mock 3 Flashcards
(59 cards)
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?
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 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:
Track the number of calls and confront the client.
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?
file police report.
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?
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?
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.
Melissa, a 34-year-old Caucasian woman, is court-referred to family therapy with her two children, Kendra, age 11, and Sam, age 6, whose clothes are slightly worn and soiled. Melissa says she is currently in a “nasty custody battle” with her ex-husband, whom she describes as “mean, vindictive, and stubborn.” Melissa tears up as she reports, “He refuses to pay any child support. I can barely pay the bills, but I don’t have the energy to get a job.” During a separate interview with the children, Kendra complains, “I hate her! She won’t let us see Daddy anymore. All she does is sit around smoking and watching TV or sleeping all day. I don’t think she even cares about us.” Sam begins to cry. How would a Narrative therapist incorporate the issue of Melissa’s depression into the middle phase of treatment based on the case described in the vignette?
Identify how the depression has affected Melissa and her family; Help the clients state their preferences regarding future effects of the depression.
(not the right answer- have family members express their authentic reactions is more of a satirian.)
Dan, a 42-year-old African-American army sergeant, and Anna, a 36-year-old Caucasian, are referred by Anna’s physician. The married couple of six years report that they have been arguing constantly for the past month. Anna shares that she has been suffering from insomnia since she had a miscarriage three months ago. Dan says, “I get that she’s upset but she just needs to get over it.” Anna shares that she’s been going to church again, but Dan refuses to join her. Dan adds, “I’m gonna be heading to the front lines again in a couple months. I don’t really want to spend any of my free time at church.” What human diversity issues should the therapist explore initially in this case?
Military culture; Ethnic difference; Religious and spiritual beliefs
(military culture is a human diversity issue.)
As initial interventions, the therapist should:
Build trust using eye contact and active listening; Clarify the client’s experience; Further explore the relationship dynamics.
(wrong answer- rebuilding self-worth is more of an overarching goal - not written as an intervention.)
A client seeks therapy following a miscarriage. She reports feeling sad and guilty about the loss. She is having a difficult time focusing at work and feels disconnected from her husband. What psychological factors should the therapist assess when formulating the initial treatment plan
How she has coped with difficulties in the past.
Who has the right to authorize counseling for a 15 y.o court-ordered ct and who is the holder of privilege in this case?
The 15-year-old client and/or the judge can authorize treatment and she is the holder of privilege.
Suzanne, age 13, is brought to therapy by her aunt, JoAnne, age 40, who was given legal custody following the incarceration of Suzanne’s mother five months ago. JoAnne states, “I don’t know what to do with her. I think she’s in a gang. She denies it, but she’s been carving tattoos in her arm.” She adds that the school called her and reported that she’s been missing a lot of school. Suzanne looks out the window and states, “The only people who care about me are my home girls.” JoAnne, responds angrily. “I do care about you, that’s why we are here. I don’t want you to end up like your mother.” What legal obligations does the therapist have in the case described in this vignette?
Obtain signed informed consent to treat a minor if treating Suzanne individually;
Assess and manage Suzanne’s risk to self and others;
Manage confidentiality if treating Suzanne individually.
A seven-year-old boy is referred to a community mental health center due to aggressive play, poor attention in class and angry outbursts. During the initial session, the mother informs the therapist that she and her son recently moved into a domestic violence shelter to escape his father. She states that her son had seen the father beat her up multiple times. What additional information would most help clarify the initial diagnosis for this child?
Onset of symptoms
A 26-year-old woman seeks therapy to address her fears of getting married. The client shares tearfully that she worked as a prostitute in college to help pay for her tuition. She adds that her fiancé thinks she worked as a stripper but he doesn’t know about the prostitution. She doesn’t want to tell him, but she feels bad keeping it from him. During the fourth session she reports feeling guilt about her past. How would a Client-Centered therapist respond in the middle phase of treatment?
Express appreciation of her struggle to accept that aspect of herself, highlighting the fact that she did eventually choose to leave it.
the couple also reports they’ve been distant from each other both sexually and emotionally. During the assessment, the therapist notes that both individuals demonstrate a high degree of self-reflection, openness, and are able to set realistic goals. The practice approach utilized by the therapist should emphasize:
Building on the clients’ strengths and competencies.
A therapist is working with a family with three children, the youngest of whom, Danny, age 12, is in a wheelchair because of cerebral palsy. The parents describe Danny’s withdrawal from outside activities and believe that he is depressed. Danny remarks that his mother hovers over him, and that his siblings dislike him because he has no chores at home. He expresses an interest in staying with his cousin over Christmas break and says he wants more responsibility at home. How should the therapist proceed?
Explore stage of life issues and help the family address Danny’s expressed desires.
A couple seeks therapy complaining of an inability to communicate. The wife is Japanese and currently a stay-at-home mother. The husband is Caucasian American and manages a local bank. They are expecting their third child in six months. The wife shares that the third child has diminished her career outlook and she feels resentment. The husband reports that she worries too much. What middle phase goal would a Structural Family Therapist consider for a treatment plan in this case?
Clarify and define relational “rules” for the marital subsystem including cultural issues.
Mark is a 35 year-old, single, gay male. He is referred to therapy by his roommate. He reports that he feels on edge and uneasy and often participates in self-destructive behaviors. Furthermore, he reports that his thoughts represent “catastrophic tendencies.” When developing a treatment plan, what initial interventions would a Satir/Communications therapist utilize after rapport has been established?
Conduct a family life chronology; Explore effects of social messages about homosexuality; Assess Marks verbal and non-verbal communication patterns and survival stance.
A therapist has been working with a client for four months and has noticed that the client often corrects the therapist when the therapist paraphrases back to him what he heard him say. He seems to be unaware of this pattern. Using a psychodynamic approach how might the therapist address this in a future session?
Directly tell the client your observation; Ask your client if he felt unheard or misunderstood in his family of origin, Process client’s reaction to the intervention.
A 55-year-old man presents for treatment six weeks after the death of his dog. Prior to this incident, he worked full time and enjoyed many hobbies. Since then, he has started missing work and isolating himself, stating that he misses his “best friend” and feels he doesn’t have a reason to get up anymore. What initial interventions should the therapist consider?
Assess for suicidal ideation; Provide psychoeducation on grief process; Identify coping strategies and social support.
Transform Mark’s family rules into guidelines is a later stage phase in..
Satirian
A therapist sees a family for family therapy. The parents are distraught about their 4-year-olds tantrums. They say they can’t agree how to respond and the preschool is threatening to have him kicked out. What is an example of circular questioning that the therapist can ask the parents in this case?
“When your son has a tantrum, how do you each respond?”
*asking about the behavior + response to behavior.
Cause + Effect circle
A 19-year old is brought to a family service agency by the parents who report a history of school truancy, fights with classmates, and problems with authority. In order to make a diagnosis of antisocial personality disorder, which of the following would need to be true?
Client has a history of setting fires, being hostile and vindictive before age 15.
A 19-year old is brought to a family service agency by the parents who report a history of school truancy, fights with classmates, and problems with authority. In order to make a diagnosis of antisocial personality disorder, which of the following would need to be true?
Client has a history of setting fires, being hostile and vindictive before age 15.
A couple brings their 4-year-old child to a therapist concerned that the child cannot yet recognize the alphabet. They tell the therapist that they know other 4-year-olds who can say the alphabet and they have tried to teach it to their child without success. They believe something may be wrong with their daughter. The most likely explanation is that:
The child may not have reached necessary level of cognitive development.
