LMFT Clinical Exam Questions And Answers Graded
A+ 2025/2026
A. The symptoms are a sign of anxiety resulting from internal family conflicts.
B. The symptoms are a sign of anxiety resulting from environmental influences.
C. The symptoms are a sign of depression resulting from a genetic predisposition.
D. The symptoms are a sign of depression resulting from intergenerational family
dynamics. - B. The symptoms are a sign of anxiety resulting from environmental
influences.
A lesbian couple in their 40's is self-referred and want to work on their marriage.
Cambria, age 41, tells the therapist that they have been married for slightly over 20
years and that things are just not the same anymore. Her wife Kaitlyn, age 44, tells you
that they hardly talk to each other and she misses the good relationship they once had.
"I wish she at least asked me how my day was every once in a while. I try hinting at it,
but it is like talking to a brick wall, all she does is play on her iPad," she notes. "If there
is something you want from me just ask me directly," says Cambria. "You have not
touched me in years and I am supposed to want to know about your day?" As a
Strategic therapist, what interventions would the therapist use with this couple in the
middle stage of therapy?
A. Give directives; explore the role that past family relationships are playing in the
present; model and educate about communi - C. Give directives; utilize restraining and
positioning strategies; model and educate about communication skills
A therapist who is a HIPAA provider receives a request from an insurance company for
the full records of several clients as part of an audit. The therapist maintains
psychotherapy notes in addition to the medical records for all clients. The therapist
should:
A. Provide the insurance company with all components of the clients' files, including
psychotherapy notes.
B. Review the policy agreement to determine what portions of the clients' files must be
provided.
C. Provide the insurance company with the medical records only.
D. Request additional authorization from clients to provide full records for the audit. - C.
Provide the insurance company with the medical records only.
A 35-year-old single woman is referred to a community mental health clinic for parenting
support and treatment of anxiety. She has two sons, ages 6 and 8, who attend the local
school. She shares that they were recently evicted because the owners were selling the
complex and adds that they have been sleeping in her van for the past 2 weeks. She
says she feels overwhelmed and doesn't know how to get back on her feet. How should
the therapist proceed?
,A. Inform the woman that a child abuse report must be filed due to the family being
homeless.
B. Refer the family to a shelter.
C. Complete a full assessment including social supports and coping strategies.
D. Recommend family therapy to ensure that the children are safe. - C. Complete a full
assessment including social supports and coping strategies.
A couple reports increased marital conflicts. The husband notes that his wife has
become irritable, isolative, and lethargic since she was laid off from her job three
months ago. She worked as an air traffic controller for 26 years and, due to recent
budget cuts, the company had to let her go. The wife states she is tired of her husband's
constant nagging for her to be more helpful around the house. Both report a lack of
physical intimacy and a sense of emotional disconnect from one another, but express a
desire to resolve their problems. Which of the following areas should the therapist
assess first to identify the degree to which current stressors are impacting the
relationship?
A. The wife's work history and her prognosis for re-employment.
B. The couple's styles of coping and their degree of effectiveness.
C. The effect of socio-economic factors on the couple's problems.
D. The effect of dysfunctional patterns i - C. The effect of socio-economic factors on the
couple's problems.
A 22-year-old Asian-American woman seeks therapy at the insistence of her father who
read a journal entry that the girl wrote stating she wanted to die. The client shares that
her parents are divorced and that she lives with her mother and her older sister. The
client reports that she doesn't have many friends, but feels more comfortable alone. She
admits to having thoughts of not wanting to be alive but no plans to hurt herself. What
diagnoses should the therapist consider?
Choose one
A. Social anxiety disorder; Major Depressive Disorder; Schizotypal Personality Disorder
B. Unspecified Depressive Disorder; Major Depressive Disorder; Schizoid Personality
Disorder
C. Social anxiety disorder; Major Depressive Disorder; Avoidant Personality Disorder
D. Unspecified Depressive Disorder; Major Depressive Disorder; Avoidant Personality
Disorder - B. Unspecified Depressive Disorder; Major Depressive Disorder; Schizoid
Personality Disorder
Which of the following elements should be included in a bio-psychosocial assessment of
a new client?
A. Baseline functioning; social support systems; information from adjunctive resources.
B. Baseline functioning; social support systems; assessment of risk.
C. Client history; mental status examination; information from adjunctive resources.
D. Client history; mental status examination; assessment of risk. - D. Client history;
mental status examination; assessment of risk.
, A 42-year-old transgender woman has been in therapy for two years for depression.
When she originally came in she set out to improve her body image together with her
self-esteem. She also wanted to develop alternative coping mechanisms, since she
found herself heavily relying on overeating to help her dull emotional pain associated
with the transition. After 2 years of treatment, she is now able to begin every morning
with a gratitude practice listing all the things she likes about her new body. She no
longer feels a sense of heavy self-hatred and is able to treat herself in a loving manner.
She is working the steps in Overeaters Anonymous and is journaling and meditating
whenever emotional pain arises. She requests ongoing therapy because she does not
want her life to go back to the way it was. What course of treatment is most indicated at
this point?
A. Discuss termination issues; maintain regularly scheduled sess - B. Normalize her
fears; discuss termination issues; gradually decrease the frequency of contact.
A 24-year-old woman seeks therapy after an unexpected break-up with her boyfriend of
two years. She shares that they had met in college and had plans to move in with each
other and get engaged by the end of the year. A month ago the boyfriend quit his job
and said he was moving to South Africa to explore the world and that he wanted to do it
alone. She hasn't had contact with him since. The client reports that her heart is broken
and she can't imagine life without him. What intervention would a Gestalt therapist
utilize in the initial session with this client?
A. Collect more information about the nature of their relationship to better understand
the break up.
B. Ask the client to describe the sensations she experiences when she talks about her
broken heart.
C. Explore the client's premorbid coping and identify strengths.
D. Request the client stay in the "here and now" when describing her feelings about her
relatio - B. Ask the client to describe the sensations she experiences when she talks
about her broken heart.
A multicultural family of four comes in for family counseling. The mother, Graciela, age
37, immigrated from Spain 17 years ago. She has been having persistent episodes
when she is crying all day, feeling down, and not interested in doing anything with her
family or friends. Her husband Nathan, age 38, was born and raised in Scotland. He
met his wife while studying in the US during his semester abroad. The stresses of
immigration and having a family to support has led him to frequent the bar a few times a
week. "It is a way for me to unwind with my mates before coming home to screaming
children and a sad wife," he declares. They both tell the therapist that the kids, 2 and 4
years old, are "out of control". The therapist should consider referrals to:
A. A child protective agency; Alcoholic Anonymous; Psychiatric Emergency Team.
B. Parenting classes; Treatment center for substance use assessment; A psychiatrist.
A+ 2025/2026
A. The symptoms are a sign of anxiety resulting from internal family conflicts.
B. The symptoms are a sign of anxiety resulting from environmental influences.
C. The symptoms are a sign of depression resulting from a genetic predisposition.
D. The symptoms are a sign of depression resulting from intergenerational family
dynamics. - B. The symptoms are a sign of anxiety resulting from environmental
influences.
A lesbian couple in their 40's is self-referred and want to work on their marriage.
Cambria, age 41, tells the therapist that they have been married for slightly over 20
years and that things are just not the same anymore. Her wife Kaitlyn, age 44, tells you
that they hardly talk to each other and she misses the good relationship they once had.
"I wish she at least asked me how my day was every once in a while. I try hinting at it,
but it is like talking to a brick wall, all she does is play on her iPad," she notes. "If there
is something you want from me just ask me directly," says Cambria. "You have not
touched me in years and I am supposed to want to know about your day?" As a
Strategic therapist, what interventions would the therapist use with this couple in the
middle stage of therapy?
A. Give directives; explore the role that past family relationships are playing in the
present; model and educate about communi - C. Give directives; utilize restraining and
positioning strategies; model and educate about communication skills
A therapist who is a HIPAA provider receives a request from an insurance company for
the full records of several clients as part of an audit. The therapist maintains
psychotherapy notes in addition to the medical records for all clients. The therapist
should:
A. Provide the insurance company with all components of the clients' files, including
psychotherapy notes.
B. Review the policy agreement to determine what portions of the clients' files must be
provided.
C. Provide the insurance company with the medical records only.
D. Request additional authorization from clients to provide full records for the audit. - C.
Provide the insurance company with the medical records only.
A 35-year-old single woman is referred to a community mental health clinic for parenting
support and treatment of anxiety. She has two sons, ages 6 and 8, who attend the local
school. She shares that they were recently evicted because the owners were selling the
complex and adds that they have been sleeping in her van for the past 2 weeks. She
says she feels overwhelmed and doesn't know how to get back on her feet. How should
the therapist proceed?
,A. Inform the woman that a child abuse report must be filed due to the family being
homeless.
B. Refer the family to a shelter.
C. Complete a full assessment including social supports and coping strategies.
D. Recommend family therapy to ensure that the children are safe. - C. Complete a full
assessment including social supports and coping strategies.
A couple reports increased marital conflicts. The husband notes that his wife has
become irritable, isolative, and lethargic since she was laid off from her job three
months ago. She worked as an air traffic controller for 26 years and, due to recent
budget cuts, the company had to let her go. The wife states she is tired of her husband's
constant nagging for her to be more helpful around the house. Both report a lack of
physical intimacy and a sense of emotional disconnect from one another, but express a
desire to resolve their problems. Which of the following areas should the therapist
assess first to identify the degree to which current stressors are impacting the
relationship?
A. The wife's work history and her prognosis for re-employment.
B. The couple's styles of coping and their degree of effectiveness.
C. The effect of socio-economic factors on the couple's problems.
D. The effect of dysfunctional patterns i - C. The effect of socio-economic factors on the
couple's problems.
A 22-year-old Asian-American woman seeks therapy at the insistence of her father who
read a journal entry that the girl wrote stating she wanted to die. The client shares that
her parents are divorced and that she lives with her mother and her older sister. The
client reports that she doesn't have many friends, but feels more comfortable alone. She
admits to having thoughts of not wanting to be alive but no plans to hurt herself. What
diagnoses should the therapist consider?
Choose one
A. Social anxiety disorder; Major Depressive Disorder; Schizotypal Personality Disorder
B. Unspecified Depressive Disorder; Major Depressive Disorder; Schizoid Personality
Disorder
C. Social anxiety disorder; Major Depressive Disorder; Avoidant Personality Disorder
D. Unspecified Depressive Disorder; Major Depressive Disorder; Avoidant Personality
Disorder - B. Unspecified Depressive Disorder; Major Depressive Disorder; Schizoid
Personality Disorder
Which of the following elements should be included in a bio-psychosocial assessment of
a new client?
A. Baseline functioning; social support systems; information from adjunctive resources.
B. Baseline functioning; social support systems; assessment of risk.
C. Client history; mental status examination; information from adjunctive resources.
D. Client history; mental status examination; assessment of risk. - D. Client history;
mental status examination; assessment of risk.
, A 42-year-old transgender woman has been in therapy for two years for depression.
When she originally came in she set out to improve her body image together with her
self-esteem. She also wanted to develop alternative coping mechanisms, since she
found herself heavily relying on overeating to help her dull emotional pain associated
with the transition. After 2 years of treatment, she is now able to begin every morning
with a gratitude practice listing all the things she likes about her new body. She no
longer feels a sense of heavy self-hatred and is able to treat herself in a loving manner.
She is working the steps in Overeaters Anonymous and is journaling and meditating
whenever emotional pain arises. She requests ongoing therapy because she does not
want her life to go back to the way it was. What course of treatment is most indicated at
this point?
A. Discuss termination issues; maintain regularly scheduled sess - B. Normalize her
fears; discuss termination issues; gradually decrease the frequency of contact.
A 24-year-old woman seeks therapy after an unexpected break-up with her boyfriend of
two years. She shares that they had met in college and had plans to move in with each
other and get engaged by the end of the year. A month ago the boyfriend quit his job
and said he was moving to South Africa to explore the world and that he wanted to do it
alone. She hasn't had contact with him since. The client reports that her heart is broken
and she can't imagine life without him. What intervention would a Gestalt therapist
utilize in the initial session with this client?
A. Collect more information about the nature of their relationship to better understand
the break up.
B. Ask the client to describe the sensations she experiences when she talks about her
broken heart.
C. Explore the client's premorbid coping and identify strengths.
D. Request the client stay in the "here and now" when describing her feelings about her
relatio - B. Ask the client to describe the sensations she experiences when she talks
about her broken heart.
A multicultural family of four comes in for family counseling. The mother, Graciela, age
37, immigrated from Spain 17 years ago. She has been having persistent episodes
when she is crying all day, feeling down, and not interested in doing anything with her
family or friends. Her husband Nathan, age 38, was born and raised in Scotland. He
met his wife while studying in the US during his semester abroad. The stresses of
immigration and having a family to support has led him to frequent the bar a few times a
week. "It is a way for me to unwind with my mates before coming home to screaming
children and a sad wife," he declares. They both tell the therapist that the kids, 2 and 4
years old, are "out of control". The therapist should consider referrals to:
A. A child protective agency; Alcoholic Anonymous; Psychiatric Emergency Team.
B. Parenting classes; Treatment center for substance use assessment; A psychiatrist.
