entitlements to determine levels of trustworthiness in the family.
C. focus on current interactional patterns between family members.
D. operationally define the problem behavior including duration, frequency, and intensity.

Answer 25

C. focus on current interactional patterns between family members.

Question 26

Internal Family Systems believes all of the following EXCEPT:

a. There are no “bad” parts and the goal of therapy is not to eliminate parts but instead to help them find their non-extreme roles.
b. Communication theory can be applied to the internal system and with the ultimate goal of a “parts party” as a means of integrating the four parts.
c. Changes in the internal system will affect changes in the external system and vice versa.
d. Systems theory can be applied to the internal system

Answer 26

b. Communication theory can be applied to the internal system and with the ultimate goal of a “parts party” as a means of integrating the four parts.

Question 27

A couple comes to therapy because their three-year-old daughter is “out of control”. During the session the wife begins complaining that her husband is never home and she is left to deal with her daughter’s behavior.

A Structural Therapist would first focus of which of the following in the first interview with the family:

a. focusing on the couple sub-system.
b. improving communication in session.
c. setting goals.
d. joining.

Answer 27

d. joining.

Question 28

Susan, a 31 yr. old, African-American woman has begun therapy for the first time. Her therapist has explained to her how how important it is for her to come on a weekly basis, that this sort of continuity and regular meeting times is important to her feeling comfortable in therapy, allowing her to develop a sense of trust and safety so that she can express her most private thoughts without fear of consequence. This is an example of the therapist:

a. Joining
b. Battle for Structure
c. HIPAA Privacy Rule
d. Setting the Frame

Answer 28

d. Setting the Frame

Question 29

The Beavers System approach to family assessment includes:

A. tracking interactional patterns that maintain the problem.
B. defining how the family structure maintains ineffective patterns.
C. family reports on cohesion and adaptability.
D. interactional competence scales and interactional style scales.

Answer 29

D. interactional competence scales and interactional style scales.

Question 30

In working with a divorced couple, the focus of attention should be:

A. children.
B. the mother and oldest child.
C. the couple.
D. a residential parent.

Answer 30

C. the couple.

Question 31

A family presents with a 7-year old child who seems to look for his parent’s acceptance and reassurance while answering every question the family therapist puts to her. When her parents express disagreement to what she has just expressed, she quickly adapts her position to that of her parents. This might be best described by of the following models:

a. Bowen’s Model
b. Minuchin’s concept of enmeshment
c. Framo’s Object Relations Model
d. Bowlby’s Attachment Theory

Answer 31

c. Framo’s Object Relations Model

Question 32

Questions are a fundamental tool used by all therapists. When a Solution Focused therapist, working with a client presenting with issues around overeating, asks “What would you not want to change regarding the way you eat?”, they are beginning to negotiate the:

a. solution talk of the therapy.
b. first-formular task.
c. exceptions to the problem.
d. miracle question.

Answer 32

b. first-formular task.

Question 33

Drawing from John Bowlby’s work, this model emphasizes the importance of healthy attachment at the infant stage of development. It also addresses the need for individuation and differentiation.

a. Erickson’s Developmental Model
b. Object Relations Family Therapy
c. Bowenian Family Therapy
d. Emotionally Focused Therapy

Answer 33

b. Object Relations Family Therapy

Question 34

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. Relative Influence questions.
b. the First Formular Task questions.
c. Mapping the System questions.
d. Scaling Questions.

Answer 34

a. Relative Influence questions.

Question 35

A similarity between Structural and Haley Strategic therapies is:

A. therapeutic paradox is employed.
B. straightforward and confrontive.
C. emphasis on importance of maladaptive behavioral sequences in dysfunction.
D. emphasis on negative-feedback cycles.

Answer 35

A. therapeutic paradox is employed.

Question 36

A couple presents in crisis after the wife discovers her husband has been involved with multiple women on the internet for 5 years and has come to realize that his lack of interest in their relationship may have less to do with work-related stress and subsequent disinterest in intimacy. A family therapist believes that there is really only one way to intervene with this couple, given their current volatility. This therapist does not seem to subscribe to the concept of:

a. Equipoteniatility.
b. Multidirectional Partiality.
c. Equifinality.
d. Circularity.

Answer 36

c. Equifinality.

Question 37

A family consisting of a lesbian couple and a 9 yr. old son who has been school refusing for the past year has asked for family therapy. In the first session, you notice that whenever the son speaks, one of his mothers is quick to finish his sentence. You adjust your chair as therapist to block the mother and her attempt to speak for her son. You do this in order to address which of the following Bowenian concepts:

a. undifferentiated ego mass.
b. enmeshment.
c. triangle.
d. fusion.

Answer 37

d. fusion.

Question 38

A couple comes to therapy because their three-year-old daughter is “out of control”. During the session the wife begins complaining that her husband is never home and she is left to deal with her daughter’s behavior.

During the first interview with this family, the first priority of a Strategic Family therapist would be to:

a. focus on the child.
b. set goals.
c. focus on the couple interaction.
d. improve communication.

Answer 38

b. set goals.

Question 39

Olson’s Circumplex Model refers to specific levels of flexibility which include all of the following except:

a. rigid.
b. disengaged.
c. chaotic.
d. structured.

Answer 39

b. disengaged.

Question 39

Which of the following theorists, a pioneer in cognitive psychology strongly influenced the Narrative model with his work “The Narrative Construction of Reality”?

a. Bateson.
b. Maturano.
c. Bruner.
d. Ellis.

Answer 39

c. Bruner.

Question 40

As a structural therapist you would most likely:

A. work with the member of family who has most energy for change.
B. tell the family they should continue to do what they are doing.
C. work with the most differentiated member of the family.
D. imitate family style and affect.

Answer 40

D. imitate family style and affect.

Question 41

A client was unhappy when he discovered that his therapist had disclosed his town of residence to a colleague during a peer supervision meeting. The meeting included an administrative assistant who was not a licensed mental health professional and lived in the same town as the client. The therapist’s response to the client was to engage him in a conversation about his concerns and then proposed a clinical hypothesis suggesting the client was excessively fearful. The client did not accept this, and instead insisted that he did not want this kind of information disclosed to anybody without his written authorization. He claimed the therapist had violated his confidentiality under the HIPAA policies given to him at the beginning of his treatment. The client stated that he was embarrassed to be identified to the administrative assistant since she might have children in the same school as his, and that his residence should not be disclosed under these circumstances.

a. The therapist is still not in violation of HIPAA because his right to make use of an administrative assistant, is described in the Privacy Rule, and there is no exception listed for residence of clients and staff.
b. The therapist is still not in violation of HIPAA because his right to make use of an administrative assistant as contracted support staff even under these circumstances is described in the Security Rule.
c. The therapist is in violation of the Privacy Rule’s disclosure of PHI principles since the administrative assistant is not a licensed mental health clinician and is therefore not a HIPAA ‘covered entity’.
d. The therapist is in violation of the Security Rule because the administrative assistant’s residence in the same town, with children in the same school, could potentially result in an ‘incidental disclosure’ and thereby compromise security of the client’s PHI.

Answer 41

a. The therapist is still not in violation of HIPAA because his right to make use of an administrative assistant, is described in the Privacy Rule, and there is no exception listed for residence of clients and staff.

Question 42

The essential feature of Anorexia Nervosa is:

A. refusal to maintain body weight.
B. frequent weight fluctuations.
C. disturbed sense of self.
D. recurrent episodes of binge eating.

Answer 42

A. refusal to maintain body weight.