You have been working with a family that reported their son's Case Manager is insisting
that the child begin In-Home Family Skills Therapy to better help manage and regulate his
behaviors. As their Family Therapist, you believe that the family is already getting their
family needs met with outpatient therapy, and that redundant services may not benefit—
and even, potentially harm-the son.
What would be the best next step as a family therapist?
a. Defer to your client's Case Manager as their specialty is in finding resources to meet the
needs of their clients.
b. Consult with the Case Manager in an effort to reach a collaborative decision between the
two professionals involved in the case.
c. Act within the best interests of your client.
d. Provide your clinical opinion to the parents and let them decide which recommendation
sounds more appropriate.
ANSWER
b. Consult with the Case Manager in an effort to reach a collaborative decision between the
two professionals involved in the case.
This would be best practice given the options as it resolves the issue in answer a. by consult-
ing with the case manager and is more specific than answer c.
At the onset of a family intake interview, the mother of the family informs you that the hus-
band decided to work late and will not be attending the first session.
A family therapist would be LEAST LIKELY to:
1
,a. Move along with the intake interview as scheduled and contact the father prior to the
next meeting to let him know what was discussed, encouraging his future participation.
b. Move along with the intake interview as scheduled but establish a rule that no one can
talk about Dad given his absence in an effort to maintain neutrality.
c. Inform the family that the intake interview must be rescheduled for a time that Dad can
be present and send them home for the evening.
d. Move along with the intake interview and assess for any potential metaphoric meaning
behind Dad's absence.
ANSWER
b. Move along with the intake interview as scheduled but establish a rule that no one can
talk about Dad given his absence in an effort to maintain neutrality.
It would not be a systemic assessment if the family was not able to discuss the role that a vi-
tal member plays in its functioning. This contradicts systems theory. Do not get tempted by
the statement regarding maintaining neutrality. There are ways in which you could still meet
the family and maintaining neutrality moving forward.
During a family intake interview, the mother quickly begins to detail the issues of each mem-
ber of the family and how the therapist should help them to change their "disappointing
qualities." The rest of the family sat quietly as Mom continued.
A marital and family therapist would be LEAST LIKELY to:
a. Validate Mom's frustrations through the use of reflective language and empathic under-
standing.
b. Ask Dad how he thinks his son experienced and interpreted Mom's disclosures.
c. Assess that Mom is reacting to Dad's authority over the family.
d. Ask Mom to describe in greater detail how she suggests that the Family Therapist can best
go about changing the behavior of everyone else in the family.
ANSWER
c. Assess that Mom is reacting to Dad's authority over the family.
2
, Based on the information provided, it suggests Dad has been passive throughout the inter-
view. There is no evidence that suggest Dad as having any authority over the family.
When meeting with a couple that has been in ongoing therapy, the husband begins pro-
cessing in moderate frustration that his wife is too emotional, and that it is exhausting for
him to keep up with her fluctuating moods and constant reactivity. He declares that every-
thing in their relationship would be fine if she were only less emotional. The Family Thera-
pist suggests that he gets his wife medicated, describing that a strong enough prescription
has the potential to result in her experiencing virtually no range of affect what
This intervention can be described as:
a. An effective use of positioning.
b. Unethical, as recommending prescription medication is beyond the scope of a Family
Therapist's competency and training.
c. A paradoxical intervention.
d. The therapist intentionally aligning with the husband in an attempt to detriangulate the
couple system.
ANSWER
a. An effective use of positioning.
This would be an appropriate intervention to use when practicing from a Strategic/MRI Sys-
temic orientation. It is pushing the husband deeper and deeper into the absurdity of his re-
quest. This is a fun one--I use it often when working with couples as this a common com-
plaint. Remember, positioning is most effective when there is a healthy therapeutic relation-
ship.
When working with a couple in the earlier phases of treatment, the therapist recognizes a
profound difficulty for them to engage in non-reactive dialogue. The Marital & Family Thera-
pist instructs the couple that for the rest of the session, they may only talk directly to the
therapist, and never directly to one another.
This intervention best fits with the following model of family therapy:
3
that the child begin In-Home Family Skills Therapy to better help manage and regulate his
behaviors. As their Family Therapist, you believe that the family is already getting their
family needs met with outpatient therapy, and that redundant services may not benefit—
and even, potentially harm-the son.
What would be the best next step as a family therapist?
a. Defer to your client's Case Manager as their specialty is in finding resources to meet the
needs of their clients.
b. Consult with the Case Manager in an effort to reach a collaborative decision between the
two professionals involved in the case.
c. Act within the best interests of your client.
d. Provide your clinical opinion to the parents and let them decide which recommendation
sounds more appropriate.
ANSWER
b. Consult with the Case Manager in an effort to reach a collaborative decision between the
two professionals involved in the case.
This would be best practice given the options as it resolves the issue in answer a. by consult-
ing with the case manager and is more specific than answer c.
At the onset of a family intake interview, the mother of the family informs you that the hus-
band decided to work late and will not be attending the first session.
A family therapist would be LEAST LIKELY to:
1
,a. Move along with the intake interview as scheduled and contact the father prior to the
next meeting to let him know what was discussed, encouraging his future participation.
b. Move along with the intake interview as scheduled but establish a rule that no one can
talk about Dad given his absence in an effort to maintain neutrality.
c. Inform the family that the intake interview must be rescheduled for a time that Dad can
be present and send them home for the evening.
d. Move along with the intake interview and assess for any potential metaphoric meaning
behind Dad's absence.
ANSWER
b. Move along with the intake interview as scheduled but establish a rule that no one can
talk about Dad given his absence in an effort to maintain neutrality.
It would not be a systemic assessment if the family was not able to discuss the role that a vi-
tal member plays in its functioning. This contradicts systems theory. Do not get tempted by
the statement regarding maintaining neutrality. There are ways in which you could still meet
the family and maintaining neutrality moving forward.
During a family intake interview, the mother quickly begins to detail the issues of each mem-
ber of the family and how the therapist should help them to change their "disappointing
qualities." The rest of the family sat quietly as Mom continued.
A marital and family therapist would be LEAST LIKELY to:
a. Validate Mom's frustrations through the use of reflective language and empathic under-
standing.
b. Ask Dad how he thinks his son experienced and interpreted Mom's disclosures.
c. Assess that Mom is reacting to Dad's authority over the family.
d. Ask Mom to describe in greater detail how she suggests that the Family Therapist can best
go about changing the behavior of everyone else in the family.
ANSWER
c. Assess that Mom is reacting to Dad's authority over the family.
2
, Based on the information provided, it suggests Dad has been passive throughout the inter-
view. There is no evidence that suggest Dad as having any authority over the family.
When meeting with a couple that has been in ongoing therapy, the husband begins pro-
cessing in moderate frustration that his wife is too emotional, and that it is exhausting for
him to keep up with her fluctuating moods and constant reactivity. He declares that every-
thing in their relationship would be fine if she were only less emotional. The Family Thera-
pist suggests that he gets his wife medicated, describing that a strong enough prescription
has the potential to result in her experiencing virtually no range of affect what
This intervention can be described as:
a. An effective use of positioning.
b. Unethical, as recommending prescription medication is beyond the scope of a Family
Therapist's competency and training.
c. A paradoxical intervention.
d. The therapist intentionally aligning with the husband in an attempt to detriangulate the
couple system.
ANSWER
a. An effective use of positioning.
This would be an appropriate intervention to use when practicing from a Strategic/MRI Sys-
temic orientation. It is pushing the husband deeper and deeper into the absurdity of his re-
quest. This is a fun one--I use it often when working with couples as this a common com-
plaint. Remember, positioning is most effective when there is a healthy therapeutic relation-
ship.
When working with a couple in the earlier phases of treatment, the therapist recognizes a
profound difficulty for them to engage in non-reactive dialogue. The Marital & Family Thera-
pist instructs the couple that for the rest of the session, they may only talk directly to the
therapist, and never directly to one another.
This intervention best fits with the following model of family therapy:
3
