MFT Practice Exam Questions And Answers With Complete Solutions Rated A+

MFT Practice Exam Questions And Answers With Complete Solutions Rated A+ One of the main differences between Freudians and neo-Freudians is that neo-Freudians: Select one: a. emphasize social and cultural influences on personality development b. stress the role of self-actualization in personality development c. emphasize the "here-and-now" d. do not view development as occurring in stages Correct Answer: Your job was to choose the answer that describes something the neo-Freudians believe (and Freudians don't).Answer A is CORRECT: The neo-Freudians (e.g., Horney, Sullivan, Fromm, and Erikson) rejected Freud's emphasis on the instincts and the role of sexual drives and, instead, emphasized the influence of social and cultural factors in personality development.Answer B is incorrect: This is not significant for neo-Freudians (or for Freudians). Instead, an emphasis on "self-actualization is associated with such theorists as Maslow and Rogers.Answer C is incorrect: Neo-Freudians (as well as Freudians) are concerned with early life experiences rather than the here-and-now.Answer D is incorrect: NeoFreudians (and Freudians) do identify developmental stages (e.g., Erikson's Eight Stages of Man). The correct answer is: emphasize social and cultural influences on personality development Some Feminist therapists view the concept of differentiation as problematic because: Select one: a. There is a gender bias against the need for emotional connectedness. b. It is an unrealistic expectation. c. Women tend to be pursuers and men distancers. d. It promotes power struggles. Correct Answer: Answer A is correct: The concept of differentiation, according to some Feminist therapists, pathologizes the need for emotional connectedness. The correct answer is: There is a gender bias against the need for emotional connectedness. Mary is a 15-year-old who has been truant for 31 days. In addition, her parents report that Mary sleeps all day and stays up most of the night. She has gained 30 pounds over the past six months. She looks sad and has isolated herself from all her friends. A strategic family therapist treating Mary and her family for the first time would most likely: Select one: a. relabel Mary's behavior as stubbornness or laziness b. emphasize in-session enactment c. deal directly with the web of invisible loyalties influencing family members' behaviors d. establish a hierarchy Correct Answer: This is another question which requires you to call on your knowledge of interventions associated with particular theories.Answer A is correct: Relabeling is associated with Strategic family therapy. Relabeling attempts to alter the meaning of a situation by altering its conceptual and/or emotional context in such a way that the entire situation is perceived differently.Enactment is associated with Structural family therapy (B). The intervention in answer C is more clearly associated with Contextual family therapy. Hierarchy is a word associated with Strategic family therapy, but not in this manner. There are many other instances in which hierarchies are used. For instance, in behavioral therapy a hierarchy is established when intervening with systematic desensitization (D). The correct answer is: relabel Mary's behavior as stubbornness or laziness An African American woman and a Chinese American man come in for their first session of couple's therapy. As you listen to their presenting problems, you find yourself interpreting their communications through stereotypical assumptions you have made about both of their cultural heritage. You would: Select one: a. Talk about your difficulty, then give them a referral. b. Talk about the cultural stereotypes that the couple confronts daily. c. Make sure to develop a therapeutic alliance with the wife first since they most likely have a matriarchal family system. d. Consult with a colleague regarding this issue after the first session. Correct Answer: Answer D is correct: The therapist's best course of action would be to get consultation before the stereotyped attitudes negatively impact therapy. If a therapist has difficulty with preconceived cultural stereotypes, talking about it with the client as a reason for referral would violate ethical standards. The therapist should obtain consultation first (A). Initiating a discussion about the cultural stereotypes this couple faces may be helpful at some point, but this would reflect your agenda, not their presenting problem, and as such would be unethical (B). You do not know the type of family system this couple has developed. A matriarchal family system in families with an African American woman is an inaccurate stereotype (C). The correct answer is: Consult with a colleague regarding this issue after the first session. Which of the following therapeutic conditions is most closely related to reflective listening? Select one: a. listening quietly b. accurate empathy c. self-actualization d. unconditional positive regard Correct Answer: The concept of "therapeutic conditions" as well as three of the terms used in the responses are associated with Rogers's client-centered therapy. The major focuses of his theory and method are the concept of "self" and the provision of three therapeutic ("facilitative") conditions--accurate empathy, unconditional positive regard, and congruence. This question becomes a bit tricky though because the technique of reflective listening is not specifically attributed to Rogers. Reflective listening, or reflection, entails rephrasing what a client has said.Answer B is CORRECT: For Rogers (and others), accurate empathy refers to a cognitive awareness and understanding of a client's emotions and feelings and the ability to properly convey this understanding. Reflective listening is a way of expressing accurate empathy in that it involves rephrasing a client's statements in a way that demonstrates an understanding of what the client has said. Reflection of feeling, for example, involves rephrasing what a client has said with an emphasis on the emotional aspects.Answer A is incorrect: Listening quietly implies that the therapist would not respond verbally to the client: this is not at all similar to reflective listening.Answer C is incorrect: Selfactualization is not a "therapeutic condition"; instead, Rogers's therapeutic conditions are thought to create an atmosphere that facilitates self-actualization. The primary goal of client-centered therapy is to help clients achieve congruence between self and experience so that they can become more selfactualizing and fully-functioning.Answer D is incorrect: Unconditional positive regard (or warmth) is one of Rogers's facilitative conditions but it is not as closely related to reflective listening as empathy is. To demonstrate unconditional positive regard, a therapist has to genuinely care for a client, affirm the client's worth, and accept the client without evaluation. The correct answer is: accurate empathy A number of authorities have pointed out that the elderly are a heterogeneous group of people due to the diversity of their backgrounds, variations in the courses of the their lives, and differences in the physical and psychological impact of aging. When working with elderly clients in therapy, it is important to keep in mind that: Select one: a. the therapeutic alliance may be more difficult to form than it would with younger clients b. elderly clients quickly become over-dependent on the therapists due to their isolation and loneliness c. cognitive therapy is contraindicated because of the cognitive demands its places on the client d. insight-oriented therapies are contraindicated because of the cognitive impairments that typically accompany aging Correct Answer: When working with elderly clients, it is important not to assume that certain types of treatment are necessarily inappropriate.Answer A is CORRECT: Elderly individuals are often unfamiliar with and suspicious of therapy and, therefore, may take longer to develop a working relationship with the therapist. For this reason, M. D. Glantz (Cognitive therapy with the elderly, in A. Freeman, et al. [eds.], "Comprehensive Handbook of Cognitive Therapy," New York: Plenum Press, 1989) argues that, with these clients, it is particularly important for a therapist to demonstrate genuineness, accurate empathy, and unconditional positive regard, which help foster the therapeutic alliance.Answer B is incorrect: While loneliness and isolation are issues for many elderly clients, it has not been found that this leads to over-dependence on the therapist.Answer C is incorrect: While cognitive therapy may be contraindicated for some elderly clients due to impairments in cognition and other aspects of functioning, this is not an accurate generalization.Answer D is incorrect: Again, while insight-oriented therapy may be contraindicated for some elderly clients, this is not an accurate generalization. The correct answer is: the therapeutic alliance may be more difficult to form than it would with younger clients What statement is most true about the therapeutic environment? Select one: a. a soothing, quiet environment is essential b. the client-therapist relationship should overshadow the environment c. the environment sets the tone for good therapy d. there is no relationship between therapeutic environment and effective therapy Correct Answer: You could have answered this question by noticing the choice of words alone. Read it carefully.Answer B is CORRECT: Notice the word "should." It is true that the aesthetics of the office "should" be a less important factor for effective therapy than the relationship between the client and the therapist.Answer A is incorrect: Notice the word "essential." A "soothing, quiet environment" may be therapeutic for some clients but it is not "essential" to effective therapy for all clients.Answer C is incorrect: What "sets the tone" for good therapy is different for every client.Answer D is incorrect: Notice the word "no." The importance of the therapeutic environment is different for every client and, for some, it may be a factor in effective therapy. The correct answer is: the client-therapist relationship should overshadow the environment The hallmark concept emphasized in Contextual Family Therapy is: Select one: a. The promotion of an ethical environment in the family. b. Creating a positive emotional context in the family. c. The integration of individual, interpersonal and systemic approaches to family therapy. d. That human beings thrive best in a supportive context. Correct Answer: Answer A is CORRECT: All of the answers given here are essentially correct in that they are in line with Contextual Family Therapy (developed by Ivan Boszormenyi-Nagy) concepts. However, the primary concept associated with CFT is that an ethical family environment is essential to the healthy emotional and relational wellbeing of its members. An ethical family environment is one in which trust, mutual support, fairness, accountability and loyalty are present, which creates a positive emotional context for human growth.Answer B is incorrect: Be careful about choosing an answer simply because it has a "buzzword" that you may recognize, such as "context," as in this case. The core meaning of the correct answer, regardless of whether it uses buzzwords, is what makes a good answer. The hallmark concept of CFT is that an ethical family environment creates a positive emotional context.Answer C is incorrect: While it is true that CFT integrates individual, interpersonal and systemic approaches to family therapy, this is not a "hallmark concept," rather it is a statement of fact describing the theory.Answer D is incorrect: While this is a statement that is certainly consistent with CFT, a supportive family context is created when the family system is an ethical one. The correct answer is: The promotion of an ethical environment in the family. The therapist is treating a Chinese family. The family members tell you their mother talks to deceased and unborn relatives. What should the therapist do? Select one: a. Confront her about her behavior b. Refer to a psychologist to test the woman's neurological functioning c. Ask the family members how they understand this behavior d. Ask if you can have a conversation with the people she talks to Correct Answer: Without knowing the ethnicity of the client, you might have chosen answer "b." You probably narrowed your answer choices to "b" and "c." See below as to why "c" seems like the better answer choice.Answer C is CORRECT: According to ethnicity texts, the Chinese people have a unique spiritual perspective of ancestor worship in addition to the other traditional spiritual beliefs of Christianity, Buddhism, and Taoism.Answer A is incorrect: This is the least likely intervention in terms of effectiveness with this particular client. Compassion is very important when working with Chinese clients, and confrontation is rarely compassionate.Answer B is incorrect: After you gain an understanding from each family member, you may still want to have her condition evaluated, but you would first need to understand her behavior within the context of her culture.Answer D is incorrect: Asking if you can have a conversation with the people she talks to would be an insult unless you are Chinese and have the same spiritual perspective. The correct answer is: Ask the family members how they understand this behavior The release of repressed emotional material from the unconscious with an appropriate outward expression of the feelings is known as: Select one: a. catharsis b. cathexis c. transference d. resistance Correct Answer: This is a straightforward "recall" question; it may have been difficult, however, since all four answers are associated with psychoanalytic theory.Answer A is CORRECT: The question describes catharsis, which is considered a key process in psychoanalysis. It involves a client's expression of repressed emotion and is usually accompanied by interpretations that help the client understand the meaning of his/her repressed feelings and conflicts.Answer B is incorrect: Cathexis is the concentration or investment of psychic energy (e.g., libido) onto an object, idea, etc.Answer C is incorrect: Transference refers to the client's experience of feelings, thoughts, and wishes toward the therapist that represent a repetition of reactions to significant people in the client's past.Answer D is incorrect: According to Freud, resistance refers to a client's reluctance to bring into conscious awareness repressed, threatening unconscious material. Interpretation of resistance is a significant part of psychoanalysis since resistance is thought to signal that the material being discussed is close to the source of the client's problem. The correct answer is: catharsis A family, consisting of a couple and their 13-year-old daughter, presents with "communication problems." The mother explains that the daughter never listens and talks back too much. The father agrees, and adds that, although their rules are easy enough for anyone to understand, their daughter "just can't be easy and follow them." The daughter sits quietly. In this system, the daughter is: Select one: a. the least differentiated b. the placator c. the identified patient d. the victim of a double-bind Correct Answer: If you used only the information in the case study, a process of elimination would have led you to the correct answer.Answer C is CORRECT: This is the most obvious answer. Clearly, the daughter is being brought for treatment as the "person with the problem," so she is functioning as the IP in the system. Answer A is incorrect: It would be normal for an adolescent to be relatively fused and unsure of her solid self, but both parents seem pretty irrational and fused with each other as well, so it's impossible to say clearly that the daughter is least differentiated.Answer B is incorrect: Although both parents are taking a blaming stance, you have no evidence that the daughter is placating, so you would not expect this answer to be the "best" answer.Answer D is incorrect: While there is probably plenty of contradictory communication in the family (which puts the daughter in a double-bind) none of it is illustrated in the case study, so this is not a good choice. The correct answer is: the identified patient The Smiths, parents Joanne, 38, and Bob, 42 and children Lorraine, 18, and Randy 16, have been in family therapy with you for two months. Joanne is tearful and says that she isn't sure family therapy is helping because Randy's behavior is worse. Since coming to therapy, Randy has become verbally confrontational toward Lorraine. During her disclosure Bob remains stoic and detached. As a strategic therapist, you believe what is needed is: Select one: a. First order change b. Cohesion among family members c. Second order change d. Equality between the siblings Correct Answer: Answer C is correct: The implication is that Randy's behavior has changed and his parents think of it being for the worse. A strategic therapist will see that these kinds of behavioral changes don't really solve the family's problems. A strategic therapist will work for second order change (C). Second order change is a deeper, long-lasting change. It addresses the overall system dynamics, structure, or rules vs. a more individually-oriented, behavioral change. The correct answer is: Second order change Which of the following was responsible for the genesis of Gerald Caplan's development of mental health consultation: Select one: a. recognition that traditional psychoanalysis was not helpful for many of his clients b. recognition that an internal consultant was needed in many organizations to address employee mental health problems c. recognition that the mental health of many more individuals can be improved through indirect services d. recognition that preventive efforts do not target the appropriate populations Correct Answer: Gerald Caplan discusses the origins of his mental health consultation in his article, Caplanian mental health consultation: Historical background and current status (Consulting Psychology Journal, 1994, 46[4], 2-12).Answer C is CORRECT: Caplan's consultation approach grew out of his experiences at residential institutions in Israel in 1949. He quickly recognized that it was not feasible to provide direct services to patients due to their large number and, consequently, developed an indirect approach (consultation) that increased his ability to ensure that patients received adequate treatment. Answer A is incorrect: See explanation for response c.Answer B is incorrect: See explanation for response c.Answer D is incorrect: See explanation for response c. The correct answer is: recognition that the mental health of many more individuals can be improved through indirect services Of the following factors, which one is least characteristic of parents who are at high risk for abusing their children? Select one: a. history of being abused themselves as children b. insensitivity to the criticism of others c. strong belief in the value of harsh punishment for misbehavior d. emotional "role-reversal" with their children Correct Answer: You needed to choose the statement that is least characteristic of abusive parents.Answer B is CORRECT: This characteristic is not associated with parents who are at high risk for engaging in child abuse.Answer A is incorrect: Most authorities agree that high a risk for engaging in child abuse is associated with parents who were, themselves, abused physically or emotionally as children.Answer C is incorrect: Abusive parents tend to believe this, and that their children's misbehavior justifies harsh punishment. They may have no malicious intent, but be mimicking the disciplinary patterns of their own parents.Answer D is incorrect: Abusive parents tend to rely on their children for satisfaction of their own emotional needs. They often have unrealistic expectations of their children, often expecting the children to serve as sources of love and comfort and to react to their needs in an adult-like manner. The correct answer is: insensitivity to the criticism of others Which of the following terms refers to the concept in general systems theory that, one cause may produce different results? Select one: a. Equifinality. b. Mimesis. c. Equipotentiality. d. Reciprocity. Correct Answer: Answer C is correct: Equipotentiality refers to the concept that one cause may produce different results. Equifinality relates to different causes producing the same result (A). Mimesis means imitation and refers to a structural therapist accommodating to a family's style, tempo and affective range (B). Reciprocity refers to the notion that individuals are likely to reinforce each other's behavior over time. This is associated with behavioral family therapy (D). The correct answer is: Equipotentiality. Social comparison theory's predictions about behavior are particularly applicable to: Select one: a. situations involving uncertainty b. inequitable situations c. people who are working on a difficult task d. people who belong to a cohesive group Correct Answer: Answer A is CORRECT: Social comparison theory applies to a variety of situations but seems to be particularly accurate in uncertain situations.Answer B is incorrect: See explanation above.Answer C is incorrect: See explanation above.Answer D is incorrect: See explanation above. The correct answer is: situations involving uncertainty A therapist using a Bowenian perspective sees a family that is exhibiting a high degree of fusion. One family member, however, is more differentiated than the others. The therapist's likely approach will be to work with: Select one: a. the least differentiated family member b. the most differentiated family member c. all family members as a group d. all family members in individual therapy until they reach a similar level of differentiation Correct Answer: The words "Bowenian perspective" were important. According to Bowen, a high degree of fusion (emotional "stuck togetherness") is the source of family dysfunction. Therefore, the goal of Bowen's extended family systems therapy is to help family members become less fused, or more differentiated.Answer B is CORRECT: Bowenians sometimes work with the most differentiated family member on the assumptions that this person is most able to change and that, when this member changes in a positive direction, his/her change will motivate other family members to move toward greater differentiation.Answer A is Incorrect: The word "least" makes this wrong.Answer C is Incorrect: Bowen would be more likely to do "b" or else to work with only the spouses since he considers the spouses to be the most important members of the family system.Answer D is Incorrect: Bowen would not do this. The correct answer is: the most differentiated family member In crisis therapy, which of the following strategies would probably be least useful? Select one: a. providing opportunities for and encouraging catharsis b. identifying the precipitating event c. directly confronting the client's unrealistic beliefs d. giving advice about the circumstances in the client's life Correct Answer: The crisis therapist uses a variety of strategies to achieve the goals of crisis treatment. Overall, these goals are to relieve the client's symptoms and return the client to his/her previous level of functioning. Your task was to determine what a crisis therapist would be least likely to do.Answer D is CORRECT: Consistent with a client's functional level and current dependency needs, a therapist doing crisis intervention should participate actively and be directive in developing activities that will help the client resolve the crisis. Crisis therapists, however, generally limit their advice to specific treatment issues (e.g., recommending a medication evaluation, suggesting increased contact with the support system) and avoid giving advice about real-life circumstances (e.g., "you should consider divorcing your husband") (see, e.g., Butcher, et al., 1983).Answer A is incorrect: Providing opportunities for discharging the strong emotions that follow a crisis is an important part of crisis therapy, especially during the initial stages.Answer B is incorrect: In contrast to other short-term therapies, the identification of the precipitating event is an important part of crisis therapy.Answer C is incorrect: Although immediately challenging a client's unrealistic beliefs about the crisis situation is not appropriate, in order to resolve the crisis and its aftereffects, it is necessary at some point to confront the client about his/her maladaptive beliefs and behaviors. The correct answer is: giving advice about the circumstances in the client's life According to Glasser, the founder of reality therapy, most mental disorders are the result of irresponsibility, which leads to the development of: Select one: a. a maladaptive style of life b. a "failure identity" c. a lack of congruence d. "basic mistakes" Correct Answer: Glasser distinguishes between two types of identity--success identity and failure identity--and proposes that irresponsibility leads to a failure identity.Answer B is CORRECT: This is the right answer. See above.Answer A is incorrect: This is associated with Adler; he viewed basic mistakes as the cause of feelings that underlie a person's maladaptive style of life.Answer C is incorrect: This is associated with Rogers; the primary goal of his client-centered therapy is helping clients eliminate the incongruence between self and experience and reclaim their self-actualizing urges.Answer D is incorrect: This is associated with Adler. See explanation for answer "a." The correct answer is: a "failure identity" The concept of an "undifferentiated family ego mass," as used by Murray Bowen, results from: Select one: a. triangles within a family system b. boundaries within a family system c. the family therapeutic system d. the family system's projection process Correct Answer: "Differentiation" is the ability to separate thoughts from feelings, both intrapsychically and interpersonally. "Ego mass" refers to a group of individuals, such as a family. Slipp (1984) has described an "undifferentiated ego mass" in the following way: "The couple and the triangulated child become locked into an overly close relationship ... the symbiotic survival pattern. They are functioning as if they were one personality, with each family member of the triangle taking a component part of self or object, either good or bad."Answer A is CORRECT: Bowen does emphasize triangles and relates them to a loss of differentiation.Answer B is incorrect: Although many family systems approaches discuss boundaries, they are most associated with Minuchin. Also, differentiation is a psychodynamic concept and boundaries are not.Answer C is incorrect: You could speculate that "therapeutic system" refers to a family's ability to cope with problems. This is only remotely related to the concept of undifferentiated ego mass.Answer D is incorrect: Family projective process is a Bowenian term referring to the chronic triangulation of the most vulnerable child in the family system. This is a good answer and, if "a" were not available, it would be the best answer. Lack of differentiation, however, can occur in a family due to any form of triangulation. A projective process is one type of triangulation but not the only type. The correct answer is: triangles within a family system The Internal Family Systems (IFS) model, pioneered by Richard Schwartz, postulates that an individual's psyche is made up of sub-personalities or "Parts," with an essential 'Self" at the core. Each Part wants something positive for the individual and will exert itself in order to gain influence over the internal system. The most common roles that Parts play are: Select one: a. Managers focus on individual functioning, Firefighters keep painful emotions at bay and Exiles employ repression of painful feelings. b. Managers focusing on individual safety and functioning, Supervisors carry the core sense of self and oversee other Parts, and Exiles carry painful emotions and memories. c. The Self resides in the Adult Part that oversees the various sub-Parts, the Orphan Part carries painful emotions and memories, and the Sibling Part manages relationships with others. d. Managers focus on keeping the individual safe, Exiles carry painful emotions and memories and Firefighters override the exiles' feelings by compulsive activities. Correct Answer: Answer D is CORRECT: The Parts described in Internal Family Systems therapy (Richard Schwartz) include three major categories: 1) Managers, who run the daily life of the individual, attempt to keep control and protect parts from rejection and hurt, and try to hide the exiles from the rest of the internal system 2) Exiles are parts that carry the emotions, memories, and sensations from past experiences when a person has been hurt, humiliated, or frightened. Exiled parts can become extreme in an effort to be cared for and heard. 3) Firefighters who try to distract from the awareness of exiled feelings with such behaviors as addictions, dissociation, self-harming behaviors, obsessions, compulsions, overexercising, workaholic behavior, etc.Answer A is incorrect: This answer is close to correct, but the description in "d." of the role of the Exiles as carrying painful emotions and memories rather than repressing them is more accurate. The Firefighters act as the repressing force in the IFS model.Answer B is incorrect: The Supervisor is not a classic Part as described in the IFS model.Answer C is incorrect: Adult, Orphan and Sibling Parts are not described in the IFS model. The correct answer is: Managers focus on keeping the individual safe, Exiles carry painful emotions and memories and Firefighters override the exiles' feelings by compulsive activities. The Prager family, which includes the divorced mother, the grandmother and stepgrandfather, and three children in their teens, comes to see you because of bickering and fighting between the generations. The six members of the family have lived together for six years, but the problems involved in dealing with the adolescents have recently become a source of misunderstanding. In working with this family, you decide to use techniques associated with Satir's conjoint family therapy. Given that context, you would be likely to agree with all of the following statements except: Select one: a. history is an unimportant and unnecessary part of the therapeutic process b. dysfunctional families can usually be described as closed systems c. faulty communication is usually the result of low self-esteem in family members d. the focus of therapy is the entire family, but it is sometimes appropriate to see family subsystems Correct Answer: Although this question was long, you simply needed to identify what a therapist using Satir's methods would not agree with.Answer A is CORRECT: The therapist would probably not agree with this: Satir believes that low self-esteem is learned while growing up (e.g., when a child's experience or developmental progress is unappreciated or invalidated by his/her parents and the child learns to feel bad about him/herself) and that faulty communication in families is caused by low self-esteem.Answer B is incorrect: The therapist would agree with this.Answer C is incorrect: The therapist would agree with this.Answer D is incorrect: The therapist would agree with this. The correct answer is: history is an unimportant and unnecessary part of the therapeutic process A therapist using a Bowenian perspective sees a family that is exhibiting a high degree of fusion. One family member, however, is more differentiated than the others. The therapist's likely approach will be to work with: Select one: a. the least differentiated family member b. the most differentiated family member c. all family members as a group d. all family members in individual therapy until they reach a similar level of differentiation Correct Answer: The words "Bowenian perspective" were important. According to Bowen, a high degree of fusion (emotional "stuck togetherness") is the source of family dysfunction. Therefore, the goal of Bowen's extended family systems therapy is to help family members become less fused, or more differentiated.Answer B is CORRECT: Bowenians sometimes work with the most differentiated family member on the assumptions that this person is most able to change and that, when this member changes in a positive direction, his/her change will motivate other family members to move toward greater differentiation. Answer A is incorrect: The word "least" makes this wrong. Answer C is incorrect: Bowen would be more likely to do "b" or else to work with only the spouses since he considers the spouses to be the most important members of the family system.Answer D is incorrect: Bowen would not do this. The correct answer is: the most differentiated family member You just finished reading many excerpts from Jay Haley's interviews with Milton Erickson. Upon putting down the papers you asked yourself, "I wonder with what condition a paradoxical intervention would work best?" The most likely answer to this would be: Select one: a. anxiety b. persistent depressive disorder c. antisocial behavior d. premature ejaculation Correct Answer: Keep in mind that the primary objective of a paradoxical intervention is to help the client regain control. Whether or not the client follows through with the therapist's request to engage in a dysfunctional behavior, the client will be forced to take control.Answer D is CORRECT: A paradoxical intervention would most likely work best with this disorder. Premature ejaculation is cured when the afflicted individual gains the perception that he has control. This coincides with the intention behind paradoxical interventions.Answer A is incorrect: Paradoxical interventions can be used successfully with some anxiety symptoms, but this is not the best answer. For instance, the word "anxiety" could refer to a wide range of symptoms or disorders (e.g., panic attacks, agoraphobia), some of which would not be treated effectively using paradoxical techniques. See answer "d."Answer B is incorrect: Even if one could intentionally produce depressive symptoms, it is not likely that there would be any lasting therapeutic effect.Answer C is incorrect: This seems like a possibility, since antisocial behavior is observable and measurable and can be intentionally performed. However, many behaviors that antisocial clients engage in are dangerous and, thus, it would be inappropriate to suggest them. The correct answer is: premature ejaculation You want to strengthen the marital dyad. What would be a second order change? Select one: a. the executive subsystem becomes stronger and boundaries become healthier b. the children begin acting out in an attempt to sabotage the new changes c. the couple tries to triangle the therapist into their new structure d. the couple become more loving as a marital dyad but less effective as a parental unit Correct Answer: "Second order change" is a term from cybernetics. It refers to a change in a system that alters the fundamental organization of the system. Thus, a symptomatic family would be said to undergo a second order change when a therapeutic intervention fundamentally disrupts the pattern of symptomatic interaction so that it ceases. In other words, the therapist might observe that, previously, the family had an organization that embodied a certain symptomatic pattern of interaction but now the family has a different organization (Watzlawick, Weakland, and Fisch, 1974). First order changes, by contrast, are adaptations such as swapping one symptom for another symptom.Answer A is CORRECT: This is a good description of second order change. You may have been distracted, however, by the use of words commonly heard when discussing structural family therapy.Answer B is incorrect: See the above explanation for a description of second order change.Answer C is incorrect: See the above explanation for a definition of second order change.Answer D is incorrect: This would be an example of first order change, which is also defined above. The correct answer is: the executive subsystem becomes stronger and boundaries become healthier A client-centered therapist would most likely respond to a client's transference by: Select one: a. interpreting it b. challenging it c. disregarding it d. reflecting it Correct Answer: Answer C is Correct: Transference is not expected to develop in clientcentered therapy, at least not at the intense level that it does in psychodynamic therapy. Transference in client-centered therapy is essentially accepted and disregarded rather than interpreted as it is in many other forms of therapy. "In a climate of empathic understanding transferences ... disappear or ... express themselves so minimally that they do not interfere with therapy progress" (L. R. Wolberg, The Techniques of Psychotherapy, Orlando, FL: Grune and Stratton, 1988, p. 175). The correct answer is: disregarding it Which of the following does not belong with the others? Select one: a. reducto ad absurdum b. prescribing the symptom c. mimesis d. relabeling Correct Answer: You had to choose the answer that does not belong with the others. Hopefully, you noticed that while "a," "b," and "d" are strategic techniques, mimesis is a structural technique.Answer C is CORRECT: Unlike the other three answers, mimesis is associated with structural family therapy. It is used when attempting to join the system and involves the therapist imitating the family's style, tempo, etc.Answer A is incorrect: This means "exaggerating the symptom" and is associated with answer "b": when prescribing a symptom, it is often useful to ask for more extreme behavior than what the client is already doing.Answer B is incorrect: This is a paradoxical intervention that forces a client to either give up the symptom or admit that it is under his/her voluntary control. For example, a therapist might instruct an overprotective mother to take better care of her children.Answer Ad is incorrect: This involves changing the way a symptom or set of behaviors is understood. For example, a teen-ager's talking back could be described as "normal adolescence." The correct answer is: mimesis Which of the following would Minuchin most likely NOT do? Select one: a. have family members state what their roles are and describe the transactions in the family b. mark boundaries c. join with the family d. provide support, education, and guidance Correct Answer: You were told to identify what Minuchin would not do.Answer A is CORRECT: Minuchin works with relatively unsophisticated client populations who could not think abstractly enough to "state what their roles are."Answer B is incorrect: This describes enactment and is a typical part of Minuchin's therapy.Answer C is incorrect: Joining is a key part of Minuchin's therapy.Answer D is incorrect: This describes boundary-marking, which is a typical part of Minuchin's therapy. The correct answer is: have family members state what their roles are and describe the transactions in the family A psychodynamic therapist working with a system would be most likely to begin the termination process when: Select one: a. individuals have worked through the emotional bonds within their families b. individuals have physically or at least emotionally separated from the families in which they were raised c. individuals have more insight into previously unconscious motivations and less reliance on egodefensive maneuvers d. the system is more differentiated Correct Answer: The key here is that the psychodynamic therapist is working with a system. In psychodynamic family therapy, the goals tend to be improving relationships within the family.Answer A is CORRECT: This is the best answer. In psychodynamic family therapy, the ultimate goals of treatment usually focus on improving relationships within the client family. Underlying this approach is the assumption that experience in the family-of-origin provides the basis for a person's sense of self, internalized images of significant others, and expectations for intimate relationships. Symptomatic behavior is thought to represent unresolved conflicts from the family-of-origin, which are re-enacted in a person's current family relationships. A family member's symptom becomes part of an ongoing interactional pattern that provides equilibrium for the individual but impairs the family's ability to adapt to change because it produces role distortions and a breakdown of role complementarity, which are associated with intrapsychic and interpersonal conflicts. Unresolved conflicts, for instance, often lead to the unconscious placement of one family member in a role in which he/she is consistently criticized and blamed for family tension. Such scapegoating provides further validation for negative introjects and, as a result, intensifies individual symptomology and family dysfunction.Answer B is incorrect: Physical separation is not necessarily a goal of treatment; patients often leave home physically but remain emotionally entangled.Answer C is incorrect: If the question had asked about the goals of treatment (i.e., when to terminate) in individual therapy, then this would be a better answer.Answer D is incorrect: This is incorrect because "differentiated" is not a psychodynamic word. The correct answer is: individuals have worked through the emotional bonds within their families To disrupt the fusion in a family, Bowen recommends that when the parents constantly focus their attention on the child who is the identified patient, the therapist should: Select one: a. direct the parents' attention to their unresolved conflicts with their families-of-origin b. join the family in a position of leadership to disrupt the emotional triangle c. work with the least differentiated family member d. restructure the family in order to increase each member's self-differentiation Correct Answer: Knowing that Bowen's approach is called family-of-origin or extended family systems therapy might have helped you find the right answer. All four answers, however, contain words associated with Bowen's work. Therefore, you needed to read carefully to determine which response is completely correct and avoid relying on just "buzz words." In addition, if you imagined that these clients were real people, you might have been able to determine what you would do with them in therapy.Answer A is CORRECT: The question tells you that this family is fused. This means that family members have overly strong emotional attachments because the emotional and intellectual boundaries between them are blurred. To disrupt fusion, Bowen recommends helping family members identify the patterns in the family system that "hook them" emotionally. He believes that these patterns can be traced back over many generations and, therefore, encourages patients to study their family history. In this family, Bowen would encourage the parents to explore their families-of-origin to resolve the conflicts that are causing dysfunction in the current family system.Answer B is incorrect: Although emotional triangles are associated with Bowen, Bowen would not "join" with the family. He encourages therapists to remain emotionally neutral and avoid taking sides.Answer C is incorrect:Because differentiation is the opposite of fusion, you might have been tempted by this answer; however, Bowen does not work with the least differentiated family member. When he works with one family member, he works with the most differentiated one since he believes that this member is the most capable of changing.Answer D is incorrect: Bowen encourages differentiation and differentiation is the opposite of fusion so this answer might have been tempting; however, the goal of restructuring the family is associated with Minuchin's structural therapy. The correct answer is: direct the parents' attention to their unresolved conflicts with their families-oforigin Systematic desensitization has been used to treat a variety of disorders, including anxiety and phobias. Systematic desensitization is based on which of the following? Continues...