mock review 1 Flashcards
(40 cards)
Structural Middle Phase Treatment
challenge hierarchy.
To strengthen the parental hierarchy in structural family therapy,
a therapist might
Have client arrange chairs to represent current hierarchy and rearrange chairs to represent her status as a parent.
Track and match client’s interactional style is what phase in what theory
1st phase in structural family therapy.
ie joining with the family.
could also do assessment/mapping of hierarchy/reframe whole problem to include system.
Three months into treatment the client is unexpectedly laid off from + can’t afford therapy. He declines to attend termination sessions because of concerns about spending money while unemployed. How should the therapist clinically manage the ethical issues in this case?
- offer termination session at reduced fee
- provide referrals
A male therapist has been meeting with a recently divorced female client for several months. During a session, the client shares that she is attracted to the therapist. The therapist recently sought consultation because he found himself attracted to the client. How should a psychodynamic therapist respond?
Explore the client’s feelings and discuss the limits of therapeutic boundaries.
Alice, age 14, is brought to therapy by her mother, Joan, after she reported having thoughts of killing herself. Joan is a single mother to Alice and Jill, age 16. Alice refuses to go to school, is often irritable and frequently argues with her mom and sister. Joan reports that Alice has cut herself in the past. Joan also shares that she herself is on medication for bipolar disorder. How would a Bowen Family Therapist assess the intergenerational issues related to the crisis issues in this case?
Construct a genogram related to suicide, defiant behavior and mental health issues; Explore emotional cutoffs between present and extended family members; Identify multigenerational patterns of parenting and rebellion
Jim, age 31, and Tina, age 32, seek therapy for intimacy issues. Tina tearfully tells of Jim’s lack of affection over the past year. He can’t control the amount of time he spends on the Internet at work or at home. Tina says angrily, “I can’t keep living like this! He is spending all our money on porn sites. You can fix him right? What will our friends and family think if they knew that we have to come to therapy?” Tim looks out the window as she speaks. What clinical issues should the therapist address with the couple in this initial session?
Their expectations of therapy and their feelings about seeking help.
A 42-year-old female client seeks therapy at the urging of her partner. The client is late to the first session and appears disheveled. The client begins crying and reports that she is distraught about the recent loss of her 82-year-old mother. How would a Client Centered therapist proceed in this case:
Use reflective listening to explore her reaction to her mother’s death.
Sue, age 70, and Larry, age 69, are referred by their gerontologist. Larry was recently diagnosed with Major Neurocognitive Disorder. Sue shares that Larry has become very irritable since starting a new medication, and that he actually pushed her down on the floor when he became upset. She shows a bruise on her elbow and knee. She states, “I don’t think I can handle taking care of him anymore, but I don’t want to leave our home.”
What resources should the therapist utilize initially in this case?
**Gerontologist; Adult Protective Services; Home Care Assistance
Michael, a 25 year-old African-American man, is court-ordered to therapy after being released from prison, where he spent time for selling drugs. Michael states that he is only there because he is required to come. Under his breath he says, “The whole system is rigged against the black man.” How should the therapist respond to the client in this case?
I imagine you’ve experienced a lot of racism.”
includes empathy.
A 45-year-old woman comes to therapy. She has a history of cutting herself when feeling overwhelmed and reports that in recent times she has felt so stressed by her life, the isolation caused by COVID, and all of the societal problems, that she has contemplated suicide. How would a Dialectical Behavioral therapist initially proceed
-validate emotionality + assess for risk.
Recently, a filipino single woman elderly mother suffered a stroke and is currently in a coma on life support. Maricel has been the primary caregiver for her mother since her father died two years ago. Maricel has decided that she wants to terminate life support. However, her uncle, who is her mother’s brother, is against it. Which of the following human diversity issues should the therapist consider when developing the comprehensive treatment plan in the case presented in the vignette?
Maricel’s spiritual beliefs regarding end-of-life issues and the influence her Filipino culture plays in this situation.
Alicia, a 22 year-old female, is court-mandated to therapy as part of her conditions of parole. She was recently released after spending two years in prison for stealing. She reports a history of heavy alcohol and crack use. She is living with her aunt but reports that she can’t find a job with her background. Angrily she adds, “I don’t see how therapy is going to help.”
what key factors to explore?
Her motivation for treatment and history of substance use.’
*make sure the answer is supported in the question stem.
A 17-year-old comes to therapy referred by his school’s attendance office. He reports being in a gang and shares that a few months ago he saw his friend get killed in a drive-by shooting. He frequently oversleeps and misses school. During the initial assessment he reports that he’s lost a lot of weight in the past month. His school counselor reports that he is fighting with others and having arguments with teachers.
what diagnosis?
PTSD and Major Depressive Disorder
A 56-year-old single woman seeks therapy following a diagnosis of terminal cancer. The client reports that she had fought it twice in the past, but doesn’t want to go through any more experimental treatments. The therapist believes the client shouldn’t give up. How should the therapist proceed in this case:
Seek consultation regarding the values conflict.
Kim, age 5, is brought to therapy with a Solution Focused therapist after being sexually molested by an older neighbor with whom she no longer has contact. Her kindergarten teacher reports that she is provocative and aggressive with her peers so they avoid her. Her mother reports that she is also aggressive at home with her little brother. The therapist utilizes a sand tray in the initial session and asks her to show her school. Kim places the figure representing herself far from the other kids in the tray. They decide that “making friends” would be an appropriate goal for treatment. What interventions would the therapist utilize to reach this goal?
Use puppets to play imaginary games together; Use puppets to practice how to play with friends at school (practicing the solution)
Describe times when Kim did play successfully with other kids at school.
Nick, a 22-year-old male, is court-mandated to receive therapy. He recently spent time in a psychiatric hospital because he was hearing voices and was in a catatonic state. Nick shares that he has been sober for three months and is living in a sober living facility. He reports that he started using crystal meth at age 14. Nick states, “I hate taking my meds, but I want to get my life together. I dropped out in ninth grade. I get really stressed out thinking about my future. I don’t want to end up like my dad. My parents were never around when I was a kid, I don’t really know how to talk to them.”
-factors to consider?
His motivation for treatment; His early childhood history; His psychiatric history.
Nick, a 22-year-old male, is court-mandated to receive therapy. He recently spent time in a psychiatric hospital because he was hearing voices and was in a catatonic state. Nick shares that he has been sober for three months and is living in a sober living facility. He reports that he started using crystal meth at age 14. Nick states, “I hate taking my meds, but I want to get my life together. I dropped out in ninth grade. I get really stressed out thinking about my future. I don’t want to end up like my dad. My parents were never around when I was a kid, I don’t really know how to talk to them.”
- motivation for treatment
- medication compliance
- psychiatric history
A 28-year-old graduate student seeks therapy for relationship problems and stress at school. During the initial session, the client mentions that she has been hospitalized several times for “severe depression.” The client becomes tense and guarded when the therapist attempts to explore the hospitalizations, saying that “it’s in the past”. She also states adamantly that she won’t give permission to get those records. How should the therapist proceed in this case?
Acknowledge her right to decide about releasing her records.
Cindy, an 8-year-old African-American girl, is brought to therapy by her mother, Nancy. They were referred by Cindy’s school because Cindy was crying when her mom dropped her off each day. Nancy reports that Cindy has been afraid to sleep by herself at night because she is having nightmares. Nancy says, “I’m so exhausted after work, I can’t deal with her neediness. I have to lock her in her room to get any sleep.” Nancy tears up and adds, “I have enough to deal with. Her older brother was hit by a car two months ago and he’s still in the hospital having surgeries. He’s the one that really needs my attention and prayers right now. She needs to toughen up. All she wants to do is talk about the accident.”
factors to consider
Cindy’s exposure to the accident; Details of mother’s discipline and parenting practices; Cindy’s functioning at school.
Stanley, a 69-year-old Chinese man whose wife died four months ago, is referred by his doctor. He recently moved in with his son’s family. When Stanley arrives at your office, he does not make eye contact and walks with a limp. His Caucasian daughter-in-law, Nancy, brings him at her husband’s request. According to Nancy, Stanley has been “acting very strange for a while and he is less and less capable of taking care of himself.” Nancy stares at Stanley angrily and appears frustrated when Stanley tells you, “I don’t want to be a burden to anyone.” Nancy adds that her husband expects her to take care of Stanley.
-what to do-
Interview Stanley alone to assess elder abuse and suicide potential
A therapist receives a court order for a client’s records. The therapist is concerned that the release of the records will cause harm to the client. The therapist contacts the client and the client states that he doesn’t want the record released. The therapist should NEXT
advocate to court to limit scope of release.
A 52-year-old woman bring her 86-year-old mother to therapy. The woman reports that her mother has seemed depressed since she relocated from another state and moved into an assisted living facility nearby. The mother confirms that she’s been feeling really down since the move but denies any suicidal ideation. What approach should the therapist consider in this case?
reminiscence therapy to review her life.
Sylvia, a 68-year-old woman, is referred by her priest from her church after a below-the-knee amputation due to complications from diabetes. Sylvia begins to cry and shares that “life is too hard without her leg.” She lives alone and her daughter visits her once a week but she lives an hour away. She tells the therapist that her doctor wants her to take medicine for depression but she is scared. She adds, “I don’t think this talking stuff is going to help me.”
What factors require primary consideration by the therapist in formulating the initial treatment plan?
Premorbid coping skills; Sylvia’s motivation for treatment; Sylvia’s religious community
