Test Questions

Question 1

Alice, age 14, is brought to therapy by her mother Joan, after she reported having thoughts of killing herself. Joan is a single mother to Alice, and Jill, age 16. Alice refuses to go to school, is often irritable and frequently argues with her mom and sister. Joan reports that Alice has cut herself in the past. Joan also shares that she herself is on medication for bi-polar disorder. How would a Bowen Family Therapist assess the intergenerational issues related to the crisis issues in this case?

A. Maintain a nonanxious presence; Role model a clear sense of differentiation; identify triangles with present and/or extended family members

B. Construct a general related to suicide, defiant behavior, and mental health issues; Determine whether family members can distinguish thoughts from feelings; Identify triangles with present and/or extended family members

C. Maintain a nonanxious presence; Teach family members how to use “I” statements; Identify each member’s sibling position;

D. Construct a genogramrelated to suicide, defiant behavior and mental health issues; Explore emotional cutoffs betweenpresentand extended family members; Identify multigenerational patterns of parenting and rebellion

Answer 1

Answer:

D. Construct a genogramrelated to suicide, defiant behavior and mental health issues; Explore emotional cutoffs betweenpresentand extended family members; Identify multigenerational patterns of parenting and rebellion

Question 2

Question 36
A 42 year old female client seeks therapy at the urging of her partner. The client is late to the first session and appears disheveled. The client begins crying and reports that she is distraught about the recent loss of her 82 year old mother. How would a Client Centered therapist proceed in this case?

A. Express sympathy for the client’s loss and assess for danger to self.

B. Use body language to communicate empathy and provide psychoeducation about grief reactions.

C. Use reflective listening to explore her reaction to her mother’s death.

D. Relate a personal experience of loss if it is similar to the client’s experience.

Answer 2

Correct Answer:

C. Use reflective listening to explore her reaction to her mother’s death.

Question 3

A 45 year old woman comes to therapy. She has a history of cutting herself when feeling overwhelmed and reports that in recent times she has felt so stressed by her life, the isolation caused by COVID, and all the societal problems, that she has contemplated suicide. How would a Dialectical Behavior therapist initially?

A. Explore what aspects of the client’s life bring her joy.

B. Guide the client through a mindfulness exercise.

C. Provide the client with a skill building task to practice in between sessions.

D. Validate client’s feelings and further assess current level of risk.

Answer 3

Correct Answer:

D. Validate client’s feelings and further assess current level of risk.

Question 4

Question 50

A 58 year old woman is referred to therapy by her oncologist. The client was recently diagnosed with breast cancer. While her prognosis is good, the client has become very depressed and withdrawn. She shares with the therapist that the cancer has forced her to look at her life and she doesn’t like what she sees. She admits that she was a workaholic when her two children were young and now has little contact with them. She also shares that feels her husband is a stranger. What intervention would an Existential therapist employ during the middle phase of treatment?

A. Explore the client’s understanding of her early relationships and how they impact her current situation.

B. Encourage the client to “play out” scenarios of choices she faces and acknowledge the accompanying fears and anxieties.

C. Teach the client communication skills to better engage with her family members.

D. Identify the underlying thoughts and beliefs that lead to her troubling feelings.

Answer 4

Correct Answer:

B. Encourage the client to “play out” scenarios of choices she faces and acknowledge the accompanying fears and anxieties.

Question 5

Question 52

A 48 year old client in treatment for anxiety is going on a three week trip with her husband. She requests to use email to communicate with the therapist while she is away. How should the therapist clinically manage this?

A. Inform the client about the limitations and risks of electronic communications

Answer 5

Correct Answer:

A. Inform the client about the limitations and risks of electronic communications

Question 6

Question 59

A 28 year old veteran of the Iraqi War comes to therapy for PTSD symptoms. She reports having flashbacks and nightmares not only from being in direct combat zones but also from being sexually harassed by the men in her platoon over the two years she was deployed. She is currently dropping out of community College because of her symptoms. After 3 months of therapy she is finding relaxation techniques helpful when she feels triggered. How should the therapist proceed with treatment in this case?

Answer 6

Correct Answer:

Continue therapy; Participate in Prolonged Exposure Therapy to reduce fear and avoidance associated with trauma; Teach mindfulness meditation

Question 7

Question 66

A 42 year old stylish and sophisticated actor seeks therapy on the advice of his uncle. The client describes a history if falling in love with many beautiful, wise women, but being disappointed shortly after getting into a relationship with them. Each of his 3 marriages ended in a bitter divorce. With his eyes looking down, the client notes: “All I want is to be loved and nurtured, but none of them live up the image they initially present.”

How would an object relations therapist conceptualize this case?

Answer 7

Correct Answer:

See the client’s inner world as filled with idealized representations of women that come into conflict with the realities of what these women are actually like.

Question 8

Question 68

A 28 year old graduate student seeks therapy for relationship problems and stress at school. During the initial session, the client mentions that she has been hospitalized several times for “severe depression.” The client becomes tense and guarded when the therapist attempts to explore the hospitalizations, saying that “it’s in the past.” She also states adamantly that she won’t give permission to get those records. How should the therapist proceed in this case?

Answer 8

Correct Answer:

Acknowledge her right to decide about releasing her records.

Question 9

Cindy, an 8 year old black client, is brought to therapy by hermother, Nancy. They were referred by Cindy’s school because Cindy was crying when her mom dropped her off each day. Nancy reports that Cindy has been afraid to sleep at night because she is having nightmares. Nancy say, “I’m so exhausted after work, I can’t deal with her neediness. I have to lock her in her room to get any sleep.” Nancy tears up and adds, “I have enough to deal with. Her older brother was hit by a car two months ago and he’s still in yhe hospital, having surgeries. He’s the one that really needs my attention and prayers right now. She needs to toughen up. All she wants to do is talk about the accident. “

What additional information should the therapist obtain in order to create a comprehensive treatment plan?

Answer 9

Correct Answer:

Cindy’s exposure to the accident; Details of mother’s disciplining and parenting practices, Cindy’s functioning at school.

Question 10

An 18 year old client seeks therapy for anxiety and depression. She shares that she doesn’t want her parents to know she’s going to therapy because they’ll say its only going to make it worse. During the second session the client reports that she had consensual sex with a previous therapist when she was in a treatment facility two years ago. How should the therapist respond to her disclosure

Answer 10

Correct Answer:

Provide client with brochure “Professional therapy never includes sex.”

Question 11

A couple, Jordan, aged 39 and Marni, age 45, seeks therapy to determine whether they should stay together. They have been together for ten years but have never married. They report that they rarely argue but have a difficult time communicating. They deny any domestic violence or substance use problems.

In formulating the treatment plan what should the therapist assess first?

Answer 11

Correct Answer:

How they handle conflict

Question 12

According to the DSM-5-TR, for an individual to be diagnosed with Attention Deficit Hyperactivity Disorder, symptoms must be present before what age?

Answer 12

12 years old

Question 13

A therapist meets with a 19 year old college student who reports that for the past year she has had trouble getting out of bed to go to class. She states that she doesn’t want to be around her friends anymore and overall feels very hopeless. When asked about her interests, the client states that she recently dropped her extracurricular activities. The client’s MOST likely diagnosis is:

Answer 13

Major Depressive Disorder

Question 14

A Client was physically attacked 2 weeks ago while walking home from work. The client states that since then she feels like she is in a daze and is afraid to leave her house at night. She reports difficulty sleeping and says that she keeps snapping at her boyfriend when he tries to comfort her. The client’s MOST likely diagnosis is :

Answer 14

Acute Stress Disorder

Rationale:
Symptoms are greater than three days but less than a month. Client also experienced a life threatening event which caused and triggered all these symptoms.

Question 15

Somatic symptom disorder

Answer 15

Symptoms without causes

Question 16

A 34 year old single female is referred to a therapist by her real estate company’s Employee Assistance Program. She has missed a significant amount of work since her mother’s death 6 months ago and has been unable to complete previously easy tasks. During the assessment, the woman reports that she spends hours every day preparing food and repeatedly cleaning her house. She adds that she can’t stop thinking that the house isn’t clean enough to meet her mother’s standards. What diagnosis should be considered?

Answer 16

Obsessive Compulsive Disorder
(Client displaying compulsions)

Question 17

Childhood onset fluency disorder

Answer 17

Child struggles with patterning speech, using repetition of words and Prolonged syllables.

Question 18

Schizophrenoform

Answer 18

NOT
Schizophrenia, less than 6 mos

Question 19

Strategic Therapy

Answer 19

Planned
Problem focused
Practical

Question 20

Strategic Therapy

Answer 20

Does not focus on root cause of problem

Tries to increase competency for interacting with others

Question 21

Strategic Family Therapy

Answer 21

Help to develop a culture of rules for kids or adolescents

Also, interventions can focus on improving interfamilial communications/interactions

Question 22

Strategic Family Therapy

Answer 22

Helps improve communication and strengthens familial boundaries and bonds

Question 23

A 38 year old male client was referred to a Cognitive Behavioral Therapist by his EAP. The client suffered severe burn injuries in his last job and is now back at work in a similar work setting. The client is failing to stay on task at work and informs the therapist he recently started engaging in non-suicidal cutting on the scarred parts of his body when he is not at work. What actions would the therapist take in the middle phase of treatment?

A. Assist the client in identifying precipitating situations that lead to self harming behavior and practice self soothing techniques to replace unhealthy behaviors.

B. Elicit automatic thoughts from the client that occur during the workday and outside of work that lead to dysfunctional behaviors.

C. Utilize self reporting symptoms inventory to establish a baseline functioning in order to track client’s progress.

D. Collaborate with client to develop goals appropriate for brief therapy and provide referrals for long term therapy to address trauma.

Answer 23

Correct answer:

B. Elicit automatic thoughts from the client that occur during the workday and outside of work that lead to dysfunctional behaviors.

Question 24

A therapist has been working for 5 months with a client who recently became involved in a lawsuit related to the presenting problems. The client was the victim of an assault and has been receiving therapy for symptoms of Post Traumatic Stress disorder since the incident. The perpetrator is now on trial. What steps should the therapist take to evaluate the effect of the lawsuit on the treatment?

A. Explore the client’s understanding of the lawsuit and their expectations regarding the therapist involvement in the lawsuit.

B. Explore the client and their legal counsel’s expectations of the therapist’s role in the lawsuit.

C. Discuss the effect of the lawsuit on the client’s presenting symptoms.

D. Ask the client how the lawsuit is affecting their commitment to engage in therapy and prior goals.

Answer 24

Correct Answer:

C. Discuss the effect of the lawsuit on the client’s presenting symptoms.

Question 25

A therapist meets with a 9 year old girl who was referred by her pediatrician due to symptoms of depression. The girl’s parents are divorced, and in accordance with the custody agreement, the father consented to treatment. The custody agreement includes a provision for weekly visitation with the girl’s mother. In a session, the girl tells the therapist that she “hates visiting her mom” and if her father makes her go again, she would end her life by jumping off her mother’s apartment balcony. What actions should the therapist take in this case?

A. Initiate a 5150 to address the imminent risk of danger presented by the client’s threat to end ger life.

B. Consider the issue of confidentiality and share her threat with the father.

C. File a child abuse report due to reasonable suspicion of abuse perpetrated by the girl’s mother.

D. Address for level of risk of suicide and potential child abuse.

Answer 25

Correct Answer:

B. Consider the issue of confidentiality and share her threat with the father.

Question 26

A therapist meets with a 43-year-old Armenian-American male who was just released from the hospital following 72-hour involuntary hold. The client explains his parents called the police on him because his behavior was scaring them. He acknowledges that he had been binge drinking for several days after being fired from his job and was told by the attending psychiatrist that he had experienced Alcohol induced psychosis. He shared that he moved to his parents’ home because he can not afford his own place now that he is divorced and has to pay child support. He is scared because he does not think he will find a job now that he’s been hospitalized and tells the therapist, “My ex-wife has destroyed my life. She won’t let me see my children but takes all of my money. It is her fault I am in this situation and I can’t wait for her to experience pain and suffering like she has caused me.” Which of the following issues in this vignette requires immediate assessment?

A. Current and prior level of substance use
Access to psychiatric resources
Level of risk client presents to self and family

B. Current and prior level of substance abuse
Current medication regimen and level of compliance
Level of risk client presents to self

C. Current medication regimen and level of compliance
Level of risk client presents to self
Access to employment resources

D. Level of risk client presents to self and family
Current level of substance use
Access to employment resources

Answer 26

Correct Answer:

B. Current and prior level of substance abuse
Current medication regimen and level of compliance
Level of risk client presents to self

Question 27

To evaluate whether or not to treat DV couple:

Answer 27

1. Both partners agree on the level of violence that occurred between them.
2. The perpetrator takes responsibility for their actions and has an arsenal of alternative coping mechanisms they regularly practice.
3. The victim takes responsibility for their safety and sticks to the safety plan if needed.

Question 28

A 49 year old male is referred by his physician to a therapist working in a substance abuse treatment facility. The client immediately expresses his reluctance in seeing g a therapist and shares that his level of drinking is not a problem because it is completely on par with his peers. During a routine blood test, the doctor detected elevated levels of liver enzyme in his blood. The client said the only reason he was attending the session was because his partner was scared by the test results and was pushing him to see a therapist and to change his drinking patterns before his health issues became more severe. What initial action would a therapist using Motivational Interviewing take in the case presented in this vignette?

A. Acknowledge the client’s reluctance in attending therapy and explore the doctor and the partner’s concerns regarding the dangers of continued drinking on the client’s overall health.

B. Utilize reflective listening to demonstrate an empathic understanding of the client’s presenting concerns and collaboratively develop treatment goals.

C. Acknowledge the difficulty of attending therapy when it doesn’t feel necessary and reflect on the social aspect of drinking as well as recent blood results.

D. Utilize reflective listening to demonstrate an understanding of the client’s problem and inquire about frequency and quantity of alcohol consumption.

Answer 28

Correct Answer:

C. Acknowledge the difficulty of attending therapy when it doesn’t feel necessary and reflect on the social aspect of drinking as well as recent blood results.

Question 29

A 24 year old woman from Nigeria meets with a therapist on the advice of a friend. The woman, who speaks limited English, shares that she arrived in the United States roughly four months earlier to join her fiance, who is an American citizen. The woman has a K1 visa and is required to marry her fiance within 90 days of arrival,but they did not fulfill the requirement so her visa is no longer valid. She explained s that her family is Muslim and she met her fiance while he was visiting her country. Since arriving in the United States, she reports he has been physically abusive, but she cannot leave because her parents will not allow her back in their home. The client is visibly scared when speaking with the therapist about her situation and reveals recent injuries on her body. Which of the following actions should the therapist take in this situation?

Answer 29

A. Provide information for a domestic violence shelter and encourage her to call while in the office
Provide referral for legal assistance regarding immigration status
Encourage the woman to seek medical attention

Question 30

A therapist meets with a teenage client who is referred to therapy by their school counselor. In the first session, the client tells the therapist they prefer the pronouns “they” and “them”. The client is distressed because their parents refuse to honor their gender identity and are forcing them to conform to their sex assigned at birth. The client cries as they express feeling alone in the world and doubtful about whether they will ever be accepted by their parents for who they are. The therapist should evaluate which of the following to develop an effective treatment plan?

Answer 30

C. Intersecting identities, such as socioeconomic status, race, & ethnicity affecting client’s presenting problems.
Presence of self harming behaviors
Ability to identify and utilize coping skills

Question 31

A therapist has been meeting with a couple that is working on rebuilding trust following an incident of marital infidelity. The therapist notices that she sometimes becomes angry with the wife when the wife seems dismissive of her husband’s expressed feelings of hurt. In one session, the therapist lashes out at the wife and expresses how painful it is to watch the wife brush aside her husband’s feelings when he is willing to be vulnerable. The wife is surprised by the therapist’s reaction, but begins to open up and the couple experiences a breakthrough in their treatment. Which of the following actions should the therapist take on this case?

Answer 31

Correct Answer:

Seek consultation to address countertransference and process experience with clients

Question 32

A therapist working in a psychiatric unit of a hospital meets with a patient who is being discharged from the hospital following a 72 hour involuntary hold. The client was admitt3d to the hospital after his therapist initiated a 5150. The client has a diagnosis of Major Depressive Disorder, and has a history of suicide attempts. Which of the following are considered key elements to the therapist’s discharge plan?

Answer 32

Correct Answer:

Identifying and engaging support systems willing and able to provide help
Ensuring collaboration between various care providers
Providing clear instructions on how to access crisis intervention and other resources

Question 33

An 8 year old child is brought by their parents to therapy. The parents tell the therapist that since a young age, their son has enjoyed playing with dolls, wearing dresses, growing long hair and identifies to others as a girl. They share that they thought it was a phase that would pass, but now that this behavior has continued on for a few years they no longer think it’s appropriate. They attempted to have the child dress in more traditional boy clothing, but the child tantrumed and boycotted any such attempts. The therapist observes the child crying as the parents speak. Which provisional diagnoses should the therapist consider in this case?

Answer 33

Correct Answer:

Gender Dysphoria
Z Code Parent-Child Relational Problem

Question 34

A 24 year old male client was released from prison following two years of incarceration. The client is on parole and is mandated to receive mental health counseling once a week as a condition of release. The man presents as guarded and tells the therapist he does not believe it is possible to be honest in therapy because his probation officer is going to ask the therapist for information. What should the therapist do in this case?

Answer 34

Correct Answer:

Inform the client of the limits of confidentiality and request a release of information to share limited information with probation required for compliance.

Question 35

A 63 year old woman seeks individual therapy to address low grade depression and body image issues. The woman characterizes herself as extremely overweight and informs the therapist she was diagnosed with diabetes approximately 5 years prior. She shares a history of struggling with diets and a tendency to overeat, especially when her Depressive symptoms are more severe. Which of the following adjunctive services should the client consider to augment the client’s treatment?

Answer 35

Correct Answer:

Nutritionist for dietary assistance
Overeaters anonymous for group support
Medical doctor to monitor medications

Question 36

A therapist meets with a 14 year old boy who was referred to address symptoms of recurrent trauma. The child fled Honduras as an unaccompanied minor when he was 11 years old, but reunited with his parents shortly after his arrival in the United States. He lives with his mother and sister in a low income that has a large gang presence and frequent violence in the streets. He recently witnessed his father and several other community members being forcefully taken away by ICE. Since his father was taken away, he has not slept and refuses to leave his mother because he is afraid she will be taken away from him too. What initial interventions should the therapist consider to address the effects of immigration in this case?

Answer 36

Correct Answer:

Normalize the client’s fears based on his past experience and identify community resources for his family.

Question 37

A therapist meets with a family consisting of two fathers, a teenage daughter, and an 11 year old son. The family attends therapy because the daughter was recently suspended from school after getting into a fight. The daughter explains that a classmate was bullying her and making homophobic comments about her parents. One father states that he is glad that his daughter put the kid in his place, while the other states “It is completely unacceptable to fight, regardless of how wrong and hateful someone behaves.” How would a narrative therapist proceed when working with this family?

Answer 37

Correct Answer:

Use deconstruction questions to understand the cultural context that is influencing the family and help develop a narrative that empowers them.

Question 38

A couple in their mid 40s and their 14 year old son attend a session with a therapist because the parents are separating. The father has been questioning his sexual identity for several years and intends to leave the marriage. His wife and he have discussed this over time, and though hurt, she accepts his decision. The son is struggling with this change and feels his entire life was a lie. What actions should the therapist take in this case?

Answer 38

Correct Answer:

Meet with the entire family to explore their understanding of the family structure and their emotional responses to the impending changes.

(You do not want to blame one any single person, and the family is the proper unit of treatment.)

Question 39

A family presents for therapy after the birth of their third child. Their two other children are significantly older, ages 10 and 12, and the couple did not plan for a third child. The couple reports the birth of their third child has placed tremendous strain on their relationship and the family’s ability to get along. What goals would a Structural therapist consider in this case?

Answer 39

Correct Answer:

Strengthening the marital subsystem and developing new family rules to accommodate the newest family member.

Question 40

A therapist meets with a long-term client who is being treated for an anxiety disorder. The client works in the security industry and arrives at his session after finishing his shift. The client presents as angry, and he speaks with the therapist in a loud and agitated voice. The therapist notices the client has a gun in his holster and feels uncomfortable sitting with somebody who is armed. How should the therapist manage the situation?

Answer 40

Correct Answer:

Discuss the effect of the weapon in the room, end session, and request client refrain from bringing it to future sessions.

Question 41

Juanita, a 55 year old Haitian American woman, attends therapy following the death of her husband. Juanita informs the therapist that she and her husband were fighting a lot before he suddenly died. She practices voodoo and informs the therapist she believes in the afterlife. How should the therapist manage the client’s disclosure?

Answer 41

Correct Answer:

Determine the client’s goals of treatment and how her religious practice affects her presenting problems.

Question 42

A 34 year old client with a diagnosis of anxiety has been meeting with a therapist for six months. She tells the therapist that she recently relapsed and has been using heroin daily for several weeks. The client informs the therapist that she no longer wants to address her heroin use, since her best efforts to quit have failed, but would like to continue working on her anxiety. How should the therapist respond to the client’s disclosure?

Answer 42

Correct Answer:

“I understand it is difficult to stop using heroin, and I also realize it would be hard to address your anxiety without first addressing your heroin use.”

Rationale: the answer both acknowledges the client’s difficulty to stop using heroin AND simultaneously makes clear that therapist cannot just continue treatment but must address heroin use

Question 43

A therapist is seeing Taylor, a young Black female client with a diagnosis of Bipolar I Disorder. Taylor tells the therapist that she believes her symptoms to have stabilized and she no longer wants to take medications. She hates the side effects, including weigh5 gain and a decreased libido, which is causing a lack of intimacy in her marriage. She also feels her psychiatrist is quick to prescribe medications and questions his motivations and attitude toward her because of her race. Which of the following actions should the therapist take in this case?

Answer 43

Correct Answer:

Validate Taylor’s feelings about medication side effects all and acknowledge historical bias against people of color in the mental health field.

Question 44

A father and his two daughters, ages 5 and 10, are referred to therapy by their rabbi following the death of their mother. The mother had been fighting pancreatic cancer for a year, and after spending several weeks in the hospital, she passed away. The father appears stoic and the daughters sit quietly next to him, the younger staring at a picture on the wall and the older keeping her eyes focused on the floor. How would a Humanistic-Existential therapist intervene in the beginning stage of treatment?

Answer 44

Correct Answer:

Provide family members space to sit with their emotions and give them the latitude to talk when they feel it is appropriate.

Rationale: Treatment unit is the family, humanistic-existential theory focuses on here-and-now, and this answer allows therapist to gather information and develop rapport with client (Treatment)

Question 45

An MFT is working with a family that includes the biological parents, 16 year old son, and a 14 year old daughter. The parents report increasing issues with the son, including truancy, argumentativeness, and defying curfew and other rules. The father shared his disappointment, and the sister is annoyed that her brother is causing so much stress at home. A structural family therapist would be most likely to handle parenting issues by doing which of the following:

A. Coaching the family on better communications

B. Have separate sessions with parents to discuss parenting issues.

C. Discuss how difficult parenting a teen is these days

D. Use problem solving and quid pro quo agreements to help the family resolve their issues.

Answer 45

Correct Answer:

B. Have separate sessions with parents to discuss parenting issues.

Why? It addresses hierarchical and separate sub systems of the family aspect (structural)

Question 46

Define First Order Cybernetics

Answer 46

First order cybernetics, also known as simple cybernetics, endeavours to place the individual outside of the system, to act as an observer.

Control has been used in first order approaches while in a second order approach the therapist is aware that one cannot actually control the client and it would be unethical to even think along those lines

Question 47

Second Order Cybernetics

Answer 47

How the observer affects the observed

Question 48

Second order change

Answer 48

Long term goals/change in family, i.e. “new” structure, etc

Question 49

First order change

Answer 49

Shifting roles in the system but not restructuring, homeostasis has not changed