Treatment Flashcards
Behaviors that are controlled by their consequences are referred to as:
Select one:
A.
respondent behaviors.
B.
operant behaviors.
C.
unconditioned responses.
D.
conditioned responses.
Answer B is correct: For the exam, you want to be able to distinguish between respondent and operant behaviors. Respondent behaviors (answer A) are automatically or reflexively elicited by certain stimuli, while operant behaviors (answer B) are voluntarily performed (or not performed) because of the consequences that follow them.
Answer C is incorrect: In the context of respondent (classical) conditioning, an unconditioned response naturally occurs in response to an unconditioned stimulus. In Pavlov’s research, dogs naturally salivated in response to the presentation of food. Salivation was the unconditioned response and food was the unconditioned stimulus.
Answer D is incorrect: In the context of respondent conditioning, a conditioned response occurs in response to a conditioned stimulus after the conditioned stimulus is repeatedly presented in conjunction with the unconditioned stimulus. Pavlov repeated the paired presentation of a ringing bell with the presentation of food to the dogs in his studies. As a result, the dogs eventually salivated in response to the ringing bell alone. In this situation, the bell was the conditioned stimulus and the salivation produced by the bell was the conditioned response.
The members of a family you are seeing are very enmeshed with one another, especially the mother and daughter. For example, the mother often answers the questions you ask the daughter and she always sticks up for her daughter whenever the daughter is criticized by her father. As a structural family therapist, you would most likely do which of the following?
Select one:
A.
Ask the mother and daughter to role-play a problem situation, have them change roles and repeat the role-play, and then assign homework designed to help them practice the new way of relating.
B.
Ask the family to role-play a problem situation, have them repeat the situation while you spatially separate the mother and daughter, and have the mother and father come up with ways to recreate the same situation at home.
C.
Ask the family to role-play a problem situation, spatially separate the mother and daughter and have the family repeat the role-play, and assign homework designed to help them practice the new way of relating.
D.
Ask mother and father to change roles as they role-play a problem situation, have the daughter describe a better solution to the problem, and then assign homework designed to reinforce the new way of relating.
Answer C is correct: This answer is the best one because it includes three interventions associated with structural family therapy: enactment (role-playing a problem situation), boundary making (spatially separating the mother and daughter), and therapist assigned homework.
The correct answer is: Ask the family to role-play a problem situation, spatially separate the mother and daughter and have the family repeat the role-play, and assign homework designed to help them practice the new way of relating.
You are a cognitive-behavioral therapist and have been seeing Justine and Nelson for their marital problems. The couple owns an interior design business together and, after six years of togetherness, they have been arguing non-stop. Their goal in therapy is to find new ways to communicate. How would you know when it is time to terminate therapy?
Select one:
A.
The couple has learned how to communicate without arguing.
B.
The stated time limit set for therapy has been reached.
C.
Justine and Nelson have altered their unrealistic ideas and expectations about their marriage.
D.
The underlying dysfunctional patterns have changed.
Answer C is correct: Cognitive-behavioral therapy focuses on altering dysfunctional thoughts (e.g., erroneous and unrealistic beliefs) that are contributing to problematic behavior. When Justine and Nelson replace their irrational belief systems about marriage with realistic ideas and expectations and find new ways to communicate by practicing with graded task assignments, therapy will be complete.
Answer A is incorrect: While it would be helpful for the couple to communicate without arguing, cognitive-behavioral therapy is more concerned with thoughts and beliefs about events than with events themselves.
Answer B is incorrect: Cognitive-behavioral therapy does not require adherence to a strict time limit.
Answer D is incorrect: Although this answer addresses “underlying dysfunctional patterns,” it does not as clearly address dysfunctional thoughts as does answer C.
The correct answer is: Justine and Nelson have altered their unrealistic ideas and expectations about their marriage.
For a therapist using Kohut’s self-psychology, __________ occurs when the therapist confirms the client’s achievements and other positive characteristics.
Select one:
A.
mirroring
B.
joining
C.
idealization
D.
self-realization
Answer A is correct: Kohut’s self psychology emphasizes strengthening the structure of the “self” through re-activating and working through pathological childhood experiences. Specifically, Kohut believed that two needs must be met for a child to develop a strong sense of self-hood: The mother must “mirror” the child (i.e., consistently recognize, approve of, and admire the child’s expressions and projects) and the father must allow himself to be idealized by the child so that the child is able to identify with someone more capable than himself or herself. In therapy, “mirroring” occurs when the therapist attempts to repair the client’s pathological upbringing by demonstrating appreciation and respect for the client’s expressions, behaviors, etc. It is similar to Rogers’s unconditional positive regard.
Answer B is incorrect: Joining is associated with structural family therapy.
Answer C is incorrect: Idealization is also associated with self-psychology but is not what is described in the question. A self-psychologist allows a client to idealize him or her (i.e., be known to the client) rather than remaining a “blank screen,” so that the client is provided with someone to look up to and admire.
Answer D is incorrect: This is a general term referring to the fulfillment of one’s potential rather than a term used by Kohut.
The correct answer is: mirroring
A family therapist working from the perspective of social learning theory is likely to describe intimate partner violence as:
Select one:
A.
a homeostatic mechanism that serves to restore the perpetrator’s control.
B.
the result of a dysfunctional transactional pattern that is related to sex-role polarization.
C.
a learned response to stress that has been reinforced.
Correct
D.
isolation of the marital dyad from outside social (corrective) influences.A family therapist working from the perspective of social learning theory is likely to describe intimate partner violence as:
Select one:
A.
a homeostatic mechanism that serves to restore the perpetrator’s control.
B.
the result of a dysfunctional transactional pattern that is related to sex-role polarization.
C.
a learned response to stress that has been reinforced.
D.
isolation of the marital dyad from outside social (corrective) influences.
Answer C is correct: Social learning theory emphasizes the role of models (e.g., parents) in learning as well as the internal, vicarious, and/or external consequences of a behavior. This answer is the only one that emphasizes learning and consequences and therefore, is the best answer.
The correct answer is: a learned response to stress that has been reinforced.
A newly licensed MFT’s new clients are a lesbian couple. The MFT has had very limited training and experience related to the treatment of gay and lesbian couples and should be aware that:
Select one:
A.
gay and lesbian couples have exactly the same problems as heterosexual couples.
B.
a therapist’s comfort level with homosexuality can affect the therapeutic process.
C.
issues of confidentiality differ when clients are homosexual.
D.
exposure to homophobia is usually the most important issue for gay and lesbian clients.
Answer B is correct: A therapist’s attitude toward homosexuality can affect the therapeutic process when he or she is treating a homosexual couple. This is true about many client characteristics (e.g., clients with criminal records, clients engaged in extramarital or premarital sex). MFTs should always evaluate whether personal values will interfere with their ability to provide objective therapy.
Answer A is incorrect: Due to exposure to prejudice and discrimination, gay and lesbian couples deal with issues that heterosexual couples do not ordinarily face. Therefore, although homosexual and non-homosexual couples deal with many of the same problems, they do not deal with “exactly the same” problems. In general, answers that contain absolutes (e.g., “exactly the same”) tend to be wrong.
Answer C is incorrect: Obligations related to confidentiality are essentially the same for all clients and do not vary based on a client’s sexual orientation.
Answer D is incorrect: Although dealing with homophobia may be a problem for many gay and lesbian clients, like all clients, they seek therapy for diverse reasons.
The correct answer is: a therapist’s comfort level with homosexuality can affect the therapeutic process.
You lead groups for children whose mother or father recently died. It is important for you to take into account the children’s developmental stages when scheduling the groups, so that you can help them in ways that are consistent with their ability to deal with their loss. For example, you should keep in mind that most children begin to understand that death is permanent during which stage?
Select one:
A.
concrete operational
B.
genital
C.
phallic
D.
preoperational
Answer A is correct: To identify this as the correct answer, you needed to know that most children begin to understand that death is permanent and irreversible between the ages of 7 and 9 and that Piaget’s concrete operational stage occurs between the ages of 7 and 12.
Answer B is incorrect: Individuals age 12 and older are in Freud’s genital stage.
Answer C is incorrect: Freud’s phallic stage occurs between the ages of three and six.
Answer D is incorrect: Piaget’s preoperational stage occurs between the ages of two and seven.
The correct answer is: concrete operational
A therapist is treating a client for panic disorder. She has frequent “anxiety attacks” that begin with a tightening in her chest, followed by a pervasive sense of fear, hyperventilation, and occasionally passing out. She says she tried anti-anxiety drugs but had to stop because they “completely zonked me out.” The woman feels hopeless about ever getting better and came to the therapist because he specializes in treating panic disorder. If the therapist adopts Beck’s cognitive approach, he will initially:
Select one:
A.
have the client identify the antecedents and consequences that are controlling her symptoms.
B.
help the client understand how the symptoms are controlling different aspects of her life.
C.
help the client identify the underlying causes of her symptoms.
D.
help the client see how she misinterprets the meaning of her symptoms.
Answer D is correct: As defined by Beck, the “goals of cognitive therapy are to correct faulty information processing and to modify dysfunctional beliefs and assumptions that maintain maladaptive behaviors and emotions” (Comprehensive Handbook of Cognitive Therapy, 1989, p. 28). From the perspective of cognitive therapy, panic disorder stems from catastrophic misinterpretations of bodily sensations and mental experiences. The first few sessions of therapy are aimed at clarifying the nature of the client’s symptoms and how he or she misinterprets them.
The correct answer is: help the client see how she misinterprets the meaning of her symptoms.
Your client says that he can’t stop thinking about his ex-girlfriend and, as a result, can’t get any work done. You instruct the client to obsess about his girlfriend for at least two hours each evening. This is an example of which of the following?
Select one:
A.
reframing
B.
symptom prescription
C.
positioning
D.
ordeal
Answer B is correct: Symptom prescription (also known as prescribing the symptom) is a paradoxical technique that involves asking the client to perform the symptom in an exaggerated way. Its goal is to reduce or eliminate the symptom by creating resistance (i.e., by causing the client to resist the instruction) or by helping the client realize the symptom is under his or her voluntary control.
Answer A is incorrect: Reframing involves changing the meaning or frame of reference of a symptomatic behavior so that it can be understood in a new way.
Answer C is incorrect: When using positioning, the therapist accepts and exaggerates a client’s assertions about his or her problems.
Answer D is incorrect: An ordeal involves instructing the client to engage in a disagreeable behavior before or after he or she engages in the symptomatic behavior.
The correct answer is: symptom prescription
A wife ignores her husband’s gestures of affection, and then immediately complains that he never acts in a loving way toward her. When he tries to comment on this, she changes the subject. This is an example of which of the following?
Select one:
A.
pseudohostility
B.
reframing
C.
manipulation
D.
a double-bind
Answer D is correct: Double-bind is the term used to refer to the conflict created when an individual receives two conflicting messages. Double-bind communications often consist of a verbal message and a contradictory nonverbal message.
Answer A is incorrect: Pseudohostility is the term used to describe superficial family bickering that blurs greater problems in a family.
Answer B is incorrect: Reframing is a therapeutic technique in which a therapist relabels or redefines a family’s behavior to make family members more amenable to treatment.
Answer C is incorrect: Though we might say the woman is manipulating her husband, manipulation implies a conscious act and it’s not clear that the woman is aware of what she’s doing. Also, “manipulation” is not the best answer because it is not a professional or technical term associated with family therapy.
The correct answer is: a double-bind
Marilyn, age 32, was referred to you by the physician who just released her from the hospital. She was hospitalized for eight days after being beaten by her live-in boyfriend who is now in jail. She says she wants to know what she is doing wrong because “this is the fourth guy I’ve been with that has beaten me.” You:
Select one:
A.
teach her about the cycle of violence.
B.
educate her about the typical profile of an abuser.
C.
construct a genogram to trace the history of abusive relationships in her extended family.
D.
educate her about the cycle of violence and the typical profile of a victim and abuser.
Answer D is correct: This question is a reminder to read all of the answers before choosing one. If you did not do this, you might have chosen answer A because it describes an important initial intervention for this situation. Answer D is the best answer since information about the cycle of violence and the characteristics of victims and abusers would help the client understand the dynamics involved in abusive relationships and reduce her self-blame.
Answer A is incorrect: Teaching this client about the cycle of violence is an excellent early stage intervention, but answer D is a better answer.
Answer B is incorrect: Educating the client about the typical profile of an abuser is a good early stage intervention but, again, answer D is a better answer.
Answer C is incorrect: A family therapist might want to determine if there is a history of abuse in the client’s family of origin, but the question states that she was just released from the hospital which suggests that the correct answer is an early stage intervention. Constructing a genogram would likely be a middle stage intervention.
The correct answer is: educate her about the cycle of violence and the typical profile of a victim and abuser.
When assessing a client’s behavior, a therapist working from the perspective of Beck’s cognitive therapy would be MOST interested in:
Select one:
A.
the relationship between a client’s emotions and behaviors.
B.
the discrepancy between the client’s actual behavior and his or her ideal behavior.
C.
the environmental antecedents and consequences of the client’s behavior
D.
the way the client perceives his or her own behaviors and the situations in which those behaviors occur.
Answer D is correct: From the perspective of Beck’s cognitive therapy, psychological distress is caused by dysfunctional “automatic thoughts,” or thoughts that arise spontaneously in response to specific stimuli or situations. Automatic thoughts reflect a person’s perceptions of a situation rather than the situation itself.
Answer C is incorrect: A behavior therapist would be interested in the environmental antecedents and consequences of the client’s behavior. Although Beck’s cognitive therapy incorporates behavioral concepts and interventions (and is now usually referred to as cognitive-behavioral therapy), the primary focus is on automatic thoughts and other aspects of cognition.
The correct answer is: the way the client perceives his or her own behaviors and the situations in which those behaviors occur.
Your new client has taken a second job to support his family because his wife was severely injured in a car accident and can’t work. The client reports feeling frustrated by this situation and exhausted every day. Right after saying this, the client expresses remorse for complaining about how he feels, given all that his wife has been through. Your initial response is to:
Select one:
A.
let him know that his feelings are normal.
B.
ask him if he has been feeling depressed.
C.
ask about the family’s financial situation to determine if he is able to make ends meet.
D.
briefly explain to him about how family systems operate and how each family member is affected by change.
Answer A is correct: You should “stay with” the client’s feeling for now, which eliminates answers C and D. Because the feelings the client has expressed seem normal for the circumstances, you best initial response should be to let him know that his feelings are similar to those of other people in similar circumstances. Doing so will counteract the client’s perception that his feelings are strange or abnormal. You may also want to determine if the man is depressed (answer B) but only after normalizing his feelings of frustration and exhaustion.
The correct answer is: let him know that his feelings are normal.
A client with borderline personality disorder is in the middle stage of therapy and often becomes extremely angry during sessions and screams at you. Your initial response to her anger will be to:
Select one:
A.
directly and strongly confront it.
B.
help the client identify its source.
C.
set limits on her anger in a gentle way.
D.
ignore her angry outbursts.
Answer C is correct: Rapidly shifting emotions are common in individuals with borderline personality disorder. However, since the client is exhibiting “extreme anger,” the best initial response would be to let the client know that you are interested in her feelings but that you will not tolerate abusive behavior.
Answer A is incorrect: Confrontation can be useful when working with clients with borderline personality disorder. However, the response described in answer C is better since it would be less likely to escalate the client’s anger.
Answer B is incorrect: Identifying the source or cause of extreme anger can be useful but not as the initial response.
Answer D is incorrect: Ignoring the angry behavior would not be a useful way to react to the client’s anger.
The correct answer is: set limits on her anger in a gentle way.
When working with clients with major depressive disorder, a practitioner of Beck’s cognitive-behavioral therapy is MOST likely to begin therapy with:
Select one:
A.
social skills training.
B.
inpatient treatment and pharmacotherapy.
C.
cognitive restructuring exercises.
D.
behavioral tasks.
Answer D is correct: Beck notes that therapy may begin somewhat differently for individuals with severe versus mild to moderate forms of depression. For clients with severe depression, it may be necessary to start with behavioral techniques that are designed to increase the client’s overall activity level (e.g., graded task assignments). For clients with mild to moderate depression, cognitive techniques are introduced during initial sessions. See A. T. Beck and M. Weishaar, Cognitive therapy, in A. Freeman, et al., Comprehensive Handbook of Cognitive Therapy, New York, Plenum, 1989.
During the first session with the victim of domestic violence, a Bowenian therapist would MOST likely:
Select one:
A.
help her rehearse an “escape plan” and provide her with referrals to shelters for abused women.
B.
help the woman identify the ways in which she provokes her husband’s anger.
C.
construct a genogram with the woman to help her recognize multi-generational transmission processes that are contributing to the problem.
D.
insist that the woman go to a shelter when her husband becomes abusive.
Answer A is correct: In this situation, a therapist’s first concern, regardless of his or her theoretical orientation, is the woman’s safety. Of the four answers, this is the one that best addresses this concern.
Answer B is incorrect: A competent therapist would not emphasize the woman’s responsibility for the abuse, at least not in terms of her “provocation” of the abuse.
Answer C is incorrect: While this answer describes a typical Bowenian intervention, it would probably not be the first step when the presenting problem is domestic violence.
Answer D is incorrect: Although this answer does address the issue of safety, “insisting” that the woman go to a shelter is overly directive. Instead, the therapist is more likely to encourage a woman to protect herself and suggest concrete ways for doing so.
The correct answer is: help her rehearse an “escape plan” and provide her with referrals to shelters for abused women.
Murray Bowen used the term “undifferentiated family ego mass” to describe the intense interdependence of many dysfunctional families. When working with an interdependent family consisting of a mother, father, and 10-year-old daughter, a Bowenian therapist would probably do all of the following EXCEPT:
Select one:
A.
work only with the mother and father in therapy.
B.
avoid becoming immersed in family conflicts.
C.
work first with the least differentiated family member.
D.
require that family members talk to him rather than to each other.
Answer C is correct: Differentiation is a key concept in Bowen’s extended family systems therapy. However, Bowen sometimes worked first with the MOST (not the least) differentiated family member since this person was most capable of changing, and a change in this person would foster change in other family members.
Answer A is incorrect: A Bowenian would do this since Bowen proposed that, when the most significant system (the spouses) in the family changes, this will affect the entire family.
Answer B is incorrect: This is consistent with a Bowenian approach. Bowen viewed the role of the therapist as that of a “coach” and encouraged therapists to avoid emotional entanglement with the family.
Answer D is incorrect: This is also consistent with a Bowenian approach.
The correct answer is: work first with the least differentiated family member.
You are seeing a 30-year-old woman who is very depressed after the breakup of a long relationship. After six weeks, she comes in very excited and tells you she has met a man online. “He could be the one!” she says. Your most appropriate response would be to:
Select one:
A.
change the treatment goals and work with her on developing a healthy relationship.
B.
invite her to bring the man in for conjoint treatment since this will help her begin a healthy relationship.
C.
suggest that she postpone any major decisions about the new relationship until the two of you have completed the work on the loss of her last relationship.
D.
warn her about the dangers of online dating and caution her to be mindful of personal safety.
Answer D is correct: This is the best answer since it is not too directive and takes the client’s welfare into account.
Answer A is incorrect: This intervention seems inappropriate since it feeds into what is likely a fantasy - i.e., the woman’s belief that “He could be the one!”
Answer B is incorrect: This is clearly premature.
Answer C is incorrect: This is too directive and may elicit resistance.
The correct answer is: warn her about the dangers of online dating and caution her to be mindful of personal safety.
The client is a 55-year-old woman, whose husband has had a stroke and has recently returned home after six months in a rehabilitation center. The woman is feeling very stressed and reports that her husband is not taking his medication or eating well and that he says he doesn’t want to live anymore. She asks the MFT to please call him and insist that he come to therapy. As a strategic family therapist, the MFT will most likely:
Select one:
A.
tell her to bring him next time, even if he doesn’t want to come to therapy.
B.
suggest she go home and tell him she’s going to help him with his will and estate planning.
C.
invite children and extended family to the next session so they can offer support.
D.
listen empathically and empower her as the caregiver.
Answer B is correct: Strategic family therapists often use paradoxical interventions to foster change in a family system. Encouraging the wife to accept that her husband wants to die is likely to have the paradoxical effect of motivating him to stay alive.
Answer A is incorrect: Forcing the husband to accept help will only encourage his resistance and continue the dysfunctional “more of the same” cycle.
Answers C & D are incorrect: Offering support and listening empathically are not consistent with the directive, almost intrusive approach of strategic family therapy.
The correct answer is: suggest she go home and tell him she’s going to help him with his will and estate planning.
A 22-year-old man was required to receive therapy as a condition of his probation. The man has a history of numerous arrests, including arrests for drug possession, shoplifting, and property damage. As a teenager, he was expelled from his high school for beating up a classmate. The client has not been making any progress in treatment with the MFT. The MFT’s best action is to:
Select one:
A.
initiate termination.
B.
attempt to strengthen the therapeutic alliance.
C.
reevaluate the treatment goals and plan.
D.
get input from the man’s probation officer.
Answer C is correct: This answer indicates that the MFT would try to determine why the client is not making progress and then use his or her findings to modify the treatment plan. In other words, the MFT would consider whether the present treatment is the best one for this client or whether it is necessary to switch to another approach or modality.
Answer A is incorrect: Simply ending treatment is not the best first approach for dealing with any client’s lack of progress in treatment. In the case of clients who persistently engage in antisocial behavior, experts specifically recommended that therapists terminate treatment only if the client’s resistance continues after the therapist has tried all other available solutions.
Answer B is incorrect: For this client, attempting to strengthen the therapeutic alliance is unlikely to increase his motivation to change. According to experts, individual psychotherapeutic relationships are almost never effective for changing antisocial behavior. (This is the case even when external controls, such as a court order, are in place.)
Answer D is incorrect: An MFT would not seek treatment input from a probation officer.
The correct answer is: reevaluate the treatment goals and plan.
A practitioner of narrative therapy is working with a family that engage in a lot of overt conflict. Family members yell at each other in session and generally disagree about everything. As an initial intervention, the therapist will most likely:
Select one:
A.
have family members write letters to each other.
B.
probe for some exceptions to their problematic behavior by asking opening space questions.
C.
identify and alter the antecedents and consequences that are maintaining the family’s problematic interaction patterns.
D.
determine each family member’s current feelings about their situation by asking scaling questions.
Answer B is correct: Opening space questions are similar to the exception questions used by solution-focused therapists and are used to uncover “unique outcomes” – i.e., to identify times when family members have had some influence or control over the problematic behavior. “Has there ever been a time when you’ve been able to spend time together without arguing?” is an example of an opening space question.
Answer A is incorrect: Letter writing is used by narrative therapists, but it is not an initial intervention and the letters are written by the therapist and given to the clients.
Answer C is incorrect: Identifying antecedents and consequences that are maintaining a problem behavior is an intervention used by behavior therapists.
Answer D is incorrect: Scaling questions are associated with solution-focused therapy and are used to determine a client’s beliefs about his or her progress or readiness to work toward achieving a specific goal.
The correct answer is: probe for some exceptions to their problematic behavior by asking opening space questions.
Research has found that Asian American individuals tend to underutilize mental health services. This is believed to be because of cultural values that inhibit self-referral and:
Select one:
A.
encourage independence.
B.
promote emotional release within the family.
C.
produce an unusually low rate of mental health problems.
D.
promote the resolution of problems within the family.
Answer D is correct: Seeking help from mental health professionals can produce a sense of shame for the members of this population. Consequently, traditional Asian individuals are more likely to seek help from elders and other trusted individuals within their own community and to be reluctant to discuss personal or family problems with an outsider, such as a therapist.
Answer A is incorrect: Asian cultural values emphasize family and interdependence.
Answer B is incorrect: Asian cultural values do not encourage a high level of emotional expression.
Answer C is incorrect: There is no evidence that Asian cultural values are associated with lower rates of mental health problems.
The correct answer is: promote the resolution of problems within the family.
Your new client has come to therapy because he has not been performing well at work and is afraid he’s going to be fired. The man wants to correct his job performance problems. Assuming that you’re a practitioner of cognitive-behavioral therapy, what is your initial intervention?
Select one:
A.
talk to his supervisor to get additional information about his job performance
B.
ask miracle and exception questions to identify possible solutions to his work-related problems
C.
have him keep a daily journal of his automatic thoughts
D.
identify positive reinforcers that would promote good work performance
Answer C is correct: Identifying automatic thoughts is an initial intervention that cognitive-behavioral therapists do to determine the contributors to a client’s presenting problem.
Answer A is incorrect: This might be useful for obtaining information on the client’s work performance, but you would have to obtain authorization from the client to do so and it might make the client feel unsafe or unsure of the confidential nature of your relationship.
Answer B is incorrect: Miracle and exception questions are used by solution-focused therapists to identify possible solutions to a client’s problems.
Answer D is incorrect: Identifying positive reinforcers is something a behavioral therapist might do to assist this client.
The correct answer is: have him keep a daily journal of his automatic thoughts
A 27-year-old man tells his MFT that he has just tested HIV positive. He is afraid to tell his parents, who are very conservative and don’t even know that he is gay. His parents are very religious, and he is sure that they would reject him if they knew. The man has been “out” in many areas of his life since he was 20 when he moved far away from his parents. He says that, because of his diagnosis, he’s very lonely and desperate and is feeling a greater need to connect with his family. The MFT’s best course of action would be to:
Select one:
A.
contact the man’s family.
B.
help the man develop a support system.
C.
reassure the man that contacting his parents may not be helpful at this time.
D.
refer the man to a gay counselor.
Answer B is correct: The client has a serious illness and, because of his diagnosis, is feeling lonely. Although it might be appropriate at some point to explore his options regarding his family, it is more important initially to help him develop some type of support system.
Answer A is incorrect: The MFT must respect the client’s wishes regarding notifying his family and cannot violate his confidentiality.
Answer C is incorrect: It would not be appropriate or productive to reassure a client that contacting his family may not be helpful.
Answer D is incorrect: Unless the MFT is uncomfortable or not competent to work with a gay client who is HIV positive (which is not indicated in the question), there is no reason to refer this man to another therapist.
The correct answer is: help the man develop a support system.
