LMFT Clinical Exam Study Guide Questions And
Answers Graded A+ 2025/2026
A 17-year-old is referred by her doctor to a mental health agency for counseling. The
client learned several weeks ago that she's pregnant. She reports she is in a
relationship with the person who got her pregnant, but they are not getting along, she
does not want him to know, and does not think she wants to have the baby. She is
conflicted about what to do and tells the therapist she would like support as she decides
what to do. The therapist has personal beliefs against abortion and feels strongly the
client should not have an abortion. How should the therapist address the conflict
presented in this case?
A. Seek immediate consultation to discuss the matter and determine if a referral would
be appropriate.
B. Seek consultation and refer the client to prenatal services.
C. Encourage the client to include her boyfriend in making a decision.
D. Share the therapist's personal beliefs and process how it effects the cli - A. Seek
immediate consultation to discuss the matter and determine if a referral would be
appropriate.
Kayla, age 15, is brought in for therapy by her Aunt Lynda who was given legal custody
following the death of Kayla's mother three years ago. Lynda reports that Kayla is
"running with the wrong crowd", has been skipping school and is lying to her about
where she goes at night. Lynda states, "She told me that she was at her friend's house,
but I went over there and nobody was home. I just can't trust her anymore." Kayla rolls
her eyes and responds "Don't pretend like you care. I'm not afraid of you anymore."
What legal obligations does the therapist have in the case described in this vignette?
A. File a child abuse report; Request documentation to verify custody; Obtain a release
to speak to school counselor.
B. Set fee before the onset of therapy; Explore expectations of therapy; Assess for child
abuse.
C. Obtain signed informed consent to treat a minor; File a child abuse report; Set fee
prior to the onset of thera - D. Obtain signed informed consent to treat a minor; Set fee
prior to treatment; Assess for child abuse.
A lesbian couple, Michelle, a 44-year-old African American and Kara, a 38-year-old
Caucasian, are referred by a friend. The couple reports that they fight all of the time and
can't agree how to parent. They have two adopted children, Josh, 6 and Logan, 4. They
report that Josh has been disruptive in class, won't stay seated and is aggressive with
other children. Kara starts crying when she says, "I don't know what to do to help him. I
am so worried about him. I can't sleep without taking something". Michelle complains
angrily, "Well, she pops pills whenever she's stressed and she worries about everything.
If she actually disciplined him, we wouldn't have this problem. He listens to me. Now,
he's completely out of control like you with that sleep drug". Kara whimpers back, "He
listens to you because he's afraid of what you'll do. "What interventions would a
,Bowenian therapist use in the beginning phase of treatment wi - B. Identify the role of
substance abuse as intrusive in their partnership and assist the couple in understanding
the role of parenting in their families of origin.
Helen, a 61-year-old woman referred by her medical doctor, is having difficulties
adjusting to a below-the-knee amputation due to complications from diabetes. A note
from her doctor indicates that Helen has elevated blood sugars and inconsistently
follows her eating plan and medication regimen. Initially, Helen is very animated,
speaking rapidly and using expansive gestures. She becomes irritable when asked how
she is feeling but admits that she has no appetite and isn't sleeping well at night. Upon
further discussion of her medical condition, Helen becomes tearful and states, "I can't
keep track of this disease. It's just too much! I'm afraid I am going to get depressed
again." What clinical issues require further assessment in the case provided in the
vignette?
A. Helen's social isolation; Suicide potential for Helen; Helen's preoccupation with
physical challenges and limitations.
B. Helen's understanding of her m - C. Helen's psychiatric history; Suicide potential for
Helen; Helen's mental status.
A therapist has been meeting with a 36-year-old client for several months. In one of the
sessions, the client discloses that when she was much younger, she had sexual
relations with one of her therapists. The therapist provides the client with the brochure
"Professional Therapy Never Includes Sex." In addition to providing the brochure, what
additional steps should the therapist consider?
A. Process the relationship with the client and encourage the client to file a report with
the BBS.
B. Process the relationship and file a report with the BBS.
C. Inform the client that her previous therapist's behavior was illegal and encourage her
to talk to a lawyer.
D. Determine how old the client was when she had a sexual relationship and file a child
abuse report, if necessary. - A. Process the relationship with the client and encourage
the client to file a report with the BBS.
An 8-year-old client is brought to therapy by her mother, who states that the client has
been moody and defiant at home and has been acting aggressively with other children
at school since they moved a few months ago. The mother states that "she's at the end
of her rope and has no idea how to deal with her daughter." She further states tearfully
that the client's father is in rehab for heroin addiction. Which of the following goals
should be included in the treatment plan for this case?
A. Decrease aggression at school and defiance at home; Re-establish appropriate
relationships between family members; Refer the mother for financial assistance.
B. Decrease aggression at school and defiance at home; Improve mother's parenting
skills; Refer the mother to Al Anon.
, C. Enhance impulse-control and attention span; Explore the marital relationship; Refer
the mother to Al Anon.
D. Enhance impulse-control and attention span; - B. Decrease aggression at school and
defiance at home; Improve mother's parenting skills; Refer the mother to Al Anon.
A therapist in private practice has been treating a 54-year-old male client for four
months. Over the past two months, the client regularly arrives late to appointments and
has also missed several of them. Although the cancellation policy was clearly explained
at the onset of therapy, the client continuously fails to call in advance to cancel. When
confronted, the client minimizes the problem and accuses the therapist of having
unreasonable expectations. How should the therapist initially respond to the client?
A. Remind client of his cancellation policies, have him sign an attendance contract and
require he pay for missed appointments.
B. Confront the client about his perception of the problem and discuss how to move
forward.
C. Reframe client's behavior as having difficulty with therapeutic work and collaborate
with client to reformulate goals.
D. Review cancellation policy and discuss possible termination with cl - B. Confront the
client about his perception of the problem and discuss how to move forward.
39-year-old Emilio and 36-year-old Helena are referred by their middle child's teacher.
They have 2 sons, ages 11 and 7, and a 9-year-old daughter, Raquel. Both parents
disclose being very busy and stressed at work, which means that neither of them is able
to be home much. They are both concerned about their daughter Raquel, who appears
more and more withdrawn and shut down lately. "I can't get her to do anything", Helena
complains. "Plus she used to love going over to her aunt's and uncle's place, but, ever
since a couple of months ago, she refuses to set foot in that house. I wonder if it has
anything to do with that incident?" How would a therapist assess and clinically manage
potential child abuse in this case?
A. Ask Helena what she means by "that incident"; inquire about any other recent
changes in Raquel's behavior; process the parents' reactions to a possible child abuse
report.
B. Review parenting skills mo - A. Ask Helena what she means by "that incident";
inquire about any other recent changes in Raquel's behavior; process the parents'
reactions to a possible child abuse report.
A therapist at a community mental health agency meets with the parents of an 8-year-
old boy who has a life threatening illness. The parents are declining appropriate medical
treatment for their son because it goes against their religious beliefs. The child is
receiving some care within the guidelines of their church's ministry but the child's
condition is progressively worsening. How should the therapist respond to this
dilemma?
Answers Graded A+ 2025/2026
A 17-year-old is referred by her doctor to a mental health agency for counseling. The
client learned several weeks ago that she's pregnant. She reports she is in a
relationship with the person who got her pregnant, but they are not getting along, she
does not want him to know, and does not think she wants to have the baby. She is
conflicted about what to do and tells the therapist she would like support as she decides
what to do. The therapist has personal beliefs against abortion and feels strongly the
client should not have an abortion. How should the therapist address the conflict
presented in this case?
A. Seek immediate consultation to discuss the matter and determine if a referral would
be appropriate.
B. Seek consultation and refer the client to prenatal services.
C. Encourage the client to include her boyfriend in making a decision.
D. Share the therapist's personal beliefs and process how it effects the cli - A. Seek
immediate consultation to discuss the matter and determine if a referral would be
appropriate.
Kayla, age 15, is brought in for therapy by her Aunt Lynda who was given legal custody
following the death of Kayla's mother three years ago. Lynda reports that Kayla is
"running with the wrong crowd", has been skipping school and is lying to her about
where she goes at night. Lynda states, "She told me that she was at her friend's house,
but I went over there and nobody was home. I just can't trust her anymore." Kayla rolls
her eyes and responds "Don't pretend like you care. I'm not afraid of you anymore."
What legal obligations does the therapist have in the case described in this vignette?
A. File a child abuse report; Request documentation to verify custody; Obtain a release
to speak to school counselor.
B. Set fee before the onset of therapy; Explore expectations of therapy; Assess for child
abuse.
C. Obtain signed informed consent to treat a minor; File a child abuse report; Set fee
prior to the onset of thera - D. Obtain signed informed consent to treat a minor; Set fee
prior to treatment; Assess for child abuse.
A lesbian couple, Michelle, a 44-year-old African American and Kara, a 38-year-old
Caucasian, are referred by a friend. The couple reports that they fight all of the time and
can't agree how to parent. They have two adopted children, Josh, 6 and Logan, 4. They
report that Josh has been disruptive in class, won't stay seated and is aggressive with
other children. Kara starts crying when she says, "I don't know what to do to help him. I
am so worried about him. I can't sleep without taking something". Michelle complains
angrily, "Well, she pops pills whenever she's stressed and she worries about everything.
If she actually disciplined him, we wouldn't have this problem. He listens to me. Now,
he's completely out of control like you with that sleep drug". Kara whimpers back, "He
listens to you because he's afraid of what you'll do. "What interventions would a
,Bowenian therapist use in the beginning phase of treatment wi - B. Identify the role of
substance abuse as intrusive in their partnership and assist the couple in understanding
the role of parenting in their families of origin.
Helen, a 61-year-old woman referred by her medical doctor, is having difficulties
adjusting to a below-the-knee amputation due to complications from diabetes. A note
from her doctor indicates that Helen has elevated blood sugars and inconsistently
follows her eating plan and medication regimen. Initially, Helen is very animated,
speaking rapidly and using expansive gestures. She becomes irritable when asked how
she is feeling but admits that she has no appetite and isn't sleeping well at night. Upon
further discussion of her medical condition, Helen becomes tearful and states, "I can't
keep track of this disease. It's just too much! I'm afraid I am going to get depressed
again." What clinical issues require further assessment in the case provided in the
vignette?
A. Helen's social isolation; Suicide potential for Helen; Helen's preoccupation with
physical challenges and limitations.
B. Helen's understanding of her m - C. Helen's psychiatric history; Suicide potential for
Helen; Helen's mental status.
A therapist has been meeting with a 36-year-old client for several months. In one of the
sessions, the client discloses that when she was much younger, she had sexual
relations with one of her therapists. The therapist provides the client with the brochure
"Professional Therapy Never Includes Sex." In addition to providing the brochure, what
additional steps should the therapist consider?
A. Process the relationship with the client and encourage the client to file a report with
the BBS.
B. Process the relationship and file a report with the BBS.
C. Inform the client that her previous therapist's behavior was illegal and encourage her
to talk to a lawyer.
D. Determine how old the client was when she had a sexual relationship and file a child
abuse report, if necessary. - A. Process the relationship with the client and encourage
the client to file a report with the BBS.
An 8-year-old client is brought to therapy by her mother, who states that the client has
been moody and defiant at home and has been acting aggressively with other children
at school since they moved a few months ago. The mother states that "she's at the end
of her rope and has no idea how to deal with her daughter." She further states tearfully
that the client's father is in rehab for heroin addiction. Which of the following goals
should be included in the treatment plan for this case?
A. Decrease aggression at school and defiance at home; Re-establish appropriate
relationships between family members; Refer the mother for financial assistance.
B. Decrease aggression at school and defiance at home; Improve mother's parenting
skills; Refer the mother to Al Anon.
, C. Enhance impulse-control and attention span; Explore the marital relationship; Refer
the mother to Al Anon.
D. Enhance impulse-control and attention span; - B. Decrease aggression at school and
defiance at home; Improve mother's parenting skills; Refer the mother to Al Anon.
A therapist in private practice has been treating a 54-year-old male client for four
months. Over the past two months, the client regularly arrives late to appointments and
has also missed several of them. Although the cancellation policy was clearly explained
at the onset of therapy, the client continuously fails to call in advance to cancel. When
confronted, the client minimizes the problem and accuses the therapist of having
unreasonable expectations. How should the therapist initially respond to the client?
A. Remind client of his cancellation policies, have him sign an attendance contract and
require he pay for missed appointments.
B. Confront the client about his perception of the problem and discuss how to move
forward.
C. Reframe client's behavior as having difficulty with therapeutic work and collaborate
with client to reformulate goals.
D. Review cancellation policy and discuss possible termination with cl - B. Confront the
client about his perception of the problem and discuss how to move forward.
39-year-old Emilio and 36-year-old Helena are referred by their middle child's teacher.
They have 2 sons, ages 11 and 7, and a 9-year-old daughter, Raquel. Both parents
disclose being very busy and stressed at work, which means that neither of them is able
to be home much. They are both concerned about their daughter Raquel, who appears
more and more withdrawn and shut down lately. "I can't get her to do anything", Helena
complains. "Plus she used to love going over to her aunt's and uncle's place, but, ever
since a couple of months ago, she refuses to set foot in that house. I wonder if it has
anything to do with that incident?" How would a therapist assess and clinically manage
potential child abuse in this case?
A. Ask Helena what she means by "that incident"; inquire about any other recent
changes in Raquel's behavior; process the parents' reactions to a possible child abuse
report.
B. Review parenting skills mo - A. Ask Helena what she means by "that incident";
inquire about any other recent changes in Raquel's behavior; process the parents'
reactions to a possible child abuse report.
A therapist at a community mental health agency meets with the parents of an 8-year-
old boy who has a life threatening illness. The parents are declining appropriate medical
treatment for their son because it goes against their religious beliefs. The child is
receiving some care within the guidelines of their church's ministry but the child's
condition is progressively worsening. How should the therapist respond to this
dilemma?
