MFT Clinical Questions Flashcards
Question 1 During a family therapy session, the therapist notices that both the 6-year-old and the 4-year-old children have bandages on their hands. The mother discloses tearfully that she can’t trust her 15-year-old stepson to stay alone with her young children because he super-glued their hands to his door. The husband shakes his head and says, “We already dealt with this. It won’t happen again.” What should the therapist do NEXT:
A. Find out how they dealt with it.
B. Document the incident in your notes.
C. Inform the family that you must file a child abuse report.
D. Ask if other incidents like this have happened before.
Answer 1 During a family therapy session, the therapist notices that both the 6-year-old and the 4-year-old children have bandages on their hands. The mother discloses tearfully that she can’t trust her 15-year-old stepson to stay alone with her young children because he super-glued their hands to his door. The husband shakes his head and says, “We already dealt with this. It won’t happen again.” What should the therapist do NEXT:
A. Find out how they dealt with it. – possibility at some point
B. Document the incident in your notes. – yes, but not NEXT
C. Inform the family that you must file a child abuse report. – can I imagine myself calling CPS, YES
D. Ask if other incidents like this have happened before. – possibly, but not our responsibility to investigate or determine if child abuse happened
Question 2
A new client is referred by her minister. The 49 year-old woman shares that she is overwhelmed taking care of her 72 year old mother who is often belligerent due to her dementia. The woman tearfully admits to giving her mother extra medication so that she will sleep longer. She asks for a referral to a support group for caregivers. What should the therapist do initially in this case?
A. Provide a referral to a caregiver support group.
B. Further assess for Elder Abuse.
C. Assist her in developing alternative coping mechanisms.
D. File a report with Adult Protective Services and process it with client.
Answer 2
A new client is referred by her minister. The 49 year-old woman shares that she is overwhelmed taking care of her 72 year old mother who is often belligerent due to her dementia. The woman tearfully admits to giving her mother extra medication so that she will sleep longer. She asks for a referral to a support group for caregivers. What should the therapist do initially in this case?
A. Provide a referral to a caregiver support group. – at some
B. Further assess for Elder Abuse. – we have enough
C. Assist her in developing alternative coping mechanisms. – do at some point
D. File a report with Adult Protective Services and process it with client. – technically do first by the letter of law and good to process
Question 3
A married couple in their 30’s seeks therapy to improve their communication. The husband reports that he wants to have children but complains that his wife “wants to wait.” The wife tears up when she shares that her mother recently died and that her husband expects her to “get over it already.” During the initial assessment, they report that their arguments frequently get physical because the wife makes the husband so mad. How should the therapist proceed in this case:
A. Discuss the ways in which the wife makes the husband mad.
B. Explore the couple’s motivation to stay together and their expectations of therapy.
C. Require the couple to sign a no violence contract to ensure they won’t get violent in the session.
D. Refer each of them to individual therapy.
Answer 3
A married couple in their 30’s seeks therapy to improve their communication. The husband reports that he wants to have children but complains that his wife “wants to wait.” The wife tears up when she shares that her mother recently died and that her husband expects her to “get over it already.” During the initial assessment, they report that their arguments frequently get physical because the wife makes the husband so mad. How should the therapist proceed in this case:
A. Discuss the ways in which the wife makes the husband mad. – makes it seem like wifes fault
B. Explore the couple’s motivation to stay together and their expectations of therapy. – good if no DV
C. Require the couple to sign a no violence contract to ensure they won’t get violent in the session. – no such thing
D. Refer each of them to individual therapy. – yes, indication of physical violence, tell them no couples and go individual
Question 4
A 45-year old male client who has been unemployed for six months is referred by his wife for therapy. In the initial session, he reports that he wants to sleep all day and he doesn’t see his situation getting any better. He says that he can’t stand having his wife and children see him like this. As part of a complete assessment, the therapist should FIRST:
A. Determine if the client is currently using substances.
B. Refer the client to a medical doctor for issues of hypersomnia.
C. Ask if the client has thoughts of suicide.
D. Explore the client’s social supports and coping strategies.
Answer 4
A 45-year old male client who has been unemployed for six months is referred by his wife for therapy. In the initial session, he reports that he wants to sleep all day and he doesn’t see his situation getting any better. He says that he can’t stand having his wife and children see him like this. As part of a complete assessment, the therapist should FIRST:
A. Determine if the client is currently using substances. - Possibility
B. Refer the client to a medical doctor for issues of hypersomnia. – Possibility at some point
C. Ask if the client has thoughts of suicide. – are there reasons to ask, yes
D. Explore the client’s social supports and coping strategies. – include in assessment, but thoughts of SI more important
Question 5
During a group therapy session, one of the group members reports that her sister-in-law has been butting into her life and if she keeps it up the client is “going to make sure she never butts in again.” A few of the group members laugh uncomfortably. How should the therapist proceed:
A. Validate the client’s anger.
B. Explore what the client means by “going to make sure she never butts in again.”
C. Encourage group members to share their reactions.
D. Identify healthy ways for client to express her frustration.
Answer 5
During a group therapy session, one of the group members reports that her sister-in-law has been butting into her life and if she keeps it up the client is “going to make sure she never butts in again.” A few of the group members laugh uncomfortably. How should the therapist proceed:
A. Validate the client’s anger.
B. Explore what the client means by “going to make sure she never butts in again.” – if you don’t follow up and something happens you’re fucked
C. Encourage group members to share their reactions.
D. Identify healthy ways for client to express her frustration.
Question 6
A 28-year-old woman seeks therapy for depression. She reports that she recently moved to the city and has had a difficult time making friends. She works as a waitress and a graphic designer. She shares that she was in therapy a few years ago but reports that the other therapist “wasn’t very good” so she stopped going to therapy. In addition to a risk assessment, what else should the therapist explore in the initial assessment?
A. Client’s thoughts of suicide or self-harm.
B. Client’s expectations of therapy and experience with other therapist.
C. Client’s motivation for treatment.
D. Client’s current and past substance use.
Answer 6
A 28-year-old woman seeks therapy for depression. She reports that she recently moved to the city and has had a difficult time making friends. She works as a waitress and a graphic designer. She shares that she was in therapy a few years ago but reports that the other therapist “wasn’t very good” so she stopped going to therapy. In addition to a risk assessment, what else should the therapist explore in the initial assessment?
A. Client’s thoughts of suicide or self-harm. – tempting, but we did it in the risk assessment
B. Client’s expectations of therapy and experience with other therapist. – Absolutely, past therapy is very important, especially cuz previous therapist not good, very important
C. Client’s motivation for treatment. – Always good, but no indication that she is not super motivated or resistant to therapy
D. Client’s current and past substance use. – Part of risk assessment
if there is a quote, focus on the quote
Question 7
A new client starts off the first session sharing how she feels overwhelmed with her life. She shares that she doesn’t like her new job but is uncertain of what career she wants to pursue. She reports feeling like her relationship with her boyfriend is unhealthy and wants to get along better with him. Then she adds that she’s been having a lot of conflict with her new roommate and can’t decide whether she should move out. When formulating the initial treatment plan, the therapist should:
A. Assist the client to prioritize her treatment goals.
B. Determine the most important issue to focus on.
C. Assess the client’s level of coping.
D. Identify her social supports.
Answer 7
A new client starts off the first session sharing how she feels overwhelmed with her life. She shares that she doesn’t like her new job but is uncertain of what career she wants to pursue. She reports feeling like her relationship with her boyfriend is unhealthy and wants to get along better with him. Then she adds that she’s been having a lot of conflict with her new roommate and can’t decide whether she should move out. When formulating the initial treatment plan, the therapist should:
A. Assist the client to prioritize her treatment goals. – No pressing issue, good to assist
B. Determine the most important issue to focus on. – Therapist should not determine goal if no crisis
C. Assess the client’s level of coping. – This has to do more with assessing and intervention
D. Identify her social supports. – This has to do more with assessing and intervention
Question 8
During the walk between the waiting room and the office, a new client declares a strong affinity for the therapist and a hopeful attitude toward therapy, saying she knows this will be different from previous treatment experiences. After acknowledging the client’s positive reactions the therapist should NEXT:
A. Ask what interfered with previous treatment.
B. Explore expectations regarding this helping relationship.
C. Determine the basis for attraction to the therapist.
D. Assess client’s reasons for seeking therapy.
Answer 8
During the walk between the waiting room and the office, a new client declares a strong affinity for the therapist and a hopeful attitude toward therapy, saying she knows this will be different from previous treatment experiences. After acknowledging the client’s positive reactions the therapist should NEXT:
A. Ask what interfered with previous treatment. – too negative
B. Explore expectations regarding this helping relationship. – Yes, cuz it’s in line with where client is at right now
C. Determine the basis for attraction to the therapist. – determine is a strong word and a little confrontational
D. Assess client’s reasons for seeking therapy. – eventually, but not with where client is at now
Question 9
A therapist has been working with a 6-year-old boy for one month. The child was brought in by his mother after witnessing his father get hit by a car. The mother reports that the child has been less anxious since starting therapy but continues to have nightmares and doesn’t want to go to bed. What intervention should the therapist employ in the middle phase of therapy?
A. Provide psychoeducation to mother about trauma in children.
B. Engage in art therapy with the child encouraging him to draw his dreams.
C. Create a bed in the office and instruct the child to practice lying down.
D. Teach the child self-soothing techniques to use when he wakes up from a nightmare.
Answer 9
A therapist has been working with a 6-year-old boy for one month. The child was brought in by his mother after witnessing his father get hit by a car. The mother reports that the child has been less anxious since starting therapy but continues to have nightmares and doesn’t want to go to bed. What intervention should the therapist employ in the middle phase of therapy?
A. Provide psychoeducation to mother about trauma in children. – This is initial phase
B. Engage in art therapy with the child encouraging him to draw his dreams. – Good, relative to what is happening, and middle phase requires more structure
C. Create a bed in the office and instruct the child to practice lying down. – Child doesn’t want to go to bed cuz of nightmare, also, the word instruct is bad
D. Teach the child self-soothing techniques to use when he wakes up from a nightmare. – Good, cuz it addressing sleep, but main issue is that he doesn’t want to GO TO bed.
Question 10
A client who has been in therapy for two years for depression has been symptom free for four months. During the final scheduled session, she begins crying and states that she is afraid her depression will come back without therapy. How should the therapist address her concern:
A. Schedule another session in a week.
B. Discuss extending treatment until client is more stable.
C. Normalize her feelings and make a plan if symptoms return.
D. Provide client with referral to support group for depression.
Answer 10
A client who has been in therapy for two years for depression has been symptom free for four months. During the final scheduled session, she begins crying and states that she is afraid her depression will come back without therapy. How should the therapist address her concern:
A. Schedule another session in a week. – avoiding talking about experience
B. Discuss extending treatment until client is more stable. – Already symptom free, stable now
C. Normalize her feelings and make a plan if symptoms return. – addresses feelings and includes plan
D. Provide client with referral to support group for depression. – could do, but not addressing core issue of clients fear
Question 11
A therapist is working with a family with three children, ages, 7, 9 and 15. The parents are concerned that the 15-year-old daughter does not want to participate in family activities and wants to spend time in her room or with her friends. They share that they are concerned she is depressed and are worried she may disengage from school. What should the therapist do FIRST?
A. Obtain a release to speak to the school.
B. Refer the 15-year-old for a medication evaluation.
C. Provide psychoeducation about normal adolescent development.
D. Encourage parents to share their concerns directly with their daughter.
Answer 11
A therapist is working with a family with three children, ages, 7, 9 and 15. The parents are concerned that the 15-year-old daughter does not want to participate in family activities and wants to spend time in her room or with her friends. They share that they are concerned she is depressed and are worried she may disengage from school. What should the therapist do FIRST?
A. Obtain a release to speak to the school. – If you determine there is a need, but right now there is not
B. Refer the 15-year-old for a medication evaluation. – Not enough to refer yet
C. Provide psychoeducation about normal adolescent development. – is there reason o psycheducate? Yes
D. Encourage parents to share their concerns directly with their daughter. – do at some point, but normalize adolescent development first
Question 12
An older couple comes to therapy. The husband reports that since he retired one year ago, he spends much of his time completing his wife’s daily chores. He does not understand why she is so upset all the time. “I feel so useless,” she says. What intervention would address their dilemma?
A. Help them set more adaptive boundaries so they can shape new roles for themselves.
B. Reframe her uselessness as an attempt to distract her husband from his feelings of loss.
C. Encourage the wife to involve herself in volunteer activities so she will feel more useful.
D. Encourage the husband to obtain part-time employment to divert his attention from his wife.
Answer 12
An older couple comes to therapy. The husband reports that since he retired one year ago, he spends much of his time completing his wife’s daily chores. He does not understand why she is so upset all the time. “I feel so useless,” she says. What intervention would address their dilemma?
A. Help them set more adaptive boundaries so they can shape new roles for themselves. – new roles, addresses dilemma and does so by having them work together
B. Reframe her uselessness as an attempt to distract her husband from his feelings of loss. – No indication that he is experiencing feelings of loss
C. Encourage the wife to involve herself in volunteer activities so she will feel more useful. – This focusing on the wife (picking sides)
D. Encourage the husband to obtain part-time employment to divert his attention from his wife. – focusing only on husband (picking sides)
Question 13
After the fourth session of couple’s therapy, a woman calls the therapist after finding sexually explicit reading material, which her boyfriend left out in their bedroom. The therapist’s best response is to:
A. Ask the woman if she would like an individual appointment to discuss this.
B. Suggest that the woman get her boyfriend to call the therapist for an individual appointment.
C. Suggest that the woman present her concern at their next appointment.
D. Ask the woman how this made her feel.
Answer 13
After the fourth session of couple’s therapy, a woman calls the therapist after finding sexually explicit reading material, which her boyfriend left out in their bedroom. The therapist’s best response is to:
A. Ask the woman if she would like an individual appointment to discuss this. – addressing as individual unit
B. Suggest that the woman get her boyfriend to call the therapist for an individual appointment. – addressing as individual unit
C. Suggest that the woman present her concern at their next appointment. – Good example of having it addressed as a couple
D. Ask the woman how this made her feel. – addressing as individual unit
Question 14
A therapist is working with a family with three children, the youngest of whom, age 12, is in a wheelchair because of cerebral palsy. The parents describe the child’s withdrawal from outside activities and believe that he is depressed. The child remarks that his mother hovers over him, and that his siblings dislike him because he has no chores at home. He expresses an interest in staying with a cousin over Christmas break and says he wants more responsibility at home. What should the therapist do FIRST?
A. Support the mother’s understandable need to be protective.
B. Focus on the 12-year-old’s need for greater self-esteem.
C. Help the family address the 12-year-old’s expressed needs.
D. Suggest the family explore outside activities for the 12-year-old.
Answer 14
A therapist is working with a family with three children, the youngest of whom, age 12, is in a wheelchair because of cerebral palsy. The parents describe the child’s withdrawal from outside activities and believe that he is depressed. The child remarks that his mother hovers over him, and that his siblings dislike him because he has no chores at home. He expresses an interest in staying with a cousin over Christmas break and says he wants more responsibility at home. What should the therapist do FIRST?
A. Support the mother’s understandable need to be protective. – No indication that mom is feeling protective, also just focuses on mom
B. Focus on the 12-year-old’s need for greater self-esteem. – Client didn’t really say there were any self-esteem issue, plus, just focusing on identified patient
C. Help the family address the 12-year-old’s expressed needs. – this included all the different family members
D. Suggest the family explore outside activities for the 12-year-old. – making a suggestion, don’t want to push
Question 15
A therapist is running a therapy group for people going through divorce. The therapist suspects that one member of the group is abusing drugs and determines that his erratic participation is detrimental to the group process. The therapist should FIRST:
A. Confront the client in the group.
B. Schedule an individual session with the client.
C. Provide the client with a referral for substance abuse treatment.
D. Process the group members’ feelings about the client’s departure.
Answer 15
A therapist is running a therapy group for people going through divorce. The therapist suspects that one member of the group is abusing drugs and determines that his erratic participation is detrimental to the group process. The therapist should FIRST:
A. Confront the client in the group. – Not best
B. Schedule an individual session with the client. - Yes
C. Provide the client with a referral for substance abuse treatment. – could do this during individual session
D. Process the group members’ feelings about the client’s departure. – After individual session do this one
Question 16
A 40 year-old accountant is referred by his Employee Assistance Program. He reports irritability, moodiness, and extreme fatigue. He shares that it is affecting his work performance and his relationships with his family. He adds, “I’m tired of not feeling like myself. I want to get better.” The therapist should FIRST:
A. Refer him to couples therapy.
B. Assess for suicidal ideation.
C. Rule out substance use issues.
D. Ask when he had his last full physical.
Answer 16
A 40 year-old accountant is referred by his Employee Assistance Program. He reports irritability, moodiness, and extreme fatigue. He shares that it is affecting his work performance and his relationships with his family. He adds, “I’m tired of not feeling like myself. I want to get better.” The therapist should FIRST:
A. Refer him to couples therapy. – takes about relationship, but don’t do first
B. Assess for suicidal ideation. – he made statement that he wants to get better, which is a good sign
C. Rule out substance use issues. – gunna wanna do at some pint
D. Ask when he had his last full physical. – Extreme fatigue is a good indicator that something might be wrong; extreme fatigue is the clue
Question 17
A family is referred by their minister for family therapy due to conflict between the parents regarding how to discipline their 5 and 7 year-old boys. During the initial assessment the therapist learns that the mother drinks alcohol daily. There is no indication of domestic violence or child abuse. Which of the following interventions should the therapist take FIRST?
A. Involve the family in creating a family map of their problem.
B. Obtain a release to speak with their minister.
C. Work with the mother regarding her need for an alcohol use assessment.
D. Conduct a comprehensive assessment of the family members.
Answer 17
A family is referred by their minister for family therapy due to conflict between the parents regarding how to discipline their 5 and 7 year-old boys. During the initial assessment the therapist learns that the mother drinks alcohol daily. There is no indication of domestic violence or child abuse. Which of the following interventions should the therapist take FIRST?
A. Involve the family in creating a family map of their problem. – Possibility, but issue is substance use
B. Obtain a release to speak with their minister. – Possibility, but not pressing
C. Work with the mother regarding her need for an alcohol use assessment. – Yes, talk about needing maybe more specialized care
D. Conduct a comprehensive assessment of the family members. – says during the initial assessment, assessment has been done
Question 18
Parents of a 6-year old are referred to the therapist by the teacher who reports that the child is struggling to complete the coursework and frequently acts out in class. The parents are confused and report that the child is healthy and well behaved at home. The therapist obtains an authorization from the parents to speak to the teacher and the teacher confirms the parents’ description. How should the therapist proceed with the parents:
A. Provide psychoeducation about ADHD.
B. Refer the child to a psychiatrist for medication evaluation.
C. Encourage the parents to get psychological testing.
D. Recommend that the parents switch teachers.
Answer 18
Parents of a 6-year old are referred to the therapist by the teacher who reports that the child is struggling to complete the coursework and frequently acts out in class. The parents are confused and report that the child is healthy and well behaved at home. The therapist obtains an authorization from the parents to speak to the teacher and the teacher confirms the parents’ description. How should the therapist proceed with the parents:
A. Provide psychoeducation about ADHD. – Not at home
B. Refer the child to a psychiatrist for medication evaluation. – do at some point, but not enough info
C. Encourage the parents to get psychological testing. – identify or rule out learning disorder
D. Recommend that the parents switch teachers. – No indication there is problem between teacher and child
Question 19
A client is referred to the therapist after being discharged from the psychiatric hospital. The records indicate that he has been hearing voices for the past four months and he believes he is being followed. According to the DSM 5 criteria, the most likely diagnosis for the client is:
A. Brief Psychotic Disorder
B. Schizophrenia
C. Schizoaffective
D. Schizophreniform
Answer 19
A client is referred to the therapist after being discharged from the psychiatric hospital. The records indicate that he has been hearing voices for the past four months and he believes he is being followed. According to the DSM 5 criteria, the most likely diagnosis for the client is:
A. Brief Psychotic Disorder – under a month
B. Schizophrenia – over 6 months
C. Schizoaffective – when there is also a mood disorder (mania or depressive disorder)
D. Schizophreniform – 1 to 6 months
Question 20
For the past year, a 21-year-old male college student reports feeling irritable, arguing with his roommates and girlfriend, and having difficulty sleeping and studying. The client reports occasionally drinking a few beers but has not done so in the past month. The client is MOST likely exhibiting:
A. Substance Induced Mood Disorder
B. Adjustment Disorder with Depressed Mood
C. Major Depressive Disorder
D. Persistent Depressive Disorder
Answer 20
For the past year, a 21-year-old male college student reports feeling irritable, arguing with his roommates and girlfriend, and having difficulty sleeping and studying. The client reports occasionally drinking a few beers but has not done so in the past month. The client is MOST likely exhibiting:
A. Substance Induced Mood Disorder – not enough for this diagnosis, hasn’t drank
B. Adjustment Disorder with Depressed Mood – nothing that says he has had recent stressors, had it over 6 moths
C. Major Depressive Disorder – irritable and difficulty sleeping and studying
D. Persistent Depressive Disorder – low level depressive symptoms for at least two years
