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Quiz Session - Attempts With Random Questions

AMFTRB MFT Exam Questions

Page 7 of 25

121.

In most states, therapists have privileged communication rights. This means that: 

  • therapists are prevented from testifying in legal settings about clients without their consent.

  • therapists cannot electronically share information about clients without their consent.

  • therapists can use their professional discretion to decide when to share confidential information.

  • therapists can disclose information about clients when legally mandated to do so.

Correct answer: therapists are prevented from testifying in legal settings about clients without their consent.

Privileged communication refers to a legal right that protects clients from having their confidential information revealed publicly without their designated permission. When privileged communication laws exist, therapists cannot testify in court without their client's permission. Sharing electronic information refers to HIPAA. When it comes to privileged communication, therapists do not have the right to use personal discretion in deciding what to disclose. 

122.

Your client, Brett, is struggling with feeling anxious during math class. He states that he becomes easily distracted and starts worrying about how he will ever pass his test. As a strategic family therapist, you decide to engage in a paradoxical ordeal. In doing this, you would BEST:

  • Instruct Brett to exercise for twenty minutes after school and dedicate his math class worries to that time.

  • Instruct Brett to practice deep breathing during math class.

  • Instruct Brett to consider changing math classes altogether.

  • Instruct Brett to imagine the worst-case scenario associated with failing his math class. 

Correct answer: Instruct Brett to work out for twenty minutes after school and dedicate his math class worries to that time.

Paradoxical ordeals entail directing clients to focus on their symptoms during an unrelated time (like when working out). 

Deep breathing or imagining worst-case scenarios are more commonly-prescribed during CBT. A therapist would likely not tell Brett to consider changing his math class (unless we had a significant reason for doing so).  

123.

A structural family therapist has been meeting with a family every week for two months. On the ninth session, the father blurts out that he's incredibly frustrated with his wife for "always" siding with their teenage daughter.

At this point, how should the therapist NEXT intervene?

  • Focus on creating a functioning parental subsystem

  • Dismantle the enmeshed boundaries between mother and daughter

  • Empower the father to set his own boundaries with his daughter

  • Invite the family to complete a genogram together

Correct answer: Focus on creating a functioning parental subsystem

One of the main goals of structural family therapy is to establish functioning subsystems, including a functioning parental subsystem. This subsystem should be placed at the top of the family hierarchy, and it is responsible for raising children. In this family, it appears the daughter has entered the parental subystem, where she does not belong from a hierarchal standpoint. The therapist should assist the family with developing a functioning parental subsystem.

This therapist might work on enmeshed boundaries between the mother and daughter, although we have no evidence that enmeshment exists.

Subsequently, the therapist might also empower the father to set boundaries with his daughter, although their current boundaries aren't clear.

Bowenian therapists are more likely to engage in a genogram exercise.

124.

If certain biases prevent a therapist from remaining curious and nonjudgmental with a client, they should ethically do what NEXT:

  • Refer the client to another therapist who can better meet their needs

  • Seek immediate consultation to support the client

  • Explore the issues in personal therapy

  • Modify the treatment plan to address more effective goals 

Correct answer: Refer the client to another therapist who can better meet their needs

Therapists have an ethical responsibility to provide safety and professionalism to clients. If they cannot set their biases aside, they need to refer those clients to other providers. It could be helpful to seek consultation or attend personal therapy, but the therapist should not be working with that client at the same time. There is no reason to modify a treatment plan to accommodate a therapist's needs. 

125.

Which of the following responses is MOST appropriate when validating a client's feelings during a crisis?

  • "I imagine that must have been extremely challenging."

  • "I understand how you must feel."

  • "I think it's important to focus on moving forward."

  • "I can't believe that happened to you."

Correct answer: "I imagine that must have been extremely challenging."

"I imagine that must have been extremely challenging" offers support, validation, and empathy.

As therapists, we do not automatically assume we know how clients feel. 

We wouldn't dismiss their current or past experiences and encourage them to only look forward. 

Telling a client you can't believe something happened to them may come across as judgmental, shaming, or dismissive.

126.

Sam is a symbolic-experiential therapist referred to work with a family. He probably operates under all the following assumptions, EXCEPT:

  • Families inherently assume control of the battle of structure

  • Cotherapy is a crucial part of treatment

  • The goal of therapy is to evoke and trigger family anxiety

  • Family roles are flexible and can be molded 

Correct answer: Families inherently assume control of the battle of structure

Therapists (not families) assume control of the battle of structure. 

Symbolic-existential therapists practice cotherapy, aim to trigger family anxiety, and believe family roles are flexible.

127.

You are working with a couple, Chuck and Bailey, who continuously have issues regarding their household division of labor. At one point, Chuck tells his wife, Bailey, that he hates when she doesn't put her clothes in the hamper. He states that he primarily handles all the laundry in the household, and he feels annoyed that he has to guess which clothes she wants to be cleaned. The BEST example of Bailey mirroring Chuck's comment would be:

  • "I hear that you are frustrated. You take care of the laundry, and I sometimes struggle to put the clothes in the hamper. This potentially makes the chore even more complicated. Did I understand correctly? Is there anything else?"

  • "I sense that you are upset with me. You take care of the laundry and feel that things are imbalanced in the home. Did I understand correctly? Is there anything else?"

  • "I feel attacked when you tell me that you are upset with me. I do my best to take care of my chores, and I feel discouraged when you point out the one task that I sometimes fail to do correctly."

  • "I understand what you are saying. What do you want me to do differently moving forward?"

Correct answer: "I hear that you are frustrated. You take care of the laundry, and I sometimes struggle to put the clothes in the hamper. This potentially makes the chore even more complicated. Did I understand correctly? Is there anything else?"

Bailey has validated and reflected Chuck's statement/feelings, which is an accurate representation of mirroring. 

Her stating that things are imbalanced in the home represents more of an assumption. Her describing how she feels attacked is an I-statement. Problem-solving (even when it's collaborative) is not a form of mirroring. 

128.

In his research, John Gottman found that healthy relationships had a ____ ratio of positive to negative interactions.

  • 5:1

  • 10:1

  • 2:1

  • Gottman did not have such a defined ratio.

Correct answer: 5:1

5:1 is the correct choice. 

The other answers are not appropriate in answering this question. 

129.

When assessing for PTSD, it is important for marriage and family therapists to consider all the following, EXCEPT:

  • How PTSD causes increased maladaptive coping responses, such as substance use

  • How culture can assign different meanings and expressions to trauma

  • How women have higher rates of PTSD than men across the lifespan

  • How PTSD correlates with higher rates of suicidal ideation

Correct answer: How PTSD causes increased maladaptive coping responses, such as substance use 

Marriage and family therapists do not operate under the assumption that a mental illness causes anything. 

Instead, they look at correlations (such as increased suicidal ideation). 

They would certainly consider how culture plays a role in shaping and defining trauma. 

They would also keep in mind that women do have higher rates of PTSD than men.

130.

When working with a family system, a structural family therapist would MOST LIKELY request to work with: 

  • The entire nuclear family

  • The parents within a family system

  • The entire nuclear family and any relevant extended family members

  • Whichever family members show an interest in attending therapy

Correct answer: The entire nuclear family

Structural family therapists prefer working with the entire nuclear family, as each member plays a pivotal role in maintaining structural patterns. 

They are focused on present issues, which means working with extended relatives is not as important. Structural family therapists might work with whichever family members commit to therapy, but they will emphasize the benefits of having everyone attend. 

131.

When measured through a centripetal dimension, family members aim to meet their needs:

  • within the family system.

  • outside the family system.

  • within themselves.

  • occasionally within the family system and occasionally outside of it. 

Correct answer: within the family system.

Centripetal dimension refers to meeting needs within the family system itself.

Outside the family system comes from a centrifugal dimension. Within themselves is not a specified dimension. Occasionally within the family system and occasionally outside of it is more of a mixed dimension. 

132.

All the following are examples of potential therapist abandonment EXCEPT: 

  • Finding a new job and ensuring your clients transfer to another therapist 

  • Refusing to take a client's calls for a few days after she screams at you in session

  • Going on maternity leave and asking clients to find appropriate referrals while you're gone

  • Switching to a private-pay practice and letting clients who use insurance know you can no longer see them 

Correct answer: Finding a new job and ensuring your clients transfer to another therapist 

While clients could still perceive you leaving as a form of abandonment, ensuring that they have transferred correctly is your best ethical move. 

It is not appropriate to just avoid a client after a rough session. It is also not appropriate to expect them to find referrals in your absence. If you are switching policies, you need to provide notice and referrals to clients to ensure they can maintain a continuity of care. 

133.

You are working with Krista (15), who states that she feels like she's always stuck raising her younger brother, Joey (8). You invite her mother, Kelly (45), to a family session, and she states that she also raised her younger brother and doesn't understand why Krista is acting so selfishly. 

As a structural family therapist, the next BEST intervention would be:

  • Validating how both clients feel

  • Assessing both clients for safety

  • Encouraging both clients to set clear boundaries

  • Directing clients to listen to one another

Correct answer: Validating how both clients feel

Validating is an important part of the joining process, and it can help both clients feel safe and supported. This joining has to occur before the therapist can work with the family system to restructure it. 

There is no information indicating safety issues at this time. 

You might encourage clients to listen to one another or set boundaries, but that would come after validating their feelings.

134.

All of the following represent potential crisis situations EXCEPT:

  • A client having a history of panic attacks

  • A client losing their job

  • A client witnessing a school shooting

  • A client having suicidal thoughts 

Correct answer: A client having a history of panic attacks

Panic attacks are more of a symptom related to crisis situations, but having a history of panic attacks would not indicate the presence of a crisis situation. 

Losing a job, witnessing a shooting, or having suicidal thoughts are all typical crises. 

135.

In which of the following therapies would a therapist likely work with one partner individually at a time while still in the presence of their partner? 

  • Emotionally-focused couples therapy

  • Narrative family therapy

  • MRI systemic therapy

  • Symbolic-experiential therapy

Correct answer: Emotionally-focused couples therapy

Emotionally-focused couples therapy often works with one partner individually while still in the presence of the other partner. This is specifically stated within the practice of EFT. 

It is not inherently a part of the other models (narrative, MRI, or symbolic-experiential). 

136.

Telling a client that therapy might "feel worse before it gets better" is an example of what? 

  • Discussing the risks of therapy

  • Discussing therapeutic goals

  • Discussing the cycle of change

  • Discussing termination 

Correct answer: Discussing the risks of therapy

Therapists overview the risks of therapy during the informed consent process, and many therapists will inform clients that things may "get worse before they get better."  This statement is not indicative of therapy goals, termination, or the cycle of change. 

137.

Cindy is a therapist working with Katrina, a 27-year-old female, who was referred to her for anxiety. Katrina discloses that she often panics about getting cancer since both her mother and grandmother have battled it. Katrina acknowledges that whenever she gets a cold, her mind goes to the worst-case scenario. She indicates that she goes to the doctor "very frequently" just to get screenings and check-ups to ensure she is okay. She acknowledges that she has never had any cancer-related symptoms, but that she often worries she is missing something.  In addition to cancer, she worries about having a random heart attack or stroke. Based on this information, Cindy would MOST likely diagnose Katrina with:

  • Illness anxiety disorder

  • Conversion disorder 

  • Somatic symptom disorder

  • Specific phobia 

Correct answer: Illness anxiety disorder

Katrina meets the criteria for illness anxiety disorder, a condition based on excessive fears of having a specific illness. 

She would need to have a change in functioning if she had conversion disorder. She would need to show exaggerated anxiety about somatic symptoms to potentially meet the criteria for somatic symptom disorder. Fearing cancer can become a phobia, but her cluster of symptoms more indicates illness anxiety disorder.   

138.

Throughout the process of narrative therapy, it is MOST important that therapists embrace:

  • the client's voice.

  • the client's thoughts and feelings.

  • the client's unique exceptions.

  • the client's family-of-origin. 

Correct answer: the client's voice.

The client's voice is one of the most important tenets in narrative therapy. 

Thoughts/feelings are associated with CBT; unique exceptions are part of solution-focused work; and family-of-origin often have to do with psychodynamic models. 

139.

All the following represent underlying assumptions within the humanistic-experiential approach, EXCEPT:

  • Low self-esteem causes family dysfunction. 

  • Growth is a natural process that happens for everyone.

  • All people have innate resources that can help them grow.

  • Low self-esteem can often lead to poor communication habits. 

Correct answer: Low self-esteem causes family dysfunction. 

The humanistic-experiential approach does not assume that low self-esteem causes family dysfunction (more that dysfunctional behaviors often manifest due to a lack of growth). 

However, it does state that growth happens naturally (and for everyone), and that everyone has resources that can help them grow. Likewise, self-esteem often correlates/leads to poor communication. 

140.

Kara (14) is referred to you because her parents are increasingly worried about her eating habits. Kara appears very thin and admits that she "doesn't eat much." She states that she can't stand the texture of most foods, particularly very crunchy or very "wet" foods. She states that she often just gets too busy to eat. She knows her parents are worried about her weight, but she insists she isn't trying to diet. 

Based on this information, you would MOST likely diagnose Kara with:

  • Avoidant/restrictive food intake disorder (ARFID)

  • Anorexia nervosa

  • Rumination disorder

  • Generalized anxiety disorder

Correct answer: Avoidant/restrictive food intake disorder (ARFID)

AFRID refers to having disturbances with food based on things like lack of interest or concern about aversive consequences of eating and failing to maintain proper weight or nutrition goals. Kara shows evidence of ARFID. 

The motive here is not about weight loss (which makes it different from anorexia). 

Rumination would refer to a pattern of chewing and spitting food. 

Kara may meet the criteria for an anxiety disorder, but we don't have enough information for that based on this vignette alone.

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