MFT Basic Marital and Family Therapy 3 — Questions and Answers
Question 1: Which concept in contextual family therapy, developed by Ivan Boszormenyi-Nagy, refers to the accumulated ledger of fairness, entitlements, and obligations across generations?
- Family loyalty
- Relational ethics
- Invisible loyalties
- Relational ledger (Correct answer)
Correct answer: Relational ledger
The relational ledger tracks the balance of give-and-take across family generations, with debts and entitlements that can be passed down to children.
Question 2: According to John Gottman's research, which of the following is the MOST reliable predictor of divorce in couples?
- High frequency of arguments
- Presence of contempt (Correct answer)
- Sexual dissatisfaction
- Financial disagreements
Correct answer: Presence of contempt
Gottman's research identified contempt — expressions of disgust, superiority, and disrespect — as the single strongest predictor of relationship dissolution.
Question 3: A family therapist notices that whenever the parents begin to argue, their teenage son acts out and diverts the parents' attention to him. This pattern best illustrates:
- Enmeshment
- Detouring (Correct answer)
- Disengagement
- Parentification
Correct answer: Detouring
Detouring is a structural pattern in which the parental dyad avoids conflict by redirecting tension through a child, who either becomes symptomatic or is scapegoated.
Question 4: In solution-focused brief therapy, the miracle question is primarily used to:
- Assess the severity of the presenting problem
- Elicit client-generated visions of a preferred future (Correct answer)
- Challenge cognitive distortions about the problem
- Establish therapeutic goals through scaling
Correct answer: Elicit client-generated visions of a preferred future
The miracle question invites clients to describe life after the problem has disappeared, helping them articulate goals and identify small steps toward change.
Question 5: Which ethical principle requires MFT therapists to disclose the limits of confidentiality at the start of treatment?
- Beneficence
- Fidelity
- Informed consent (Correct answer)
- Nonmaleficence
Correct answer: Informed consent
Informed consent requires therapists to provide clients with information about the nature, risks, and limits of treatment — including when confidentiality must be broken — before therapy begins.
Question 6: In strategic family therapy, the technique of prescribing the symptom (symptom prescription) works primarily through which mechanism?
- Operant conditioning of the symptom
- Paradoxical intention reducing symptom anxiety (Correct answer)
- Extinction of secondary gains
- Behavioral rehearsal of alternative responses
Correct answer: Paradoxical intention reducing symptom anxiety
When clients are instructed to deliberately enact their symptom, the anxiety and automaticity surrounding it decrease, and the symptom often loses its involuntary quality.
Question 7: A client discloses that their spouse is having an extramarital affair but insists the information be kept secret from the spouse. The MOST ethically appropriate initial response is to:
- Immediately disclose the secret to protect the spouse
- Refuse to continue therapy unless the secret is revealed
- Explore the secret's impact and clarify your no-secrets policy (Correct answer)
- Maintain the secret to preserve therapeutic alliance
Correct answer: Explore the secret's impact and clarify your no-secrets policy
The therapist should explore the clinical implications and refer back to a pre-established no-secrets policy rather than unilaterally disclosing or indefinitely holding the secret.
MFT Basic Marital and Family Therapy 3
Which concept in contextual family therapy, developed by Ivan Boszormenyi-Nagy, refers to the accumulated ledger of fairness, entitlements, and obligations across generations?