Practice Exam Questions

Question 1

A solution focused therapist using the miracle question would start out in which of the following ways?

Answer 1

Suppose one night you were asleep a miracle happened in your problem was solved. How would you know?

Question 2

Mrs. and Mr. Doherty present for family therapy complaining that their son John will not listen to them and is acting out. In implementing a treatment plan, a strategic therapist would:

Answer 2

Track disabling sequences

Question 3

Feminist have faulted over family therapist models as:

Answer 3

Favoring masculine values, devaluing mother child nuturance, been primarily based on male development.

Question 4

Family therapist who believe that, if left alone, people tend towards self actualization are primarily working from the:

Answer 4

Emotionally focused therapy perspective

Question 5

The family therapist best known by their investment in spontaneity, creativity and risk taking are:

Answer 5

Experiential

Question 6

A statement such as “men only do anger “might be used as an example in which of the following models

Answer 6

Emotionally focused couples therapy

Question 7

The narrative model uses the term external invaders to describe

Answer 7

destructive internalized emotional states and beliefs

Question 8

An MFT reviews a study that concludes, “of all the families included in the study, only two failed to achieve significant improvement in symptom relief by termination of treatment. A one-year follow-up, only four showed signs of return to their original symptomatic state. “A proper conclusion from this information is:

Answer 8

We want to know if the reported findings can be considered representative of what a clinician would find one replicating the treatment in the general population. Therefore we need to check Back in the research report for sample size, correlation and significance.

Question 9

Entropy is:

Answer 9

The tendency for a system to break down into less organized states.

Question 10

Family therapy would probably be the primary intervention choice for all of the following except:

Answer 10

Borderline personality issues.
Problems with relationships.
Problems with children.
Problems in an individual around times a family transitions.

Question 11

Olson’s circumflex Model of family functioning is based on the intersection of two basic family dimensions. They are:

Answer 11

Cohesion and adaptability

Question 12

An MFT routinely discusses some of her clinical work with her husband she can avoid violations of that HIPAA privacy rule is:

Answer 12

PHI is de-identified

Question 13

Systems trained clinicians will manage client crises similarly to individually trained clinicians except:

Answer 13

The systems trained clinician will always consider the clients social context

Question 14

All of the following are similarities between structural and strategic except:

Answer 14

A view of families as rule governing system.
Consideration of the family life cycle.
Concerned with the subsequent organizational structure of the family system. (Correct answer)
Utilization of therapeutic contracts and behavioral test.

Question 15

Syrupy session a husband implies that his wife appears to get her own way most of the time. The therapist and suggest that the husband says “no “to the wife, once during the following week. The model which emphasizes expectations formed by early experiences is:

Answer 15

Psychodynamic

Question 16

A therapist may assign a group of friends to watch over a young adult who is abusing drugs in another group to arrange for him to move out of his parents house this therapist is most likely implementing a technique used in:

Answer 16

Network therapy

Question 17

During the process of treatment, Mr. Medeiros recognized how he was victimized by his parents, and that the past generations were also victimized by their parents. In recognizing this he began to see his parents less as monsters and more as struggling human beings, themselves acting out invisible loyalties. Therefore he was able to block the transgenerational pattern of destructive entitlement and allowed the positive transmission of relational resources. The process by which he earned entitlement by dealing with issues with his own parents is called:

Answer 17

Exoneration

Question 18

Mrs. ask him to therapy complaining that she had been unhappy and abnormal all her life the therapist asked how do you know you were unhappy?
Mrs. ass expressed being unhappy with friendships and in her relationships with her family. The therapist then asked how Mrs. S knew those unhappy feelings were not normal. Mrs. Allison mentioned some days in which she did feel happy. This attempt by the therapist to help Mrs. us to identify expections is a technique used in:

Answer 18

Solution focused model

Question 19

Katharine asked her mother for candy at breakfast time. Her mother says no and Katharine continues to ask her mother. Each time her mother says no Katharine so I need becomes more persistent until she has a full fledge tantrum, at which time her mother gifts in so as not to wake her baby sister and KATHRYN stops whining. Katharine is apt to learn from this interaction that:

Answer 19

If she whines enough she will get her way

Question 20

A family comes to therapy because their 10-year-old child is stealing money from them. After three sessions, the ceiling stops in the family decides to terminate therapy. A collaborative therapist would:

Answer 20

Maintain input from all members of the system including him/her self in mutually determine if the therapy should end.

Question 21

Both the constructivist and Mulan systemic therapists agree that:

Answer 21

Living systems are characterized by “loop formations “rather than linear cause and affect

Question 22

A husband and wife are in couples therapy. They both are experiencing depression at a level that is altering their lives. They have both experienced some improvement in depression and some improvement in their marital satisfaction. After next session, they ask the MFT if they could be better off if they took time off of couples work in both entered separate individual therapies. From the perspective of current outcome research alone:

Answer 22

The therapist should encourage continuing the couples therapy because there is research evidence that it is as effective or more effective in relieving symptoms of depression

Question 23

Which of the following therapist believes that when treating alcoholics, the culvert do used to drinking is only an appropriate go, if it is also a goal of the clients? The therapist may also state that the more traditional concepts of the disease model May, in fact, be counterproductive for many alcoholic clients.

Answer 23

Insoo Berg

Question 24

Mrs. J called a Bowenian therapist and told him she wanted to set up an appointment with her and her husband and their daughter Mary, age 3, who has a behavioral problem the therapist suggested that Mr. and Mrs. J come for their first visit with aunt Mary because:

Answer 24

Including Mary in the session could possibly detract from his desired focus

Question 25

Mr. and Mrs. Dority present to family therapy complaining that their son John will not listen to them and is acting out. Which of the following would be a response by milan systemic Therapist?

Answer 25

Who in the family is most upset when John ask out?

Question 26

According to Bowens theory, the extent to which ones emotional and intellectual systems are distinguishable is called:

Answer 26

Differentiation of self

Question 27

A technique developed by Milan model that utilizes a third person’s perspective on a subsystem or other Diaz within the system is also known as:

Answer 27

Circular questioning

Question 28

A 12-year-old boy was brought to therapy because he went to bed almost every night. The mother had been hospitalized at one time for depression. The father worked long hours, and the mother complained about his lack of interest in her and his attraction to other women. The therapist hypothesized that the bedwetting was both A metaphorical expression of the fathers improper behavior and attempt to help the parents by eliciting their concern in distracting them from their own problems. This assessment of the problem is associated with:

Answer 28

Strategic therapy

Question 29

A family therapist working with the family around the acting out eight-year-old boy goes to great lengths to inform the family that he does not have a particular answer for them as to how they should proceed. There’s not knowing stands reminiscent of Goolishian and Anderson is used to help the clients:

Answer 29

Acknowledge their own expertise on their own lives

Question 30

Research and found one year following the voice to be the peak of maximum negative behavior for children. Such behaviors were “most likely” sustained in:

Answer 30

Boys then in girls

Question 31

If you were a structural family therapist and the husband of the couple said, “I am angry quote, what would you most likely say in response?

Answer 31

“Who in the family are you angry with?”

Question 32

A mother calls the therapist sounding very panicky, wanting an immediate appointment. At the end of the first session, the mother states that her 12-year-old son Sam has just been caught in the bathroom of a neighbors home with a six-year-old boy. The six-year-old says that Sam is playing with his bun and kissing his penis. When confronted by his mother, Sam admitted to having played with the boy on four previous occasions. The neighborhood boys parents have been Sam from their home and informed other parents at the school about his “perversion quote. Sam‘s mother called a psychiatrist prior to calling you who she says stated, “you can put him into therapy and give him drugs, but it’s probably already too late “you begin seeing Sam and his family. You are also seeing another family living in the same neighborhood as Sam and his family, with a boy two years younger than Sam Who given this new information, you are now concerned about. In your work with Sam and his family, you should:

Answer 32

Explain to the family what a mandated reporter is in file a suspicion of sexual abuse report

Question 33

The DSM-V has replaced important language as required by what is commonly known as roses law ( public law 111 – 256). This federal statute changed:

Answer 33

The use of the term mental retardation

Question 34

Which of the following therapist emphasized the importance of transgenerational themes:

Answer 34

Satir, Minuchin, Whitaker(correct), erikson

Question 35

Epston and White regard problems as something which influence or operate on people, rather than as something they are doing wrong. The Negative technique utilized to accomplish this is:

Answer 35

Externalizing

Question 36

One important way that a family system therapist crisis management work will differ from an individually oriented therapist is:

Answer 36

The family therapist will always explore the possibility that other family members are also in crisis

Question 37

Systems that are self organizing in South maintaining, such as biological and human systems, are known as:

Answer 37

Autopoetic systems

Question 38

A family therapist has in session goals to accentuate the clients expression of attachment needs. Such an emotional expression might be termed:

Answer 38

Primary emotions

Question 39

Dr. a train‘s family therapist. Mary B is Dr. A’s student. Midway through the year it becomes evident to Dr. a that and Mary could benefit from therapy. When she approaches Mary with her recommendation, Mary Grace and ask Dr. a to be her therapist. Dr. A:

Answer 39

Declines on the grounds that it would be unethical

Question 40

A doctoral candidate had difficulties meeting his deadlines due to procrastination. He reports to his therapist his fear of doing a poor job. The therapist responds by telling him to write one chapter in his usual way, and in writing the next to submit only a quick first draft. The quick first draft chapter receives praise and acceptance and the problem maintaining sequence was broken this therapist most likely was trained in the:

Answer 40

MRI Approach

Question 41

Structural and MRI strategic different in their orientation to all of the following except:

Answer 41

The punctuation of sequences. Therapist use of confrontation. Negative and positive feedback use of symptom dysfunction. Emphasis on process over content (correct)

Question 42

You were seen a single father and his two children and therapy. You find yourself physically and sexually attracted to him. As an ethical family therapist, you should:

Answer 42

Discussed the issue with a colleague in order to determine your objectivity and ability to continue working with the family

Question 43

A family presents with a seven-year-old child who seems to look for his parents acceptance and reassurance well answering every question the family therapist puts to her when her parents expressed disagreement to what she has expressed, she quickly adapts her position to that of her parents. This might be best described by the following models:

Answer 43

Framo’s objective relations model

Question 44

Which of the following statements are true of emotionally focused therapy.

Answer 44

A. Emotionally focused therapy is generally contra indicated for bulimic symptoms, including the frequency and severity of perching or vomiting. B. All of the possible choices. C. Emotionally focused therapy adds to cognitive therapy a focus on the construct of aspects of specific emotions. D. Emotionally focused therapy is generally contracting indicated in the short term for those conditions in which there is an under control of Emotion, i.e. panic disorder and impulse disorders. (Correct answer)

Question 45

All of the following variables are measured by the GARF except:

Answer 45

Sub skills of problem-solving/interactional. Sub skills of emotional climate. Sub skills of interactional competence a scale (correct). Subscales of organization.

Question 46

What does “tickling the defenses“ mean?

Answer 46

Provoking people to open up and say what’s really on their mind

Question 47

Hey therapist reports to her supervisor that a family she is seen complains to her that she doesn’t listen well to what they tell her. Her supervisor response, “I’m sorry what were you saying? “This is an example of a/an?

Answer 47

isomorphism

Question 48

Solution focused therapists hold the following to be a primary therapeutic goal:

Answer 48

A Perceptional shift from talking about problems to talking about solutions.

Question 49

Process research has shown that emotional focused therapy correlate strongly with Lassing therapeutic outcomes when there is:

Answer 49

A deep level of emotional processing.

Question 50

A couple comes to therapy because their 3yr old daughter is "out of control". During the session the wife begins complaining that her husband is never home and she is left to deal with her daughter's behavior. During the first interview w/ this family, the first priority of a Strategic Family Tx would be:

Answer 50

Set Goals

Question 51

A 60yr old woman is referred for depression and feeling 'lost' in life. As she takes the client's history, the clinician should be particularly concerned about:

Answer 51

Erickson's developmental stage of "generativity" in which older individuals struggle to find meaning while coping with knowing the number of years they have left is dwindling. History of suicidality, substance abuse and impulsive control which might be signs of current suicidality. Does the client have any fear of her life partner and is he making any extraordinary efforts to please them, which might be signs of domestic abuse.

Question 52

A Haitian family therapist has just been given assigned a new case. The mandated family consists of a Dominican mother, 23, with a set of 2 yr. old twin girls. She has brought her "aunt and uncle" to the therapy, both of who seem cold and dismissive of the therapist. Over the course of the first session, it appears that aunt and uncle are not related to the mother at all. Which of the following would be most helpful in both joining and assessing this family?

Answer 52

Extended and compound households are common in Dominican culture, and the aunt and uncle should be treated as family. There is historically tension between Dominicans and Haitians and these cultural differenes between therapist and clients ethnicities may need to be addressed with the family. Assessing how traditional this Dominican family is.

Question 53

All of the following are examples of physiologically-based sexual dysfunction except:

Answer 53

Hypoactive sexual desire: Hypoactive or inhibited sexual desire is a sexual disorder that refers to an individual's arousal capabilities, rather than physiological responses. The other sexual dysfunctions are based upon known physiological phenomena that can prevent a person from functioning sexually. While these problems may also have a psychological basis, they are known to be physiologically- based as well.

Question 54

In a therapy session a husband implies that his wife appears to get her own way most of the time. The therapist then suggests that the husband say 'no' to the wife once during the following week. In initially assessing this client, a Strategic therapist would do all of the following except

Answer 54

A. Define the problem B. Think of the problem that simultaneously offers a solution to the problem and is a problem itself C. Develop a plan for the problem D. Take family history (Correct)

Question 55

Harmonious relationships are more difficult to achieve for gay and lesbian couples because:

Answer 55

Our society presents them with far more obstacles.

Question 56

Jacobson’s Pretreatment Assessment for Marital Therapy includes all of the following EXCEPT:

Answer 56

A. Individual functioning of each spouse. B. Strengths and skills of the relationship c. cohesion (correct) D. presenting problems Neil Jacobson offers an outline for pretreatment assessment. After completing the assessment, the therapist presents the couple with an analysis of their relationship in social learning terms. The assessment includes: strengths and skills of the relationship, presenting problem, sex and affection, future prospects, assessment of social environment and individual functioning of each spouse.

Question 57

Prior to the DSM, the 'Statistical Manual for the Use of Institutions for the Insane' was developed by

Answer 57

National Commission on Mental Hygiene. Prior to the DSM being developed in 1952, in 1917 the APA in conjunction with the National Commission on Mental Hygiene developed the Statistical Manual for the Use of Institutions for the Insane which included 22 diagnoses. The current DSM-5 was released in 2015, expanding and collapsing many diagnostic categories.

Question 58

Questions that provide information about how a problem has managed to disrupt a family versus how much they have been able to control it are referred to as:

Answer 58

Relative influence questions: These questions serve to “map or chart the relative influence of the problem” and are an essential part of the understanding how the problem is controlling family members.

Question 59

A person's experience shapes the way they think about it, this notion is called:

Answer 59

Social Constructionism: Experience shapes the meaning we attach to reality and is the foundation of Social Constructionism.

Question 60

An MFT in private practice keeps some of her clinical records on her laptop computer, which she carries back and forth to work every day. One evening after work she stopped to meet a friend for dinner before going home. When she returned to her car she noticed the trunk was open and then found that her computer had been stolen.According to the HIPAA Security Rule:

Answer 60

She is in violation of the Security Rule only if she did not password protect her computer, anticipating the possibility that it could be stolen.

Question 61

As a structural therapist you would most likely:

Answer 61

Imitate family style and affect: Imitating certain family patterns is considered a helpful step to connecting and being accepted early on in the therapy by Structural therapists. This aspect of the engagement process is called “accommodation.”

Question 62

Biracial children have unique circumstances for identity development because:

Answer 62

they may not look like their monoracial parents and therefore feel isolated from the family unit.

Question 63

A Contextual therapist views family dysfunction as caused by:

Answer 63

Two of the basic concepts of the theory of dysfunction in Contextual Therapy are lack of justice and lack of trust.

Question 64

Autism Spectrum disorder now encompasses which of the previous DSM-IV diagnostic categories?

Answer 64

A. Pervasive developmental disorder - not otherwise specified (PDD-NOS) B. Asperger's disorder C. Childhood Disintegrative Disorder D. All of the above (correct)

Question 65

Your focus of practice is with 'gamers' and internet game addiction. Naturally, you reach out to your clientele through the internet and make yourself available for video therapy sessions. You notice that your practice is expanding when your first client from out of state asks for your services. Your first response to the potential client is to

Answer 65

check with your state licensure board and the licensing regulations of the state the client lives in to determine the limits of your practice.

Question 66

Circular causality speaks to the non-linear nature of systems. This concept originates from?

Answer 66

General Systems Theory and Cybernetics

Question 67

Which of the following statements are true?

Answer 67

a. For boys whose parents divorce, the risk of dying from accidents and violence was particularly robust, as they grew up to be more reckless. b. The experience of parental divorce was strongly linked to earlier mortality from all causes, including accidents, cancers, and cardiovascular disease. c. Children’s standards of living decreased, on average, when their parents divorced, but the psychological effects went beyond the economic changes. d. All of the above (correct)

Question 68

According to research conducted by Beavers-Timberlawn, which family type is most at risk for domestic violence?

Answer 68

Centripental: Centripetal family members look for gratification from within the family and are less trustful of the outside world.

Question 69

LoPiccolo is a well-known sex therapist who helped developed:

Answer 69

a sexual growth program for women who have problems in experiencing orgasm. be familiar with LoPiccolo's and others' work in sex therapy. Heiman, J., LoPiccolo, L., & LoPiccolo, J., (1988) wrote a book titled, "Becoming Orgasmic: A Sexual Growth Program for Women".

Question 70

The therapist least likely to rely on self-report data is:

Answer 70

Haley did not rely on self-report data but the interactional patterns that took place in the session. He focused on process not content.

Question 71

An MFT retired to a rural area. She decided to volunteer for the local community mental health agency to do some home-based family therapy. Her work was entirely free, not receiving any compensation from the agency or from the clients. After a few months working with one particular family, the father mentioned that he often drove past her farm and noticed her barn door didn't close and was off its hinges. He stated that he would be happy to fix it for her, since she had done so much for his family. The correct statement about her obligation under HIPAA rules is:

Answer 71

She is a 'covered entity' unless she is separated from the agency as totally independent, has no access to other agency clients' PHI, and does not transmit any PHI electronically.

Question 72

A couple comes in for therapy. The husband complains his wife is too close to her family and she has trouble separating from them. In fact, he states that his wife is in constant contact with her mother and looks to her mother constantly to help her make decisions. Often these decisions are in opposition to decisions made previously by he and his wife. A Structural therapist in assessing this couple would:

Answer 72

assess boundaries between the wife and her family. Minuchin assesses functioning of subsystems (including individuals), paying particular attention to the boundaries between them. Only "clear" boundaries support the successful functioning of subsystems, while "rigid" boundaries will prevent the exchange of needed information and affect, and "diffuse" boundaries will permit too much exchange.

Question 73

Which of the following theorists, a pioneer in cognitive psychology strongly influence the narrative model with his work "The Narrative Construction of Reality"?

Answer 73

Bruner. In an article from the journal Critical Inquiry, Bruner argued that the mind structures its sense of reality through mediation through "cultural products, like language and other symbolic systems". He specifically focused on the idea of narrative as one of these cultural products. He defined narrative in terms of ten things: Narrative diachronicity: The notion that narratives take place over some sense of time. Particularity: The idea that narratives deal with particular events, although some events may be left vague and general. Intentional state entailment: The concept that characters within a narrative have "beliefs, desires, theories, values, and so on" (7). Hermeneutic composability: The theory that narratives are that which can be interpreted in terms of their role as a selected series of events that constitute a "story." See also Hermeneutics Canonicity and breach: The claim that stories are about something unusual happening that "breaches" the canonical (i.e. normal) state. Referentiality: The principle that a story in some way references reality, although not in a direct way that offers verisimilitude. Genericness: The flipside to particularity, this is the characteristic of narrative whereby the story can be classified as a genre. Normativeness: The observation that narrative in some way supposes a claim about how one ought to act. This follows from canonicity and breach. Context sensitivity and negotiability: Related to hermeneutic composability, this is the characteristic whereby narrative requires a negotiated role between author or text and reader, including the assigning of a context to the narrative, and ideas like suspension of disbelief.

Question 74

A Contextual family therapist interviews a family and discovers that Mr. Medieros, the father, comes from a family in which his father was irresponsible and unavailable. Mr. Medieros reports that as the eldest son, he took responsibility along with his mother for the well-being of the family. Mrs. Medieros smirks and states how ironic it is that her husband withdraws from her and her children. In obtaining this information, the therapist is able to see:

Answer 74

the transgenerational issues and destructive entitlement.

Question 75

According to Lyman Wynne, pseudo-mutual families may create a flexible yet unstable boundary called:

Answer 75

Rubber fence boundary: Wynne has coined the rubber fence boundary concept to describe a flexible, yet non-stable family boundary in families characterized by a pseudo-mutual pattern. Rules that govern this type of boundary are in constant flux, allowing in whatever is deemed acceptable, while unpredictably excluding that which is deemed unacceptable. A pseudo-mutual pattern is a collusive family maneuver which presents an harmonious picture to the outside world, covering up dysfunction.

Question 76

A behavioral family therapist working with a wife who is having trouble getting her husband's attention when she talks, offers the following instruction: "This time when he turns his head away, I want you to squeeze his hand gently and tell him you really want him to listen." These verbal instructions are called:

Answer 76

Coaching: Classical conditioning is pure stimulus-response, as in pavlov's dogs.

Question 77

Mr. and Mrs. M. were in therapy with their minister, Rev. A. A colleague of the minister's reprimanded her, stating that Rev. A. was in a dual relationship with the couple. Rev. A. replied that she was well within the AAMFT code of ethics because she was getting supervision for this case. The minister was correct because:

Answer 77

all dual relationships are not prohibited. Section 1.2 of the current AAMFT Ethics Code does not prohibit all dual relationships. The Code states that when dual relationships cannot be avoided (such as marriage and family therapist also serves as pastor to his/her congregation) the therapist must "....take appropriate precautions to ensure judgment is not impaired and no exploitation occurs." Precautions usually consist of supervision and/or consultation

Question 78

A couple comes to therapy because they feel their sex life is not satisfying. The female reports that she is always anxious and is unable to reach orgasm and feels that her husband thinks she is an inadequate sex partner. In the first session, a Bowenian therapist would do all of the following EXCEPT:

Answer 78

A. assess the inequality of power in the couple system and the extended family. (correct) B. assess the family life cycle phase. C. assess the level of anxiety/stress in the couple system and the extended family. D. assess the level of differentiation of the couple, in relation to their extended families.

Question 79

Relevant concepts of Bowen theory include all of the following Exect:

Answer 79

A. degree of differentiation of self of each family member. B. Search for strengths (correct) C. Family's anxiety level and emotional reactivity D. family projection process

Question 80

A family comes to therapy because their son has just been diagnosed as schizophrenic. The parents report that the hospital report alluded to the fact that their son’s schizophrenia was caused by the family’s dysfunction. The therapist states that schizophrenia is genetically based, and that the family had “no control over it”. This therapist is MOST LIKELY coming from which model?

Answer 80

Psychoeducational

Question 81

An MFT has been seeing a divorced father with two daughters, 8 and 12 years old. After not showing up for an appointment, the MFT receives a call from the police stating that the mother reported the children and the father as missing and that he is the primary suspect in the childrens' disappearance. The police demanded copies of his psychotherapy notes to see if there's anything in them that will help determine the childrens' location. In this situation:

Answer 81

The MFT should hand over his psychotherapy notes so that the police can determine if there's anything of value to them in the notes

Question 82

A mother calls the therapist sounding very panicky, wanting an immediate appointment. At the first session, the mother states that her 12-year old son Sam has just been caught in the bathroom of a neighbor’s home with a 6-year old boy. The 6-year old says that Sam was playing with his “bum” and kissing his penis. When confronted by his mother, Sam admitted to having “played” with the boy on 4 previous occasions. The neighbor boy’s parents have banned Sam from their home and informed other parents and the school about his “perversion”. Sam’s mother called a psychiatrist prior to calling you who she says stated, “You can put him into therapy and give him drugs, but it’s probably already too late.” You begin seeing Sam and his family. In your first meeting with this family, you begin by speaking for a time with each member of the family, asking them about themselves. This engagement technique might be used in which school of family therapy?

Answer 82

Strategic / Haley.

Question 83

During a session a client stated that she had had it with a co-worker's verbal abuse, had bought a hand gun and was developing a plan to kill him. The therapist, although concerned about confidentiality, called the police who said they would take care of it. The therapist:

Answer 83

did not fulfill his duty to warn because he did not contact the co-worker directly.

Question 84

The Rodriquez family has been run like clockwork for the last 12 years. Mother and Father both agree that it is important to have clear rules in the family. But since the oldest daughter has turned 14, the rules are no longer working. An MRI therapist asks the family what they have done to solve the problem thus far. Father explains that they have increased the daughter’s curfew from 9 to 10pm on weekends. This is an example of a:

Answer 84

1st order change. -a change in behavior. While a second order change is a change in the beliefs or rules that govern behavior or emotions.

Question 85

A couple presents for family therapy saying that “whenever they talk, they argue,” and that their conflict has been escalating and is getting scary. The husband Bob is 48; his wife Donna is 29. They have two teenage children from Bob’s previous marriage. Bob is a project manager for a large corporation with responsibility for numerous national and international locations which frequently take him away from home. Donna is getting a graduate degree. Donna complains that neither of the teenage boys will listen to her when he is away from home. In working with this family, a therapist working from the Feminist Model of Family Therapy would most likely:

Answer 85

align with the wife in the couple systemc

Question 86

A new client comes into your office for intake with a number of pages printed from the internet. He goes on to explain that the papers all contain information about you that he has collected online. There is a story from your hometown newspaper from ten years ago that has a picture of your mom, there is your Facebook page that you have privatized but still identifies people in your network, and there is your LinkedIn professional page. As a family therapist,what would be the appropriate stance for you to work with this client.

Answer 86

Acknowledge with the client that with the advent of the internet that the traditional boundaries between therapist/client are easy to blur and explore with the client what they might have hoped regarding a response from you.

Question 87

A twelve year old boy told a friend in school that he was going to kill himself so that he didn’t have to tell his parents about a recent poor test grade. The friend told a teacher who contacted the mother who became very upset on the phone. The teacher recommended an urgent appointment with a local family therapist. The boy has an older sister who has been in treatment for depression and a father who abuses alcohol. Before his initial interview with the boy, the clinician learns from the parents through a phone call, that although he did go home and tell his parents about the poor grade, he has repeated his suicide threat to other people, including to the clinician herself. From this new information the clinician concludes:

Answer 87

it is not good practice to determine the risk level from this information alone.

Question 88

A family therapist would label the type of relationship that demonstrates the exchange of different types of behavior as:

Answer 88

Complementary.

Question 89

Feminist family therapists are critical of the cybernetic concept of circular causality in male-female relationships because of the implication of:

Answer 89

equal power and control.

Question 90

A family therapist is working with one member of a family who reports that when she feels vulnerable, she desperately searches for ways to numb the pain. This family member seems to be describing the role of the:

Answer 90

Firefighter

Question 91

One of the methods used by LoPiccolo when treating an inorgasmic dysfunction is:

Answer 91

Directed masturbation training.

Question 92

Guillermo, age 14 is the first child to his father and the oldest brother to his three half-siblings. The father, a Mexican-American was raised in Orange County, California and his wife is of Jewish heritage and was raised in New Jersey. She is the mother to the three younger children. The family has come to therapy with Guillermo because Guillermo has begun to terrorize his younger sister. He looks very much like his dad while the younger children resemble their mother much more. The girl being terrorized by Guillermo has bright blue eyes and curly blond hair. "She gets everything!", Guillermo protests. What is the most culturally sensitive way to address this possible race related issue with this family?

Answer 92

Address possible race issues in the beginning of therapy directly with the family.

Question 93

Heather, a 16-year-old, was caught at school with marijuana and has been expelled. She comes to therapy with her father, Mike. Mike is divorced from Heather's mother and has custody of Heather and her two siblings. He owns slot machines and is out all day servicing them and collecting money. He smokes marijuana around his children. From a Solution-Focused model, the presenting problem around which a goal is to be created is:

Answer 93

Unknown

Question 94

Olsen’s Circumplex model, sometimes called 'FACES' identifies:

Answer 94

flexibility and cohesion facilitated by communication as the most important characteristics to assess when families are in crisis.

Question 95

Which of the following statements regarding divorce are NOT true:

Answer 95

a. Boys and girls from divorced homes were more likely to smoke and drink when they got older, as compared to their peers from intact families. b. Girls and boys from divorced homes tended to end their education earlier than those from intact families, with the expected problems that then ensued. c. Children’s standards of living decreased, on average, when their parents divorced, but the psychological effects went beyond the economic changes. d. A positive family environment—having positive feelings about one’s family—will ameliorate the detrimental effects of divorce. Boys with positive family feelings lived longer lives, as it turns out not to be especially traumatic to have a seemingly positive, functional home change its parental structure. (Correct)

Question 96

The notion that a person's experience shapes the way they think and understand the meaning of things and relationships in their life is called:

Answer 96

Social Constructionsim:

Question 97

A family comes to therapy and during the first session, the therapist observes that the 7-year-old daughter sits between her parents and looks toward her mother before answering any questions. The father appears bored during the session and constantly looks up toward the ceiling whenever the daughter looks toward the mother. The 5-year-old son and 9-year-old daughter are sitting opposite the parents and appear distracted and uninvolved. As a Structural therapist you most likely would:

Answer 97

instruct the 7-year-old to sit next to her siblings and ask the parents to sit next to each other.

Question 98

Which of the following assumptions about systemic functioning is not accepted as valid and useful?

Answer 98

a. Assessment focuses on linear vs. circular causality. (correct) B. Families who are having problems are stuck in a phase of the family development life cycle C. Problems are the result of ineffective interactional and organizational rules in the family rather than the result of individual pathology. D. The presenting problems are a result of family rules which are an ineffective way of dealing with stress.

Question 99

An MFT in a 3-person group practice keeps her client PHI on her office computer. She uses clinical practice management software that keeps most information she needs conveniently organized. In addition to all insurance information, the software does her billing via direct internet connection to a payer clearinghouse, resulting in quick turn-around of payments, and also allows for email communications with the client, keeping the emails organized and associated with the client record. The software also provides a text entry area to record the session information. However, during her original clinical training, she developed the habit of scribbling a few notes on a pad next to her as she conducted her therapy sessions, which she still does. Her computer is password protected, she uses an encryption technology for all client and insurance company electronic/email transactions and her handwritten session notes are kept on paper and filed in a locked cabinet in her office. Two of the clinicians in the practice described above share the same family therapy case. One sees the parents in couples therapy, the other works with their 16 year old daughter individually, also offering occasional family meetings. The daughter often tells her therapist that there is information that she does not want disclosed to her parents. Which of the following statements is correct?

Answer 99

The therapists can exchange HIPAA protected PHI without authorization from either parent because they are within the same covered entity. HIPAA rules state specifically that PHI can be exchanged among workforce members of each covered entity for 'normal healthcare operations', just as it can be exchanged with insurance companies for billing purposes. Each person receiving the PHI must be either a licensed clinician operating under the covered entity guidelines or a trained staff member, working either as an employee or contractor with written contract. The corporation must be in full compliance and have all security measures fully documented.

Question 100

The goal of Emotionally Focused Therapy is:

Answer 100

Emotionally Focused Therapy works to re-organize primary and secondary emotions through the creation of a strong attachment (trust) bond between partners. Once achieved, new interactional patterns are developed based on the more secure bond.

Question 101

The Solution Focused therapist believes that solutions to problems are often:

Answer 101

Unrelated to the way the problems developed.

Question 102

An MFT works as a 1/3 time employee of a local high school. His primary responsibility is to meet with students together with their family members to help them understand and coordinate educational goals with teachers and guidance personnel. Occasionally, the MFT will hold a series of family therapy sessions when school guidance counselors indicate they believe the student and their families are in conflict about the student's school activities. During the remainder of his work hours, the MFT has a solo private practice in which he bills insurance companies for his services, making use of a billing clearinghouse service. In this situation:

Answer 102

Whether the MFTs work in the school is considered healthcare depends on the understanding created with each family, as to whether educational counseling or family therapy is being provided.

Question 103

A wife complains that her husband is upset because she refuses to have sex after a long day. She feels little or no sexual feelings when he approaches her at bedtime. However, when they are on vacation she has absolutely no problem reacting to her husband's advances; in fact, she is often the aggressor. The therapist diagnosis this as:

Answer 103

situational dysfunction.

Question 104

Aeisha is a beginning therapist working with the Robinson family. The family is seeking treatment because their 15 year old son, was caught shoplifting. Aeisha feels like the family is challenging and resistant to her suggestions for change. In her next session, Aeisha spends more time joining with the family and asking how they thought therapy should proceed. After this session, Aeisha begins to reformulate an approach that is more consistent with the family’s view of the problem. She soon discovers that movement is beginning to happen in therapy. According to research, Aeisha this family may have been presenting:

Answer 104

therapist resistance.

Question 105

A family therapist is trained in the Solution-Focused model. What would be their primary therapeutic goal?

Answer 105

A perceptual shift from talking about problems to talking about solutions.

Question 106

A family consisting of a mother, father, two daughters ages 13 and age 15, and a son, age 17, enter therapy. The parents are complaining that their 15-year old daughter is coming in drunk every night and is very abusive to the family. During the first interview the therapist begins the session by greeting each family member and asking each member to tell her a bit about themselves before asking for his/her view of the problem. The therapist would be:

Answer 106

Joining

Question 107

With regard to MFTs, licensed or certified, HIPAA states:

Answer 107

Nothing specifically.

Question 108

An MFT is using a differentiation approach in treating an internet affair. After completing an assessment of the couple and the circumstances of the affair the therapist will

Answer 108

confront the distressed spouse about his/her sense of betrayal.

Question 109

Some Feminist family therapists are critical of Minuchin's emphasis on family hierarchies because they believe:

Answer 109

it reinforces gender stereotypes. Feminist Family Therapists have outlined three major mistakes of mainstream family therapy theory. These mistakes are: 1) overlooks gender, one of the major building blocks of any theory of family; 2) overlooks power as a valid construct of family systems within generations (although noted power issues cross-generationally); 3) supports the main bias in our culture, that autonomy and the differentiation of self is valued more than relational competence and affiliation. Feminist thought equally values autonomy, differentiation of self, competence, and affiliation

Question 110

A couple comes to therapy because the woman is having problems "being sexual". The therapist gives a sensate focus homework assignment. During the next session the woman comments that she couldn't allow her partner to touch her. What did the therapist fail to do?

Answer 110

take an adequate sexual history from the couple.

Question 111

A couple comes to therapy because their three-year-old daughter is “out of control”. During the session the wife begins complaining that her husband is never home and she is left to deal with her daughter's behavior. An initial goal that a Structural Family Therapist working with this family might set is to:

Answer 111

help the couple function together as a cohesive executive subsystem. Minuchin believes that the most important of all the general goals for families is the creation of an effective hierarchical structure

Question 112

Which school of thought has recently emerged placing a renewed emphasis on language and meaning, rather than a strict adherence to the more common theories of family therapy? This school of thought is more pluralistic, crossing disciplinary boundaries while breaking free of old paradigms. It views the therapist as part of the therapy process, rather than as an expert.

Answer 112

Postmodernism-- emphasizes language and meaning, placing the therapist inside the therapeutic focal unit.

Question 113

The Contextual model regards which of the following dimensions as the most essential and powerful in family relations?

Answer 113

Relational Ethics The relational ethics dimension emphasizes the subjective balance of justice and determines relational trustworthiness, regarded as being the most essential and powerful in the family.

Question 114

Mr. Oesco comes to therapy with his son Josh. Mr. Oesco and his wife are divorced. He and Josh live together and Mrs. Oesco and her daughter Jessica live in another state. The presenting problem appears to be Josh’s anger at his mother and his refusal to conform to the visitation arrangement set up by the court when the Oesco’s divorced. Josh appears to have a good relationship with his sister which at times presents a problem to his father and mother. In assessing this family, the majority of family therapists would most likely do all of the following except:

Answer 114

identify family of origin patterns that are transmitted across generations.

Question 115

Systems that are self-organizing and self-maintaining, such as biological and human systems are know as:

Answer 115

autopoetic Systems

Question 116

Children adapt most easily to remarriage if they are:

Answer 116

Preschoolers - either sex

Question 117

The AAMFT Code of Ethics sets the ethical standards for:

Answer 117

all members of AAMFT.

Question 118

Mary is a 15-year-old who has been truant for 31 days. In addition her parents report that she sleeps all day and stays up most of the night. She has gained 30 pounds over the past six months. She looks sad and has isolated herself from all her friends.A Strategic family therapist treating Mary and her family for the first time would most likely:

Answer 118

relabel Mary's behavior as stubbornness or laziness.

Question 119

The Johnson family first presents as with the middle child , an 8 year old boy, school refusing. Neither of his older or younger sibs is presenting with any apparent difficulties. It quickly becomes apparent that the couple is not living together and is in the process of a difficult divorce. The couple asks you about the long term effects of divorce, to which you respond

Answer 119

Studies have shown divorce is a predictor of many future difficulties for children including early mortality. THE IMPACT OF DIVORCE ON CHILDREN 1. Children from divorced families died almost five years earlier than those from intact families. 2. Facing parental divorce during childhood was the single strongest social predictor of early death, many years into the future. 3. Having one’s parents divorce during childhood was a much stronger predictor of mortality risk than was parental death. 4. The experience of parental divorce was strongly linked to earlier mortality from all causes, including accidents, cancers, and cardiovascular disease. 5. For boys whose parents divorce, the risk of dying from accidents and violence was particularly robust, as they grew up to be more reckless. 6. Children’s standards of living decreased, on average, when their parents divorced, but the psychological effects went beyond the economic changes. 7. Girls and boys from divorced homes tended to end their education earlier than those from intact families, with the expected problems that then ensued. 8. Boys and girls from divorced homes were more likely to smoke and drink when they got older, as compared to their peers from intact families. 9. Girls from divorced families were than 100% more likely to become heavy smokers. 10. Those who had lived through their parents’ divorce when they were children were more likely to have their own marriages end in divorce, thus perpetuating the vicious cycle. 11. A positive family environment—having positive feelings about one’s family—did not ameliorate the detrimental effects of divorce. Boys with positive family feelings lived shorter lives, as it was especially traumatic to have a seemingly positive, functional home torn apart. 12. Men who divorced were at much higher mortality risk than those who remained married. Even remarried men didn’t live as long as those who stayed steadily married.

Question 120

Beth and Paul come to counseling because Beth feels that after two years of marriage she and Paul have nothing in common. She complains that for the past six months she has been complaining to Paul that there are problems with their relationship. Paul states that he doesn’t feel there are problems, he feels his wife is just overreacting. The therapist asks, "How does overreaction affect the relationship?" This type of question is a good example of getting the couple to:

Answer 120

externalize the problem.

Question 121

What is the purpose of licensure for Marriage and Family Therapists?

Answer 121

to maintain integrity of the profession.

Question 122

A therapist may assign a group of friends to watch over a young adult who is abusing drugs and another group to arrange for him to move out of his parent's house. This therapist is most likely implementing a technique used in:

Answer 122

Network therapy. Speck and Attneave (1973), co-founders of Network Family Therapy, described breaking the client family's social network into problem solving subgroups, using action instead of affect to move beyond despair. A breakthrough can be achieved when the network's energies are unleashed and directed toward active resolution of problems.

Question 123

Which of the following are similarities between strategic and structural models?

Answer 123

They both consider the impact of the life cycle stage. The treatment is symptom oriented. They use in-session interactions to assess the family & emphasize process over content. All of the above ***

Question 124

Multi-ethnic and multi-racial families often present with rich and complex histories and dynamics. The best assessment tool for outlining the complexities of a multiracial family is a:

Answer 124

cultural genogram.

Question 125

The DSM-5 has evolved from the DSM-IV TR in a variety of ways and now

Answer 125

assesses development across the life span.

Question 126

All of the following are considered communication theorists EXCEPT:

Answer 126

Haley Watzlawick White *** Stir

Question 127

Sex therapy with a couple would end when:

Answer 127

Client's goals are completed.

Question 128

Drawing from John Bowlby's work, this model emphasizes the importance of healthy attachment at the infant stage of development. It also addresses the need for individuation and differentiation.

Answer 128

Object Relations Family Therapy

Question 129

A mother calls the therapist sounding very panicky, wanting an immediate appointment. At the first session, the mother states that her 12-year old son Sam has just been caught in the bathroom of a neighbor’s home with a 6-year old boy. The 6-year old says that Sam was playing with his “bum” and kissing his penis. When confronted by his mother, Sam admitted to having “played” with the boy on 4 previous occasions. The neighbor boy’s parents have banned Sam from their home and informed other parents and the school about his “perversion”. Sam’s mother called a psychiatrist prior to calling you who she says stated, “You can put him into therapy and give him drugs, but it’s probably already too late.” You begin seeing Sam and his family. From a Milan Systemic approach you would:

Answer 129

Inquire about the family processes that preceded and followed the incident, as you maintain a neutral posture. *Inquiring about the family processes infers neutrality, hypothesizing and circularity, all of which are hallmarks of Milan Systemic therapy.

Question 130

Bowen believed that functional shifts in differentiation often occurred during all of the following EXCEPT

Answer 130

a. inability to allow for individual differences b. mishandling of attempted solutions ** c. transitions through the individual and family cycle d. Responses to triangulation

Question 131

Rational/scientific, approval, worrier, protective all describe parts of:

Answer 131

Schwartz's parts of the therapist. | *Part of Internal Family Systems Model

Question 132

Maturano speaks of systems that can be controlled from the outside, similar to machines, as being:

Answer 132

Allopoietic

Question 133

A family whose members are constantly struggling while battling over control issues, would fall into Beavers-Timberlawn’s competence dimension of:

Answer 133

Mid-range * The optimal and adequate range is where families have the skills needed to balance between individual choices and larger family’s needs. The severely dysfunctional families are inflexible, have poor boundaries, confused communication, and lack of shared focus of attention.

Question 134

A couple come into therapy because the wife has an absence of orgasm during intercourse. She reports that although she gets sexually aroused, she has never experienced an orgasm and is wondering what is wrong with her. The therapist diagnoses her as having:

Answer 134

Anorgasmia

Question 135

The philosopher Foucault exposed how various discourses within a society:

Answer 135

are dehumanized, objectified, and marginalized by various social groups who are in power over the other groups. *Foucault saw groups in power, government for example, creating a machinery of sorts that established the norms for behavior or society; norms that allowed for the manipulation of those groups not in power.

Question 136

A therapist seeing an extended family consisting of a grandmother, mother and 2 daughters, notices that the grandmother speaks to her daughter with a certain disdain. This seems similar to the way the older daughter speaks to her sister. This is an example of:

Answer 136

Isomorphism ^ is a structure or pattern that repeats itself from one level of a system to another.

Question 137

A family therapist begins to map the various ways in which a family is organized. This technique is most associated with:

Answer 137

Structural Therapists

Question 138

Haley believed that normal family functioning includes all of the following EXCEPT:

Answer 138

a. a large repertoire for handling problem resolutions b. connectedness ** c. flexibility d. clear rules for governing hierarchy

Question 139

One of the changes from the DSM-IV TR to the DSM-5 is how a disorder is named and classified. Which of the following is the incorrect ICD-9 classification?

Answer 139

Childhood-onset fluency disorder (stuttering) 580.81

Question 140

A couple presents in crisis after the wife discovers her husband has been involved with multiple women on the internet for 5 years and has come to realize that his lack of interest in their relationship may have less to do with work-related stress and subsequent disinterest in intimacy. A family therapist believes that there is really only one way to intervene with this couple, given their current volatility. This therapist does not seem to subscribe to the concept of:

Answer 140

Equifinality ^A cybernetic principle, equifinality states that a similar outcome may result from many different initial events. In this instance, believing that there is only one possible way to proceed does not support the notion that there are many interventions that can achieve the same result.

Question 141

A woman reports that she wants to be close to her husband and do more things together, but every time she broaches the subject he seems to distance himself even more. As a transgenerational therapist you detect a pursuer/distancer pattern. If you wanted to increase intimacy with this couple, you would most likely recommend:

Answer 141

the pursuer distance themselves from the distancer.

Question 142

A study of family therapy, rated outcomes in two different ways. The first way was a self-report in which family members were asked to rate their improvement on a scale of 1 – 5. The second rating was by trained observers watching for changes in specific behaviors on video playback of the families in their sessions. They also rated improvements on a scale of 1 – 5. Which of the following statements is correct?

Answer 142

We can be more confident in the findings to the extent that the self-reports and observer ratings correlate.

Question 143

Therapeutically, family rituals are designed to:

Answer 143

a. address a family conflict b. intervene in established family patterns c. change behavior d. all of the above**

Question 144

A family therapist is working with a family with a large extended family. Boundaries have been very diffuse between the family and some of the younger cousins. The therapist tells a story about her own family, specifically noting a time during adolescence when a cousin dropped by unannounced and how it threw the family into a small crisis. This therapist is most likely working from:

Answer 144

Collaborative

Question 145

Mary, age 27, had sought therapy for unremitting problems with binge eating and laxative abuse for the past six years. Her therapist, trained from a Symbolic-Experiential model, saw her alone for two sessions at her insistence and clarified that no changes were likely without inclusion of her husband. Mary indicated marital discord and indicated she might soon end the marriage, but that she and her husband were willing to engage in marital therapy. During the first session, the husband was unwilling to acknowledge any concern for his wife’s symptoms or marital dissatisfaction.The husband’s unwillingness to acknowledge these concerns was seen by the therapist as:

Answer 145

a struggle for initiative

Question 146

A mother who, guilty about her early sex life, pressures her oldest son to be a priest or her oldest daughter to be a nun would be engaged in which behavior?:

Answer 146

projective identification

Question 147

What is the most important factor towards achieving a positive therapeutic outcome with a Puerto Rican family system?

Answer 147

Engaging in warm and personable manner in the first session while maintaing an active and respectful stance throughout the therapy.

Question 148

According to a Behavioral therapist, a therapeutic intervention might be designed to do all of the following EXCEPT:

Answer 148

a. have each member write self-report logs listing complete records of daily dysfunction thoughts, upsetting marital/family interaction, etc. b. encourage the spouses to interact during the session. c. looking at the ways the family will resist change and the ways the family will take charge of their own growth*** d. probe for stream-of-consciousness thoughts and visual images held by each member of the couple or family system when describing past events that elicit negative affect.

Question 149

A strategic therapist responds, "I understand why you want to stay with him" to a woman whose spouse has had multiple affairs. This response would be considered a(an):

Answer 149

paradox

Question 150

An MFT was contacted by the father of a 6 year-old boy requesting that she begin counseling to help the child adjust to the recent family divorce. Following the HIPAA Privacy Rule, the therapist should:

Answer 150

be sure to separate the child's PHI and her therapy notes in her records.

Question 151

Therapists are required to keep electronic files of clients

Answer 151

in encrypted electronic form in a secure off site location.

Question 152

Mr. & Mrs. A. report that the school has called and informed them that their fifth grader has been disruptive and inattentive in class. The teacher has called on a number of occasions saying they could not control the son's behavior. The parents had a meeting with the school and the school staff suggested family therapy. In questioning the parents, the therapist found out that the child has had difficulty in school from first grade, but is not a behavioral problem at home. The therapist should:

Answer 152

Suggest the child be tested to rule out a learning disability.

Question 153

A couple comes to therapy because their three-year-old daughter is “out of control”. During the session the wife begins complaining that her husband is never home and she is left to deal with her daughter's behavior. A Structural Therapist would first focus of which of the following in the first interview with the family:

Answer 153

Joining

Question 154

Studies have found that 76% of bulimics were at least much improved using the following approach:

Answer 154

Structural / Strategic approach.

Question 155

Oldest children tend to gravitate to leadership positions and youngest children often prefer to be followers. The characteristics of one position are not "better" than those of another position, but are complementary. This concept comes from the works of:

Answer 155

Toman ^The basic idea is that people who grow up in the same sibling position predictably have important common characteristics.

Question 156

According to Jellinek’s theory of Progressive Phases of Alcoholism, the phase associated with gross drinking behavior, blackouts, gulping and sneaking drinks is:

Answer 156

the Prodromal Phase. *Jellinek has developed a progressive model for Alcoholism: Pre-Alcoholic Phase, Prodromal Phase, Crucial Phase and Chronic Phase. The Prodromal Phase begins when the drinking is no longer social but becomes a means of psychological escape from tensions, problems and inhibitions. Although the eventual problem drinker is still in reasonable control, their habits begin to fall into a definite pattern: 1. Gross Drinking Behavior: They begin to drink more heavily and more often than their friends. "Getting wasted" becomes a habit. When drunk, they may develop a "big shot" complex, recklessly spending money, boasting of real and imagined accomplishments, etc. 2. Blackouts: A "blackout," temporary loss of memory, is not to be confused with "passing out," or loss of consciousness. The drinker suffering from a blackout cannot remember things they said, things they did, places they visited while carousing the night before - or for longer periods. Even a social drinker can have a blackout. With prospective alcoholics, the blackouts are more frequent and develop into a pattern. 3. Gulping and Sneaking Drinks: Anxious to maintain an euphoric level, they begin to pass off drinks at parties and instead slyly gulp down extra ones when they think nobody is looking. They may also "fortify" themselves before going to a party to insure their euphoria. They feel guilty about this behavior and skittishly avoid talking about drinks or drinking.

Question 157

Greenberg and Johnson's emotionally focused couples therapy draws on

Answer 157

Attachment Theory

Question 158

The Beavers Model integrates FST with developmental theory, classifying families on two axis. The first identifies the stylistic quality of family interaction, the second axis classifies the family as:

Answer 158

Optimal, Adequate, Midrange, Borderline or Severely Disturbed.

Question 159

Research has shown that a successful predictor to a positive outcome utilizing Emotionally Focused Therapy is

Answer 159

how well established the therapeutic alliance is, especially the task aspects of engagement.

Question 160

A mother calls the therapist sounding very panicky, wanting an immediate appointment. At the first session, the mother states that her 12-year old son Sam has just been caught in the bathroom of a neighbor’s home with a 6-year old boy. The 6 year old says that Sam was playing with his 'bum' and kissing his penis. When confronted by his mother, Sam admitted to having 'played' with the boy on 4 previous occasions. The neighbor boy’s parents have banned Sam from their home and informed other parents and the school about his 'perversion'. Sam’s mother called a psychiatrist prior to calling you who she says stated, "You can put him into therapy and give him drugs, but it’s probably already too late." You begin treatment with this family by seeing Sam along with his family. Which of the following approaches would a strategic family therapist not use in working with this family?

Answer 160

A. attempt to find out what has been tried to solve the problem before. B. ask the miracle question.*** (The miracle question is associated with Solution-Focused while all other choices are clearly used from the MRI perspective.) C. take full responsibility for change. D. use paradoxical intent.

Question 161

The belief that the complaint is the problem, not a symptom of an underlying disorder, is a therapeutic distinction made by which approach?

Answer 161

MRI approach ^The complaint being the problem is a hallmark of the MRI or Brief approach, associated with the work of Watzlawick.

Question 162

A 29 year old man is referred for having made threats against the new boy friend of his previous girl friend. The clinician sets an appointment for the client and his two parents for early the next morning. During the initial interview, the client repeats the threat, making explicit statements about the steps he plans to take to harm or kill the other man, and states that he has access to a weapon. The clinician is alarmed but the parents state that they are not overly concerned because the client has made numerous threats in the past and has never acted on them. Taking more family history, the clinician learns that the client is still dependent on his parents financially and often returns home for meals and to get his laundry done by his mother. He attended two colleges but never graduated. He has a part-time job and is in touch with some high school friends. The clinician:

Answer 162

has a clear “duty to warn” because the threat appears specific and credible to him.

Question 163

According to research alcohol abuse is the most studied phenomenon in family therapy research. According to some outcome studies which of the following approaches have been particularly useful in dealing with substance abuse in families, especially for engaging young substance abusers?

Answer 163

Psychoeducational approach.

Question 164

A family therapist is working with a family of a mother and father whose children refuse to listen to them. She decides to use the miracle question with the family. How would she begin introducing it?

Answer 164

Suppose one night you were asleep, a miracle happened and your problem was solved. Upon waking, what would be the first thing you would notice that would tell you that the miracle had occurred?

Question 165

A 16 year-old has been sent home from school numerous times due to his inability to control his behavior in class. Now he’s refusing to go back. The parents have tried setting consequences, reasoning with him, and arguing, but nothing has worked. They are referred to you for family therapy. During your first session the parents make it clear that they are extremely upset and that their goal is to get their son back to school, but he says he absolutely won’t go. Good crisis management from a family systems perspective would be:

Answer 165

to calm the parents, normalize the situation, and help the family to step-down their perspective from “emergency” to “crisis,” and see that there are important long term goals that are developmentally necessary for their son, as well as for the entire family, to accomplish.

Question 166

Questions that provide information about how a problem has managed to disrupt a family versus how much they have been able to control it are referred to as:

Answer 166

Relative Influence questions. *The task of mapping the relative influence of the problem is a Narrative task that looks to establish how the problem has exercised control over the family and individual family members

Question 167

Greenberg and Johnson's Emotionally focused couples therapy draws on:

Answer 167

Bowlby’s Attachment theory, along with the works of Carl Rogers serves as the theoretical underpinnings to EFT.

Question 168

The Jones family is an African-American family referred to Mrs. B., a Caucasian family therapist. In working with this family, Mrs. B. should be aware of which of the following?

Answer 168

A. For many African American families the idea of going for treatment is a very new one, and often the questions asked by therapist can be perceived as intrusive. B. All answers provided.** (Discussion: A key to understanding families of any ethnic origin is to learn how the family perceives mental health and social service agencies. The familial boundary of African-American families has developed from a kinship model which utilizes the larger family system as its support, rather than social service agencies. African-American families can often appear cautious or guarded when dealing with a social service agency seen as being part of the majority culture. It is often important to clarify exactly what is the scope your involvement with the family system and how clinical work is separate from other social service agencies.) C. One of the issues that has led to the resistance of African American families toward mental health services has come from confusion about the relationship between mental health clinics and other agencies. D. The type of resistance and suspicion often manifested by African American families should not be summarily categorized as a contraindication for successful treatment.

Question 169

The AAMFT Code of Ethics for Technology-Assisted Professional Services includes these following subsets, excluding:

Answer 169

signs of internet addiction.

Question 170

Vignette: A 6’2' 16 year old male is brought for an evaluation by his parents. They report that he has been alternately crying and enraged. He punched the walls in his room numerous times in the last 3 days, threw a baseball at his younger sister and pushed his father when he was trying to calm him down. When talking to him alone, the client abruptly stands up and starts shouting at the therapist. The therapist’s best immediate next step would be:

Answer 170

create a diversion using humor and respect, by saying something like, “This conversation has been really intense. I’m ready for a break. How about you?”

Question 171

In which one of the following models would the therapist explore legacies, invisible loyalties, and ledger balances and thus guide family members toward those tasks necessary to restore some balance in the ledger?

Answer 171

Nagy’s Contextual approach is a transgenerational model that looks at how fairness and balance are maintained by the family.

Question 172

A family consisting of a lesbian couple and a 9 yr. old son who has been school refusing for the past year has asked for family therapy. In the first session, you notice that whenever the son speaks, one of his mothers is quick to finish his sentence. You adjust your chair as therapist to block the mother and her attempt to speak for her son. You do this in order to address which of the following Bowenian concepts:

Answer 172

Fusion *This is an example of the mother and son being fused to the extent mother is finishing his sentences. Note the structural technique of blocking used to confound you in your thinking. Undifferentiated ego mass, is a related concept and might be used if fusion was not included.

Question 173

The DSM-5 Dimensional Concepts address such things as:

Answer 173

Measurement of distress, disability and severity

Question 174

Jose and Maria bring their son Joe to counseling because of poor academic performance and behavior. A Strategic therapist would:

Answer 174

coach the family on improving its problem-solving skills. *The Strategic family therapist defines the focus of treatment as the family and its interactive process, paying particular attention to the family's process of problem solving.

Question 175

A family consisting of a mother, father, two daughters ages 13 and age 15, and a son, age 17, enter therapy. The parents are complaining that their 15-year old daughter is coming in drunk every night and is very abusive to the family. A family therapist first observes the family over the course of a session and then intervenes to change the dysfunctional transaction patterns. This technique is known as a(an):

Answer 175

An enactment is a punctuation of a behavioral sequence amongst family members. It can be used diagnostically or paradoxically by drawing attention to a particular pattern of behavioral interchange.

Question 176

Beth and Paul come to counseling because Beth feels that after two years of marriage she and Paul have nothing in common. She said that for the past six months she has been complaining to Paul that there are problems with their relationship. Paul states that he doesn’t think there are problems; he feels his wife is just overreacting. Which therapeutic model would directly confront Paul's pathologizing of Beth as problematic?

Answer 176

Feminist model *Feminist Family Therapists challenge traditional family roles by questioning gender roles and their stereotyping and how these have affected the family. Pathologizing the female experience, as in the usual model of codependency, is emphasized as problematic. Feminists work to move blame from an individual person to one's socialization process with special emphasis on the validation of the female experience

Question 177

During a therapy session your client confides in you that he has made plans to kill his wife's boss because she had an affair with him. You should:

Answer 177

Inform the police, and then the boss.

Question 178

According to a behavioral therapist, a therapeutic intervention might be designed to do all of the following EXCEPT:

Answer 178

A. Probe for stream-of-consciousness thoughts and visual images held by each member of the couple or family system when describing past events that elicit negative affect. B. Encourage the spouses to interact during the session. C. Looking at the ways the family will resist change and the ways the family will take charge of their own growth.* (Behavioral family therapists do not concern themselves with resistance and personal growth. Change is measured via behavioral change.) D. Have each member write self-report logs listing complete records of daily dysfunction: thoughts, upsetting marital/family interaction, etc.

Question 179

A Saudi family who has been in the US for 7 years comes to your office for an initial session. They have come to family therapy because their eldest son who is 15 has become defiant, speaking back to both parents and was recently caught cutting school. The father and mother are at odds around how to deal with the son. The mother states that this is normal for boys in the US to behave this way while the father wants impose much more stringent discipline and supervision of the boy, restricting him to the house when he is not in school. The initial goal of the therapy should be:

Answer 179

working towards strengthening parental subsystem so that they might parent as a more unified front.

Question 180

Olson’s Circumplex Model refers to specific levels of flexibility which include all of the following except:

Answer 180

Disengaged *In Oslon's circumplex model, the concept of disengaged is a lvel of cohesion, not flexibility.

Question 181

A family is referred for therapy because their 14-year-old son has threatened suicide. His grades have dropped from honors to failing and he spends much time in his room. He has begun giving his things away and reveals to the therapist that he has thought about suicide and has a plan for how he would kill himself. The therapist should:

Answer 181

discuss their son's active suicidality and encourage them to take it seriously.

Question 182

Which of the following research groups attempted to look at the underlying structures inherent in an abusive relationship and found that abuse co-exists with understanding and friendship in a unique and painful way?

Answer 182

The Ackerman Institute *Research was done at the Gender and Violence Project at the Ackerman Institute during the mid-1980's. While conceived as a pilot project, most of the families with whom the clinicians worked came for treatment voluntarily. The project was kept small and represents a collaborative process between clinicians and clients.

Question 183

An MFT performs an evaluation at the request of a judge in a divorce case. In response to the court clerk's request for expediting the report, the clinician faxes the report to the court. The clerk calls back and states that the fax was not received, and they determine that it was sent to the wrong fax number. The MFT's fax machine report states that the fax was sent normally, meaning it was received by someone else's fax machine. The MFT cannot:

Answer 183

be held liable for a HIPAA violation because no PHI was sent.

Question 184

Couple therapy has been shown to be effective when:

Answer 184

One member of the couple is depressed and conflict is high.

Question 185

A client well known to the clinician reported serious suicidal feelings. She has a history of feeling suicidal previously, uses alcohol too much, lives alone and has taken risks with driving and casual sexual relationships. To avoid worrying the clinician, she offered to contract to 'tell you before I do anything to harm myself.' The clinician should:

Answer 185

change the contract wording to be, “I will tell you instead of doing anything to harm myself or others.”

Question 186

A Feminist approach to family therapy includes all except:

Answer 186

A. the idea that family therapists often have stereotypical expectations of men and women. B. a recognition of women's subordination and inferior social position. C. an awareness of attempts to counteract the ways in which family therapy may reinforce women's subordinate position. D. the idea that family therapy attempts to empower and strengthen all family members.*** (A Feminist approach is singular for its emphasis on empowering women in particular. This is a corrective measure to counteract women's usual paradoxical position of having primary responsibility for the family while having reduced power for carrying out that responsibility.)

Question 187

What is the term that explains this definition: those events that exemplify the clients preferred outcome rather than his/her problem-saturated stories?

Answer 187

Sparkling Events.

Question 188

A same sex couple comes to therapy because they are having problems regarding their parenting of their ten year old son. In the course of the first interview, it is clear that each parent has very different expectations for their son's behavior. A family therapist should treat the couple:

Answer 188

according to the problem being presented.

Question 189

Beth and Paul come to counseling because Beth feels that after two years of marriage she and Paul have nothing in common. She adds that for the past six months she has been complaining to Paul that there are problems with their relationship. Paul states that he doesn’t feel there are problems; he feels his wife is just overreacting. The therapist asks himself: "How can I bring about change with this couple?" This question would most likely be asked by a:

Answer 189

Strategic therapist *According to Strategic therapist, especially Haley, the therapist is responsible for therapy, goals, and process and controls sessions by encouraging members to interact with each other.

Question 190

Originated by postmodern Chilean biologist, Maturana, systems that are self-organizing and self-maintaining, such as biological and human systems. Autopoietic Systems can be described by:

Answer 190

2nd Order cybernetics

Question 191

A young woman was hospitalized with a diagnosis of schizophrenia. During one of the family therapy sessions, the daughter walked into the room and went toward her father to greet him. The father stiffened, the young woman withdrew and the father said, “I thought that you’d be happy to see me?” A family therapist would consider this interaction an example of a (an)

Answer 191

Double Bind *In 1956, Bateson and his colleagues published their famous report, “Toward a Theory of Schizophrenia,” in which they introduced the concept of the double bind . They assumed that psychotic behavior might make sense in the context of pathological family communication. Patients weren’t crazy in some autonomous way, rather their behavior was an understandable extension of a crazy family environment. Consider someone in an important relationship where escape isn’t feasible and a response is necessary; when he or she receives two related but contradictory messages on different levels, and yet finds it difficult if not impossible to detect or comment on the inconsistency, that person is in a double bind.

Question 192

AAMFT’s code of ethics covers all of the following EXCEPT:

Answer 192

a. confidentiality b .Licensure as a MFT* c. responsibility to clients d. financial arrangements

Question 193

A fundamental tenant of a Constructivist perspective is that language shapes reality. In Solution-Focused Therapy this notion was:

Answer 193

accentuated to stating that language creates reality.

Question 194

Which one of the following therapists would emphasize that difficulties are turned into chronic problems by the persistence of misguided attempted solutions, forming positive feedback escalation?

Answer 194

Watzlawick *Among the strategic and systemic models there are three basic explanations for the way problems develop. The first, described earlier, is cybernetic: difficulties are turned into chronic problems by the persistence of misguided attempted solutions, forming positive feedback escalations (Watzlawick, Weakland, and Fisch). The second is structural: problems are the result of flaws in a family's hierarchy or boundaries. The third is functional: problems result when people try to protect or control one another indirectly, such that their problems come to serve a function for the system. The MRI group limits itself to the first explanation, while the other strategic or systemic models embrace all three, although each model emphasizes one explanation over the others.

Question 195

Circular causality speaks to the non-linear nature of systems. This concept originates from:

Answer 195

Both General Systems and Cybernetics speak to the significance of circular causality and its role in all systems.

Question 196

A couple comes to therapy because their three-year-old daughter is “out of control”. During the session the wife begins complaining that her husband is never home and she is left to deal with her daughter's behavior. An initial goal that a Structural Family Therapist working with this family might set is to:

Answer 196

help the couple function together as a cohesive executive subsystem. *Minuchin believes that the most important of all the general goals for families is the creation of an effective hierarchical structure.

Question 197

In comparing Transgenerational with Experiential models, the one concept that both models have in common is:

Answer 197

the attention to impact of past generations on the present. *Whitaker is known for his inclusion of both whole families and multiple generations of families in the therapy session, inferring that "marriage is not really a combination of two persons; rather it is the product of two families, who send out a scapegoat to reproduce themselves"

Question 198

Crisis management is:

Answer 198

short term treatment designed to help the client to achieve new adaptations to changed life circumstances.

Question 199

An MFT working at a clinic as a "fee-for-service' clinician stayed home sick one day and needed to cancel her appointments. She called the administrator who offered to have the clinic's telephone receptionist call all her clients to cancel. The clinic administrator gave the receptionist client folders for each of the MFTs clients scheduled that day and asked her to make all the calls. While she was on the phone with the mother of one client, the receptionist asked about her son by name, having come across it in the client file. The mother was uncomfortable with the receptionist's conversation and later complained to the MFT directly about releasing confidential information unnecessarily. In this situation:

Answer 199

The use of the son's name was a violation of the HIPAA Privacy Rule's principle of 'minimal information necessary.'

Question 200

The goals of family therapy are to establish the members' sense of belongingness and simultaneously to provide the freedom to individuate. In our system of therapy, social adaptation is not a goal: we seek to increase the creativity (what we call craziness) of the family and of the individual members." This statement was made by:

Answer 200

Whitaker. | *known fro his therapeutic use of "his craziness" in the experiential model.

Question 201

In assessing a couple which of the following family therapists would use an approach that includes:(1) Probing for stream-of-consciousness and visual images each spouse has when describing past marital events that did (or presently do) elicit negative affect and (2) Using a series of questions of the form "and if that were true, then what would the implications be?" to identify the "bottom line" most upsetting meanings the person attaches to the event?

Answer 201

Cognitive Behavioral --approach looks at the meanings attached to behavior

Question 202

Clinicians looking for guidance from outcome research want to know if the model being tested works in real-world clinical settings. To respond better to this concern, the most important next step researchers should take is:

Answer 202

Include clients with dual morbidity in their studies.

Question 203

A 17 year old female is referred by her parents for having an 'outburst' at a movie theater while with friends four days earlier. During the initial interview she tells the clinician that she has no idea why it happened and that this is her first such incident. She has no history of mental health issues or past treatment. She says she’s not concerned and that she is in the clinician’s office only because her parents were concerned. She says the police were called to the theater to manage the situation, but she was not arrested. She says also that the person sitting in front of her said she was slapped a number of times, but the client doesn’t remember doing that. The therapist should:

Answer 203

attempt to engage the client in a conversation about her life circumstances, including family, friends and school, to see if a crisis management or therapeutic relationship can be established that has a reasonably good chance of averting another incident.

Question 204

The Beavers System approach to family assessment includes:

Answer 204

interactional competence scales and interactional style scales. *These are clinical rating scales used to measure interactional competence (normal, mid-range, highly dysfunctional families), e.g. overt power, parental coalition, closeness, clarity of expression, etc. and interactional style (centrifugal vs. centripetal families), i.e. dependency, adult conflict, social presentation, etc.

Question 205

A community agency which employs an MFT as an hourly fee-for-service contractor, has designed a new treatment program for delinquent youths. The MFT is asked to be one of many clinicians delivering this new program. The program design includes a cognitive-behavioral approach adapted to family counseling. The idea came from the agency’s new clinical director who came back from a conference excited about the model. The MFT:

Answer 205

is not responsible for telling the agency what do to, but should check the available research to determine if there are any studies supporting the proposed treatment plan, and discuss his findings with the agency director.

Question 206

Katherine asks her mother for candy at breakfast time. Her mother says "no" and Katherine continues to ask her mother. Each time her mother says "no", Katherine’s whining becomes more persistent until she has a full-fledged tantrum, at which time her mother gives in so as not to wake her baby sister and Katherine stops whining. The therapist suggests to Katherine’s mother that she ignore Katherine when she whines. This technique used to eliminate behavior by not reinforcing is known as:

Answer 206

Extinction--occurs when reinforcement of behavior is withdrawn.

Question 207

In a therapy session a husband implies that his wife appears to get her own way most of the time. The therapist then suggests that the husband say “no” to the wife once during the following week. This Strategic technique is called a:

Answer 207

directive *This is an example of a directive in the Haley-Strategic tradition. Haley's directives are of two types: suggestions to behave differently and suggestions to continue to behave the same. Often Haley's directives are for changes that seem so small that the full ramifications aren't immediately apparent.

Question 208

Prior to beginning therapy or supervision using electronic means, a therapist or supervisor must

Answer 208

a.determine which technology based services are appropriate for the client or supervisee. b. All of the choices offered.*** (Cited from the AAMFT Code of Ethics, Standard VI, 6.1 Technology Assisted Services. All of these components are required for delivering services ethically using an electronic format only after receiving training, supervision or education using the relevant technology. Note: Given COVID many HIPAA related rules have been temporarily relaxed. Check with HHS for guidelines over the course of the COVID Pandemic.) c. ensure the confidentiality of all communication via electronic means. d. inform clients or supervisees of potential risks or benefits associated with the use of technology.

Question 209

During a session with a couple, a husband states to the therapist that his wife often nags and belittles him. The therapist's intervention is to give the wife homework in which she is to only say positive things to her husband and abstain from any negative comments. When she appears to be negative or belittling to her husband he is to put his hand up and say, "Stop." A feminist therapist would be critical of the above technique because it:

Answer 209

A. gives the husband more power. B. appears to be hierarchical. C. is therapist-driven. D. all of the above.***

Question 210

The DSM-5 has a new approach to the axial assessment system of the DSM-IV TR. Which of the following best represents these changes?

Answer 210

a. Separate notations for important psycho-social and contextual factors and disability. b. Axis II and V codes merged. c. Axes I, II, and III from DSM-IV TR are collapsed into one category. d. a. and c.****

Question 211

When having discovered that a client is HIV positive and has withheld this information from his spouse, the therapist's ethical responsibility is:

Answer 211

to protect client confidentiality unless mandated by state law to do otherwise.

Question 212

to protect client confidentiality unless mandated by state law to do otherwise.

Answer 212

first order change.

Question 213

Rituals and ordeals are specific techniques for:

Answer 213

Strategic therapists.

Question 214

In Contextual therapy the intent of multidirectional partiality is to:

Answer 214

give due consideration to each individual's interests in the various relational dimensions.

Question 215

Vaginismus is diagnosed in:

Answer 215

a female experiencing painful spasms during intercourse.

Question 216

Which one of the following statements is true?

Answer 216

a. Positive feedback is corrective, adjusting the input and returning the system to a steady state. B. Negative feedback is corrective, adjusting the input and returning the system to a steady state.*** C. Information processing refers to the set of family rules developed through the life cycle. D. Feedback loops refer to escalating quarrel patterns between spouses.

Question 217

David Olson’s Family Circumplex Model maps the dynamic relationships within families; identifying the following dimensions as critical to show how all family members and their behaviors are interconnected. Which of the following are Olson’s dimensions?

Answer 217

Cohesion, Flexibility and Communication

Question 218

This therapy works to frame change in ways that reduce resistance, decrease dependence on therapy and bypass the need for insight while removing the presenting problem and allowing families to take full credit for changes achieved in therapy. This approach was devised by:

Answer 218

Milton Erickson -- Hypnotherapy

Question 219

A couple you have been seeing for a while come to you with a story about going to the playground with their 2 year old daughter. The mother allows her daughter to climb challenging courses up a rather tall structure while within arms reach. The father is upset at his wife for putting their child at danger and not seeing the potentially long term consequences of having a paralyzed child should she fall off.

Answer 219

ask the father to notice the developmental benefits his daughter gains when being physically challenged by age appropriate play, and to gauge her attitude and self-confidence after accomplishing a difficult task.

Question 220

When a therapist decides to close his/her practice and the client wishes to continue with treatment the therapist should provide at least _______ referrals.

Answer 220

3

Question 221

"Conversational questions come from a position of not knowing and are the therapist's primary tool." This statement would most likely be made by a:

Answer 221

Collaborative therapist

Question 222

The 12-year-old brother of an 8-year-old acting-out girl was described by the parents as a symbol of family loyalty and proper behavior. He was a good student and an excellent athlete. The brother’s role would be labeled the 'well sibling' by which of the following therapists?

Answer 222

Contextual *The “well sibling” is a role maintained by dysfunctional dynamics every bit as much as the “parentified” sibling is. When you see “family loyalties,” think Contextual.

Question 223

A characteristic that distinguishes one particular approach from others is its emphasis on the self-development of the therapist. The belief is that it is hard for the patient to mature beyond the maturity level of the therapist, no matter how good his or her technique. This approach is:

Answer 223

Bowenian | *Bowen is know for his premise that clients cannot mature beyond the therapist's level of development

Question 224

The concept of the “saturated family”, the notion that the myriad of relationships, responsibilities, opinions and choices make it difficult for individuals to have a clear sense of their desires and beliefs, was developed by:

Answer 224

Ken Gergen--- developed the concept of the Saturated Family and writes extensively on the subject in his book of the same name.

Question 225

A therapist is seeing a 7-year-old girl who reported that when her daddy kisses her, he puts his tongue in her mouth. An ethical therapist would err if he:

Answer 225

contracted with the father to not kiss his daughter this way.

Question 226

A family enters therapy, having a 21 year old son who lives in the basement. He dropped out of college 2 years ago and is currently not working or going to school. He has refused all counseling. The father states he found evidence of marijuana smoking in his son’s room. The mother states that the father and son argue and sometimes push each other. A 16 year old daughter is in high school but is increasingly avoiding coming home.During the second family session the boy becomes enraged at his parents, blaming them for his failures and declaring that he’ll never set foot outside the house again. The clinician next step should be:

Answer 226

address him directly, telling him you want to hear whatever he has to say.

Question 227

Murray Bowen was a pioneer in having a systematic theory for utilizing family of origin as a therapeutic resource. Another therapist who is closely associated with a treatment method of adults and their family of origin is:

Answer 227

Framo--- known for his work with transgenerational issues in families. His work utilization of an object relations framework emphasizes transgenerational projection of good and bad interjects.

Question 228

According to Ackerman, families should be understood as having a fluid nature of family interaction influenced by addition or loss, individual developmental stages, socioeconomic factors and changes in health rather than seeing families in fixed, static state. The term he used to describe this phenomena is:

Answer 228

Homeodynamic ---the term coined by Ackerman to describe the fluid nature of family interaction rather than seeing families in fixed, static state. The family therapy field ultimately adopted the term "homeostasis" which is actually a misnomer.

Question 229

Internal Family Systems believes all of the following EXCEPT:

Answer 229

A. Communication theory can be applied to the internal system and with the ultimate goal of a "parts party" as a means of integrating the four parts.*** B. Changes in the internal system will affect changes in the external system and vice versa. C. There are no "bad" parts and the goal of therapy is not to eliminate parts but instead to help them find their non-extreme role. D. Systems theory can be applied to the internal system.

Question 230

During a session a Solution-Focused therapist with a depressed client asks the client, "on a scale of zero to ten, with zero being how depressed you felt when you called me, and ten being how you feel the day after the miracle, how do you feel right now?" This is a good example of a/an

Answer 230

scaling question

Question 231

A family is seeking therapy because of their child's behavior. During the first interview the therapist asked the parents "to what extent they thought their son was presently under the influence of the problems that had plagued his life so." This question might be asked by a:

Answer 231

Narrative therapist.

Question 232

When doing therapy with an Italian family, the therapist must be aware that many Italian families can be concerned about:

Answer 232

Disloyalty to the family ***According to McGoldrick's research in different ethnic groups ideas vary about what is problematic. WASP families may be concerned with dependency or emotionality, Irish families about "making a scene", Italian families about disloyalty to the family, Greek families about any insult to their pride, Jewish families about their children not being "successful", and Puerto Rican families about their children showing respect.

Question 233

Clinical practice in today's regulatory environment requires MFTs to attend to guidelines originating from the following sources:

Answer 233

HIPAA Security & Privacy Rules, state-specific licensing regulations, state-specific ethics code, industry standards of practice.

Question 234

Family therapy would probably be the primary intervention choice for all EXCEPT which of the following?

Answer 234

a. Problems with children b. Problems with relationships. c. Problems in an individual around times of family transitions. d. Borderline personality issues.****

Question 235

A couple comes in for therapy. The husband complains his wife is too close to her family and she has trouble separating from them. In fact, he states that his wife is in constant contact with her mother and looks to her mother constantly to help her make decisions. Often these decisions are in opposition to decisions made previously by he and his wife. In the first session Haley would:

Answer 235

help the couple to define the problem to be resolved. *Although answers helping define the problem, tracking disabling patterns, and establishing a hierarchy are all techniques used by Strategic therapists, helping to define the problem is the correct answer. The key words in the question being "the first session." Haley conducts a structured initial interview which involves four stages: 1. social stage, 2. problem stage. 3. interaction stage, 4. goal setting stage. Helping the couple understand each other’s perception of the problem is a technique used by social constructivists.

Question 236

A family therapist is “tickling the defenses” of a couple they are working with in order to:

Answer 236

Increase anxiety.

Question 237

The "not knowing" stance used by Goolishian and Anderson was used to help the clients:

Answer 237

Become experts on their own lives.

Question 238

The Object Relations approach to treatment of bulimia does NOT suggest which of the following?

Answer 238

a. There is a bio-psychological thrust toward individuation and creative self-expression. b. Families are organized around specific developmental issues and the systemic dynamics tend to be translated intergenerationally. c. The well-being of the family group is at least as important as the needs of the individual member. d. All of the choices.***

Question 239

A family therapist has in-session goals to accentuate the client's expression of attachment needs. Such emotional expression might be termed:

Answer 239

Primary Emotions.

Question 240

When working with couples, Satir was not interested in:

Answer 240

a change in or removal of the presenting problem.

Question 241

In a practice that includes over 50 active client families, a licensed marriage & family therapist bills only one client's insurance company through a billing service. All the rest of his clients are billed directly or pay at the time of the therapy. Some of the self-pay clients obtain insurance reimbursement using claim forms and/or billing statements signed by the therapist. In his disclosure statement at the beginning of treatment, the therapist would be wrong in stating

Answer 241

I will not be transmitting any of your confidential information electronically for any reason. Therefore, the HIPAA Privacy Rules will not apply to our therapeutic relationship.

Question 242

In the course of therapy with a single-parent mother (age 54) and her adopted daughter(16) who has a history of bulimia, the therapist reinforces with praise both mother and daughter's success over the past week at not listening to bulimia. The therapist then asks the daughter to make contact with the person in her life this next week who would be least surprised at her success. This technique is called:

Answer 242

historicizing unique outcomes.

Question 243

An MFT in private practice keeps some of her clinical records on her laptop computer, which she carries back and forth to work every day. One evening after work she stopped to meet a friend for dinner before going home. When she returned to her car she noticed the trunk was open and then found that her computer had been stolen. The clinician kept only her psychotherapy notes on her laptop. All client-identifying information (PHI) was kept in her office in locked file cabinets. According to the Security Rule:

Answer 243

Psychotherapy notes that do not contain specific PHI identifiers are not covered by the Privacy and Security rules.

Question 244

Greenberg and Johnson's Emotionally focused couples therapy draws on:

Answer 244

Bowlbys' Attatchment theory

Question 245

Mary is a 15-year-old who has been truant for 31 days. In addition, her parents report that Mary sleeps all day and stays up most of the night. She has gained 30 pounds over the past six months and she looks sad. Mary has isolated herself from all her friends.These symptoms best describe

Answer 245

Persistent Depressive Disorder.

Question 246

During an emergency interview the clinician uses humor, direct conversation and personal respect to bring the client back into a calmer more communicative state. A good next step would be:

Answer 246

encourage the client to plan a healthy and safe evening, and then call the next day to describe how it went.

Question 247

A family consisting of a mother, father, two daughters ages 13 and 15, and a son age 17 enter therapy. The parents are complaining that their 15-year old daughter is coming in drunk every night and is very abusive to the family. The therapist asks the brother, “Who is most upset by your sister's behavior?” Which of the following therapists would ask this question?

Answer 247

Milan Systemic -- therapists are known for their use of circular questioning. Circular questioning is a Milan Systemic technique introduced by Selvini-Palazzoli and her associates. Circular questions are interview questions, often in the form of comparing and contrasting family members' behavior.

Question 248

One of the defining characteristics of the therapist's stance of the Narrative Therapy movement is its emphasis on:

Answer 248

Neutrality

Question 249

A family comes to therapy and during the first session, the therapist observes that the 7-year-old daughter sits between her parents and looks toward her mother before answering any questions. The father appears bored during the session and constantly looks up toward the ceiling whenever the daughter looks toward the mother. The 5-year-old son and 9-year-old daughter are sitting opposite the parents and appear distracted and uninvolved. A primary goal of a Bowenian therapist working with this family would be:

Answer 249

the differentiation of family members.

Question 250

Historically, the theory most associated with brief therapy is:

Answer 250

Milan Systemic

Question 251

This approach represents a multidimensional theoretical model for the understanding of relationships in which men are violent toward women and argues that abusive relationships exemplify, in extremes, the stereotypical gender arrangements that structure intimacy between men and women generally; it furthermore proposes that paradoxical gender injunctions create insoluble relationship dilemmas that can explode in violence. This multifaceted approach to treatment, which incorporates feminist and systemic ideas and techniques was designed by:

Answer 251

Goldner, Penn, Sheinberg & Walker

Question 252

A couple comes to therapy because they feel their sex life is not satisfying. The female reports that she is always anxious and is unable to reach orgasm and feels that her husband thinks she is an inadequate sex partner. The therapist prescribes a sensate focus exercise. During the next visit, the female partner reports crying when touched. What is the most useful next step in treatment?

Answer 252

Question the female partner about the nature of her crying during the sensate focus exercise

Question 253

A family comes to therapy because their 16-year-old daughter is diabetic and has recently stopped taking her insulin on a regular basis. During the session the therapist learns that their 19-year-old son, who is Mom's favorite child, has just gone into the army. A Structural therapist would make the following therapeutic intervention:

Answer 253

congratulate the daughter for distracting the mother from feeling sad over her son's leaving.

Question 254

A couple is seen by a Behavioral therapist for sexual problems. He instructs the couple to engage in a series of progressively more intimate encounters, avoiding all thoughts about erection or orgasm. This technique is referred to as:

Answer 254

Systematic Desensitization -- a step-wise and gradual behavioral procedure, utilizing a hierarchy of anxiety provoking situations to be overcome, one at a time.

Question 255

The Family Preservation Model seen in many federally-funded programs grew out of:

Answer 255

the MRI model.

Question 256

Common techniques used in Structural Therapy include:

Answer 256

unbalancing the family equilibrium and re-aligning boundaries.

Question 257

After reviewing the Security Rule, an MFT in an individual, private practice renting space in a large office building, decided he had to be much more careful protecting confidential records. He purchased locking file cabinets, password protected his client files on his computer, and added a confidentiality notice to all work-related emails and faxes. However he did not communicate with the cleaning service that enters his office in the evenings unsupervised. The following statement about these precautions is correct according to the HIPAA Security Rule:

Answer 257

The MFT was not required to contract with the cleaning service directly because he is exempted from this requirement by the Scalability Principle.

Question 258

A family is referred for therapy because their 14-year-old son has threatened suicide. His grades have dropped from honors to failing and he spends much time in his room. He has begun giving his things away and reveals to the therapist that he has thought about suicide and has a plan for how he would kill himself. The therapist should:

Answer 258

discuss their son’s active suicidality and encourage them to take it seriously.

Question 259

Studies show that children of gay and lesbian couples compared with straight couples have:

Answer 259

Same problems

Question 260

Paradoxical tasks given by the Strategic therapist are:

Answer 260

expected to be resisted.

Question 261

The goal of Emotionally Focused Therapy is

Answer 261

a. To create a shift in partner’s interactional positions and initiate new cycles of interaction. b. To expand and re-organize key emotional responses–the music of the attachment dance c. To foster the creation of a secure bond between partners. d. All of the answers provided.***

Question 262

A couple presents in crisis after the wife discovers the husband has been involved with a woman on the internet for 2 years and has come to realize that his lack of interest in their marriage may have less to do with the stress he brings home from work and his subsequent lack of interest in intimacy. A family therapist believes that there many possible ways to intervene with this couple, given their current volatility. This therapist does not seem to subscribe to the concept of:

Answer 262

Equipoteniatility *This General Systems concept states in effect, that "all things will be equal in the end" and is the basis for the belief that many different sorts of interventions or approaches can yield the same results, so that this therapist has many therapeutic paths open to them and does not need to find the single "correct" path.

Question 263

In one study, OCD patients and their families were given psychoeducation sessions. The results were positive, but the sample size was small. Therefore:

Answer 263

We cannot generalize from this study to the broader population. We don’t know if the positive effect will hold up when the same treatment is used in clinical settings.

Question 264

When videotaping families, it is imperative that you:

Answer 264

get a signed release.

Question 265

A tool which Bowenian therapist use in order to reduce the anxiety level in a highly charged session would be:

Answer 265

Genogram

Question 266

Mary is a 15-year-old who has been truant for 31 days. In addition her parents report that she sleeps all day and stays up most of the night. She has gained 30 pounds over the past six months. She looks sad and has isolated herself from all her friends.A Structural family therapist treating Mary and her family for the first time would most likely:

Answer 266

join with the family and adapt their language, behaviors and style.

Question 267

Solution-focused therapists prefer to focus on:

Answer 267

the past and the future.

Question 268

A statement such as "Men only do anger" might be used as an example in which of the following models:

Answer 268

Emotionally Focused Couples Therapy.

Question 269

According to the communication theorists the content aspect of communication is known as:

Answer 269

Report *All communications have a report and command elements. The report element refers to the content, while the command element refers to the relationship between the sender and receiver. Metacommunication is communication about communication. This term usually refers to the covert, nonverbal message (e.g., tone of voice, inflection, body language) that gives additional meaning to an overt, verbal message. Examples of an analogical or symbolic message are certain behaviors (fighting over who cleans the bathroom) that may have a metaphoric meaning for a couple (who is in charge)

Question 270

Questions are a fundamental tool used by all therapists. When a Solution Focused therapist, working with a client presenting with issues around overeating, asks "What would you not want to change regarding the way you eat?", they are beginning to negotiate the:

Answer 270

first-formular task.

Question 271

Post-traumatic stress disorder (PTSD) is prevalent in children, adolescents and adults. It can occur alone or in comorbidity with other disorders. A broad range of psychotherapies such have been developed to treat PTSD. Which of the following does current research show to be most effective?

Answer 271

Eye movement desensitization and reprocessing (EMDR)

Question 272

An MFT is treating a family with a 12 year old girl who was experiencing intense crying spells, agitation, loss of appetite and was becoming increasingly argumentative at home. After 8 sessions applying Bowen’s family therapy model in which the focus was reducing anxiety, increasing individuation and teaching the family projection process, she began to be concerned that her approach was not being successful. In her search of the literature for guidance she found:

Answer 272

Research on depressed children being successfully treated with a family based “attachment” model similar to Structural Family Therapy.

Question 273

A family consisting of a mother, father, two daughters age 13 and age 15, and a son age 17 enter therapy. The parents are complaining that their 15-year old daughter is coming in drunk every night and is very abusive to the family. The primary treatment goal of a structural therapist in treating this family is:

Answer 273

altering the family structure.

Question 274

A therapist working with a family, hypothesizes that a scapegoated child’s behavior may be his/her means of loyally acting out his/her parents’ need for expressing anger (a cycle that may have connections to behavioral sequenes begun generations before). This therapist is most likely assessing from the:

Answer 274

contextual model.

Question 275

Mr. & Mrs. Doherty present for family therapy complaining that their son Jon will not listen to them and is acting out. A Bowenian family therapist would:

Answer 275

ask the parents if they acted out when they were younger and if so, how their parents responded.

Question 276

A 42 year-old woman reports panic attacks most nights. Her recent history includes the breakup of her engagement to be married. Her father died when she was 9 and she has lived alone with her mother throughout most of her childhood and adult life. The clinician's next steps should be:

Answer 276

assess her impulse control to rule out the possibility of harming herself or anyone else.

Question 277

Known for his work with alcoholic systems, David Treadway suggests that a common coping mechanism for children in such systems is that of adopting certain rigid roles such as:

Answer 277

scapegoat, hero and lost child.

Question 278

A therapist may assign a group of friends to watch over a young adult who is abusing drugs and another group to arrange for him to move out of his parent's house. This therapist is most likely implementing a technique used in:

Answer 278

Network therapy. *Speck and Attneave (1973), co-founders of Network Family Therapy, described breaking the client family's social network into problem solving subgroups, using action instead of affect to move beyond despair. A breakthrough can be achieved when the network's energies are unleashed and directed toward active resolution of problems.

Question 279

A mother calls the therapist sounding very panicky, wanting an immediate appointment. At the first session, the mother states that her 12 year old son Sam has just been caught in the bathroom of a neighbor’s home with a 6 year old boy. The 6 year old says that Sam was playing with his “bum” and kissing his penis. When confronted by his mother, Sam admitted to having “played” with the boy on 4 previous occasions. The neighbor boy’s parents have banned Sam from their home and informed other parents and the school about his “perversion”. Sam’s mother called a psychiatrist prior to calling you who she says stated, “You can put him into therapy and give him drugs, but it’s probably already too late.” You begin seeing Sam and his family. In working with this family, you are asked by the parents, “Does this mean our son is gay?” The most likely response a family therapist might make to such a question is:

Answer 279

To carefully explain that there is a high likelihood that some sort of sexual trauma may have occurred to their son.

Question 280

When a Solution-Focused therapist, working with a client presenting with issues around alcohol abuse, asks "What needs to be different with your drinking?", they are beginning to negotiate the:

Answer 280

exceptions to the problem.

Question 281

In the AAMFT Code of Ethics, Technology-Assisted Professional Services includes:

Answer 281

a. all of choices presented.* b. use of internet for delivering services. c. documentation of therapy. d. communication with client via electronic means

Question 282

A relationship in which one person is assertive and the other submissive, with each mutually reinforcing and sustaining each other's position is known as:

Answer 282

a complementary relationship.

Question 283

The DSM-5 diagnostic categories pay special attention to development by

Answer 283

how they present in childhood and adolescence

Question 284

A family is referred to Kathy A. by the school for therapy because John, age12, is disruptive at school and has been diagnosed as having attention deficit disorder. The mother in her phone conversation with Kathy A. says how reluctant they are to start therapy again since the previous therapist had spent most of the time talking about the mother being too inconsistent and overprotective and the father being angry and uninvolved. They felt blamed and still found no relief for John. After meeting with the family and reading the medical reports, Kathy A. agreed with the diagnosis and decided to help the family and John understand about ADD and to teach them how to cope with it. She decided to use the following model:

Answer 284

a Psychoeducational approach.

Question 285

A strategic therapist response to a woman whose spouse has had multiple affairs but wants to stay married would be:

Answer 285

I understand why you want to stay with him.

Question 286

A couple comes to therapy because they feel their sex life is not satisfying. The female reports that she is always anxious and is unable to reach orgasm and feels that her husband thinks she is an inadequate sex partner. The female partner feels that her male partner is more experienced about sex, therefore, the therapist would:

Answer 286

assess where she feels that she has a deficit about sexuality.

Question 287

In working with a divorced couple, the focus of attention should be:

Answer 287

the couple

Question 288

After a HIPAA audit from the US Dept. of Health & Human Services, an MFT receives a letter informing him that 16 specific violations were identified. One of the more important violations was the lack of documentation of his security review. Others included no documentation of training of his part-time adminstrative assistant, no record of the security procedures used by his billing service, inadequate computer back-up procedures and a missing disclosure information on his client contracting forms. The penalties he would not be subject to are:

Answer 288

$50,000 and up to 1 year in prison if significant harm was caused to a client by neglecting the Security Rule.

Question 289

Which stage of the Family Life Cycle is most conducive to immigrating to a new country?

Answer 289

Young Adult Stage

Question 290

Actions of the therapist aimed directly at relating to family members or the family system are commonly known as:

Answer 290

joining.

Question 291

All of the following are characteristics of a double bind EXCEPT:

Answer 291

a. a primary negative injunction. b. a tertiary negative injunction prohibiting escape. c. overt communication is protest.*** d. two or more persons in an important relationship

Question 292

All of the following are examples of insider models of assessment except:

Answer 292

a. GARF.*** b. SAFE. c. FES. d. FACES III. *Discussion: The concept of insider models refers to assessments that are generated by client self-reports, while the concept outsider models refers to clinical rating scales used by a therapist/observer. The Global Assessment of Relational Functioning (GARF) measure the following variables: Problem Solving/Interactional, Organization & Emotional Climate. Family Adaptability and Cohesion Evaluation Scales (FACES III) developed by David Olson, measure the variables: cohesion & adaptability. Family Environment Scale (FES) developed by Moos & Moos measure the variables: cohesion, expressiveness, conflict, independence, achievement orientation, intellectual-cultural orientation, active-recreational orientation, moral-religious emphasis, organization, & control. Systemic Assessment of the Family Environment (SAFE) developed by Lynelle Yingling measures the variables: dyadic marital/executive subsystem organizational structure & interactional processes, nuclear family subsystem organizational structure and interactional processes, and extended family subsystem organizational structure and interactional processes.

Question 293

Watzlawick would describe couples who are free to pursue careers and share childrearing and household chores as having a:

Answer 293

symmetrical relationship

Question 294

A term that Maturana used to describe systems that can be controlled from the outside, such as machines is:

Answer 294

Allopoietic Systems

Question 295

A clinician contracted for safety with a 32 year old woman who was referred for suicidality. Although she reported a history of self-cutting from an early age, she never attempted suicide. However she reported that her father committed suicide while drunk many years earlier.

Answer 295

Take further history, specifically inquiring about recent losses, level of depression, strength of suicidal ideation and planning, and substance abuse.

Question 296

A male couples therapist is working with a lesbian couple. Which of the following statements are true?

Answer 296

The therapist should approach the couple like any other couple.

Question 297

After returning from a tour in Afghanistan, an Army nurse reports having difficulty engaging with her friends and family, stating she no longer feels like herself and that activities that once gave her pleasure, no longer do. The therapist wonders if she may be suffering with PTSD. According to the DSM-5, in order to meet the criteria for a PTSD diagnosis, which of the following need to be met:

Answer 297

a. Persistent negative emotional state. b. Loss of interest in many life activities. c. All answers presented.* d. Distorted cognitions. * Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others. Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). Markedly diminished interest or participation in significant activities.

Question 298

An assessment tool used by Structural therapists is:

Answer 298

a family map *Structural therapists use a family structural map in assessing a family's boundaries and subsystem structure. This map has graphic symbols representing boundary types as follows: rigid _____ clear ------- diffuse ....... Structural mapping also includes graphic representation of other relationship dynamics including: conflict === disconnection -----||----