ENG 1302 MFT Practice Set Exam Question Questions And Answers Available Year:

ENG 1302 MFT Practice Set Exam Question Questions And Answers Available Year: A young woman comes to therapy alone. She has been dating a man for almost a year and they recently began having sexual relations. Although the woman is sexually aroused during intercourse, she is unable to achieve orgasm through either intercourse or clitoral stimulation. The woman says that, while this is her first experience with intercourse, she has masturbated to orgasm several times. In treating the woman a therapist using Masters and Johnson's approach to sex therapy is most likely to recommend that the woman use which of the following techniques? Select one: a. The bridge technique b. The stop-start technique c. Sensate focus d. The squeeze technique - answerAlthough many questions that ask you to choose an intervention are "best answer" questions, this is a "one-correct-answer" question because Masters and Johnson suggest specific procedures for treating each sexual dysfunction.Answer C is correct: In treating secondary Orgasmic Disorder, Masters and Johnson emphasize the sexual value system and recommend giving the couple permission to be sexual, using sensate focus with constant communication of likes and dislikes to the partner, genital play, penile containment without thrusting, and, finally, coitus.Answer A is incorrect: Be careful: this is associated with Kaplan's treatment for secondary Orgasmic Disorder.Answer B is incorrect: This is associated with Kaplan's treatment for Premature Ejaculation.Answer D is incorrect: This technique is associated with Masters and Johnson, but is used to treat male sexual dysfunction, such as Premature Ejaculation. The correct answer is: Sensate focus Based on the initial evaluation of a 15-year-old boy, a clinician believes the nature and number of his symptoms suggest a DSM-5 diagnosis of Attention-Deficit or Hyperactivity Disorder, predominantly inattentive presentation. Before assigning the diagnosis, the clinician will want to confirm that some symptoms were present before the boy was years of age and that he exhibits them in at least settings. Select one: a. 7; 2 b. 12; 2 c. 6; 3 d. 10; 3 - answerAnswer B is correct: For a diagnosis of ADHD, the DSM-5 requires that "several inattentive or hyperactive-impulsive symptoms were present prior to age 12" (p. 60) and that symptoms are present in at least two settings. Answer A is incorrect: This answer describes the DSM-IV-TR requirements for the diagnosis. The correct answer is: 12; 2 Bipolar I Disorder is distinguished from Bipolar II Disorder by the presence of which kind of episode? Select one: a. Manic episode b. Psychotic episode c. Mixed episode d. Depressed episode - answerThis is another straightforward recall question about diagnosis.Answer A is correct: The presence of a manic episode rules out Bipolar II Disorder. The criteria for diagnosing Bipolar I Disorder include one or more manic episodes.Answer B is incorrect: With psychotic features is a specifier for Bipolar I Disorder, but psychotic episodes are not one of the types of episodes associated with the Bipolar Disorders. The correct answer is: Manic episode Charles and Martha bring their two children to therapy. The parents are concerned with how disrespectful the youngest child is to the mother. Whenever she tries to discipline him, he engages in name-calling and has threatened violence. The therapist asks the mother to recall a recent event that occurred and notes that the husband rolls his eyes and looks away as she begins to speak. When the therapist calls attention to the husband's response, the youngest child immediately lashes out at his mother. A structural therapist would view this interaction as: Select one: a. Conflict-detouring. b. Reciprocal inhibition. c. Equifinality. d. Nonsummativity. - answerAnswer A is correct: Conflict-detouring occurs when conflict from one subsystem is detoured to another subsystem. This is often what is occurring in situations where there is a family scapegoat. Reciprocal inhibition is a Behavioral Family therapy term that describes the pairing of responses that are incompatible with anxiety to the previously anxiety-producing stimuli (e.g. systematic desensitization) (B). Equifinality means that the same results may arise from different origins. For example, an inhibited child may develop from experiences of physical abuse or emotional abuse (C). Nonsummativity is the concept that a system cannot by analyzed by isolated segments: "The whole is greater than the sum of its parts" (D). The correct answer is: Conflict-detouring. Cindy and Tom Thomas come to counseling with their 6-year-old son, Michael, who was adopted from a Romanian orphanage three years ago. Michael has been slow to learn English, is behind at school, and often doesn't seem focused or socially engaged. Cindy and Tom tell you they often fight about Michael and Tom says, "I think that Cindy spoils him and now he doesn't want to do anything himself." Your next step would be to: Select one: a. Refer Michael for psychological and psychiatric testing. b. Refer Cindy and Tom to a parenting class. c. Normalize Michael's cultural adjustment process. d. Get a release to speak with his teacher. - answerAnswer A is correct: It is important to refer Michael for a psychological and psychiatric evaluation. Because Michael's prenatal and first three years of care are questionable, it cannot be assumed that his problems are acculturation issues or weak parenting. In recent years there have been many couples who have been stunned to find children who were adopted from abroad were not properly cared for during their formative years and permanent cognitive deficits have been the result. Russian and Romanian adoptions have been under specific scrutiny in this regard. Referring Cindy and Tom to a parenting class would not address any possible existing organic or psychological problems. Because Michael's prenatal and first three years of care are questionable, it cannot be assumed that his problems are strictly the result of trial and error parenting attempts (B). Helping to normalize Michael's bicultural adjustment for his parents is not enough in this case (C). Getting a release to speak with Michael's teacher might be somewhat helpful, but it doesn't address the possible organic problems this child may be having as a result of prenatal or early neglect or abuse (D). The correct answer is: Refer Michael for psychological and psychiatric testing. Clementine, an 18-year-old high school senior, is referred for therapy by her physician. She went to see her doctor due to constipation and menstrual irregularity. Though slightly underweight, Clementine talks excessively about being fat and unattractive. When prompted by the MFT, she admits to thinking that food is a "tyrant" in her life. She also discloses that she sometimes "gorges on food" to a point where she feels sick and throws up, but is quick to add that she does this no more than a couple of times a week. Based on this information, the most likely diagnosis for Clementine is: Select one: a. Anorexia Nervosa, binge eating or purging type. b. Bulimia Nervosa. c. Major Depressive Disorder with atypical features. d. Body Dysmorphic Disorder. - answerThe information presented in this question suggests that Clementine has an eating disorder.Answer A is incorrect: Anorexia and Bulimia share some features (e.g., disturbed body image), but a person with Anorexia refuses to maintain weight over a minimal normal level for her height and age.Answer B is correct: The primary clue indicating that Clementine has Bulimia, rather than Anorexia, is that she is only slightly underweight. Other signs of Bulimia include her lack of control over eating ("food is a tyrant"); her preoccupation with her body shape and weight; and her gorging on food and vomiting. Finally, menstrual irregularity (and even amenorrhea) occurs in some females with Bulimia and constipation can develop in individuals who chronically abuse laxatives.Answer C is incorrect: Major Depressive Disorder with atypical features often includes overeating, but Clementine is not exhibiting other symptoms of depression.Answer D is incorrect: You can rule this out since Clementine clearly seems to have an eating disorder. The essential feature of Body Dysmorphic Disorder is a preoccupation with an imagined or minor physical flaw. The correct answer is: Bulimia Nervosa. During an initial interview with a patient who was recently admitted to the hospital, a therapist finds that the patient tends to take an unusually long time to answer questions because he spends a lot of time providing minute details and making parenthetical comments. However, the patient doesn't seem to lose track of the point he is trying to make and usually ends up answering the questions. The man's speech pattern is best described by which of the following terms? Select one: a. Loosening of associations b. Circumstantiality c. Confabulation d. Flight of ideas - answerA key feature of this person's speech is that he does not lose the original point.Answer B is correct: The man's speech pattern illustrates circumstantiality. His speech wanders somewhat but he continues to be aware of the original point.Answer A is incorrect: Loosening of associations involves incoherent, rambling speech and loss of the original point.Answer C is incorrect: Confabulation involves the fabrication of details or events in order to fill in information gaps resulting from memory loss.Answer D is incorrect: Flight of ideas involves a nearly continuous flow of rapid speech with abrupt changes from one topic to another. The correct answer is: Circumstantiality During your first session, a new client tells you that she sometimes gets very light-headed and "shaky" and that, during these periods, she has an impending sense of doom and feels like she's going to die. She says these feelings "come and go" and don't seem to be related to anything she's doing at the time. A representative from her insurance company calls a few days after this session and requests a diagnosis. He says the company will not reimburse for the session unless it receives a diagnosis with the first billing. You generally do not like to assign a diagnosis without doing a complete assessment, but you want to get paid. Therefore, you hazard an "educated guess" and assign which of the following diagnoses? Select one: a. Panic Disorder b. Generalized Anxiety Disorder c. Schizoid Personality Disorder d. Schizophreniform Disorder - answerThis vignette does not offer much in terms of symptoms, so you have to do the best you can to arrive at a tentative diagnosis. Many questions on the MFT exam will not list the full criteria for a diagnosis but will, instead, only hint at the probable diagnosis.Answer A is correct: Panic Disorder requires the occurrence of at least two unexpected panic attacks that include physical symptoms (e.g., light headednes) and cognitive symptoms (fear of dying).Answer B is incorrect: Generalized Anxiety Disorder (GAD) is characterized by excessive anxiety and worry about multiple events. It is not associated with an impending sense of doom or fear of dying.Answer C is incorrect: Schizoid Personality Disorder does not involve the symptoms described in the question.Answer D is incorrect: Schizophreniform Disorder does not fit the clinical picture described here. The correct answer is: Panic Disorder During your first session with Mr. and Mrs. Desvelo, Mr. Desvelo says his wife has insisted that he get "some help" with his sleep problems. Mrs. Desvelo states that she's awakened by his frightening screams at least once a week, usually a few hours after they go to sleep, and that this is having a negative effect on her mood and their relationship. Mr. Desvelo has no history of trauma or substance abuse, and he says he recently had a physical and his health is good. In response to your questions, Mrs. Desvelo tells you that her husband sometimes wakes up when he screams and seems agitated but usually goes right back to sleep and doesn't respond to her attempts to calm him; and Mr. Desvelo says that, in the morning, he has no memory of the episode and usually can't recall having had any dreams. Mr. Desvelo's symptoms are most suggestive of which of the following DSM-5 diagnoses? Select one: a. Nightmare Disorder b. Sleep Terror Disorder c. Rapid Eye Movement Sleep Behavior Disorder d. Non-Rapid Eye Movement Sleep Arousal Disorder - answerAnswer D is correct: A person with Non- Rapid Eye Movement Sleep Arousal Disorder, sleep terror type experiences sleep terror episodes that are usually accompanied by a panicky scream. The person shows signs of autonomic arousal, usually does not fully awaken, is unresponsive to the efforts of others to comfort him/her, rarely remembers any dreams he/she may have had, and has amnesia for the episode on awakening in the morning. Answer A is incorrect: A person with Nightmare Disorder awakens easily and completely and reports having had a vivid dream involving a threat to survival or security. Answer B is incorrect: Sleep Terror Disorder and Sleepwalking Disorder were separate diagnoses in DSM- IV-TR but are included in the DSM-5 as Non-Rapid Eye Movement Sleep Arousal Disorder. Answer C is incorrect: Rapid Eye Movement Sleep Behavior Disorder involves episodes of arousal during REM sleep that are usually associated with vocalizations and/or complex motor behaviors that are consistent with the person's dream. Upon awakening, the person is alert and oriented. The correct answer is: Non-Rapid Eye Movement Sleep Arousal Disorder Eliana, age 32, tells you that she often has trouble concentrating on her work and falling asleep at night because she's constantly worrying about having cancer. She states that her older sister had surgery for breast cancer last year and her mother's sister and uncle both had lung cancer. Eliana says she gets a physical exam every six months and has been reassured by the doctor that she's okay; but she knows that, for some people, there are no symptoms of cancer until it's too late to do anything about it. Eliana also tells you that she keeps checking her breasts for lumps and gets scared whenever she coughs because she thinks it might be an early sign of lung cancer. Eliana's symptoms are most suggestive of which of the following DSM-5 disorders? Select one: a. Body Dysmorphic Disorder b. Somatic Symptom Disorder c. Hypochondriasis d. Illness Anxiety Disorder - answerAnswer D is correct: Illness Anxiety Disorder is characterized by a preoccupation with having a serious illness, an absence of somatic symptoms or the presence of mild somatic symptoms, a high level of anxiety about one's health, and performance of excessive health- related behaviors (care-seeking type) or maladaptive avoidance of doctors, hospitals, etc. (care-avoidant type). Answer A is incorrect: Body Dysmorphic Disorder is characterized by a preoccupation with a defect or flaw in appearance that appears minor or is unobservable to others. Answer B is incorrect: Somatic Symptom Disorder involves the presence of somatic symptoms, while Illness Anxiety Disorder is characterized by the absence of somatic symptoms or the presence of only minimal symptoms. Eliana is worried about her health but does not actually have physical symptoms. Answer C is incorrect: Hypochondriasis is a DSM-IV-TR diagnosis. The correct answer is: Illness Anxiety Disorder Common sense solutions to problems rarely work. What theoretical orientation supports this belief? Select one: a. experiential family therapy b. structural family therapy c. strategic family therapy d. extended family systems - answerTo answer this question correctly, you needed to have some knowledge of each theory presented in the responses.Answer C is CORRECT: Strategic family therapists are united in the belief that "common sense" solutions to problems rarely work. They believe that objectivity has been lost regarding what is perpetuating the problem and, as such, people become increasingly stuck in doing more of the same. Answer A is incorrect: Experiential family therapy focuses on the present and the therapist observes here-and-now data from experiences. This theoretical orientation does not support the statement that common sense solutions don't work.Answer B is incorrect: Structural family therapy focuses on the present and the past, along with the family's current structure carried over from earlier transactional patterns. This theoretical orientation does not support the statement that common sense solutions don't work.Answer D is incorrect: Extended family systems therapy views behavioral disorders as the result of a multigenerational transmission process in which progressively lower levels of differentiation occur as the family's lack of differentiation is transmitted from one generation to the next. This theoretical orientation does not support the statement that common sense solutions don't work. The correct answer is: strategic family therapy Derrick, a 16-year-old boy, is mandated to counseling by the juvenile court due to stealing and vandalism. He says to you that he does not want to see you, but he has no choice because he has to fulfill his probation requirement. He says, "don't bother to fix me. I just want you to write a letter to tell my P.O. that I am fine. I am happy; you are happy!" As a psychodynamic therapist, which of the following would be a good intervention in the initial stage? Select one: a. Help him explore and understand his resistance. b. Ask him how he feels about not having a choice to come see you. c. Establish a safe holding environment. d. Assess if he sees you as a "bad" object like he sees the probation officer. - answerAnswer B is correct: This is a good initial stage psychodynamic intervention to explore and understand how Derrick feels in order to establish trust and rapport. Derrick is showing resistance to help but it is premature to help him understand his resistance in the initial stage as the therapeutic relationship is still forming (A). Establishing a safe holding environment is an initial stage treatment goal for psychodynamic therapy (C). The ways to achieve this are through clarifying and containing feelings, recognizing client concerns, clarifying therapeutic boundaries and expectations, etc. Considering Derrick's perception of you would be relevant, but it is not an intervention (D). The correct answer is: Ask him how he feels about not having a choice to come see you. Dialectical Behavior Therapy targets behaviors in which order: Select one: a. Decreasing suicidality, decreasing therapy interfering behaviors, increasing quality of life reduction, acquisition of behavioral skills b. Decreasing high-risk behaviors, decreasing therapy interfering behaviors, decreasing quality of life interferences, acquisition of relational skills c. Decreasing high-risk behaviors, acquisition of behavioral skills, decreasing therapy interference, increasing quality of life d. Decreasing high-risk behaviors, decreasing therapy interfering behaviors, decreasing quality of life interferences, acquisition of behavioral skills - answerAnswer A is incorrect: "increasing quality of life reduction," means reducing quality of life, which is the opposite of the goals of Dialectical Behavior Therapy (DBT).Answer D is CORRECT: The priorities of DBT are, in order of emphasis over the course of therapy to: 1) reduce the client's high risk behaviors; 2) reduce behaviors that interfere with the client being able to benefit from therapy; 3) decrease behaviors that interfere with or reduce the client's quality of life; 4) deal with any post-traumatic type stress responses; 5) enhance self respect; 6) help the client aquire behavioral skills taught in group; and 7) work on additional goals that are set by the client. Answer B is incorrect: "Acquisition of behavioral skills" includes "relational skills," making "d." a better, more inclusive answer. Answer C is incorrect: This answer is out of order. Answer "d." demonstrates the proper heirarchical order of goals in DBT. The correct answer is: Decreasing high-risk behaviors, decreasing therapy interfering behaviors, decreasing quality of life interferences, acquisition of behavioral skills Divita and Mahvesh are referred by their pastor because of marital problems, that have included rather severe battering of Divita in the past. She has been hospitalized several times due to severe bruising and several broken bones. Mahvesh has been arrested twice, but never served jail time. You are concerned with doing an intensive assessment so that you can decide what is the best treatment plan. What behavioral characteristics would you be MOST likely to see in a couple that has a chronic domestic violence pattern? Select one: a. impulsivity and isolation b. coercive behaviors and isolation c. coercive behaviors and mutual dependence d. mutual dependence and isolation - answerAnswer C is CORRECT: Coercive behavior -- which is used to maintain power and control over the victim -- is likely to be present. Mutual dependence is also characteristic of those involved in battering relationships: The batterer is likely to be emotionally dependent on his or her partner (and children, if any), and the victim is often either emotionally or economically dependent on the batterer, or both. Answer A is incorrect: It may seem that impulsivity is present but, as Lenore Walker (1979) has indicated in her research, there is actually an underlying, predictable cycle in domestic violence relationships. So, while the batterer may isolate the victim by controlling what he or she does, who he or she sees and talks to, and where he or she goes, the inclusion of impulsivity in this answer makes it a poor choice.Answer B is incorrect: In this context, isolating could be considered a coercive behavior, which make these two terms synonymous. "C" is a better choice.Answer D is incorrect: Isolation could be a factor that contributes to mutual dependence. However, these characteristics (assuming that the isolation is not due to coercive behavior) can be found in non-violent relationships, as well. The correct answer is: coercive behaviors and mutual dependence Don and Ginny, a couple in their 30's, come to see you with their 6-year-old daughter, Ellen. They tell you that Ellen was frightened by an earthquake two years ago and came into their bed to sleep. Since then, she refuses to sleep in her own bed. Don wants this stopped, but Ginny says she can't stand hearing Ellen scream when she's returned to her own bed. As a behavioral therapist how would you intervene? Select one: a. Have the couple get a lock for their bedroom door. b. Utilize a reward system to get Ellen to sleep in her own bed. c. Refer Don and Ginny to parenting classes. d. Refer Ellen to an M.D. for an evaluation. - answerAnswer B is correct: Utilizing a reward system is the best answer available. In this situation, Ellen needs to have permission to state her fears and realize she can soothe herself. This acknowledgment of her feelings can be coupled with the behavioral approach. One way to reinforce the "staying in her own bed" behavior would be to utilize a reward system. Having the parents lock their bedroom door is likely to increase the child's anxiety (A). Referring the parents to a parenting class might be helpful, but it is not specific to this question looking more for a behavioral intervention (C). A physician referral is never wrong. However, the question is looking for a behavioral intervention (D). The correct answer is: Utilize a reward system to get Ellen to sleep in her own bed. Dorrie is a 68-year-old widow who lives alone in her home of 32 years. Her neighborhood now has an alarmingly high crime rate. Dorrie maintains that she loves her home and wouldn't consider moving. She seems unaware of any danger, although her neighbors often talk about local attacks and robberies. Dorrie has reduced her anxiety by unconsciously blocking her awareness of threatening ideas and impulses that could feed it. She is using a defense mechanism known as: Select one: a. regression b. repression c. projection d. introjection - answerThis was a "recall" question but it could have been difficult because all four answers are defense mechanisms.Answer B is CORRECT: The woman is "repressing" unwanted thoughts and impulses.Answer A is incorrect: Regression occurs when, in response to threatening thoughts and feelings, an individual returns to an earlier stage of development that was more pleasurable, secure, and free from anxiety.Answer C is incorrect: Projection involves attributing undesirable impulses to the external world.Answer D is incorrect: Introjection is the opposite of projection and involves ascribing others? thoughts and behaviors to oneself in order to better control one's affective response to the thoughts and behaviors. The correct answer is: repression During a divorce, the children are least likely to: Select one: a. try to find a "replacement" for the absent parent b. idealize the non-custodial parent c. blame themselves for causing the divorce d. feel anger toward the custodial parent - answerBy reducing this item to the "question's question," you can see that it is asking for the least likely effect of divorce on children.Answer A is CORRECT: It is not common for children to look for someone to replace the absent parent. Rather, they often idealize the absent parent (i.e., the one who sees them for visitation but doesn't live with them).Answer B is incorrect: It is common for children to idealize the absent parent.Answer C is incorrect: It is common for children, especially younger children, to blame themselves for their parents' divorce.Answer D is incorrect: It is common for children of divorce to take out their anger on the parent who lives with them (i.e., the custodial parent). The correct answer is: try to find a "replacement" for the absent parent During a therapy session, the husband says, "I think A-B, A-B." His wife responds, "No, it's B-A, B-A." In this situation, Don Jackson would most likely recommend that the therapist respond by: Select one: a. saying nothing b. saying "Well, it might be both A-B and B-A" c. saying "Well, I think its C-D" d. asking their son what he thinks about "A and B" - answerYour task was to apply what you know about Jackson's approach to therapy to this clinical situation.Answer B is CORRECT: Jackson would say that this couple has a symmetrical, competitive relationship. In order to discover the rules that underlie the disturbances in family relationships, Jackson frequently unbalances the family's homeostasis by breaking the family's rules. In this case competition is a rule, so he might challenge the system by saying, "Well, I think it might be both A-B and B-A."Answer A is Incorrect: Jackson would not recommend this. See explanation for answer "b."Answer C is Incorrect: Jackson would not recommend this. See explanation for answer "b."Answer D is Incorrect:Jackson would not recommend this. See explanation for answer "b." The correct answer is: saying "Well, it might be both A-B and B-A" Edward and Marion have been participating in experiential family therapy with their two children, Kate and John, and Edward's daughter from his previous marriage, Maureen. The family has been struggling with issues of blending successfully and boundary ambiguity. Maureen says that her father always sides with her step-mom and doesn't care about her anymore. Edward says that Maureen has never given Marion a chance. In the middle stage of therapy, what might happen next? Select one: a. The family practices communicating differently. b. An enactment. c. A family life chronology. d. Everyone journals privately between sessions. - answerAnswer A is correct: In the middle stage of therapy, an experiential Family therapist would be working to change the communication patterns in the family. An enactment is a structural therapy intervention utilized to observe family patterns (B). Experiential family therapy would utilize the family life chronology in the early stage of therapy to gather information about the roles, rules and communication patterns in the family. This family is in the middle stage of therapy (C). Journaling is not a particularly experiential family therapy intervention. Experiential Family therapy is more focused on working in the session, and in the here-and-now. Journaling is more frequently used in Bowenian/Multigenerational family therapy (D). The correct answer is: The family practices communicating differently. Father-daughter incest may produce either sexual promiscuity or sexual inhibition in the daughter during adulthood. This illustrates which of the following? Select one: a. equifinality b. wholeness c. equipotentiality d. non-summativity - answerThe question illustrated a clear example of equipotentiality, which is a general systems theory concept proposing that one cause (e.g., incest) may produce different results (e.g., promiscuity or sexual inhibition).Answer C is CORRECT: This is correct; see above.Answer A is incorrect: The general systems theory concept of "equifinality" proposes that no matter where one enters a system, the patterning will be the same. According to this concept, different causes can produce the same results and, thus, a therapist should study patterns of behavior and interaction in a client family rather than individual topics.Answer B is incorrect: The general systems theory concept of "wholeness" proposes that every part of a system is so related to its fellow parts that a change in one part of the system inevitably causes a change in the other parts and in the whole system.Answer D is incorrect: Non-summativity means "the whole is equal to more than the sum of its parts"; thus, the family has a history and function of its own beyond the identities of its members and is a treatable entity, not just a collection of individuals. The correct answer is: equipotentiality For an American Indian client with depressive symptoms, treatment is most likely to be effective if: Select one: a. the therapist is familiar with traditional tribal medicine and spiritual practices b. the therapist works from a humanistic-existential perspective c. the therapy is primarily cognitive behavioral d. the whole family is in treatment - answerChoosing the best answer requires you to have some knowledge of American Indian culture.Answer B is CORRECT: It would be best to choose the psychotherapy approach that would be most consistent with American Indian tradition. Most traditional tribal spiritual practices involve telling stories, experiencing intense emotions, guided imagery, and/or meditation. These are most consistent with humanistic/existential therapy. This orientation is also present-oriented, which is another reason it is a good choice.Answer A is incorrect: This answer choice might have tempted you, but the majority of American Indians are not actively involved in traditional healing practices, so understanding these practices may not help you in planning effective treatment.Answer C is incorrect: The research suggests that this would not be a good answer choice because this orientation is too directive.Answer D is incorrect: This is also a good choice, because American Indian families tend to be close and connected, but traditional spiritual and healing practices are usually individual solitary quest experiences, which might suggest family sessions would be less effective. The correct answer is: the therapist works from a humanistic-existential perspective For an ego analyst, the primary intervention strategy is to help the client: Select one: a. gain insight into how his or her past continues to influence the present b. become more fully and completely the person he or she is capable of becoming c. replace irrational thoughts, ideas, and verbalizations with rational, healthy ones d. reintegrate into conscious awareness the disowned parts of the self - answerIf you didn't know that answer "a" describes ego analysis, you might have figured this out by using a process of elimination (assuming that you recognized the therapies described in answer "b," "c, " and "d"). The ego analysts (e.g., Anna Freud, Erikson) stress the role of the ego in personality development and propose that the ego is involved in a wide variety of psychological functions. They believe that healthy behavior is under the conscious control of the ego and that pathology results when the ego loses its autonomy from the id or from reality and behavior is no longer under the individual's conscious control (Wolberg, 1988).Answer A is CORRECT: Although ego analysts tend to emphasize current problems over past experience, an important goal of therapy is to help clients identify what things in the present can be altered to correct the harmful effects of the past.Answer B is incorrect: This describes client-centered therapy and other humanistic therapies.Answer C is incorrect This describes rational emotive therapy.Answer D is incorrect This describes gestalt therapy. The correct answer is: gain insight into how his or her past continues to influence the present For Minuchin, scapegoating and overprotection of a child by the child's mother and father are both forms of: Select one: a. triangulation. b. detouring. c. a stable coalition. d. marital skew. - answerMinuchin describes three types of "rigid triangles" that all involve boundary disturbances.Answer B is CORRECT: As defined by Minuchin, detouring occurs when the tension between husband and wife is reduced through the attention they pay to the child. This attention can involve either blaming the child for the family's problems (scapegoating) or overprotection of the child who is identified by them as ill or weak. Answer A is incorrect: Minuchin uses the term triangulation to refer to the situation in which the child's loyalty to one parent means rejection of the other parent.Answer C is incorrect:A stable coalition occurs when the child and a parent consistently "gang up" against the other parent.Answer D is incorrect:Marital skew is a term used by Lidz to describe situations in which a dominant partner has serious pathology, while the other partner is dependent and provides support. The correct answer is: detouring. When should the therapist begin discussing termination? Select one: a. At the beginning of therapy b. During formulation of the treatment plan c. Mid-way through the therapy d. Before the termination process begins - answerAnswer A is CORRECT: Discussing termination at the beginning of therapy builds in the expectation that the client will get better. It also is a good way to begin defining goals - when the client has achieved certain goals or has become adept at handling certain issues, therapy will no longer be necessary. Also, some clients may be anxious about becoming dependent on the therapist, or be afraid that therapy will go on indefinitely, so discussing an endpoint to therapy early on may be helpful to them. Answer B is incorrect: While discussing termination in relationship to achieving goals outlined in the treatment plan is helpful, the question asks when should the therapist begin discussing termination (see the rationale for "a."). Answer C is incorrect: See rationale for "a."Answer D is incorrect: See rationale for "a." The correct answer is: At the beginning of therapy Which of the following accurately describes termination criteria for solution-focused therapy? Select one: a. Emotional reactivity has been reduced. b. The therapist concludes that the client has found a solution to their presenting problems. c. The client has concluded they no longer need therapy. d. The client has gained insight into the root causes of his/her problems. - answerAnswer C is correct: The client is considered to be the expert in his/her own life and therefore is in control of the therapy. If the client decides s/he is done, then therapy is complete. The reduction of emotional reactivity would be a goal of, and possible termination criterion for multigenerational (Bowenian) therapy (A). The therapist is not considered the expert in solution-focused therapy and therefore would not conclude that the client is ready to terminate; that decision would come from the client (B). Gaining insight into problems is a more psychodynamically-oriented termination criterion. In fact, a solution-focused therapist would not consider a client to have problems as much as s/he would focus on strengths and pay attention to what is working in the client's life (D). The correct answer is: The client has concluded they no longer need therapy. You are a cognitive-behavioral therapist who has been treating Gail, a woman in her late-forties who has raised three children. Her husband urged her to return to work part-time and you have been helping her with her anxiety and self-esteem issues about returning to work. She has now been working for 6 weeks in a new job she likes, and you begin the termination process. During the last termination session, Gail says she still worries sometimes, "I'll mess up and I won't be able to handle the responsibility." Your BEST intervention would be to: Select one: a. Normalize her fear of messing up. b. Tell Gail that you also have had periods in your life when your irrational beliefs got the better of you. c. Explore Gail's regression and ask clarification and amplification questions. d. Acknowledge her irrational belief, remind her of an alternative belief she has created and encourage her to continue to remind herself of these alternative beliefs in the future. - answerAnswer D is correct: These are all appropriate interventions for a client in the last stage of cognitive-behavioral therapy who is expressing self-doubt based on previously held irrational beliefs in the last session(s). Cognitive- behavioral therapists would not normalize a distorted thought or irrational belief; they would instead challenge it (A). Answer choice B is self-disclosure that would be unlikely to be made by a cognitive behavioral therapist. Identifying regression and providing clarification are techniques from Psychodynamic therapy rather than Cognitive-behavioral approaches; in addition, this is her last session, and these types of interventions presume ongoing therapy (C). The correct answer is: Acknowledge her irrational belief, remind her of an alternative belief she has created and encourage her to continue to remind herself of these alternative beliefs in the future. You are a psychodynamic therapist successfully ending long-term therapy with a client. Which of the following is most likely to be going on? Select one: a. An increase in transferential phenomena. b. The client is expressing feelings of sadness at the ending of the therapy. c. The original symptoms will recur. d. Previously unexpressed hostility will surface. the ending of the therapy. - answerThe key word in this question is that therapy was successful.Answer B is CORRECT: Successful therapy often results in a real attachment and the client will be very appropriately processing sadness as the relationship ends.Answer A is incorrect: Successful psychodynamic therapy includes the working through of transferential material.Answer C is incorrect: The return of the original symptoms are unlikely to recur, since presumably the successful therapy has brought the unconscious conflicts underlying those symptoms to awareness.Answer D is incorrect: Hostility is more likely near the beginning of therapy as an expression of resistance. The correct answer is: The client is expressing feelings of sadness at You are referred a new client with a number of unusual symptoms. You call a colleague and share with him the highlights of the case, being careful to disguise the identity of your client. Why would you confer with another mental health professional about a current client? Select one: a. to make a comprehensive treatment plan b. to determine whether the case is within your scope of practice c. to decide whether you should bill the client at the high end of your sliding scale d. to develop good will and referral potential with this colleague - answerAlthough it described a specific case, this question simply asked for the main purpose of consultation.Answer A is CORRECT: This is not a great answer, but is the best of the four given here. Marital and family therapists confer with colleagues about clients to gain information, check their assessment, and develop a treatment plan.Answer B is incorrect: A marital and family therapist should know whether a case is within his/her scope of practice without having to seek consultation from a peer.Answer C is incorrect: A sliding scale is predetermined and should not be changed on the basis of advice from another professional. A therapist may, however, want to periodically check with his/her peers to see what they are charging in order to remain competitive and fair.Answer D is incorrect: Sharing a case with a colleague so that he/she will send you referrals is not in the best interests of the client and not an appropriate purpose for consultation. The correct answer is: to make a comprehensive treatment plan You have been seeing Matthew for 5 months. He feels that no progress is being made in treatment. He says that he likes you but wonders why he keeps coming. You admit to yourself that he seems to be right and that not much, if anything, has happened during the 5 months you have seen him. Your ethical responsibility in this case is to: Select one: a. Refer the client to another therapist who has a different orientation. b. Try a different theoretical approach. c. Evaluate your treatment plan and consider if you are the best therapist for this person. d. Terminate with your client. - answerAnswer C is correct: Ethical standards require therapists to continue therapeutic relationships only so long as clients are benefiting from the relationship. You may need to refer this client to another therapist, but you would first reevaluate your treatment plan and consider possible causes for the lack of progress (A). Trying a different theoretical approach might be something determined in collaboration with the client, if the two of you recognized that your approach did not suit him and determined that another theoretical approach would be better (B). Terminating would be the final step, after other possibilities, such as those mentioned above, had been considered (D). The correct answer is: Evaluate your treatment plan and consider if you are the best therapist for this person. You have been seeing your client David for 8 months now and it is obvious that there has been no real change. You should: Select one: a. Confront your client about his resistance to making the necessary changes in his life. b. Seek consultation with another colleague about this case. c. Raise the possibility of termination and give referrals to another therapist. d. Read literature about similar cases that have been treated and reported by others. - answerAnswer C is correct: After 8 months of therapy, it is safe to assume that you would have already done the things suggested in the other choices, such as talking to colleagues regarding the case, reading relevant literature to help you with this case, and dealing with your client's resistance in therapy. At this point, it is in the client's best interest to be referred to another therapist, while also processing termination with him. The correct answer is: Raise the possibility of termination and give referrals to another therapist. You have been treating a single father of four children for the last six months and have been planning for termination. He comes into session very distraught and tells you that his mortgage cannot be refinanced, and the bank is starting foreclosure proceedings on his home. How BEST would you proceed? Select one: a. Renegotiate the treatment contract. b. Continue with termination as planned. c. Refer to Consumer Credit Counseling. d. Postpone termination for an additional month. t. - answerAnswer A is correct: Renegotiating the treatment contract changes the treatment process from termination to addressing the new psychosocial stressor. An even better response would have been to ask the client if he wanted to continue treatment or not. Continuing with termination ignores the client's new and very significant psychosocial stressor (B). Referring to Consumer Credit Counseling does not address the client's emotional reactions (C). Postponing termination for an additional month does not address the need to renegotiate the terms of the treatment contract, as it only focuses on a time frame of treatment (D). The correct answer is: Renegotiate the treatment contrac The Randazzos have been in couples counseling for 6 months. In session, it appears the couple has made tremendous progress, improving both their communication skills and their level of intimacy. During the last session, however, the couple announced that they have decided to file for divorce. The decision comes as a shock to the therapist who was convinced that this couple was committed to their marriage. The therapist expresses concern that the couple's decision may be hasty and suggests they take time to determine whether this is the best decision considering all the progress they have made. The therapist should: Select one: a.Consult with a colleague. b.Explain the nature of couples therapy and how sometimes things get worse before they get better. c.Determine how goals should be adjusted considering this new information. d.Review the progress they have made and explore how they came to this decision. - answerAnswer A is correct: The therapist would benefit from a consultation with a colleague to explore possible countertransference issues that may be impacting the therapeutic relationship. The way the vignette is worded indicates the therapist's own agenda may be coming into play. The fact that the therapist is "shocked" and was "convinced that this couple was committed to their marriage," along with his suggestion that the couple's decision is "hasty," indicate that this therapist may have a strong desire or need for this couple to stay together. Relationships often change as a result of couples counseling, and sometimes the change means that the relationship no longer serves either party. The correct answer is:Consult with a colleague. Under HIPAA's Privacy Rule, a health care provider may disclose protected health information (PHI) without a patient's authorization: Select one: a. only when the disclosure meets the "minimum necessary" standard. b. only when the information is needed to provide the patient with emergency services. c. when the information will be used for routine treatment, payment, and health care operations. d. whenever the provider has determined that it is in the patient's best interests to do so. - answerNote that this question is asking about HIPAA's Privacy Rule and not about other legal or ethical requirements.Answer C is correct: Of the answers given, this one is most consistent with the Privacy Rule, which states that a written authorization from the patient is required before a provider discloses PHI except when the information is being disclosed for routine purposes related to treatment, payment, or health care operations ("TPO") or in other legally defined situations (e.g., when disclosure is necessary to avert a serious threat to the health or safety of the patient or other person). The correct answer is: when the information will be used for routine treatment, payment, and health care operations. What are the restrictions, according to AAMFT, upon a therapist acting as a custody evaluator? They may perform a custody evaluation if: Select one: a. They receive informed consent from the client about the risks and benefits. b. The child is not also in treatment with the therapist. c. MFTs are prohibited by AAMFT working in this area. d. Information is shared with the client's attorney. - answerAnswer B is correct: A therapist can be a custody evaluator if the child is not also a client because the therapist would not be biased against one parent or the other for having treated the child. Conversely, doing therapy and evaluating custody for a child who is a client puts the therapist in a dual role and objectivity is compromised. Informed consent is not sufficient to allow a therapist to act as a custody evaluator. This puts a therapist in an avoidable dual relationship that, even if agreed to by the client, puts objectivity and boundaries at risk (A). LMFTs are not prohibited by AAMFT working in this area; they just cannot operate in dual roles as therapist and custody evaluator (C). Providing information to the client's attorney is not what qualifies a therapist to be a custody evaluator from an ethical point of view. Only if a therapist is not also treating a client can the therapist perform a custody evaluation (D). The correct answer is: The child is not also in treatment with the therapist. When a therapist dies, what is most likely to happen to the therapist's records? Select one: a. the records will be given to his or her clients b. the records will be given to the therapist's spouse or executor c. the records will be disbursed as specified in the therapist's will d. the records will be destroyed - answerThe Code of Ethics requires MFTs to make arrangements for the storage, transfer, or disposal of client records subsequent to moving from the area, closing their practice, or upon their death.Answer C is correct: This is the best of the four answers. Although there are no standard guidelines for the handling of records after a therapist dies, records are the property of the therapist. As such, arrangements should be made by the therapist for the proper handling of records after his/her death. The most competent person to handle the records would likely be a colleague but, if a professional will does not specify such an arrangement, then the person assigned as the executor of the estate would handle this. Answer A is incorrect: The records are the property of the therapist, not his/her clients.Answer B is incorrect: This may be the outcome but is not always the case. Also, the therapist may not have a spouse.Answer D is incorrect: The minimum duration for retaining client records is determined by law and organizational or agency policy, but a common practice is to retain them for at least seven years after termination of therapy. This answer does not take legal or organizational/agency requirements into consideration. The correct answer is: the records will be disbursed as specified in the therapist's will Which of the following is true about the provisions of the AAMFT Code of Ethics regarding the exchange of goods or services for therapy? Select one: a. The exchange of goods or services for therapy is discouraged but not completely prohibited. b. The exchange of goods or services for therapy for clients who would not otherwise be able to afford therapy is encouraged. c. The exchange of goods (but not services) for therapy is acceptable in most situations. d. The exchange of goods and services for therapy is prohibited. - answerClient welfare is the overriding concern when deciding whether or not the exchange of goods or services for therapy is acceptable. Answer A is correct: Standard 8.5 of the Code of Ethics (AAMFT, 2015) states that MFTs "ordinarily refrain from accepting goods and services from clients in return for services rendered" but also notes that this exchange may be acceptable when the client requests it, the exchange is not exploitative and doesn't adversely affect the therapeutic relationship, and a written contract describing the nature of the exchange is created. Answer B is incorrect: Bartering may be an option when a client cannot otherwise afford therapy, but it would be acceptable only when the conditions described above are met. Answer C is incorrect: The Code of Ethics doesn't provide different requirements for bartering goods and services. Answer D is incorrect: As noted above, bartering goods or services for therapy is not prohibited by the Code as long as certain conditions are met. The correct answer is: The exchange of goods or services for therapy is discouraged but not completely prohibited. Which situation is LEAST likely to be an inappropriate dual relationship? Select one: a. A small town where a therapist and cashier (client) see each other at the local store. b. A small town where a therapist and next-door neighbor (client) see each other in the neighborhood watch meetings. c. A small town where a therapist's brother-in-law's sibling comes to therapy for couples counseling. d. A small town where a therapist's CPA seeks couple's counseling with the therapist. - answerAnswer A is correct: The cashier-client would not present an inappropriate dual relationship. Not all dual relationships are unethical, and some dual relationships cannot be avoided. This would be an instance, especially in a small town where the number of stores may be limited, where contact in the community may be unavoidable. The correct answer is: A small town where a therapist and cashier (client) see each other at the local store. You are recently licensed and have no experience in custody matters. A couple in a heated custody battle is referred to you. You should: Select one: a. refer the couple to a therapist with expertise in custody matters b. refer the couple to a lawyer c. see the couple but seek consultation d. keep the focus of therapy on matters other than custody - answerEthically, therapists should not advise clients on issues that are beyond their scope of competence. However, if a therapist can get consultation and continue treatment effectively, he/she may treat the clients.Answer C is correct: Seeking consultation and continuing treatment with this couple is the preferred course of action among the choices given.Answer A is incorrect: This isn't necessary, as long as you get adequate consultation from another professional with expertise in custody cases.Answer B is incorrect:They probably already are seeing a lawyer if they are in a custody battle. If not, you might refer them to a lawyer but this wouldn't affect your therapeutic relationship with them.Answer D is incorrect: This is clearly not in the best interests of the clients. The correct answer is: see the couple but seek consultation Franklin, a 47-year-old gay male, comes to therapy telling you that he's, "a bundle of nerves all the time." He is very concerned he might get sick or lose his job, and he worries his partner of 15 years will leave him for another man. He knows that some of his fears are unreasonable, but says he worries about them anyway. "I've always been a worrywart," he tells you. As a narrative therapist, how would you respond to Franklin's presenting problem? Select one: a. "Franklin, it sounds like you worry more often than you would like." b. "How did the worrywart first come into your life?" c. "Franklin, maybe you are not worrying effectively enough." d. "How many times a day do you find yourself worrying and for how long?" - answerAnswer B is correct: Asking, "How did the worrywart first come into your life," is an example of the use of externalizing language. This language separates Franklin from the worry. Franklin said he was a worrywart, owning the worry. Asking how the "worrywart" came into his life separates Franklin from the problem. "Saying, "Franklin, it sounds like you find yourself worrying more often than you would like," doesn't address the problem and uses basic reflective language. A narrative therapist would work to externalize the problem (A). Suggesting that Franklin isn't worrying effectively enough takes a paradoxical approach. Narrative therapists do not use paradoxical interventions. This concept is more reflective of strategic therapy (C). Narrative therapists are not interested in the problem saturated story and would be unlikely to delve into it by asking such questions (D). The correct answer is: "How did the worrywart first come into your life?" From a systems perspective, the information that family members continuously exchange, which helps minimize deviation and maintain the family's stability, is referred to as: Select one: a. mimesis b. the family projection process c. negative feedback d. positive feedback - answerFeedback In general systems theory, the information exchanged between family members can act as either positive or negative feedback.Answer C is CORRECT: Negative feedback is corrective and helps the system return to or maintain its steady state. Thus, a "negative feedback loop" helps to minimize deviation and thereby maintain the family's stability. Answer A is incorrect: Mimesis is a therapeutic technique in which the therapist joins the family system by imitating its manner, style, or affective range, or the content of its communication.Answer B is incorrect: Bowen described the family projection process as the mechanism through which parental conflicts are transmitted onto the children.Answer D is incorrect:Positive feedback increases deviation from a steady state and, therefore, disrupts the family system's homeostasis (or "stability" as the question says). Franklin came to treatment 2 weeks after an automobile accident. Although he was not injured, the driver of the other car was killed instantly. He reported having flashbacks, nightmares, and an inability to go near a car. As part of his treatment, the therapist had him repeatedly recall the event in vivid detail, talking about and visualizing all aspects. As a homework assignment, the therapist asked him to journal, in detail, about the event twice a day. The therapist is: Select one: a. At risk of re-traumatizing the patient. b. Utilizing cognitive restructuring. c. Utilizing systematic desensitization. d. Utilizing exposure therapy. - answerFeedback Answer D is correct: Exposure therapy includes repeated discussions or in vivo experiences with the original stressor or trauma. The thought behind exposure therapy is that the client's discussion of the original stressor or trauma will lessen its impact on the him/her (A). This vignette is exposing the client to the trauma by having him visualize it. The therapist is not using Cognitive restructuring, which involves helping the client understand the relationship among thoughts, feelings, and behaviors, helping her/him recognize and change maladaptive thought patterns, and engage in balanced thinking (B). The therapist is not pairing the client's exposure with relaxation, so systematic desensitization would not be correct (C). The correct answer is: Utilizing exposure therapy. For Minuchin, scapegoating and overprotection of a child by the child's mother and father are both forms of: Select one: a. triangulation. b. detouring. c. a stable coalition. d. marital skew. - answerFeedback Minuchin describes three types of "rigid triangles" that all involve boundary disturbances.Answer B is CORRECT: As defined by Minuchin, detouring occurs when the tension between husband and wife is reduced through the attention they pay to the child. This attention can involve either blaming the child for the family's problems (scapegoating) or overprotection of the child who is identified by them as ill or weak. Answer A is incorrect: Minuchin uses the term triangulation to refer to the situation in which the child's loyalty to one parent means rejection of the other parent.Answer C is incorrect:A stable coalition occurs when the child and a parent consistently "gang up" against the other parent.Answer D is incorrect:Marital skew is a term used by Lidz to describe situations in which a dominant partner has serious pathology, while the other partner is dependent and provides support. The correct answer is: detouring. George and Brenda Wills come to counseling with their family on the advice of their son's school counselor. Andy, age 15, has been cutting classes and falling behind in his schoolwork. "We are very worried about both children," says Brenda. "Even Sarah, at age 6, has been talking back to us." At that moment, Sarah says "Mommy, I want to go home!" As a structural family therapist, what might you do NEXT? Select one: a. Ask the family to dramatize what happens when they find out Andy cuts class again; have the family practice a new approach in session; assign homework for everyone. b. Tell Sarah she must stay for an extra 10 minutes; ask Andy what he should do to stay in school; encourage Brenda to worry about her children more often. c. Ask the family to dramatize what happens when they find out Andy cuts class again; intellectualize with Andy about why he should go to school; assign homework to everyone except Andy. d. Tell Sarah she must stay for an extra 10 minutes; tell Andy you didn't always like doing your homework either; have the Wills explore their beliefs about homework on a thought record this week. - answerFeedback Answer A is correct: Asking the family to dramatize what happens when they find out Andy cuts class again is a description of an enactment, a common structural intervention to see how a family interacts. Having the family practice a new approach in session is a common way Minuchin would reinforce his structural moves with the family. Finally, assigning homework for everyone is part of Minuchin's directive approach. He would not ask a family to create their own homework. Telling Sarah she must stay for an extra 10 minutes and encouraging Brenda to worry about her children more often would be possible paradoxical structural interventions. However, asking Andy what he should do to stay in school is not. Minuchin preferred a more directive approach and he did not advocate clients having their own insight into their problems. He believed insight happens through a therapist's directives (B). Asking the family to dramatize what happens intellectualizing with Andy about why he should go to school would not be a structural therapist's strategy. A structural therapist prefers to join and accommodate to the style of the family. Intellectualizing with a teen who doesn't like school would be more distancing than joining (C). Paradoxically telling Sarah she must stay for an extra 10 minutes and joining with Andy by telling him you didn't always like doing your homework would be structural interventions. However, having the Wills' explore their beliefs about homework on a thought record this week would be more of a cognitive intervention (D). The correct answer is: Ask the family to dramatize what happens when they find out Andy cuts class again; have the family practice a new approach in session; assign homework for everyone. Gestalt therapy, originally developed by Fritz Perls and based on the principles of gestalt psychology, emphasizes all of the following except: Select one: a. here-and-now-experiences b. the development of "awareness" c. assignment of an accurate diagnosis d. avoidance of questions - answerFeedback The question asked you to choose what gestalt therapy does not emphasize.Answer C is CORRECT: Gestalt therapy avoids the assignment of diagnostic labels; in fact, diagnosis is viewed as a method for escaping the patient-therapist process.Answer A is incorrect: This is a key element