MFT Practice Exam

Question 1

1. Which of the following is listed under “Other Conditions That May Be a Focus of Clinical Attention” in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DMV-IV-TR)?
   a. Locura
   b. Adjustment to Family Life-Cycle Transition
   c. Dystemia
   d. Parent–Child Relational Problem

Answer 1

d. Parent–Child Relational Problem

Question 2

2. A therapist creates a situation, which enables the family to function as it might outside the therapy session. In Structural therapy, this process is called:
   a. Enactment.
   b. Mimesis.
   c. Intensification.
   d. Spontaneous regression

Answer 2

a. Enactment.

Question 3

3. Which of the following characteristics of Latino families is it important for a marital and family therapist to know?
   a. Family concerns take precedence over individual concerns.
   b. Women are socialized to not express their emotion.
   c. Gender roles are very fluid.
   d. Women do not need strong familial ties.

Answer 3

a. Family concerns take precedence over individual concerns.

Question 4

4. When progress in therapy becomes stalled, an intergenerational family therapist MOST LIKELY will:
   a. Involve a co-therapist in the therapy sessions.
   b. Invite more family members to express their emotions.
   c. Attempt to raise the anxiety in the system.
   d. Look for the existence of a hidden triangle.

Answer 4

d. Look for the existence of a hidden triangle.

Question 5

5. Within the field of family therapy, it is generally recognized that family myths’:
   a. Describe humorous, harmless, shared experiences.
   b. Impact members at a conscious level.
   c. Support members of the system equally.
   d. Maintain alignments, structures, and procedures

Answer 5

d. Maintain alignments, structures, and procedures.

Question 6

6. The parents of an eight-year-old child who has school phobia have incompatible beliefs about how to manage the problem. A practitioner who is familiar with the early writings of the Milan group is MOST LIKELY to use which of the following interventions to deal with the parental split?
   a. Prescribe parental neutrality.
   b. Tell the parents to do what they think is appropriate, on alternating days.
   c. Tell the parents to generate alternative solutions.
   d. Prescribe that the child be returned to school as quickly as possible.

Answer 6

b. Tell the parents to do what they think is appropriate, on alternating days.

Question 7

7. Case Scenario: A single mother brings in her only child, a 6-year-old son, Sam, who is chronically encopretic. This behavior is creating major problems at the boy’s school. The therapist suspects that, by being encopretic, the boy activates his depressed mother by making her angry.
   Question: If the therapist decides to use White’s strategy of externalizing the problem, which of the following statements would be MOST APPROPRIAT.
   a. “Sam, Mr. Poop seems to be stinking up your life. I’d like to help you figure out how to outsmart Mr. Poop so that he isn’t your boss anymore.”
   b. “Mom, when you got sad after Sam’s father abandoned the family and you didn’t grow for a while, Sam didn’t grow either. My hope is that I can help you help Sam grow up to six-year-old size.”
   c. “Mom, Sam won’t have the energy to get to the bathroom as long as he has to carry your anger around all day.”
   d. “Sam, you are a magic kid who is able to turn a sad, quiet mother into a strong, brave one. Let’s see what else you can do with your magic at school.”

Answer 7

a. “Sam, Mr. Poop seems to be stinking up your life. I’d like to help you figure out how to outsmart Mr. Poop so that he isn’t your boss anymore.”

Question 8

8. While the therapist is interviewing a couple, the husband casually mentions that he inadvertently injured his wife during one of their fights. After all legal requirements are fulfilled; the therapist’s NEXT goal should be to:
   a. Arrange for the wife to be admitted to a women’s shelter.
   b. Conduct a thorough assessment and develop a systemic view of the situation.
   c. Strongly recommend that the couple separate until the treatment is successful.
   d. Conduct a thorough assessment and develop a treatment plan that will ensure the wife’s safety.

Answer 8

d. Conduct a thorough assessment and develop a treatment plan that will ensure the wife’s safety.

Question 9

9. An identified patient is diagnosed with Intermittent Explosive Disorder. A Structural family therapist would:
   a. Uncover which relationship circumstances elicit and maintain the behavior.
   b. Give the family insight into causal sequences and connections in relationships.
   c. Assign responsibility for the behavior to the family system.
   d. Exonerate the identified patient and externalize the symptoms.

Answer 9

b. Give the family insight into causal sequences and connections in relationships.

Question 10

10. A wife complains that her husband is overweight and sexually unappealing. He has tried dieting to please her, but has repeatedly failed to lose weight. As she urges him to lose weight, he actually continues to gain. An MRI Strategic therapist would understand this wife ‘s efforts to change her husband as an example of:
    a. The “utopia syndrome.”
    b. The “Devil’s Pact.”
    c. “More of the same.”
    d. “Terrible simplification.”

Answer 10

c. “More of the same.”

Question 11

11. An important element in malpractice is that a:
    a. Treatment procedure was utilized.
    b. Written contract was signed.
    c. Therapeutic relationship was established.
    d. Diagnosis was not assigned.

Answer 11

b. Written contract was signed.

Question 12

12. The mother of four children seems unable to relate to people outside of her immediate family. She appears to have no friends or support system other than a social service agency. Her social worker says she is socially withdrawn and dependent on her children. According to Structural Family Therapy, the MOST BASIC hypothesis about this mother ‘s relational dysfunction would be that:
    a. Transference and counter transference issues are involved.
    b. Adverse contextual issues such as economic stressors are primary.
    c. The mother is over involved with her children.
    d. The mother has Antisocial Personality Disorder.

Answer 12

c. The mother is over involved with her children.

Question 13

13. As a condition of probation, a client completed an inpatient substance abuse program in a state psychiatric hospital. The client is now seeking aftercare in a community-based mental health center. In discussing confidentiality with the client, the MOST IMPORTANT information the therapist needs to know is whether:
    a. After-care treatment is mandated by the probation order.
    b. After-care is to include the co-dependent family.
    c. The client is attending AA or NA.
    d. The therapist is to receive the results of random VA tests.

Answer 13

a. After-care treatment is mandated by the probation order.

Question 14

14. The PRIMARY purpose of state licensure and certification of marital and family therapists is to:
    a. Facilitate third-party payment of clinicians.
    b. Establish a clear professional identity for practitioners.
    c. Provide credentials for private practitioners.
    d. Protect the public from unqualified and unethical providers.

Answer 14

d. Protect the public from unqualified and unethical providers.

Question 15

15. The Systemic concept that “problems determine the system” is another way of acknowledging that:
    a. Assessing family patterns is essential to developing structural interventions.
    b. The system relevant to therapy is not always the nuclear family system.
    c. Cybernetic concepts adequately explain families and family dysfunction.
    d. Paradox is central to family systems therapy.

Answer 15

b. The system relevant to therapy is not always the nuclear family system.

Question 16

16. In cases of domestic violence in which steps have been taken to ensure safety and the perpetrator has taken responsibility for his/her actions, the therapeutic goal should focus on:
    a. Looking at the couple’s shared responsibility for the abuse.
    b. Seeing whoever is willing to come for treatment.
    c. Exploring what attracts the victim to the perpetrator.
    d. Helping the couple to manage their interactional patterns.

Answer 16

d. Helping the couple to manage their interactional patterns.

Question 17

17. Case Scenario: A mother and father come into therapy regarding their 17-year-old son, the second of three children, with a 19-year-old brother and a 16-year-old sister. The parents report that the son has “changed drastically” within the past year, going from a pleasant, cooperative, and compliant son to being almost no communicative and even hostile. He hints of “not wanting to be here” and has a consistent darkness about his presence. The son comes to therapy but only for individual sessions. He voices great disdain toward his parents, their lifestyle, his older “perfect” brother, and his spoiled “baby” sister. His perception is that his parents had each chosen one child to “pet,” leaving him somewhat alone until the departure of his older sibling. During therapy, his public behavior changes, but he continue to voice hostility toward his family and exhibits no effort to enter into cooperative encounters with them. A brief course of antidepressants helped, but he stopped taking the medication without telling his parents. He reverted back to the hostility, causing his parents to investigate and discover that he was no longer taking the medication. He left therapy, declaring that now he knew how to do many things differently with his friends and that he was just waiting until he could leave home. Question: An important pattern to explore with these parents through an intergenerational genogram would be:
    a. Male entitlement.
    b. Launching.
    c. Abandonment.
    d. Marital satisfaction.

Answer 17

b. Launching.

Question 18

18. According to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), which of the following would be considered a V-Code diagnosis?
    a. Partner Relational Problem
    b. Post-traumatic Stress Disorder
    c. Adjustment Disorder with Depressed Mood
    d. School phobia

Answer 18

a. Partner Relational Problem

Question 19

19. In a family session, a client has just disclosed that she is binge eating and vomiting two or three times a day. The therapist should:
    a. Refer the client immediately for a medical evaluation.
    b. Have the client’s family monitor their eating patterns.
    c. Refer the client to an eating disorders support group.
    d. Reframe the symptoms as a way to detour family conflict.

Answer 19

a. Refer the client immediately for a medical evaluation.

Question 20

20. A recently married middle-aged couple has a dispute about whom to invite to the wedding of the husband’s daughter by a previous marriage. The wife wants to invite her children from her prior marriage, while the husband wants to include “only immediate family.” This dispute BEST exemplifies:
    a. Conflict avoidance.
    b. Triangulation.
    c. Boundary ambiguity.
    d. Enmeshment.

Answer 20

c. Boundary ambiguity.

Question 21

21. The double bind was originally conceptualized by Bateson and colleagues as a description of:
    a. The ways by which couples give each other mixed messages.
    b. Communication patterns in schizophrenic families.
    c. The dilemma facing the therapist treating families.
    d. The dilemma facing the wife of an alcoholic.

Answer 21

b. Communication patterns in schizophrenic families.

Question 22

22. A therapist is treating a single-parent family, consisting of a divorced mother (aged 40 [M]), son (aged 18 [S]), and daughter (aged 16 [D]). The mother states that her daughter has been coming home late, and she worries that she has lost control of her; the son agrees. During the initial interview, the son and the mother do most of the talking. The son declares that he is tired of his sister’s “acting-out” and that his mother does not need “this kind of grief.” How is a structural therapist MOST LIKELY to diagram this family?
    a. b. c. d.

Answer 22

d.

Question 23

23. When false, misleading, or inaccurate representations are made by others concerning a therapist’s qualifications, services, or products, the therapist should: a. Know that the accurate description in his/her professional brochure is sufficient protection.
    b. Ignore the error so as not to embarrass anyone.
    c. Move directly to the clinical issues, since these comments are most likely innocent mistakes.
    d. Correct the misrepresentations at the first opportunity.

Answer 23

d. Correct the misrepresentations at the first opportunity.

Question 24

24. A therapist uses a light hypnotic trance to help a couple become emotionally closer, since they typically fight in a symmetrically escalating fashion. Such an intervention will not work UNLESS:
    a. The hypnotic experience is discussed, at least briefly, afterwards.
    b. The husband is amenable to hypnotism.
    c. They are willing to be more intimate as a couple.
    d. The therapist can help them use self-hypnosis on an ongoing basis later.

Answer 24

c. They are willing to be more intimate as a couple.

Question 25

25. In helping a married couple, a therapist asks the wife, “What do you do when he gets depressed and withdraws, and when you get frustrated and angry, what does he do?” and then asks the husband, “What do you do when she gets frustrated and angry, and when you get depressed and withdraw, what does she do?” In this situation, the therapist ‘s intended outcome would be to:
    a. Increase awareness of the couple’s definition of the problem by highlighting communication patterns.
    b. Illustrate the circular nature of the problem through exploring the different perspectives of the partners.
    c. Demonstrate the Circumplex model of communication.
    d. Assist the couple in understanding each other’s feelings.

Answer 25

b. Illustrate the circular nature of the problem through exploring the different perspectives of the partners.

Question 26

26. A family presents for therapy. A 13-year-old has been acting out at school, the two older siblings are sneaking out of the home at night to drink, the mother is overworked and depressed, and the father is working nights. From a Structural perspective, the PRIMARY intervention with this family is to:
    a. Assist the parents in establishing teamwork and appropriate boundaries.
    b. Explore the sibling subsystem’s collusion and boundary.
    c. Offer support to the children to compensate for family deficits.
    d. Relieve the internal distress by turning the family’s attention to the marriage.

Answer 26

a. Assist the parents in establishing teamwork and appropriate boundaries.

Question 27

27. Sociological studies of power relationships in marriage reveal that certain patterns are more — or less — satisfying than others. The pattern that has repeatedly been shown to be the LEAST satisfying for both partners is the:
    a. Autonomic.
    b. Egalitarian.
    c. Husband-dominant.
    d. Wife-dominant.

Answer 27

c. Husband-dominant.

Question 28

28. Pat and Terry come in for couple’s therapy. Pat wishes to work outside the home, and Terry thinks their young children need a parent at home all of the time. A feminist narrative therapist would:
    a. Externalize their structural ledgers.
    b. Deconstruct the troubled story.
    c. Construct a gendergram.
    d. Elicit dominant gender-role stories.

Answer 28

c. Construct a gendergram.

Question 29

29. A marital and family therapist was asked by a husband whose wife and children were being seen with him in family therapy to provide information about his progress to his employer. The therapist had the husband sign a written release and then called the client’s employer to provide the information. The therapist ‘s actions were:
    a. Unethical, but maybe legal.
    b. Ethical, but legal.
    c. Ethical, but illegal.
    d. Unethical and illegal.

Answer 29

d. Unethical and illegal.

Question 30

30. Which of the following statements is consistent with the literature concerning treatment of marital violence?
    a. Men are genetically predisposed to violence.
    b. The abuser must be held responsible for the violence.
    c. Conjoint interviewing must be used to assess circular processes.
    d. Under certain circumstances, violence between spouses is understandable.

Answer 30

b. The abuser must be held responsible for the violence.

Question 31

31. A Strategic therapist might assess a successful outcome by pursuing a discussion of:
    a. The aspects of the problems originally brought into therapy that the client might wish to keep.
    b. How the client would now tell his or her dominant story.
    c. How soon the client should schedule a follow-up appointment.
    d. What the client might be able to share with his or her family about how he or she has changed.

Answer 31

c. How soon the client should schedule a follow-up appointment.

Question 32

32. The MOST COMMON criticism by feminist family therapists of Bowen ‘s model of family therapy is that:
    a. Its concept of differentiation values the rational over the emotional.
    b. It encourages the technique of “coaching,” which encourages hierarchical relationships.
    c. It recommends unbalancing through the mother.
    d. It is based on biological systems.

Answer 32

a. Its concept of differentiation values the rational over the emotional.

Question 33

33. Prevention is defined as any process that is designed to:
    a. Hinder multi-generation repetition of pathological behaviors.
    b. Isolate high-risk families.
    c. Inhibit therapist burnout.
    d. Improve the relational wellness of a family.

Answer 33

a. Hinder multi-generation repetition of pathological behaviors.

Question 34

34. In treating patients with severe depressive symptoms, research has shown family therapy to be as effective as individual treatment among which of the following types of patients.
    a. Depressed outpatients experiencing marital distress
    b. Depressed outpatients whose spouses were mildly depressed
    c. Depressed inpatients experiencing marital distress
    d. Depressed inpatients with unsupportive spouses

Answer 34

d. Depressed inpatients with unsupportive spouses

Question 35

35. During the first session, a client states that she is depressed because of her marriage and has decided to obtain a divorce. The therapist insists on getting the husband’s side of the story, and the client reluctantly agrees to bring him to a session. For the next several sessions, the therapist focuses on marital issues, attempting to bring about reconciliation. This therapist has:
    a. Not applied a systemic framework by agreeing to see the wife individually.
    b. Appropriately acknowledged the therapist’s personal values to the client.
    c. Used professional expertise in the long-term best interest of the client.
    d. Failed to respect the client’s goals by imposing the therapist’s own.

Answer 35

d. Failed to respect the client’s goals by imposing the therapist’s own.

Question 36

36. A family follows a paradoxical injunction to “fight normally” between sessions. A Strategic therapist would assess this behavior as:
    a. Evidence of severe conflict and dysfunction.
    b. Willingness to follow directives.
    c. Lack of commitment to change.
    d. Objectivity in parentheses.

Answer 36

b. Willingness to follow directives.

Question 37

37. According to Watzlawick, the term “utopia syndrome” refers to the behavior of families who:
    a. Seek ideal solutions to common everyday difficulties.
    b. Defend and protect the symptomatic members.
    c. Blame the therapist for the lack of change in their system.
    d. Constantly change therapists in search of an “ideal” one.

Answer 37

b. Defend and protect the symptomatic members.

Question 38

38. A client begins therapy because he is having problems relating to women. According to the MRI Strategic approach, the therapist should FIRST:
    a. Investigate the successes that have been achieved so far.
    b. Develop a clear definition of the problem.
    c. Investigate the client’s relationship with the problem.
    d. Develop a plan to produce change with the client.

Answer 38

b. Develop a clear definition of the problem.

Question 39

39. A therapist engages as a non-expert in a collaborative conversation with a client. This can be conceptualized as:
    a. Linear causality.
    b. Subjects that are separate from the objects of observation.
    c. Paradoxes of communication.
    d. Contexts within which relationship issues emerge.

Answer 39

c. Paradoxes of communication.

Question 40

40. According to the literature on the family life cycle, the MOST STRESSFUL transitions occur in connection with:
    a. Changes in family rituals.
    b. The gain or loss of family members.
    c. Shifts in the roles of family members.
    d. Changes in social and economic status.

Answer 40

b. The gain or loss of family members.

Question 41

41. Case Scenario: Rebecca and Tom, a couple in their mid-20s, have been referred to therapy by child welfare authorities as a condition of regaining custody of their 6-year-old daughter, who was placed in foster care 2 weeks ago. After an investigation stemming from a teacher’s report of suspicious bruises, it was determined that Tom had struck Erin repeatedly with a yardstick. Upon questioning by the therapist, Tom states that the investigator “overreacted” and expresses resistance to “a caseworker telling me I can’t discipline my own kid to keep her in line.” When asked if she agrees, Rebecca hesitates, then states, “Tom and I don’t always agree on that. I guess we were brought up differently. Even now, when his parents and my parents come over for dinner, they argue about whether Tom and I are too strict or too lenient with Erin.” Question: A Milan group therapist might hypothesize that Tom’s and Rebecca’s parents were part of the:
    a. Executive subsystem.
    b. Significant system.
    c. Undifferentiated egomass.
    d. Transference relationship.

Answer 41

a. Executive subsystem.

Question 42

42. According to the AAMFT Code of Ethics, marital and family therapists should:
    a. Offer payment to managed care organizations for referrals, but not to individuals.
    b. Clearly disclose information regarding referral fees and payments received.
    c. Neither offer nor accept payment for referrals they may receive or provide.
    d. Offer to pay for referrals but may not accept payment for providing them.

Answer 42

c. Neither offer nor accept payment for referrals they may receive or provide.

Question 43

43. From an Object Relations perspective, setting the frame refers to the process of:
    a. Defining intergenerational boundaries between members.
    b. Building an alliance and establishing trust.
    c. Establishing the number and length of sessions and fees.
    d. Determining which family member is in control of sessions.

Answer 43

a. Defining intergenerational boundaries between members.

Question 44

44. The MOST IMPORTANT skill for a marital and family therapist working with a family preservation program is the ability to:
    a. Create a balance of fairness in the costs and benefits of the family members ‘ lives.
    b. Establish meaningful emotional contact with the identified patient.
    c. Manage complex relationships and boundaries.
    d. Accurately diagnose the social environment.

Answer 44

c. Manage complex relationships and boundaries.

Question 45

45. Case Scenario: A mother and father come into therapy regarding their 17-year-old son, the second of three children, with a 19-year-old brother and a 16-year-old sister. The parents report that the son has “changed drastically” within the past year, going from a pleasant, cooperative, and compliant son to being almost noncommunicative and even hostile. He hints of “not wanting to be here” and has a consistent darkness about his presence. The son comes to therapy but only for individual sessions. He voices great disdain toward his parents, their lifestyle, his older “perfect” brother, and his spoiled “baby” sister. His perception is that his parents had each chosen one child to “pet,” leaving him somewhat alone until the departure of his older sibling. During therapy, his public behavior changes, but he continues to voice hostility toward his family and exhibits no effort to enter into cooperative encounters with them. A brief course of antidepressants helped, but he stopped taking the medication without telling his parents. He reverted back to the hostility, causing his parents to investigate and discover that he was no longer taking the medication. He left therapy, declaring that now he knew how to do many things differently with his friends and that he was just waiting until he could leave home.
    Question: What would be appropriate for the therapist to say to normalize this family’s experience?
    a. “Your son is attempting to strengthen the marital relationship with his behavior.”
    b. “Your son’s behavior indicates an expected life-cycle stage of transition.”
    c. “Your son doesn’t ‘ need further therapy since he has learned to behave differently.”
    d. “Your son’s non-compliance with medication is a step toward differentiation.”

Answer 45

b. “Your son’s behavior indicates an expected life-cycle stage of transition.”

Question 46

46. Case Scenario: You receive a call from a former professor who also served as your clinical supervisor during your recently completed graduate work. He and his wife would like you to see their 5-year-old daughter, whom they suspect may have been sexually abused by their babysitter’s boyfriend. The professor states that his wife is very anxious about their child seeing a therapist and wants it to be someone he knows. He indicates that he has always appreciated your abilities and thinks that you would do well with his daughter.
    Question: The professor reports that child protective services has not been notified because they aren’t ‘t certain of the identity of the abuser, nor are they even certain that their daughter was sexually abused. You inform him that:
    a. A report of sexual abuse should be filed only if physical signs of such abuse are present.
    b. The reporter need only have “reasonable cause” to believe or suspect that a child has been abused.
    c. Reporting of all forms of abuse is an ethical, not a legal, issue.
    d. Not all states require that suspected sexual abuse cases be reported.

Answer 46

b. The reporter need only have “reasonable cause” to believe or suspect that a child has been abused.

Question 47

47. Case Scenario: A mother and father come into therapy regarding their 17-year-old son, the second of three children, with a 19-year-old brother and a 16-year-old sister. The parents report that the son has “changed drastically” within the past year, going from a pleasant, cooperative, and compliant son to being almost noncommunicative and even hostile. He hints of “not wanting to be here” and has a consistent darkness about his presence. The son comes to therapy but only for individual sessions. He voices great disdain toward his parents, their lifestyle, his older “perfect” brother, and his spoiled “baby” sister. His perception is that his parents had each chosen one child to “pet,” leaving him somewhat alone until the departure of his older sibling. During therapy, his public behavior changes, but he continues to voice hostility toward his family and exhibits no effort to enter into cooperative encounters with them. A brief course of antidepressants helped, but he stopped taking the medication without telling his parents. He reverted back to the hostility, causing his parents to investigate and discover that he was no longer taking the medication. He left therapy, declaring that now he knew how to do many things differently with his friends and that he was just waiting until he could leave home.
    Question: Which of the following would describe second-order, rather than first-order, change in this family system?
    a. The parents affirm their son’s behavior as his way of leaving home.
    b. The son’s public behavior changes, but his behavior within the family remains the same.
    c. The parents decide to investigate and monitor the son’s compliance with taking medication.
    d. The son participates in therapy until he learns to be less hostile and more compliant.

Answer 47

d. The son participates in therapy until he learns to be less hostile and more compliant.

Question 48

48. To rule out suicidal ideation for both husband and wife, the MOST LIKELY instrument the marital and family therapist should consider using is the:
    a. FACES.
    b. Dyadic Adjustment Scale.
    c. Meyers–Briggs Type Indicator.
    D. Beck Depression Index.

Answer 48

b. Dyadic Adjustment Scale.

Question 49

49. Case Scenario: You receive a call from a former professor who also served as your clinical supervisor during your recently completed graduate work. He and his wife would like you to see their 5-year-old daughter, whom they suspect may have been sexually abused by their babysitter’s boyfriend. The professor states that his wife is very anxious about their child seeing a therapist and wants it to be someone he knows. He indicates that he has always appreciated your abilities and thinks that you would do well with his daughter.
    Question: After careful consideration, you decline to work with the child and provide a list of appropriate referrals. Your decision is based on the ethical issue of:
    a. Agency/therapist triangulation.
    b. Confidentiality.
    c. Duty to protect.
    d. Dual relationships.

Answer 49

d. Dual relationships.

Question 50

50. In working with problematic adolescents, there are frequently multiple systems or agencies involved. To facilitate a successful intervention in such cases, a therapist should:
    a. Limit the involvement of non-professional agency personnel.
    b. Keep agencies apprised of the family’s reaction to each intervention.
    c. Request permission to share the family’s treatment plan with involved systems.
    d. Initiate and develop collaboration between the various helping systems and the family.

Answer 50

d. Initiate and develop collaboration between the various helping systems and the family.

Question 51

51. The more the child misbehaves, the more the parent threatens. The more the parent threatens, the more the child misbehaves. According to Watzlawick et al., this cycle is an example of:
    a. Rigid complementarity.
    b. Quid pro quo behavior.
    c. Symmetrical escalation.
    d. Projective identification.

Answer 51

c. Symmetrical escalation.

Question 52

52. In giving a “ritualized prescription,” a Strategic family therapist assumes that insight:
    a. Will be transmitted from the executive system to the rest of the system.
    b. Can take place after change has occurred.
    c. Must precede family change.
    d. Will facilitate system change.

Answer 52

b. Can take place after change has occurred.

Question 53

53. In an initial session, a marital and family therapist provides information about treatment content and process, legal requirements, and fees in a manner understandable to the client. The therapist is:
    a. Structuring therapy.
    b. Obtaining informed consent.
    c. Engaging in value ethics.
    d. Modeling the use of privilege.

Answer 53

b. Obtaining informed consent.

Question 54

54. During a therapy session, a client states, “Tom and I don’t always agree on discipline with our daughter. I guess we were brought up differently. Even now, when his parents and my parents come over for dinner, they argue about whether he and I are too strict or too lenient.” A Milan Systemic therapist might hypothesize that this couple ‘s parents were part of the:
    a. Generational subsystem.
    b. Significant system.
    c. Undifferentiated egomass.
    d. Transference relationship.

Answer 54

a. Generational subsystem.

Question 55

55. From a Systems perspective, one method for getting family members to perceive family patterns is the use of:
    a. Circular questioning.
    b. Paradoxical techniques.
    c. Hypothesizing.
    d. Nonlinear formatting.

Answer 55

a. Circular questioning.

Question 56

56. The PRIMARY purpose of marital and family therapy outcome research is to:
    a. Demonstrate the overall effectiveness of marital and family therapy.
    b. Support the academic training of marital and family therapists.
    c. Inform other professionals about the field of marital and family therapy.
    d. Enhance eligibility for third-party reimbursement.

Answer 56

a. Demonstrate the overall effectiveness of marital and family therapy.

Question 57

57. Framo believes that the TREATMENT OF CHOICE for marital problems is:
    a. Individual coaching with regard to family-of-origin issues.
    b. Couples groups focused on family-of-origin issues.
    c. Clarifying and rewriting the marital contract.
    d. Behavioral marital therapy.

Answer 57

c. Clarifying and rewriting the marital contract.

Question 58

58. Which of the following statements BEST defines a family paradigm?
    a. Family systems eschatology
    b. An organized theory of family functioning
    c. An invariant prescription in family therapy
    d. The way a family defines and organizes experience

Answer 58

d. The way a family defines and organizes experience

Question 59

59. A therapist utilizing a Solution-Focused approach to therapy would ensure that treatment goals are:
    a. Hierarchically structured.
    b. Morphogenic.
    c. Focused on past events.
    d. Stated positively.

Answer 59

d. Stated positively.

Question 60

60. Some victims of incest continue to respond to their abusers with care, consideration, and protection. In Contextual therapy theory, this mode of relating is explained as an expression of:
    a. Loyalty.
    b. Pseudomutuality.
    c. Fusion.
    d. Parentification.

Answer 60

c. Fusion.

Question 61

61. After eighteen therapy sessions with a family, there is greater distance in the father–child relationship but enhanced closeness in the marital relationship. This change would be referred to as a change in family:
    a. Structure.
    b. Meaning.
    c. Complementarity.
    d. Behavior.

Answer 61

a. Structure.

Question 62

62. Gender-sensitive family therapy includes use of the following techniques:
    a. Encouraging family members to examine their attitudes about their genders.
    b. Acknowledging the relative physical strength of the men and the women in a family.
    c. Paying attention to the income and work opportunities of both the husband and the wife.
    d. Discuss traditional roles so that family members can more easily adapt to them.

Answer 62

a. Encouraging family members to examine their attitudes about their genders.

Question 63

63. A Feminist therapist would be MOST LIKELY to encourage clients to utilize more of their:
    a. Independence and their cognitive ways of knowing.
    b. Emotional than their cognitive ways of knowing.
    c. Emotional and cognitive ways of knowing equally.
    d. Ability to be equally independent.

Answer 63

d. Ability to be equally independent.

Question 64

64. Holding opposing views about discipline, two parents seek help about their demanding 5-year-old child. A Constructivist therapist INITIALLY would:
    a. Discuss the child’s demanding behavior.
    b. Prescribe a task for coming to agreement about rules for the child.
    c. Encourage each parent to elaborate upon his/her parenting perspective.
    d. Reframe the problem as a control issue between the couple.

Answer 64

c. Encourage each parent to elaborate upon his/her parenting perspective.

Question 65

65. Sometimes termination remains “open-ended.” When this is appropriate, the therapist should:
    a. Clarify the therapeutic relationship for future use.
    b. Teach a set of skills applicable to future family problems.
    c. Reach joint agreement by all family members to termination.
    d. Present the course of progress in the treatment plan.

Answer 65

a. Clarify the therapeutic relationship for future use.

Question 66

66. A mother contacts a Symbolic–Experiential therapist for therapy for her teenage son. She agrees to the therapist’s requirement that all members of the family come to the first session. During the session, the therapist sits quietly. The therapist is engaged in the battle:
    a. Of the absurd.
    b. For connectedness.
    c. For initiative.
    d. For structure.

Answer 66

d. For structure.

Question 67

67. Yolanda and Luis bring in their 18-year-old son, Carlos, who has recently joined the Army, and their 16-year-old daughter, Anna, who does not control her diabetes. Carlos is described as being very close to his mother. A systemic reframe of Anna’s behavior might include which of the following statements?
    a. “Sounds like Anna is competing for attention.”
    b. “If Anna lets herself get sick, does that mean she doesn’t care about school or the family?”
    c. “Anna’s behavior must make the family worry about her health.”
    d. “Sounds like Anna is drawing attention to herself so that Mother won’t grieve about Carlos.”

Answer 67

d. “Sounds like Anna is drawing attention to herself so that Mother won’t grieve about Carlos.”

Question 68

68. In the treatment of ethnically diverse families, it is important for therapists to be:
    a. Unconcerned about social-class distinctions between themselves and the families.
    b. Most empathic with the male members of the families.
    c. Aware of the cultural influences that may be presented by the families.
    d. Unaffected by the cultural differences between themselves and the families.

Answer 68

c. Aware of the cultural influences that may be presented by the families.

Question 69

69. Whenever Johnny’s mother sets a limit, he vehemently protests and argues until she gives in. According to Behavioral theory, this transaction is explained in terms of:
    a. Punishment.
    b. Escape learning.
    c. Aversive conditioning.
    d. Reinforcement contingencies.

Answer 69

c. Aversive conditioning.

Question 70

70. Structural therapists who challenge family patterns by intensifying stress during sessions must be aware of the potential for:
    a. Anxiety syndrome.
    b. Projective identification.
    c. Therapeutic neutrality.
    d. Post session confusion.

Answer 70

d. Post session confusion.

Question 71

71. While providing therapy to a managed-care client, a therapist should:
    a. Adapt diagnoses to fit the managed-care plan guidelines.
    b. Maintain the integrity of therapy and ethical standards of the profession.
    c. Keep separate therapy client records for the practitioner and the plan.
    d. Develop new models of therapy amenable to short-term goals.

Answer 71

b. Maintain the integrity of therapy and ethical standards of the profession.

Question 72

72. A therapist sees a couple for an initial visit. The man admits he has been physically violent with the woman, but she makes no complaint and states that she loves him. The therapist should:
    a. Call the social services unit and report the man for domestic violence.
    b. See the partners separately to determine safety issues.
    c. Urge the woman to leave the man immediately.
    d. Look for unconscious material related to hitting, threatening, and similar behavior.

Answer 72

b. See the partners separately to determine safety issues.

Question 73

73. A family therapist is conducting marital therapy. The wife is considering a divorce and is troubled by the spiritual/religious implications of such a decision. The therapist has suggested that the wife speak with her clergy person. The wife would also like her therapist to talk with the clergy person about her marital circumstances. What procedures MUST be followed for disclosing information between the two professionals?
    a. A written waiver from the wife is sufficient for the therapist to disclose information about the wife.
    b. Verbal waivers by both the wife and the husband are required for the therapist to disclose information about the wife to the clergy person.
    c. A written waiver must be obtained by the therapist from both the husband and the wife.
    d. No written waiver is required for consultation with clergy.

Answer 73

c. A written waiver must be obtained by the therapist from both the husband and the wife.

Question 74

74. During the first session, a client reports that he has lost interest in some activities, including sex. He also states that he increasingly has difficulty controlling his temper. He does not feel sad and has never been suicidal. When asked about his relationship, he says that he and his wife have been arguing more lately and have less in common than they used to. The MOST EFFECTIVE course of action for the therapist is to:
    a. Arrange for a telephone consultation with the client’s wife.
    b. Implement a cognitive–behavioral approach with the client individually.
    c. Suggest that the client talk with his physician about an antidepressant.
    d. Ask the client to invite his wife to join him for couple’s therapy.

Answer 74

d. Ask the client to invite his wife to join him for couple’s therapy.

Question 75

75. When confronted by a family that does not seem to be changing, a strategic therapist should:
    a. Refer the clients to a therapist better matched to their needs.
    b. Recognize that clients communicate how to work with them.
    c. Attempt to gain control by interpreting unconscious obstacles.
    d. Accommodate to the system as a way to initiate change.

Answer 75

b. Recognize that clients communicate how to work with them.

Question 76

76. A therapist has been working with a client for several months when the client begins to have memories of childhood sexual abuse. The therapist has had little experience working with such problems, but believes referral would be detrimental to the client. The therapist should:
    a. Require the client to participate in a group for survivors of sexual abuse.
    b. Focus on current problems so that the client is not overwhelmed by the past.
    c. Seek supervision from someone who is experienced in this area.
    d. Begin working with the client’s anger.

Answer 76

c. Seek supervision from someone who is experienced in this area.

Question 77

77. In a pursuer–distancer relationship, if the therapist succeeds in stopping the distancer from distancing, the MOST LIKELY initial result of this intervention will be that the:
    a. Distancer will opt out of the relationship.
    b. Pursuer and the distancer will switch roles.
    c. Pursuer will opt out of the relationship.
    d. Pursuer and the distancer will finally be able to work on their pattern.

Answer 77

b. Pursuer and the distancer will switch roles.

Question 78

78. A family therapist new to an agency is distressed to see that the staff uses approaches that have resulted in some difficult clients being declared hopeless. The therapist is trained in approaches shown to be effective with the problems at issue. The most productive action for the therapist would be to:
    a. Report the failure to comply with ethical standards to the proper organization.
    b. Offer an in-service training session on alternative treatment approaches.
    c. Arrange for all patients with similar difficulties to begin group therapy.
    d. Recommend to the difficult clients that they go elsewhere.

Answer 78

b. Offer an in-service training session on alternative treatment approaches.

Question 79

79. Which of the following statements reflects current thinking on the effects of divorce on children and adolescents?
    a. Exposure to chronic parental conflict, whenever it occurs, is likely to produce negative outcomes in children.
    b. A child’s close attachment to the same-sex parent eliminates most negative effects of divorce.
    c. The majority of children under age 15 display negative behaviors post-divorce.
    d. Behavior problems in children are more strongly associated with a parent’s death than with parents ‘ divorce.

Answer 79

a. Exposure to chronic parental conflict, whenever it occurs, is likely to produce negative outcomes in children.

Question 80

80. A therapist using Social Exchange theory would create a treatment plan recognizing how clients:
    a. Strive to maximize rewards and minimize costs in relationships.
    b. Create quid pro quo contracts.
    c. Attempt to focus on themselves rather than on relationships.
    d. Seek to equalize responsibility for behavior.

Answer 80

a. Strive to maximize rewards and minimize costs in relationships.

Question 81

81. When using the “miracle question,” the therapist is identifying:
    a. In what situations the client feels most overwhelmed by the problem.
    b. How the client’s family of origin contributed to the inability to set treatment goals.
    c. What solutions have already been tried?
    d. What the client will be doing differently when the problem is resolved.

Answer 81

d. What the client will be doing differently when the problem is resolved.

Question 82

82. A husband diagnosed with depression is placed on antidepressant medication and is seen monthly for individual treatment and a medication check by a psychiatrist. The husband and wife wish to be seen by a family therapist for marital problems. In this case, it will be ESSENTIAL for the family therapist to:
    a. Negotiate with the psychiatrist on who will retain primary responsibility for the case.
    b. Provide individual treatment to the wife before initiating conjoint sessions.
    c. Collaborate with the psychiatrist to decrease potentially destructive triangulation.
    d. Offer treatment after the husband has completed individual psychotherapy.

Answer 82

c. Collaborate with the psychiatrist to decrease potentially destructive triangulation.

Question 83

83. In a family therapy session, a 15-year-old boy mentions that he considers suicide an option to deal with his school problems. In this situation, the therapist ‘s best INITIAL RESPONSE would be to:
    a. Refer the boy for a psychiatric evaluation.
    b. Establish a suicide contract with the boy.
    c. Conduct an immediate assessment of the suicide risk.
    d. Work with the parents to initiate a suicide watch.

Answer 83

c. Conduct an immediate assessment of the suicide risk.

Question 84

84. A lesbian couple comes to therapy reporting conflict and decreased affection on the part of one of the partners. The therapist initially decides to work on their communication pattern to help them determine its effect on their feelings. The FIRST step is to ask them to:
    a. Try to calmly listen to each other, because intensifying the interaction may be contraindicated.
    b. Talk about their reasons for staying together in order to discourage their separating.
    c. Talk about separating so that the less-involved partner can better understand her partner’s pain.
    d. Discuss a topic and intensify their interaction so that they can raise their tolerance for conflict.

Answer 84

a. Try to calmly listen to each other, because intensifying the interaction may be contraindicated.

Question 85

85. A therapist asking circular questions is attempting to assess:
    a. The homoeostatic functioning of the system.
    b. The ways that individual members make sense of their relational problems.
    c. Hidden internalized conflicts and fears.
    d. How problematic behavior is maintained by current reinforcements.

Answer 85

b. The ways that individual members make sense of their relational problems.

Question 86

86. In treating families in which the parents are separating and divorcing, the HIGHEST priority for the therapist is to:
    a. File custody recommendations with the court.
    b. Identify the major areas of conflict between spouses.
    c. Mitigate the impact of parental emotions on the children.
    d. Recommend mediation concurrent with therapy.

Answer 86

c. Mitigate the impact of parental emotions on the children.

Question 87

87. A correct statement about conflict detouring within the family is that this process:
    a. Occurs more frequently in single-parent families.
    b. Reduces pressure on the spouses, but places more stress upon the children.
    c. Enables families to resolve their problems.
    d. Reduces pressure on the children, but places more stress upon the spouses.

Answer 87

b. Reduces pressure on the spouses, but places more stress upon the children.

Question 88

88. It is characteristic of Family Preservation programs to be:
    a. Dependent on the use of a co-therapy team.
    b. Less intrusive than traditional forms of marital and family therapy.
    c. Used within the actual family environment.
    d. An intervention for joining with involuntary clients.

Answer 88

c. Used within the actual family environment.

Question 89

89. According to Emotionally Focused Therapy theory, the tasks and interventions structured by a therapist should:
    a. Target third-order reactive emotions.
    b. Identify the positive interaction cycle.
    c. Reprocess emotional experiences.
    d. Consolidate each person’s position.

Answer 89

c. Reprocess emotional experiences.

Question 90

90. Brief Therapy is generally considered effective when change occurs in:
    a. The underlying family dynamics.
    b. The original complaint.
    c. The perception of the situation.
    d. Communication patterns.

Answer 90

b. The original complaint.

Question 91

91. Which of the following statements would a Strategic family therapist be MOST LIKELY to make to a spouse whose partner has had repeated affairs but who expresses the wish to remain married?
    a. “I agree that you have many good reasons for staying with your partner.”
    b. “What is your role in your partner’s marital dissatisfaction?”
    c. “You need to get your partner into treatment.”
    d. “How will you ever be able to trust your partner again?”

Answer 91

a. “I agree that you have many good reasons for staying with your partner.”

Question 92

92. Which of the following is an accurate statement about the Feminist approach to family therapy?
    a. It seeks to empower women by helping them understand how their behavior reinforces dysfunctional family patterns.
    b. It emphasizes the influence of power on family dynamics and claims that the major models of therapy often blame women for problems.
    c. It encourages men to become more involved with their families and cautions women about over involvement with their children.
    d. It encourages women to be more rational so that men can be free to be more emotional.

Answer 92

b. It emphasizes the influence of power on family dynamics and claims that the major models of therapy often blame women for problems.

Question 93

93. A same-sex couple comes to therapy in conflict over whether to adopt a child. The therapist has no experience with this concern. The therapist should initially:
    a. Admit the lack of experience and ask if the couple wishes to continue therapy.
    b. Secure professional resources and proceed with the case.
    c. Refer to a specialist in same-sex couple’s therapy.
    d. Assume that therapy is the same for opposite-sex and same-sex couples.

Answer 93

a. Admit the lack of experience and ask if the couple wishes to continue therapy.

Question 94

94. A child is in therapy because of grief reactions to the death of her father. The therapist wishes to tell a metaphoric story to engage her attention and empathy. An example of a therapeutic metaphor would be a story that:
    a. Matches the problem theme.
    b. Suppresses fearful emotions.
    c. Dictates a moral.
    d. Teaches spirituality.

Answer 94

a. Matches the problem theme.

Question 95

95. During assessment, the therapist asks a couple about their goals for treatment. The husband says that he would like them to communicate better. The wife rolls her eyes and repeats his words in an angry mocking manner. She says that she has begged him to go to therapy with her for years, but now he has waited too long, and she will leave him as soon as the children leave home. In assessing the wife’s motivation for therapy, the therapist should first:
    a. Suggest a trial of therapy to see if her feelings change.
    b. Encourage the husband to apologize for his previous reluctance to enter therapy.
    c. Acknowledge the wife’s ambivalence about participating in therapy.
    d. Point out that improving the marriage will be helpful for the children.

Answer 95

c. Acknowledge the wife’s ambivalence about participating in therapy.

Question 96

96. Case Scenario: A single mother brings in her only child, a 6-year-old son, Sam, who is chronically encopretic. This behavior is creating major problems at the boy’s school. The therapist suspects that, by being encopretic, the boy activates his depressed mother by making her angry.
    Question: According to a Feminist therapist, which of the following treatment strategies has the BEST chance of working with Sam and his mother?
    a. Support the mother’s explicit efforts and reassure her that challenging Sam’s behavior will not damage him.
    b. Have Sam’s mother demand that his father get more involved in Sam’s well-being.
    c. Refer Sam to a male therapist who could provide male reinforcement for the mother’s reasonable toileting demands.
    d. Help the mother to understand her over involvement with Sam and how this hampers her ability to be firm with him.

Answer 96

a. Support the mother’s explicit efforts and reassure her that challenging Sam’s behavior will not damage him.

Question 97

97. A Strategic therapist is interviewing a single parent who often explodes in anger at her children; her parents are regularly critical of her parenting. A Strategic therapist would likely attempt to intervene in the parenting by:
    a. Pointing out the ways in which she is a good mother and acts maturely.
    b. Asking the children’s father to participate in therapy.
    c. Teaching parenting skills.
    d. Asking the children what their opinions are of their mother’s parenting skills.

Answer 97

d. Asking the children what their opinions are of their mother’s parenting skills.

Question 98

98. In assisting a couple to change their patterns of argument, a Bowen therapist would be MOST LIKELY to:
    a. Encourage the couple to express their feelings more clearly by talking to each other.
    b. Encourage each partner to share how he or she feels the other needs to change.
    c. Help the couple modify their anxiety through reconnecting with family members.
    d. Increase the intensity between the couple so that they can more easily differentiate.

Answer 98

c. Help the couple modify their anxiety through reconnecting with family members.

Question 99

99. During the process of treatment, a family begins missing appointments, canceling, and arriving late. When the therapist asks what is behind these occurrences, the family members indicate that they are considering ending treatment, and ask for the therapist’s recommendation. Which of the following would be the MOST detrimental course of action?
    a. Encourage the family to remain in therapy if there is reason to believe that without treatment deterioration is likely.
    b. Accept the family’s wish to end treatment if it appears that the therapist’s motivation is stronger than the family’s.
    c. Recommend that the family not terminate until they have achieved all of the original goals of therapy.
    d. Support the family’s wish to end treatment if it appears that they now have the resources to deal with the remaining problems.

Answer 99

c. Recommend that the family not terminate until they have achieved all of the original goals of therapy.

Question 100

100. In a session with Mrs. Thomas and her 10-year-old daughter, Lisa, the therapist observes that they are stuck in an ongoing argument about whether or not Lisa can spend a week at the beach with teenage friends. In order to intervene on the level of PROCESS, the therapist should ask: a. Them to work out a compromise to resolve the situation.
     b. The mother to assert her parental role with more clarity.
     c. Them if this discussion reminds them of their prior arguments.
     d. The mother to design an appropriate alternative.

Answer 100

c. Them if this discussion reminds them of their prior arguments.