NCMHCE NCMHCE - National Clinical Mental Health Counseling Examination Family Systems and Couples Counseling 4 — Questions and Answers
Question 1: A couple presents with chronic conflict over finances. The husband hides purchases while the wife monitors all accounts obsessively. Which family systems concept BEST describes the wife's monitoring behavior?
- Triangulation
- Reactive pursuit (Correct answer)
- Enmeshment
- Undifferentiation
Correct answer: Reactive pursuit
Reactive pursuit occurs when one partner increases closeness-seeking behaviors in response to the other partner's distancing, creating a pursuer-distancer cycle.
Question 2: In structural family therapy, a therapist deliberately sides with one family subsystem to shift a rigid coalition. This technique is called:
- Reframing
- Enactment
- Unbalancing (Correct answer)
- Joining
Correct answer: Unbalancing
Unbalancing involves the therapist temporarily aligning with one family member or subsystem to challenge existing hierarchies and disrupt rigid, dysfunctional coalitions.
Question 3: A same-sex couple reports that one partner's family of origin refuses to acknowledge the relationship. Using an Emotionally Focused Therapy (EFT) lens, the FIRST priority is to:
- Coach the rejected partner on assertiveness with family members
- Identify each partner's attachment fears and needs underlying the conflict (Correct answer)
- Refer the couple to family mediation with the family of origin
- Educate the couple about minority stress and its effects
Correct answer: Identify each partner's attachment fears and needs underlying the conflict
EFT prioritizes de-escalating negative interaction cycles by first identifying the underlying attachment emotions and needs driving each partner's responses.
Question 4: A family therapist notices that the parents never disagree in front of their children and that the children are unusually well-behaved and anxious. This pattern is MOST consistent with:
- A healthy authoritative parenting style
- Conflict detouring through children (Correct answer)
- An effective parental alliance
- Sibling subsystem rigidity
Correct answer: Conflict detouring through children
Conflict detouring occurs when parents suppress their marital conflict and the family's anxiety is redirected onto the children, who then develop symptoms to maintain parental stability.
Question 5: In Gottman's Sound Relationship House model, 'turning toward' bids for connection is associated with which foundational level?
- Shared meaning system
- Fondness and admiration
- Positive perspective
- Building love maps (Correct answer)
Correct answer: Building love maps
Building love maps—deeply knowing your partner's inner psychological world—is the foundational level, and turning toward bids consistently is the behavioral mechanism that builds this intimacy.
Question 6: A counselor using a narrative therapy approach with a couple would MOST likely begin by:
- Mapping the couple's family-of-origin attachment patterns
- Identifying the problem-saturated story each partner holds about the relationship (Correct answer)
- Teaching the couple active listening communication skills
- Assessing the couple's level of differentiation of self
Correct answer: Identifying the problem-saturated story each partner holds about the relationship
Narrative therapy begins by externalizing the problem and exploring the problem-saturated story, then seeks to identify unique outcomes that contradict that dominant story.
Question 7: A multigenerational family therapist constructs a genogram and notices that three generations of men in a family had alcoholism and abandoned their families. This pattern is BEST described as:
- Vertical stressor transmission (Correct answer)
- Undifferentiated ego mass replication
- Triangulated legacy
- Horizontal stress accumulation
Correct answer: Vertical stressor transmission
Vertical stressors are patterns, myths, secrets, and legacies that are transmitted down through generations in a family, as described in the Family Systems Stress-Adaptation Model.
NCMHCE NCMHCE - National Clinical Mental Health Counseling Examination Family Systems and Couples Counseling 4
A couple presents with chronic conflict over finances.
The husband hides purchases while the wife monitors all accounts obsessively.
Which family systems concept BEST describes the wife's monitoring behavior?