MFT Child and Adolescent Therapy 5 — Questions and Answers
Question 1: A 9-year-old presents with intrusive thoughts, compulsive hand-washing, and significant distress. The most indicated evidence-based treatment is:
- Psychodynamic therapy exploring unconscious conflicts
- Exposure and Response Prevention (ERP) as part of CBT for OCD (Correct answer)
- Hypnotherapy to access repressed memories
- Strict behavioral contracts with reward charts only
Correct answer: Exposure and Response Prevention (ERP) as part of CBT for OCD
ERP, the gold-standard component of CBT for OCD, is the most evidence-based treatment for pediatric obsessive-compulsive disorder.
Question 2: When using Multisystemic Therapy (MST) for an adolescent with serious conduct problems, the therapist primarily works:
- In an office setting with the adolescent alone
- Across multiple systems including family, peers, school, and community (Correct answer)
- Using only individual psychodynamic techniques
- In a residential treatment center
Correct answer: Across multiple systems including family, peers, school, and community
MST is an intensive home- and community-based model that intervenes simultaneously across the adolescent's multiple social systems.
Question 3: An MFT is working with a 5-year-old child using Child-Parent Psychotherapy (CPP). The primary therapeutic target in CPP is:
- The child's individual intrapsychic conflicts
- The quality of the relationship between the child and the caregiver (Correct answer)
- The child's classroom behavior and academic functioning
- Parental psychopathology independent of the child
Correct answer: The quality of the relationship between the child and the caregiver
CPP, developed by Alicia Lieberman, uses the child-caregiver relationship as the primary vehicle for healing, targeting relationship disturbances in young traumatized children.
Question 4: Which of the following best describes 'parentification' as it relates to family therapy with children?
- Teaching parents effective discipline strategies
- A child being assigned age-appropriate household tasks
- A child taking on emotional or instrumental caretaking responsibilities that belong to adults (Correct answer)
- A parent adopting the child's perspective to improve empathy
Correct answer: A child taking on emotional or instrumental caretaking responsibilities that belong to adults
Parentification occurs when children assume adult roles—either emotional (supporting parents) or instrumental (managing household)—reversing appropriate generational hierarchy.
Question 5: During a family session, an 8-year-old becomes the scapegoat for all family tension. Using Bowen's family systems theory, this pattern reflects:
- Triangulation and the projection of family anxiety onto the child (Correct answer)
- An enmeshed boundary between the sibling subsystem
- A positive feedback loop strengthening the family
- Healthy differentiation of self within the family system
Correct answer: Triangulation and the projection of family anxiety onto the child
Bowen's family projection process describes how undifferentiated parental anxiety is triangulated onto a child, making them the identified patient.
Question 6: A therapist working with an autistic child and their family should prioritize which of the following in treatment planning?
- Eliminating all autistic traits to normalize the child's behavior
- Identifying the child's strengths and supporting communication and adaptive functioning (Correct answer)
- Focusing exclusively on ABA without involving the family
- Deferring entirely to the school's IEP recommendations
Correct answer: Identifying the child's strengths and supporting communication and adaptive functioning
Neurodiversity-affirming, family-centered care identifies the child's strengths while supporting communication, relationships, and adaptive skills.
Question 7: An MFT discovers mid-treatment that a 15-year-old client has been self-harming non-suicidally. The most clinically appropriate immediate step is to:
- Hospitalize the client immediately regardless of lethality
- Conduct a thorough safety assessment and develop a collaborative safety plan (Correct answer)
- Terminate therapy and refer to a higher level of care without further assessment
- Inform the school counselor before speaking with the client or parents
Correct answer: Conduct a thorough safety assessment and develop a collaborative safety plan
Non-suicidal self-injury requires a thorough safety and lethality assessment followed by collaborative safety planning before determining the appropriate level of care.
MFT Child and Adolescent Therapy 5
A 9-year-old presents with intrusive thoughts, compulsive hand-washing, and significant distress.
The most indicated evidence-based treatment is: