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Quiz Session - Attempts With Random Questions

AMFTRB MFT Exam Questions

Page 9 of 25

161.

You are a systemic therapist working with a family. In the middle of treatment, it becomes evident to you that Sarah, the oldest child, is clearly the identified patient within the family system. 

Based on this information, you should do what NEXT?

  • Aim to decrease the pathologizing of Sarah and help other family members recognize how they contribute to problems

  • Aim to decrease the conversations about Sarah and shift attention onto other family members

  • Aim to provide psychoeducation on why families have identified patients

  • Aim to offer additional support for Sarah by recommending individual therapy

Correct answer: Aim to decrease the pathologizing of Sarah and help other family members recognize how they contribute to problems

You would want to decrease the pathologizing of Sarah and help other family members understand their role in contributing to problems. 

This does not inherently mean decreasing conversations about Sarah (although it might). 

Psychoeducation might be important, but you would want to first focus on shifting blame away from Sarah.

We don't have information supporting that Sarah would benefit from individual therapy at this time.

162.

John and Julie Gottman cite contempt as one of the Four Horsemen of the Apocalypse. Which of the following BEST describes an interaction that includes contempt? 

  • I can't believe you forgot to pick up the kids. You're such an irresponsible father!

  • I can't believe you forgot to pick up the kids. I'm just really upset.

  • I can't believe you forgot to pick up the kids. I don't even want to talk to you tonight.

  • I can't believe you forgot to pick up the kids. Didn't I remind you twice?

Correct answer: I can't believe you forgot to pick up the kids. You're such an irresponsible father!

Contempt consists of negative thoughts about someone else, manifesting as a personal attack that challenges someone's sense of self (like being an irresponsible father).

Mentioning feeling upset simply indicates sharing a feeling about a situation (which may be reasonable and appropriate).

Mentioning not wanting to talk is more of a threat than a form of contempt.

Bringing up reminding someone could potentially signify contempt, but not as much as a direct attack on someone's character.

163.

You are working with Noah, a thirty-two-year-old male referred to treatment because he struggles with depression. Noah states that he doesn't feel depressed when he's with his girlfriend, but that he feels depressed whenever she's not around. He states that he hates when she travels for work and that he feels extremely unmotivated when he's home alone. As a solution-focused therapist, you might best intervene by:

  • Exploring this particular exception to Noah's depression further

  • Asking Noah a scaling question about his depression

  • Challenging Noah to "be depressed" during a specific time of the day each day

  • Validating Noah's feelings about being unmotivated

Correct answer: Exploring this particular exception to Noah's depression further

It would be helpful to continue exploring this exception at this point. 

You might have used scaling questions earlier to assess the severity of his depression (and the progress he is making in treatment). Challenging Noah to "be depressed" during a specific time of the day each day is more of a strategic intervention. Validating Noah's feelings about being unmotivated could be helpful, but it's likely more important to review what feels different about Noah being with his girlfriend when it comes to his depression. 

164.

You are working with a couple, Rachel and Seth. After the sixth session, Rachel calls you privately to inform you that she has been having an affair with. She states that she wants you to know, but asks you to please not tell him and that she will tell him when she is ready. Ethically speaking, you should NEXT:

  • Act accordingly to the guidelines listed on your informed consent 

  • Inform Rachel that she either needs to tell Seth by the next session or you will 

  • Respect Rachel's confidentiality and not tell Seth

  • Tell Rachel that you are unable to continue couples therapy if she wants you to hold this secret

Correct answer: Act accordingly to the guidelines listed on your informed consent 

Therapists should review their policies with clients at the onset of therapy. This includes outlining anything to do with secrets or confidentiality. As a therapist, this is your best course of action. You wouldn't demand Rachel tell Seth or risk breaching her confidentiality. You also wouldn't necessarily hold the secret unless that is what has been explicitly outlined at the start of therapy. 

165.

Bridget (6) is a foster child who was referred to work with you after being placed in a new home. Even though it's your first session, she asks if she can sit in your lap. You know from her past therapist that Bridget becomes very clingy to mental health providers, teachers, and other helping professionals. After the session, she jumps up, gives you a huge hug, and says she wishes you could take her home. She seems completely unfazed when leaving with her foster mom, it's as if they are complete strangers. Based on this information, you would MOST LIKELY give Bridget a preliminary diagnosis of:

  • Disinhibited social engagement disorder

  • Reactive attachment disorder

  • Insecure attachment disorder

  • Nothing - there is not enough information to warrant a diagnosis. 

Correct answer: Disinhibited social engagement disorder

Bridget shows symptoms of disinhibited social engagement disorder, as she actively attaches to caretakers and appears to have limited boundaries even around strangers. 

Reactive attachment would refer to more withdrawal and minimal social interaction (the opposite of how Bridget presents herself). Insecure attachment disorder is not a mental illness. 

166.

With respect to boundaries, a structural family therapist would prioritize that:

  • All individuals and subsystems establish transparent boundaries. 

  • All rigid boundaries become diffused.

  • All subsystems align with the same boundaries.

  • Therapists prioritize healthy boundaries above any other therapeutic task. 

Correct answer: All individuals and subsystems have transparent boundaries. 

Structural therapists aim to establish clear boundaries within all individuals and subsystems. 

You wouldn't want rigid boundaries to become diffused (you'd want both to become clear). It's not necessary for everyone to have the same boundaries. Likewise, boundaries are important, but without other information, we have no way of knowing that they are the most important task (especially if there are safety or crisis issues).  

167.

All the following are different family therapies within the constructivist model (or postmodern wave), EXCEPT:

  • Experiential family therapy 

  • Solution-focused therapy

  • Collaborative family therapy

  • Feminist family therapy 

Correct answer: Experiential family therapy 

Experiential family therapy is within the classical schools of general systems theory. 

Solution-focused, collaborative, and feminist family therapies are all part of the postmodern wave. 

168.

All the following represent Satir techniques, EXCEPT:

  • Genograms 

  • Family sculpting

  • Humor

  • I-statements 

Correct answer: Genograms 

Satir did not mention using genograms in her work (Murray Bowen did).

She did use family sculpting, humor, and I-statements. 

169.

During your fifth session in working with a young girl, Maria, and her mother, Sarah, you instruct Maria to pretend to hate her mom. You decide to do this intervention after Sarah repeatedly states that she's convinced Maria hates her. This type of suggestion represents which kind of strategic intervention?

  • Pretending 

  • Triangulation

  • Dramatization

  • Make-believe play 

Correct answer: Pretending 

This is an example of pretending (you are asking the child to pretend to have a specific symptom). 

Triangulation would occur if you intentionally unbalanced the relationship. Dramatization is a version of heightening an emotion. Make-believe play happens when a child shields their parents through their symptoms. 

170.

Susie is a therapist who works in a small, rural town where she is the only mental health provider. She receives a referral to work with a client who she quickly discovers is her son's teacher. Ethically, what is the BEST course of action Susie should take?

  • Agree to work with the client after thoroughly discussing the risks, benefits, and potential ethical issues associated with a multiple relationship 

  • Agree to work with the client after assessing that the client is in an acute crisis 

  • Agree to work with the client after asking if she can transfer her son to a different teacher

  • Refuse to work with the client on the grounds that they have an existing relationship

Correct answer: Agree to work with the client after thoroughly discussing the risks, benefits, and potential ethical issues associated with a multiple relationship 

Some multiple relationships are inevitable, and that does not make them inherently harmful. Multiple relationships can exist in all situations, not just in crises. It would not be appropriate for Susie to recommend that her son switch teachers (unless we had more information in this vignette). Susie would probably not have to refuse working with this client unless there was another reason/bias preventing her from doing so. 

171.

What is MOST TRUE when it comes to assessing a client for suicide after they have endorsed suicidal ideation during a state of crisis? 

  • You should continue assessing during follow-up sessions until stability has been maintained for a sustained period of time.

  • You should stop assessing after the client denies suicidal ideation for at least three sessions in a row.

  • You should assess the client whenever the topic of suicide or depression emerges.

  • You should assess the client before moving forward with other treatment goals or terminating care. 

Correct answer: You should continue assessing during follow-up sessions until stability has been maintained for a sustained period of time.

When it comes to managing suicidal ideation, therapists should continue assessing during follow-up sessions until stability has been maintained for a sustained period of time. 

Three is an arbitrary number, and therapists do not follow arbitrary numbers when it comes to assessing lethality. You shouldn't just rely on assessing when topics of suicide or depression emerge (it's your job to thoroughly check-in even if that's not what the client is presenting with that day). You can still address other treatment goals while assessing for safety. 

172.

Juan, a therapist, was born in Mexico and immigrated to the U.S. as a teenager. He is working with Ricardo, a teenager, who just immigrated to the U.S. Given this information, in working with Ricardo, it's MOST important for Juan to consider that: 

  • He may overidentify with his client's background.

  • He may have transference towards Juan.

  • He may need to recommend assimilation as a treatment goal.

  • He may need to engage in self-disclosure. 

Correct answer: He may overidentify with his client's background.

Overidentifying with clients poses a significant risk when working with clients from similar backgrounds. 

Transference refers to a client's feelings about a therapist, so that wouldn't be applicable here. Assimilation would not necessarily be a treatment goal, as we don't have context for that. Juan may engage in self-disclosure, but that likely wouldn't be the most important consideration.  

173.

You are a therapist who uses social media as a primary marketing tool for your practice. Over the past few months, you have become more popular. You've been invited to a few podcasts and have spoken at several workshops. Which of the following is ethically MOST important when considering how you professionally conduct yourself?

  • You should avoid giving advice or feedback in areas where you lack training.

  • You should avoid giving your opinion and stick only to evidence-based facts.

  • You should avoid diving into controversial issues, as it can harm potential clients. 

  • You should reconsider using social media as a marketing tool, as it creates multiple relationships.

Correct answer: You should avoid giving advice or feedback in areas where you lack training.

In representing yourself as a therapist, you still need to consider your scope of competence and avoid speaking on topics where you lack training. 

It is still okay to share your opinion (even with controversial issues!), as long as you maintain professionalism. Furthermore, as long as you consider the ethical ramifications, social media is an appropriate marketing tool.

174.

Based on DSM-5-TR criteria, which of the following diagnoses is MOST likely susceptible to hospitalization?

  • Bipolar 1 disorder

  • Generalized anxiety disorder

  • Attention-deficit/hyperactivity disorder

  • Social anxiety disorder

Correct answer: Bipolar 1 disorder

People with bipolar 1 disorder are susceptible to manic episodes, which tend to be severe and may lead to hospitalization. They significantly impair someone's functioning. 

It's true that generalized anxiety disorder, ADHD, and social anxiety disorder may lead to serious consequences (which could result in hospitalization), but these are not inherently listed as risk factors in the DSM-5-TR, and that is not a common trajectory for these conditions.

175.

All the following represent various Milan systemic therapy interventions, EXCEPT:

  • Explicit directives

  • Odd/even days prescription

  • Reflexive questions

  • Triadic questioning

Correct answer: Explicit directives 

Explicit directives are strategic family therapy interventions. 

Odd/even day prescriptions, reflexive questions, and triadic questioning all fit within the Milan systemic therapy framework.

176.

All the following represent times when it would be appropriate for an EFT therapist to terminate treatment, EXCEPT when:

  • Couples can identify patterns that maintain attachment insecurity

  • Couples can demonstrate using new solutions to old relationship problems

  • Couples can consolidate new positions of attachment behavior

  • Couples can engage in attachment-related tasks independently

Correct answer: Couples can identify patterns that maintain attachment insecurity

It is important that couples can identify patterns that maintain attachment insecurity. However, this is more of an early phase goal, and it is not sufficient enough to warrant terminating treatment. 

If couples can demonstrate using new solutions to old relationship problems, consolidate new positions of attachment behavior, and engage in attachment-related tasks independently, they are appropriate candidates for termination.

177.

Your client, Sasha, comes to you stating that she frequently experiences intense moments of physical distress. She describes these moments as "feeling like I'm going to die." She cites that her chest feels tight, she feels dizzy, and she has a pronounced fear of dying. After the moment "passes," she reports feeling extremely exhausted and anxious. 

Based on this information, Sasha is MOST likely experiencing:

  • Panic attacks

  • Hallucinations

  • Intrusive thoughts

  • Delusions

Correct answer: Panic attacks

This cluster of symptoms aligns with a panic attack. 

She does not report experiencing sensations that are not there (hallucinations) or believing things that are not true outside the anxiety (delusions). 

While she may be having some intrusive thoughts about dying, they are within the context of the panic attack itself.

178.

You are working with Joe, a male client who struggles with feeling incompetent in his management role. He frequently complains that he feels like he's an imposter and that it's only a matter of time before other people catch onto him. He states that he feels like "less of a man" because of his feelings, and that he's annoyed that he can't just power through despite his insecurity. As a feminist therapist, you would MOST LIKELY set which goal for Joe?

  • Challenge societal beliefs about what it means to be male in modern society 

  • Challenge the status quo in his workplace

  • Challenge societal beliefs about what it means to be a manager in modern society

  • Challenge the distorted thoughts maintaining his insecurity and inferiority 

Correct answer: Challenge societal beliefs about what it means to be male in modern society 

A feminist therapist would encourage Joe to challenge societal beliefs about what it means to be male in modern society. 

We don't know that the workplace status quo is problematic based on this information, so that would not be an appropriate goal. We also don't know what Joe's thoughts are about being a manager (only that he feels insecure as one), so challenging that probably wouldn't be a feasible goal. Challenging the distorted thoughts maintaining his insecurity and inferiority is viable, but it is more of a CBT goal. 

179.

Concepts like overt and covert rules, roles, and interactional styles are central to which type of therapy?

  • Structural Family Therapy

  • Solution-Focused Therapy

  • Narrative Family Therapy

  • Cognitive-Behavioral Therapy

Correct answer: Structural Family Therapy

Structural Family Therapy views families as systems that structure themselves around patterns of interaction and rules that govern these interactions. Overt and covert rules, roles, and interactional styles are all central to Structural Family Therapy.

Solution-focused therapy is brief and focuses on solving here-and-now problems. 

Narrative family therapy views families as experts, and cognitive-behavioral therapy aims to decrease problematic behaviors.

180.

A prospective young adult woman meets with you for an intake session. At the end of the session, she asks if you can "bill her insurance" instead of paying your typical fee. She reports that she saw that you accept her insurance on your practice website. How should you respond NEXT?

  • You should request a copy of her insurance card in order to determine her policy's provisions and exceptions. 

  • You should discuss the pros and cons of using insurance to pay for therapy.

  • You should explore her hesitation about paying your typical fee. 

  • You should determine whether she will save money using her insurance before submitting the claim. 

Correct answer: You should request a copy of her insurance card in order to determine her policy's provisions and exceptions. 

All the following answers may be appropriate, but it is your first responsibility to ensure her policy's provisions. This information will help you and your client understand factors related to her deductible, co-pay, and the number of sessions that may be covered. 

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