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Quiz Session - Attempts With Random Questions

AMFTRB MFT Exam Questions

Page 10 of 25

181.

An associate therapist, Carla, is seeking supervision about her client, Bridget, who she suspects has borderline personality disorder. At one point during the discussion, Carla tells the therapist that she feels completely exhausted by "all her over-the-top behavior." Why is this kind of statement MOST problematic?

  • It indicates that Carla might be perpetuating a stigma about mental illnesses.

  • It shows that Carla has not adequately worked through her countertransference.

  • This kind of statement indicates Carla needs personal psychotherapy.

  • It does not actually ask a purposeful question for Carla's supervisor to help her. 

Correct answer: It indicates that Carla might be perpetuating a stigma about mental illnesses.

Although therapists have biases, it is important to be mindful of these stigmas, as they can create problematic biases and affect treatments.

We do not know that Carla is not working through her countertransference. She may also be in her own therapy at this time. Supervision isn't just about asking purposeful questions- it's reasonable to discuss the therapist's thoughts and feelings without it being a specific Q&A session.  

182.

When working with a family from a symbolic-experiential framework, a common middle-phase treatment goal would be: 

  • Achieve a sense of reorganization around the symptom

  • Have the therapist win the battle for structure

  • Have the family win the battle for initiative 

  • Convey empathy for the family and its thoughts around the symptom 

Correct answer: Achieve a sense of reorganization around the symptom

Achieving a sense of reorganization around the symptom is part of the middle phase of this kind of therapy. 

Having the therapist win the battle for structure, and the family win the battle for initiative are early-phase treatment goals. Conveying empathy is more of a technique and intervention than a goal. 

183.

As a symbolic-experiential family therapist, your main goal during the middle phase of treatment would be:

  • Reorganizing the interpersonally expanded symptom

  • Winning the battle for structure

  • Having the family experience a flight toward health

  • Modeling fantasy alternatives

Correct answer: Reorganizing the interpersonally expanded symptom

Reorganizing the interpersonally expanded symptom is an ideal middle phase treatment goal. 

Winning the battle for structure is the early phase of treatment goal. 

Having the family experience a flight toward health refers to the termination process. 

Modeling fantasy alternatives is an intervention and not a goal.

184.

As a Milan systemic therapist, you might BEST use the no-change prescription when:

  • you hope the family members will rebel against the prescription.

  • you want the family members to abide by the prescription.

  • you want the family members to feel confused by the prescription.

  • you want to collaborate with the clients to enhance the prescription.  

Correct answer: you hope the family members will rebel against the prescription.

No-change prescriptions are paradoxical, so you would use them when you actually hope the family will rebel against what you say. 

Abiding to the prescription, therefore, is counterintuitive. You don't want to confuse anyone (as that defeats the point). You may want to enhance the prescription by collaborating with the clients later, but that's not the intention of the no-change prescription. 

185.

Your client, Martin, has disclosed that he is HIV-positive. He states that he has not told his current partner, but that they are having unprotected sex. He feels ashamed and states that he wants help being honest with his partner. Based on this information, you should do what NEXT? 

  • Maintain confidentiality, but help Martin meet his goal of being honest with his partner.

  • Break confidentiality as you have a duty to warn Martin's partner.

  • Review your no-secrets policy to determine if you should break confidentiality.

  • Maintain confidentiality, but tell Martin you want to engage in couples therapy with him and his partner. 

Correct answer: Maintain confidentiality, but help Martin meet his goal of being honest with his partner.

Based on this information, you should maintain confidentiality but help Martin meet his goal of being honest with his partner. 

Being HIV-positive is not a reason to break confidentiality, and it does not trigger the duty to warn. A no-secrets policy generally applies to family/couples therapy, so it is not applicable in this case. You might consider engaging in couples therapy (if that is within your current scope of competence), but it's more important to focus on helping Martin meet his expressed goal of being honest with his partner. 

186.

Generally speaking, until you have won the battle for structure as a therapist, you should NOT:

  • Move beyond the early phase of therapy

  • Move beyond the middle phase of therapy

  • Terminate therapy

  • Break confidentiality 

Correct answer: Move beyond the early phase of therapy

Achieving the battle for structure is paramount for symbolic-experiential family therapists, and it needs to be achieved before moving beyond the early phase of therapy (not middle, late, or termination phases).

It has nothing to do with confidentiality beyond understanding the limits of informed consent. 

187.

When working with individuals, it is MOST important for systemically trained marriage and family therapists to remember that:

  • Clients are part of a greater system beyond their individual selves

  • Clients have the right to an appropriate and accurate mental health diagnosis

  • Clients are largely responsible for their own behavior and willingness to change

  • Clients benefit most from having an individual therapist to explore their feelings and needs

Correct answer: Clients are part of a greater system beyond their individual selves

MFTs think systemically, which means they always consider the greater context when working with individuals. 

It is true that clients have the right to an accurate diagnosis, although not all therapists diagnose (and not all clients meet the criteria for a diagnosis). 

A systemic therapist would consider the numerous barriers that make individual change difficult. 

In some cases, individual therapy would be "best." But, in other cases, a therapist would certainly recommend family, couples, or group therapy.

188.

As a Bowenian systemic therapist, your assessment phase might include all the following, EXCEPT: 

  • Conducting a genogram

  • Assessing for safety

  • Assessing levels of differentiation

  • Assessing patterns of togetherness 

Correct answer: Conducting a genogram

A Bowenian systemic therapist would typically conduct a genogram after thoroughly assessing a family system. 

As a general rule of thumb in ANY family therapy, the therapist would comprehensively screen for safety. Assessment would include evaluating differentiation and patterns of togetherness. 

189.

You are working with Janet (45), her husband, Mario (47), and their two biological children, Tristan (14) and Jamie (12). 

Based on this information, you are working with a:

  • Nuclear family

  • Extended family

  • Parental subsystem

  • Identified patient

Correct answer: Nuclear family

This dynamic best represents a nuclear family.

If you were working with grandparents or other relatives, you'd be working with the extended family. 

If you were only focusing on the parents, you might be working with the parental subsystem. 

If you only labeled one client as the issue, that would be working with the identified patient.

190.

All the following are true about informed consent EXCEPT:

  • The client needs to legally sign informed consent documents. 

  • The language used within the informed consent should be generally understandable for clients.

  • The client needs to have the mental capacity to consent to treatment.

  • The informed consent should address the potential risks and benefits of therapy.

Correct answer: The client needs to legally sign informed consent documents. 

It is not a legal requirement for clients to sign informed consent documents (although it is strongly encouraged). 

Informed consent language should be clear and understandable, and clients need to have the capacity to understand the contents prior to consent to treatment. Likewise, informed consent does need to review the potential risks and benefits of therapy.

191.

You are working with Sienna, a 27-year-old woman, who discloses that her boyfriend of 2 years, Johnny, sometimes hits her when he's "really mad." You suspect that she is downplaying the severity of the abuse, as she has frequently come to sessions with very layered clothing or blackened eyes. She states that she loves Johnny and believes that he's genuinely working on improving his anger. 

Based on this information, you should respond by:

  • Providing ongoing support and safety planning with Sienna

  • Making a mandated report due to the disclosure of physical abuse

  • Recommending couples therapy for Sienna and Johnny

  • Encouraging Sienna to leave the relationship

Correct answer: Providing ongoing support and safety planning with Sienna

Although it can be a challenging dynamic, therapists should provide support and safety planning for clients in violent relationships. 

Sienna is an adult, so this kind of abuse does not fall under the criteria of mandated reporting. 

Couples therapy is generally not recommended when violence is present unless the abuser can make a contract for non-violence. 

You would not point-blank ask Sienna to leave the relationship, although you could continue weighing the risks and benefits together. Asking her to leave the relationship may violate her autonomy. 

You can best behave ethically and promote Sienna's rights by engaging in safety planning with her.

192.

Haley (29) comes to therapy after a significant history of volatile relationships. She reports that she is "always the one getting dumped." She has been engaged twice, and both times, her partners left her for being overly clingy and jealous. 

Haley has good insight into her behavior and states she often fears abandonment, and it stems from her father leaving home and never returning when she was eight. 

Based on Bowlby's attachment styles, Haley BEST presents as:

  • Having an insecure attachment style

  • Being enmeshed with partners

  • Having diffused boundaries in relationships

  • Meeting the criteria for borderline personality disorder

Correct answer: Having an insecure attachment style

Based on Bowlby's work, Haley has an insecure attachment style, as she tends to present as vulnerable, jealous, and clingy in relationships (likely driving away partners). 

Enmeshment and diffused boundaries are not inherent attachment terms. 

Borderline personality disorder is not an attachment style.

193.

You are a therapist receiving therapy from a licensed psychologist. You believe you have made substantial progress towards your goals and would like to discuss termination. 

Based on this information, what should you do NEXT?

  • Discuss your thoughts about termination with your psychologist

  • Ask your psychologist directly if you are ready to end treatment

  • Review your state laws about termination

  • Review your psychologist's informed consent paperwork about termination

Correct answer: Discuss your thoughts about termination with your psychologist

All clients (even when they are therapists) should be encouraged to discuss their thoughts about termination with their mental health providers. 

You might ask them directly, but it's often more effective to simply review how you feel/think about the situation. 

There are no specific state laws about termination.

Informed consent paperwork will only provide general information about the termination process, and it will not necessarily answer your questions about when it's time to end care.

194.

Family therapy tends to be recommended as an appropriate treatment approach for all the following mental health conditions, EXCEPT:

  • Premature ejaculation

  • Adolescent depression

  • Oppositional-defiant disorder

  • ADHD

Correct answer: Premature ejaculation

Sexual disorders are not appropriate for family therapy (although it may be appropriate for couples therapy). 

Childhood/adolescent conditions like depression, ODD, and ADHD are all typically appropriate for family therapy.

195.

Tarasoff v. Board of Regents of the University of California led to what outcome for marriage and family therapists:

  • Marriage and family therapists have a legal duty to warn intended victims of imminent threats.

  • Marriage and family therapists have an ethical duty to warn intended victims of imminent threats.

  • Marriage and family therapists have a legal duty to warn law enforcement personnel of imminent threats.

  • Marriage and family therapists have an ethical duty to warn law enforcement personnel of imminent threats.

Correct answer: Marriage and family therapists have a legal duty to warn intended victims of imminent threats.

The Tarasoff case led to legislation where therapists must warn intended victims of imminent threats of harm. 

This is a legal requirement (not an ethical one). Notifying law enforcement personnel is not enough - the therapist must take reasonable action to warn the victim.

196.

One of the early-phase treatment goals in object-relations theory is:

  • Assessing early childhood experiences

  • Developing insight based on past relationships

  • Working through internalized conflicts

  • Experimenting with new behaviors

Correct answer: Assessing early childhood experiences

Assessing early childhood experiences is an early-phase treatment goal.

Developing insight based on past relationships and working through internalized conflicts are middle-phase treatment goals. Experimenting with new behaviors is a late-phase treatment goal. 

197.

When might a cognitive-behavioral therapist introduce the concept of a behavior chart when working with parents of young children?

  • When the therapist and parent want to monitor the child's behavioral frequency

  • When the therapist and parent want to eliminate a child's problematic behavior

  • When the therapist and parent want to introduce the concept of positive reinforcement

  • When the therapist and parent want to motivate a child's desire for change

Correct answer: When the therapist and parent want to monitor the child's behavioral frequency

A behavior chart allows parents and therapists to monitor the frequency of a specific behavior. 

This may lead to eliminating a problematic behavior (but not always). It often sets the stage for introducing the concept of positive reinforcement, which can motivate a child's desire for change. 

198.

Bowen largely believed that a child's problematic behavior resulted from:

  • Parents inappropriately or ineffectively involving children in their marriage 

  • Parents creating unbalanced hierarchies within the family

  • Parents lacking healthy communication with their children

  • Parents scapegoating children for their own dysfunction 

Correct answer: Parents inappropriately or ineffectively involving children in their marriage 

Bowen preferred working with couples, as he believed that parents ineffectively involved children in the marriage (he sought to replace the child in their triangle). 

Them lacking healthy communication or scapegoating their children falls under this MAIN category of inappropriately involving them in their marital problems. Unbalanced hierarchies are more of a structural family therapy term. 

199.

You are engaging in play therapy with a four-year-old boy, Bennett. At one point in your session, he begins pretending that two dolls are having sex with each other. He puts one of the dolls on top of the other and states, "now kiss him!" Based on this information, you should NEXT proceed by:

  • exploring this enactment further with Bennett.

  • making a mandated report given reasonable cause to believe Bennett has been sexually abused.

  • inquiring about this sexual scene with Bennett's parents.

  • asking Bennett directly where he learned about this behavior. 

Correct answer: exploring this enactment further with Bennett.

Although this scene can be alarming, it's important to explore and assess the situation further (he could have watched a movie or overheard people talking about sex/kissing). 

We do not have enough evidence to assume that he's been sexually abused. You would probably want to share and inquire about this scene with Bennett's parents, but you'd want to talk to him first. Asking directly may be appropriate in some cases, but simply exploring the enactment is a better call-to-action when engaging in play therapy with very young children.

200.

Your male client, Stuart, frequently makes derogatory comments about how the women in his office dress. He states that they are "literally asking for attention," and that their inappropriate attire should be condemned in professional settings. 

These types of comments BEST represent:

  • Misogyny

  • Patriarchy

  • Emotional abuse

  • Narcissism

Correct answer: Misogyny

This level of anger/hostility towards women is a prime example of misogyny. 

Patriarchy refers to the notion of men having a superior sense of authority (which may be the case here, although it is not certain). 

We have no indication that he is emotionally abusing these women. 

Although he may show themes of narcissism, misogyny is a more comprehensive answer in this case.

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