LMFT TDC Mock Final Exam Questions And Answers
Graded A+ 2025/2026
Brian, age 38, and his wife Melody, age 35, come in with their two children, Mark, age 9,
and Sara, age 6. Their insurance panel referred them after Melody's doctor encouraged
them to get therapy. Melody was diagnosed with cancer three years ago and recently
found out that it has come back in several areas in her body. Brian, an Army officer,
says, "We'll fight it like we did last time. We're fine." Melody cries and says, "I am
worried about my kids. Brian is deployed a lot and I worry about who will take care of
them if something happens to me. He doesn't want to deal with reality." Sara looks at
her mom with concern, starts crying, and says, "I'll take care of you mommy." Mark
stares at the floor, motionless. Brian asks about fees because of all the medical
expenses. How would a Systems therapist treat this family in the middle stage of
therapy?
A. Explore their patterns of interaction when they are dealing with s - A. Explore their
patterns of interaction when they are dealing with stressful issues and assist the family
in identifying supports outside of the immediate family.
A 55-year-old Native American man seeks therapy for alcohol use issues at the urging
of his daughter. In developing a treatment plan, how should the therapist take into
consideration both his culture and his struggle with alcoholism?
A. Refer him to a substance abuse facility.
B. Ask how many friends in the Native American community he has.
C. Recommend that he enroll in a group for Native Americans dealing with alcoholism.
D. Consult his tribe in regard to how to treat this issue. - C. Recommend that he enroll in
a group for Native Americans dealing with alcoholism.
A 32-year-old woman who has been in treatment for five months goes through a major
crisis and calls the therapist many times during that period. After the crisis passes, the
client continues to call the therapist excessively. The therapist should:
A. Track the number of calls and confront the client.
B. Tell the client that you will only accept a certain number of calls.
C. Inform the client you will start billing them for phone calls.
D. Recommend the client meets with you more frequently because it is clear he needs
higher level of care. - A. Track the number of calls and confront the client.
Tracy, a 38-year-old corporate lawyer, and her 28-year-old wife, Jill, a musician, self-
refer for couples therapy. Tracy recently gave birth to a son with special needs. Tracy
states, "Jill doesn't understand my stress. I have to bill a certain number of hours or
there is no way I am going to make partner." She complains that Jill drinks and smokes
pot nightly and doesn't get out of bed all day. I can't trust her with our baby." Jill
responds, "You're the one who wanted the baby. Don't blame me for your child care
,problems while you keep working 15 hours a day." How should the therapist assess and
clinically manage potential child abuse based on the case described in the vignette?
A. Determine whether the couple can adequately care for the baby; Review parenting
skills modeled by their parents; Obtain a release to consult with the pediatrician.
B. Evaluate the current child care arrangements; Explore why Tracy can't - C. Evaluate
the current child care arrangements; Explore why Tracy can't trust Jill with the baby;
Process reactions to a possible child abuse report.
A therapist is moving offices. On the evening she is transporting some of her records,
her car is broken into and her records are stolen. How should the therapist initially deal
with this issue?
A. Determine which client files have been stolen.
B. Contact the therapist's clients and inform them of the situation.
C. File a police report.
D. Consult with a lawyer. - C. File a police report.
A 22-year-old client with Bipolar is referred by his psychiatrist for therapy. He shares
that he is currently living at home with his parents. During the third session he
expresses anger that his parents frequently tell him how to manage his life and argue
with each other about his treatment. How would a Systems therapist proceed in this
case?
A. Suggest that the therapist talk with his parents and obtain a release to speak to the
parents.
B. Explore how he's been dealing with it and encourage him to express his feelings to
his parents.
C. Acknowledge his anger and offer a family session to address the issues.
D. Explore his early relations with his parents to identify patterns to their behavior. - C.
Acknowledge his anger and offer a family session to address the issues.
Tonya, a 64-year-old self-employed real estate agent, is referred to therapy by her
neighbor. Tonya has been feeling "depressed and lonely" since her husband left her for
another woman six months ago. She shares that the she's been taking pain killers to
help her sleep and that most of the time she wishes she just wouldn't wake up. She
adds, "Now all I worry about is money and how I'm going to manage by myself. The only
thing that gives me satisfaction is planning my revenge on the two of them." Which of
the following issues in this case require immediate assessment?
A. Tonya's possible suicidality; Tonya's substance use; Possible danger to others
B. Severity of Tonya's symptoms; Tonya's level of suicidality; Socioeconomic stressors
C. Tonya's social support; Socioeconomic stressors; Tonya's substance use
D. Tonya's possible suicidality; Severity of Tonya's symptoms; Tonya's substance use -
A. Tonya's possible suicidality; Tonya's substance use; Possible danger to others
,A 29-year-old client reports having a history of relationship difficulties. He is currently in
a new relationship and shares that he gets angry when he is not in control of the
situation. He adds that he speaks to his mom on a daily basis and she is highly critical
of him. What intervention would a Cognitive therapist use in the middle phase of
treatment:
A. Explore the client's feelings toward the therapist and the history of the client's
relationship with his mother.
B. Assign homework to identify triggers to his anger.
C. Instruct client to limit contact with mother.
D. Confront the client's problematic automatic thought patterns. - B. Assign homework
to identify triggers to his anger.
Foster parents, Joan, age 37 and Melissa, age 40, are referred for therapy with their two
foster children, ages 4 and 6. The children were placed with them two weeks prior.
During the initial session the therapist notes that the foster parents do not interact very
much with the children. How should the therapist address this issue?
A. Suggest activities the parents can do with the children.
B. Acknowledge how difficult it is to be a foster parent.
C. Highlight when the parents interact with the children.
D. Refer them to a parent education class. - C. Highlight when the parents interact with
the children.
Kamal, a 14-year-old Iranian-American boy, is referred for therapy by his school
counselor. Parents, Emad and Darya, and younger sister Lila, age 9, attend the first
session with Kamal. Emad angrily complains that his son's grades have dropped over
the past few months and says, "He needs to shape up and stop spending so much time
alone in his room." Lila sits quietly close to her mother, nervously playing with her hair
and revealing a mark on her cheek. Kamal stares at the floor during the session and
appears uncomfortable when answering questions. At the end of the session, as the
family exits the office, Darya whispers, "I'm tired of the way my husband treats us, but I
don't know what to do." How would a Bowenian therapist incorporate human diversity
issues into the initial treatment plan based on the case described in the vignette?
A. Explore Emad's and Darya's beliefs about parenting and analyze how Darya's and -
D. Draw a family tree for both Darya's and Emad's families going back at least two
generations and explore Emad's and Darya's beliefs about parenting roles in their family
of origins.
A couple seeks treatment for communication issues and on-going conflict. If a therapist
was using a cognitive approach, what would be one focus of treatment?
A. Identifying how their pasts influence their understanding of each other.
B. Exploring how their patterns of engagement stem from their family of origin.
C. Identifying their underlying assumptions about each other and their relationship.
, D. Setting clear boundaries with their extended families. - C. Identifying their underlying
assumptions about each other and their relationship.
A therapist is hired as a supervisor at a residential treatment facility. During a
supervision session with one of the team members, the supervisee complains about
another team member's treatment of him. How should the supervisor address the
concern?
A. Tell the supervisee that the supervisor will watch out for the problem.
B. Encourage the supervisee to confront the team member.
C. Document the concern in the supervision notes.
D. Address the concerns to the team member in the next supervision. - B. Encourage
the supervisee to confront the team member.
Sheri, age 14, is brought in for therapy by her half-sister Kelly, age 28, who was given
legal custody following the death of Sheri's biological parents 7 months ago. Sheri has
been getting into trouble at school for cheating on exams, skipping class, and
threatening classmates. Kelly caught her sneaking a boy into her room over the
weekend and caught her smoking marijuana. Kelly states, "I just don't know what's
wrong with her. I'll pay for as many sessions as you need. My toddler keeps me busy
enough, I don't have time to deal with this!" Sheri angrily responds, "I wish I would have
died in the accident too." What crisis issues are presented in the case described in the
vignette?
A. Loss of parents; Substance use; Academic problems.
B. Academic problems; Sheri's possible suicidality; Family restructure.
C. Substance use; Sheri's potential for self-harm; Sheri's at-risk behavior.
D. Substance use; Lack of social su - C. Substance use; Sheri's potential for self-harm;
Sheri's at-risk behavior.
A 32 year-old single mother of two comes to therapy complaining of depression. She
reports difficulty sleeping, performance problems at her work, a contentious relationship
with her former husband, and frequent fights with both of her children, Jane, aged 9 and
William, aged 5. The therapist has worked with the client for three sessions and in each
session the client focuses on a new pressing issue. In the third session her children
take center stage and the client asks if the therapist will see her and her children
together as a family instead of continuing with individual sessions. What actions would a
Client Centered therapist take in response to this request?
A. Accept the client's decision as a way to empower her; Begin seeing the family as the
new treatment unit.
B. Ask the client to draw a diagram representing her family of origin; Suggest that she
continue with individual therapy and refer her to another the - C. Reflect on how the
client seems to have many topics that are all very important to her and express empathy
for how challenging this is for her; Suggest focusing on individual therapy for a few more
sessions.
Graded A+ 2025/2026
Brian, age 38, and his wife Melody, age 35, come in with their two children, Mark, age 9,
and Sara, age 6. Their insurance panel referred them after Melody's doctor encouraged
them to get therapy. Melody was diagnosed with cancer three years ago and recently
found out that it has come back in several areas in her body. Brian, an Army officer,
says, "We'll fight it like we did last time. We're fine." Melody cries and says, "I am
worried about my kids. Brian is deployed a lot and I worry about who will take care of
them if something happens to me. He doesn't want to deal with reality." Sara looks at
her mom with concern, starts crying, and says, "I'll take care of you mommy." Mark
stares at the floor, motionless. Brian asks about fees because of all the medical
expenses. How would a Systems therapist treat this family in the middle stage of
therapy?
A. Explore their patterns of interaction when they are dealing with s - A. Explore their
patterns of interaction when they are dealing with stressful issues and assist the family
in identifying supports outside of the immediate family.
A 55-year-old Native American man seeks therapy for alcohol use issues at the urging
of his daughter. In developing a treatment plan, how should the therapist take into
consideration both his culture and his struggle with alcoholism?
A. Refer him to a substance abuse facility.
B. Ask how many friends in the Native American community he has.
C. Recommend that he enroll in a group for Native Americans dealing with alcoholism.
D. Consult his tribe in regard to how to treat this issue. - C. Recommend that he enroll in
a group for Native Americans dealing with alcoholism.
A 32-year-old woman who has been in treatment for five months goes through a major
crisis and calls the therapist many times during that period. After the crisis passes, the
client continues to call the therapist excessively. The therapist should:
A. Track the number of calls and confront the client.
B. Tell the client that you will only accept a certain number of calls.
C. Inform the client you will start billing them for phone calls.
D. Recommend the client meets with you more frequently because it is clear he needs
higher level of care. - A. Track the number of calls and confront the client.
Tracy, a 38-year-old corporate lawyer, and her 28-year-old wife, Jill, a musician, self-
refer for couples therapy. Tracy recently gave birth to a son with special needs. Tracy
states, "Jill doesn't understand my stress. I have to bill a certain number of hours or
there is no way I am going to make partner." She complains that Jill drinks and smokes
pot nightly and doesn't get out of bed all day. I can't trust her with our baby." Jill
responds, "You're the one who wanted the baby. Don't blame me for your child care
,problems while you keep working 15 hours a day." How should the therapist assess and
clinically manage potential child abuse based on the case described in the vignette?
A. Determine whether the couple can adequately care for the baby; Review parenting
skills modeled by their parents; Obtain a release to consult with the pediatrician.
B. Evaluate the current child care arrangements; Explore why Tracy can't - C. Evaluate
the current child care arrangements; Explore why Tracy can't trust Jill with the baby;
Process reactions to a possible child abuse report.
A therapist is moving offices. On the evening she is transporting some of her records,
her car is broken into and her records are stolen. How should the therapist initially deal
with this issue?
A. Determine which client files have been stolen.
B. Contact the therapist's clients and inform them of the situation.
C. File a police report.
D. Consult with a lawyer. - C. File a police report.
A 22-year-old client with Bipolar is referred by his psychiatrist for therapy. He shares
that he is currently living at home with his parents. During the third session he
expresses anger that his parents frequently tell him how to manage his life and argue
with each other about his treatment. How would a Systems therapist proceed in this
case?
A. Suggest that the therapist talk with his parents and obtain a release to speak to the
parents.
B. Explore how he's been dealing with it and encourage him to express his feelings to
his parents.
C. Acknowledge his anger and offer a family session to address the issues.
D. Explore his early relations with his parents to identify patterns to their behavior. - C.
Acknowledge his anger and offer a family session to address the issues.
Tonya, a 64-year-old self-employed real estate agent, is referred to therapy by her
neighbor. Tonya has been feeling "depressed and lonely" since her husband left her for
another woman six months ago. She shares that the she's been taking pain killers to
help her sleep and that most of the time she wishes she just wouldn't wake up. She
adds, "Now all I worry about is money and how I'm going to manage by myself. The only
thing that gives me satisfaction is planning my revenge on the two of them." Which of
the following issues in this case require immediate assessment?
A. Tonya's possible suicidality; Tonya's substance use; Possible danger to others
B. Severity of Tonya's symptoms; Tonya's level of suicidality; Socioeconomic stressors
C. Tonya's social support; Socioeconomic stressors; Tonya's substance use
D. Tonya's possible suicidality; Severity of Tonya's symptoms; Tonya's substance use -
A. Tonya's possible suicidality; Tonya's substance use; Possible danger to others
,A 29-year-old client reports having a history of relationship difficulties. He is currently in
a new relationship and shares that he gets angry when he is not in control of the
situation. He adds that he speaks to his mom on a daily basis and she is highly critical
of him. What intervention would a Cognitive therapist use in the middle phase of
treatment:
A. Explore the client's feelings toward the therapist and the history of the client's
relationship with his mother.
B. Assign homework to identify triggers to his anger.
C. Instruct client to limit contact with mother.
D. Confront the client's problematic automatic thought patterns. - B. Assign homework
to identify triggers to his anger.
Foster parents, Joan, age 37 and Melissa, age 40, are referred for therapy with their two
foster children, ages 4 and 6. The children were placed with them two weeks prior.
During the initial session the therapist notes that the foster parents do not interact very
much with the children. How should the therapist address this issue?
A. Suggest activities the parents can do with the children.
B. Acknowledge how difficult it is to be a foster parent.
C. Highlight when the parents interact with the children.
D. Refer them to a parent education class. - C. Highlight when the parents interact with
the children.
Kamal, a 14-year-old Iranian-American boy, is referred for therapy by his school
counselor. Parents, Emad and Darya, and younger sister Lila, age 9, attend the first
session with Kamal. Emad angrily complains that his son's grades have dropped over
the past few months and says, "He needs to shape up and stop spending so much time
alone in his room." Lila sits quietly close to her mother, nervously playing with her hair
and revealing a mark on her cheek. Kamal stares at the floor during the session and
appears uncomfortable when answering questions. At the end of the session, as the
family exits the office, Darya whispers, "I'm tired of the way my husband treats us, but I
don't know what to do." How would a Bowenian therapist incorporate human diversity
issues into the initial treatment plan based on the case described in the vignette?
A. Explore Emad's and Darya's beliefs about parenting and analyze how Darya's and -
D. Draw a family tree for both Darya's and Emad's families going back at least two
generations and explore Emad's and Darya's beliefs about parenting roles in their family
of origins.
A couple seeks treatment for communication issues and on-going conflict. If a therapist
was using a cognitive approach, what would be one focus of treatment?
A. Identifying how their pasts influence their understanding of each other.
B. Exploring how their patterns of engagement stem from their family of origin.
C. Identifying their underlying assumptions about each other and their relationship.
, D. Setting clear boundaries with their extended families. - C. Identifying their underlying
assumptions about each other and their relationship.
A therapist is hired as a supervisor at a residential treatment facility. During a
supervision session with one of the team members, the supervisee complains about
another team member's treatment of him. How should the supervisor address the
concern?
A. Tell the supervisee that the supervisor will watch out for the problem.
B. Encourage the supervisee to confront the team member.
C. Document the concern in the supervision notes.
D. Address the concerns to the team member in the next supervision. - B. Encourage
the supervisee to confront the team member.
Sheri, age 14, is brought in for therapy by her half-sister Kelly, age 28, who was given
legal custody following the death of Sheri's biological parents 7 months ago. Sheri has
been getting into trouble at school for cheating on exams, skipping class, and
threatening classmates. Kelly caught her sneaking a boy into her room over the
weekend and caught her smoking marijuana. Kelly states, "I just don't know what's
wrong with her. I'll pay for as many sessions as you need. My toddler keeps me busy
enough, I don't have time to deal with this!" Sheri angrily responds, "I wish I would have
died in the accident too." What crisis issues are presented in the case described in the
vignette?
A. Loss of parents; Substance use; Academic problems.
B. Academic problems; Sheri's possible suicidality; Family restructure.
C. Substance use; Sheri's potential for self-harm; Sheri's at-risk behavior.
D. Substance use; Lack of social su - C. Substance use; Sheri's potential for self-harm;
Sheri's at-risk behavior.
A 32 year-old single mother of two comes to therapy complaining of depression. She
reports difficulty sleeping, performance problems at her work, a contentious relationship
with her former husband, and frequent fights with both of her children, Jane, aged 9 and
William, aged 5. The therapist has worked with the client for three sessions and in each
session the client focuses on a new pressing issue. In the third session her children
take center stage and the client asks if the therapist will see her and her children
together as a family instead of continuing with individual sessions. What actions would a
Client Centered therapist take in response to this request?
A. Accept the client's decision as a way to empower her; Begin seeing the family as the
new treatment unit.
B. Ask the client to draw a diagram representing her family of origin; Suggest that she
continue with individual therapy and refer her to another the - C. Reflect on how the
client seems to have many topics that are all very important to her and express empathy
for how challenging this is for her; Suggest focusing on individual therapy for a few more
sessions.
