Theories for the CA LMFT Clinical Exam Questions with Correct Answers Graded A+
Dialectical Behavioral Therapy - Answers Change happens through (1) mindfulness, (2) developing skills
to manage distress tolerance and emotional regulation, and (3) improving interpersonal problem solving
skills.
DBT goal - Answers For the client to improve their emotional and cognitive regulation.
Mindfulness - Answers To practice being fully aware and present in this one moment.
Distress Tolerance - Answers How to tolerate pain in difficult situations, not change it.
Interpersonal Effectiveness - Answers How to ask for what you want and say no while maintaining self-
respect and relationships with others.
Emotional Regulation - Answers How to change emotions that you want to change.
DBT The 5 Key Concepts - Answers Mindfulness
Distress Tolerance
Interpersonal Effectiveness
Emotional Regulation
Homework
Reality Therapy - Answers Change occurs through identifying and meeting needs as well as developing
satisfying interpersonal relationships.
Reality Goals - Answers (1) Client to learn more effective ways of meeting their needs, (2) Engage in self
evaluation, (3) Gain a sense of inner control over their lives, and (4) learn to change what they do as a
key to changing how they feel and getting what they want.
Reality is based on what? - Answers Choice Theory which asserts that each of us is a self determining
being who can choose future behaviors and hold ourselves consciously responsible for how we are
acting, thinking, feeling, and also for our physiological states.
Reality Needs - Answers Love/Belonging, power/achievement, freedom, fun/relaxation, survival
Reality interventions - Answers Focus on where the client has choices, Focus on Present (avoid
discussions on past problems/symptoms), Challenge the Client (examine their own behavior), Explore
(wants/needs/perceptions), Doing and Directing, discuss feelings on relation to behaviors/choices, Teach
Self Evaluation (Does present behavior have a reasonable change of getting you what you want?),
Formulate Action Plan (Focus on positive/attainable steps), Adjust plan as needed, use humor
,Cognitive Behavioral Therapy - Answers Change occurs by learning to modify dysfunctional thought
patterns. Teaching the relationships between thoughts, feelings, and behaviors so client is able to
modify/change the patterns of thinking to cope with stressors.
CBT treatment goals - Answers Patients learn to recognize negative patterns of thought, evaluate their
validity, and replace with healthier ways of thinking. Development of cognitive coping skills.
Negative Cognitive Triad - Answers negative thoughts about the self ("me"), the world ("everyone"), and
the future ("future").
Automatic Thoughts - Answers Thoughts about ourselves or others that individuals are often not aware
of and thus are not assessed for accuracy or relevancy.
Schemas - Answers A network of rules or templates for information processing that are shaped by
developmental influences and other life experiences. These rules dictate how individuals think about
and interpret the world and play a role in regulating self-worth and coping skills.
Overgeneralization - Answers Single negative event is seen as a never-ending pattern of defeat. One
mistake leads to "I never do anything right."
Arbitrary Inference - Answers Cognitive distortion that leads to drawing conclusions without evidence or
facts to support those conclusions.
Selective Abstraction - Answers Attending to a small detail while ignoring the total context. Taking detail
out of context and missing the totality of the situation.
Socratic Questioning - Answers Questioning allows the therapist to stimulate the
client's self-awareness, focus in on the problem definition, expose the client's
belief system, and challenge irrational beliefs.
Reframing - Answers Thinking differently by "reframing" negative or untrue assumptions and thoughts
into ones that promote adaptive behavior and lessen anxiety and depression.
Cognitive Restructuring - Answers Teaches client to identify irrational, distorted, or maladaptive beliefs,
question the evidence for the belief, and generate alternative responses.
Self-monitoring - Answers Also called diary work, record the amount and degree of thoughts and
behaviors. This provides the client and the therapist information regarding the degrees of a client's
negative affirmations.
Behavioral Experiments - Answers The experiment process includes experiencing,
observing, reflecting, and planning. These steps are conducted through thought testing, discovery,
activity, and/or observation.
, Systematic Desensitization - Answers Pairs relaxation with exposure to something stressful. Client are
taught to relax in anxiety producing situations.
Anxiety Management Training - Answers Teaches skills for specific situations using imagery. The client
practices relaxation until anxiety is reduced then continues with imagery.
Assertiveness Training - Answers Teaches client to specify desires and needs using minimally effective
responses to assert their position. Used with unassertive and overly aggressive clients.
Behavioral Activation - Answers Increases activity for depressed or passive clients by using activity
scheduling and incentives.
Communication Skills Training - Answers Used in couples therapy to help couples talk about feelings and
problems.
Downward Arrow - Answers Used to uncover underlying assumptions, "If this is true, what does it mean
about you and your life?"
Exposure - Answers Client faces fear stimuli without resorting to escape or avoidance maneuvers. Can
be done in real life or with imagery.
Finding Alternatives - Answers Clients review all possible options for either interpreting a situation or
resolving a problem.
Labeling Distortions - Answers Teaches client to recognize label particular distortions in thinking that can
lead to problems with interpretations of events.
Mastery / Pleasure Ratings - Answers Client use activity chart and rates mastery or pleasure they derive
from activity.
Opposite Action - Answers Client is encouraged to engage in behavior that is counterintuitive or
opposite to what she or he may feel at time (i.e. when feeling very mad say something kind).
Problem - Solving Training - Answers Teaches a step approach of orienting to the problem, problem
definition, generation of alternatives, decision making and solution implementation and verification of
results.
Relaxation Training - Answers Teaches client to relax muscles to condition a relaxation response to
counter tension. Uses imagery, music and other stimuli to assist in acquiring response.
Successive Approximation - Answers Client and therapist collaborate in developing a plan for the client
to engage in steps that approximate an ultimate goal, to allow the client to have success at each step
along the way to the goal.
Three Column Technique - Answers Client collects automatic thoughts and lists the situations in which
the thought occurred, the automatic thought, and the associated feelings.
Dialectical Behavioral Therapy - Answers Change happens through (1) mindfulness, (2) developing skills
to manage distress tolerance and emotional regulation, and (3) improving interpersonal problem solving
skills.
DBT goal - Answers For the client to improve their emotional and cognitive regulation.
Mindfulness - Answers To practice being fully aware and present in this one moment.
Distress Tolerance - Answers How to tolerate pain in difficult situations, not change it.
Interpersonal Effectiveness - Answers How to ask for what you want and say no while maintaining self-
respect and relationships with others.
Emotional Regulation - Answers How to change emotions that you want to change.
DBT The 5 Key Concepts - Answers Mindfulness
Distress Tolerance
Interpersonal Effectiveness
Emotional Regulation
Homework
Reality Therapy - Answers Change occurs through identifying and meeting needs as well as developing
satisfying interpersonal relationships.
Reality Goals - Answers (1) Client to learn more effective ways of meeting their needs, (2) Engage in self
evaluation, (3) Gain a sense of inner control over their lives, and (4) learn to change what they do as a
key to changing how they feel and getting what they want.
Reality is based on what? - Answers Choice Theory which asserts that each of us is a self determining
being who can choose future behaviors and hold ourselves consciously responsible for how we are
acting, thinking, feeling, and also for our physiological states.
Reality Needs - Answers Love/Belonging, power/achievement, freedom, fun/relaxation, survival
Reality interventions - Answers Focus on where the client has choices, Focus on Present (avoid
discussions on past problems/symptoms), Challenge the Client (examine their own behavior), Explore
(wants/needs/perceptions), Doing and Directing, discuss feelings on relation to behaviors/choices, Teach
Self Evaluation (Does present behavior have a reasonable change of getting you what you want?),
Formulate Action Plan (Focus on positive/attainable steps), Adjust plan as needed, use humor
,Cognitive Behavioral Therapy - Answers Change occurs by learning to modify dysfunctional thought
patterns. Teaching the relationships between thoughts, feelings, and behaviors so client is able to
modify/change the patterns of thinking to cope with stressors.
CBT treatment goals - Answers Patients learn to recognize negative patterns of thought, evaluate their
validity, and replace with healthier ways of thinking. Development of cognitive coping skills.
Negative Cognitive Triad - Answers negative thoughts about the self ("me"), the world ("everyone"), and
the future ("future").
Automatic Thoughts - Answers Thoughts about ourselves or others that individuals are often not aware
of and thus are not assessed for accuracy or relevancy.
Schemas - Answers A network of rules or templates for information processing that are shaped by
developmental influences and other life experiences. These rules dictate how individuals think about
and interpret the world and play a role in regulating self-worth and coping skills.
Overgeneralization - Answers Single negative event is seen as a never-ending pattern of defeat. One
mistake leads to "I never do anything right."
Arbitrary Inference - Answers Cognitive distortion that leads to drawing conclusions without evidence or
facts to support those conclusions.
Selective Abstraction - Answers Attending to a small detail while ignoring the total context. Taking detail
out of context and missing the totality of the situation.
Socratic Questioning - Answers Questioning allows the therapist to stimulate the
client's self-awareness, focus in on the problem definition, expose the client's
belief system, and challenge irrational beliefs.
Reframing - Answers Thinking differently by "reframing" negative or untrue assumptions and thoughts
into ones that promote adaptive behavior and lessen anxiety and depression.
Cognitive Restructuring - Answers Teaches client to identify irrational, distorted, or maladaptive beliefs,
question the evidence for the belief, and generate alternative responses.
Self-monitoring - Answers Also called diary work, record the amount and degree of thoughts and
behaviors. This provides the client and the therapist information regarding the degrees of a client's
negative affirmations.
Behavioral Experiments - Answers The experiment process includes experiencing,
observing, reflecting, and planning. These steps are conducted through thought testing, discovery,
activity, and/or observation.
, Systematic Desensitization - Answers Pairs relaxation with exposure to something stressful. Client are
taught to relax in anxiety producing situations.
Anxiety Management Training - Answers Teaches skills for specific situations using imagery. The client
practices relaxation until anxiety is reduced then continues with imagery.
Assertiveness Training - Answers Teaches client to specify desires and needs using minimally effective
responses to assert their position. Used with unassertive and overly aggressive clients.
Behavioral Activation - Answers Increases activity for depressed or passive clients by using activity
scheduling and incentives.
Communication Skills Training - Answers Used in couples therapy to help couples talk about feelings and
problems.
Downward Arrow - Answers Used to uncover underlying assumptions, "If this is true, what does it mean
about you and your life?"
Exposure - Answers Client faces fear stimuli without resorting to escape or avoidance maneuvers. Can
be done in real life or with imagery.
Finding Alternatives - Answers Clients review all possible options for either interpreting a situation or
resolving a problem.
Labeling Distortions - Answers Teaches client to recognize label particular distortions in thinking that can
lead to problems with interpretations of events.
Mastery / Pleasure Ratings - Answers Client use activity chart and rates mastery or pleasure they derive
from activity.
Opposite Action - Answers Client is encouraged to engage in behavior that is counterintuitive or
opposite to what she or he may feel at time (i.e. when feeling very mad say something kind).
Problem - Solving Training - Answers Teaches a step approach of orienting to the problem, problem
definition, generation of alternatives, decision making and solution implementation and verification of
results.
Relaxation Training - Answers Teaches client to relax muscles to condition a relaxation response to
counter tension. Uses imagery, music and other stimuli to assist in acquiring response.
Successive Approximation - Answers Client and therapist collaborate in developing a plan for the client
to engage in steps that approximate an ultimate goal, to allow the client to have success at each step
along the way to the goal.
Three Column Technique - Answers Client collects automatic thoughts and lists the situations in which
the thought occurred, the automatic thought, and the associated feelings.
