MFT Marital and Family Therapy 3 — Questions and Answers
Question 1: In Strategic Family Therapy, 'paradoxical directives' are used primarily to:
- Reinforce existing problematic patterns until clients choose to change (Correct answer)
- Provide direct behavioral instructions to reduce symptoms
- Map family communication hierarchies
- Explore intergenerational trauma
Correct answer: Reinforce existing problematic patterns until clients choose to change
Paradoxical directives (e.g., prescribing the symptom) are designed to create change by making the problem behavior feel controlled or absurd.
Question 2: A genogram is best described as:
- A structured questionnaire assessing couple satisfaction
- A multigenerational family map depicting relationships and patterns (Correct answer)
- A behavioral log of family interactions over time
- A diagnostic tool for identifying personality disorders
Correct answer: A multigenerational family map depicting relationships and patterns
A genogram is a pictorial diagram of a family's multigenerational relationships, patterns, and significant events used in assessment.
Question 3: When an adolescent client discloses in individual session that they are using marijuana occasionally, the MFT should first:
- Immediately disclose this to the parents
- Assess for level of risk and review what was agreed in informed consent (Correct answer)
- Terminate the individual session and bring in the family
- File a report with child protective services
Correct answer: Assess for level of risk and review what was agreed in informed consent
The therapist should assess the risk level and refer to what was outlined in the informed consent agreement before deciding how to proceed.
Question 4: The concept of 'triangulation' in Bowen theory describes:
- A family's use of three therapeutic modalities simultaneously
- The involvement of a third person to reduce tension in a two-person relationship (Correct answer)
- Three-generation patterns of dysfunction
- A strategic alliance between two family members against a third
Correct answer: The involvement of a third person to reduce tension in a two-person relationship
Triangulation occurs when a dyad under stress pulls in a third person to reduce anxiety, stabilizing the relationship at the expense of the third party.
Question 5: A key feature of the Gottman Method in couples therapy is assessing the couple's ratio of positive to negative interactions, also called:
- The attachment index
- The Five-to-One ratio (Correct answer)
- The love map score
- The emotional bank balance
Correct answer: The Five-to-One ratio
Gottman's research found that stable relationships maintain a roughly 5:1 ratio of positive to negative interactions during conflict.
Question 6: A solution-focused brief therapist would most likely open a first session by asking:
- Tell me about the history of your problem.
- What would be different if this problem were solved? (Correct answer)
- How has your family of origin contributed to this issue?
- What defenses do you use when conflict arises?
Correct answer: What would be different if this problem were solved?
SFBT focuses on preferred futures, so therapists open with questions like the 'miracle question' to orient clients toward solutions rather than problems.
Question 7: Under HIPAA, when a client requests access to their own therapy records, the MFT must generally:
- Deny access if the records could be harmful to the client
- Provide access within 30 days of the request (Correct answer)
- Require a court order before releasing any records
- Obtain written consent from all family members involved
Correct answer: Provide access within 30 days of the request
HIPAA grants clients the right to access their protected health information, and covered entities must respond within 30 days.
MFT Marital and Family Therapy 3
In Strategic Family Therapy, 'paradoxical directives' are used primarily to: