MFT Licensure Exam Study Guide PDF

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MFT Licensure Exam Study Guide...

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Genogram 1

1. Who is the identified client in this three generation genogram? Correct answer: Keith Explanation: An enclosure such as the one that is drawn around Keith is typically the symbol that is used to indicate who the identified client is. 2. Which relationship in this family or family history indicates an abusive relationship? Correct answer: Sally towards Mark Explanation: A zig-zag line with an arrow typically indicates an abusive relationship, with the arrow pointed in the direction of the victim, in this case Mark. The arrow is outlined, which means emotional abuse rather than a shaded arrow which would indicate physical abuse. 3. Which transgenerational pattern is most notable in this genogram? Correct answer: The distant relationship among mothers and daughters Explanation: The distant relationship among mothers and daughters is seen in the relationship between Fiona and her daughter Sue, and then later with Sue and her daughter Maggie. 4. What does the dotted line around Brian Sr. indicate? Correct answer: He may be distant and/or disengaged from the rest of the family Explanation: A dotted line drawn completely around an individual usually indicates distance, disengagement, or cutoffs from the rest of the family. 5. Which two individuals have a close and healthy relationship, as indicated by this genogram?

Correct answer: Brian Jr. and Keith Explanation: Two solid lines that are drawn, as opposed to three solid lines, indicate a close relationship that is not fused or enmeshed. 6. If you were Keith's counselor, what transgenerational issues would you want him to be aware of in order to begin developing treatment goals? Correct answer: The family pattern of alcohol and other drug use Explanation: The horizontal shading in the boxes indicates that Keith, his father, two uncles, and grandfather all struggled with substance use issues. Keith would benefit initially from psychoeducation regarding family history of substance abuse as a risk factor. 7. What insight could be gained regarding Sue's relationship with men? Correct answer: Sue might have some co-dependency issues. Explanation: The genogram indicates that Sue has married and divorced twice, both to partners with substance use; the counselor would want to be aware of the possibility that Sue might benefit from education regarding co-dependency in relationships. 8. Which of the following is NOT a transgenerational pattern for this three generational family? Correct answer: Abuse Explanation: While there is some evidence of conflict among a couple marital partners, there is only one indication of abuse, that of Sally to Mark. This would be an example of a transgenerational pattern in the identified client's family. 9. Which is an example of a fused or enmeshed relationship? Correct answer: Sue and Keith Explanation: Enmeshed or fused relationships are unhealthy close relationships, and are indicated by drawing three solid lines. 10. Which symbol in this genogram indicates that a miscarriage occurred? Correct answer: A triangle with an 'x' in it. Explanation: Typically, a miscarriage is drawn as a triangle with an 'x' in it. Miscarriages and stillbirths are important to a genogram as they may represent significant losses in a family and could help paint a picture as to how a family might have learned to grieve.

Genogram 2

1. What kind of relationship does Natalie have with her daughter Maria? Correct answer: Fused-Hostile Explanation: A fused-hostile relationship is symbolized by a jagged line within three parallel lines. This dynamic exists for two individuals who maintain an unhealthy enmeshed relationship who are often engaged in conflict with each other. 2. Which of the following best explains the fused relationship Isabella had with Natalie? Correct answer: The distant or poor relationship Isabella had with her husband. Explanation: From a system's perspective, Isabella most likely turned to her daughter for comfort as a result of the poor marital relationship she had with her husband. 3. Who in this genogram is most likely the product of triangulation? Correct answer: Maria Explanation: Murray Bowen conceptualized a triangle as a relationship system consisting of three people where two members (usually the parental subsystem) who are experiencing an uncomfortable amount of stress in their relationship draw in a third member (usually a child) to help release emotional tension. In this case, Maria's parents have a history of conflict and appear to project their conflict onto her.

4. If you were Natalie's therapist, which family event is least likely to explain her recent depressed mood? Correct answer: Her father-in-law's suicide Explanation: Natalie was enmeshed with her mother and would likely have a difficult time with her death. This would be compounded by the fact that her only daughter may be attempting to move more towards independence. It would be important for Natalie to express any feelings of loss, including the divorce as well as difficulties about her brother's cancer, whom she is close to. 5. Who is the identified client in this family? Correct answer: Natalie Explanation: While a family therapist might typically classify "the family" as the identified client, drawing a circle around an individual pinpoints a selected member to work with. It is likely that Natalie sought out counseling for herself or her family. 6. What members of this family have experienced cutoffs? Correct answer: Adam and Natalie Explanation: The only cutoff that is seen in this genogram is the divorce between Adam and Natalie. Adam and Maria have a distant or poor relationship, but there is no indication that either has decided to cut themselves off emotionally from the other. 7. Which Bowenian concept best explains the close relationship Adam had with his parents? Correct answer: Differentiation Explanation: Differentiation of self: refers to people’s ability to separate themselves from their family of origin without cutting themselves off from their families. Adam experience a close relationship with his parents 8. Which of the following transgenerational dynamics best explains Natalie's fused-hostile relationship with Maria? Correct answer: Natalie's own pattern of enmeshment with her caregiver, Isabella. Explanation: Bowen's multigenerational transmission process demonstrates how relational patterns, coping strategies, and levels of differentiation are passed on from generation to generation. 9. The following interpretations may help explain Ron's suicide, except: Correct answer: Adam and Natalie's divorce Explanation: It is important to consider significant dates in a Genogram, as Adam and Natalie's divorce occurred fourteen years following Ron's suicide. Perhaps not coincidentally, Ron took his life about a year following the death of Constance, which would be something to explore if you were working with Adam and his family.

10. Which relationship in this genogram is characterized by abuse? Correct answer: There is no indication that any abuse has occurred Explanation: While the genogram does indicate hostility and conflicts between Natalie and Maria as well as Natalie and Adam, abuse would be indicated by drawing an arrow from the hostility towards the person who would be identified as a victim. Diagnosis Case 1 Case Study: Henry, a 13-year-old boy, comes to your office with his parents. Both parents are frustrated with Henry's behavior at home and at school. Henry has been swearing and using obscene language with other students. Henry is also very disrespectful at home to his mother and siblings. He will not do any chores or clean his room. He has frequent outbursts and blames others for his mistakes. He is a bully and has been caught spray painting signs around town. The whole family is disrupted by Henry's acting out, and his parents would like to put him in a residential program. 1. What would you do first with Henry? Correct answer: Investigate the discipline process in the home Explanation: You must investigate how the parents are currently responding to Henry to see how that is contributing to the behaviors. 2. What additional information do you need to formulate your initial diagnosis for Henry? Correct answer: Duration Explanation: You will need know the duration of his symptoms. 3. The parents report that these symptoms have been present for over a year. Based on this additional information, what would be your diagnosis for Henry? Correct answer: Oppositional Defiant Disorder Explanation: Henry's symptoms meet criteria for Oppositional Defiant Disorder. 4. What duration of symptoms would you expect to see with a diagnosis of Oppositional Defiant Disorder? Correct answer: Six months 5. Which of the following behaviors would you NOT see in Oppositional Defiant Disorder? Correct answer: Gets along with younger children Explanation: Getting along with younger children is NOT part of the criteria for Conduct Disorder. 6. What would you do next with Henry?

Explanation: You should get a second opinion from a physician to rule out physical problems that might be causing difficulties. 7. Henry reports that his uncle touched him inappropriately when he was ten years old and his mother never did anything about it. You should: Correct answer: Contact the abuse registry Explanation: You must contact the abuse registry as it was reported to you, but do advise the mother that you are calling. 8. Using a behavioral approach to working with Henry, what would be your role? Correct answer: To eliminate his maladaptive behaviors Explanation: Behaviorists attempt to eliminate their clients' maladaptive behavior and replace them with new ones. 9. Using a behavioral approach, which technique below would you be utilizing? Correct answer: Rehearsal Explanation: Rehearsal is a behavioral technique. 10. When terminating treatment with Henry, what would be the best recommendation? Correct answer: Group for adolescents who have been sexually traumatized Explanation: Henry would most benefit from a group for adolescents who have been sexually abused. There is also a need for family therapy to resolve the conflicts between parents and siblings. MFT Case 1 Case Study: Your practice has grown, and more clients have made an appointment for counseling with you. Jared, a new client is considering pursuing therapy with you. Jason has been in therapy with you, and you feel that you may have reached an impasse in counseling him. Jason has discussed the progress of his therapy and feels like he has not been making progress rapidly enough. He informs you that as he walked to his car in the supermarket parking lot, another therapist approached him, asking if he could help, because Jason appeared to be troubled. The other therapist spoke to Jason about counseling with him, if Jason felt his current counseling was not effective. Rachel informs you that she plans to move out of the area and plans to terminate counseling with you in the near future. Marjorie has been in counseling with you for approximately one year, feels comfortable talking to you and in one session, attempted to hold your hand and hug you (a male therapist). In addition to your private practice, you counsel at a local for profit corporation in their EAP program, where you supervise two other therapists. 1. You are in the first therapy session with a new client. During the initial therapy session, you inform the client about ________________, _________________, and ___________________:

Correct answer: Your education and qualifications; the nature of the therapeutic process; procedures and goals of therapy Explanation: In the initial session with the client, therapists must follow ethical guidelines. The appropriate course of action for therapists to follow is to inform the client about the therapist's education, and qualifications. This may include degrees, training, certification and licensure in counseling. Therapists are to inform clients about the nature of the therapeutic process, and the procedures and goals of therapy. Therapists discuss fees and sliding fee scales, the limits of confidentiality and obtain informed consent to treat the client. At the outset of therapy, therapists explain potential risks and reasonable benefits of therapy. Therapists also explain the process of counseling, the therapist's theoretical orientation and the right to terminate therapy at any time. 2. Jared, your new client informs you that he is considering therapy with you. Jared is concerned about how counseling may affect him. Your responsibility as a therapist is (to)__________________. Correct answer: Inform the client of the potential harms/risks and reasonable benefits of therapy Explanation: Before proceeding with counseling, a therapist's responsibility is to inform the client of the potential harms or risks of therapy and the reasonable benefits to be expected of therapy. 3. When beginning therapy with Jared, it is your responsibility to discuss all of the following except (your) ________________: Correct answer: Experience counseling clients, counseling policies and theoretical orientation Explanation: When beginning therapy with a new client, it is the therapist's responsibility to discuss with the client your professional qualifications to do therapy, the therapy process and what to expect from therapy, counseling policies, theoretical orientation, the client's rights concerning confidentiality, and fee disclosure. therapists do not discuss their experience counseling others, and keep counseling session information confidential. 4. Jason informs you that he does not feel that therapy is going well and he feels that he is not making progress as rapidly as he expected. He tells you that he spoke to a therapist in a parking lot, and was told that he could begin counseling with their office, if he felt that therapy was not beneficial with you. Your policy, which you explained to Jason in the initial counseling session, is to inform the client about his _______________ Correct answer: Ability to terminate counseling at any time Explanation: It is a client's right to terminate therapy at any time. A therapist's responsibility is to accept the client's right to terminate therapy, discuss any closing issues with the client, and inform them that they may return to counseling with you in the future-that the door is open. Therapists must ensure that they do not abandon the client and the client is free to terminate therapy at any time. Reasonable follow up is to contact the client to ensure that the client is receiving appropriate treatment.

5. Rachel informs you that she plans to move out of the area and will terminate counseling with you after the next session. The appropriate course of action that you should take toward her is __________________ Correct answer: Reassurance of referral sources for further treatment Explanation: When a client wishes to terminate counseling, the appropriate course of action is to reassure the client of referral sources for treatment. Generally, giving the client three referral sources is within the ethical standard of care. After allowing time for the client to contact a therapist in the area where he/she resides, it is reasonable to contact the client to follow up to ensure that he/she was able to find appropriate treatment. 6. Marjorie has been in counseling with you for nearly one year. She feels comfortable talking in counseling sessions with you, and freely discusses her personal and home life. She recently began asking you about your personal life. You should _____________ Correct answer: Keep personal issues out of the counseling relationship Explanation: Therapists are advised to not discuss issues in their personal life. Limited disclosure may be acceptable, if it is beneficial to therapy; disclosure should be very limited and the therapist should ensure that any disclosure would not harm the client. 7. You are a therapist, and supervise two other therapists as part of an EAP program. You suspect that one of the therapists you supervise may be acting questionably toward a client off the job site. A coworker has advised you that this has happened in the past, and that this is part of the job requirement. Your primary concerns are all of the following except ____________ Correct answer: Losing your position as supervisor Explanation: Therapists need to be aware of statutes, case law and regulations concerning their practice. Vicarious liability statutes, case law and regulations state that employers and supervisors are held accountable/liable for their subordinate's actions. Moreover, if an employee/therapist's actions are essential to their job requirements, even though they may not occur on the job site, the employer is still held liable for such actions. A therapist's first concern is to do no harm to the client. 8. Manuel is biracial (Hispanic and Native American). In his culture, men do not seek counseling, as the norm. You have considered bringing in Manual's family for counseling with him, however you sense resistance to the idea. You should ________________. Correct answer: Respect the cultural values of the client Explanation: Therapists should make decisions and take actions that foster growth, rather Therapists are required to practice within the boundaries of his/her competence (education, training, licensure and certification). Therapists need to understand how to counsel multicultural clients, understand multicultural attitudes and values and incorporate multicultural techniques and interventions in therapy. Competent, ethical therapists implement treatments and techniques to benefit the client, rather than promoting the therapist's personal values. 9. Within the context of counseling, your goal with all of your clients is to _____________.

Correct answer: Determine the ethical course of action at all times Explanation: Ethics is the study of what constitutes good and bad human conduct, including related actions and values. It is important for therapists to be able to apply ethics appropriately in practice, that is, determine the appropriate response in counseling situations is critical. If the therapist should act at all, the ethical response must be determined. Codes of ethics define the role of the profession, define values and goals of the profession, define the standards that professionals and clients may expect within the realm of professional interactions, and guide conduct for the profession. 10. You explain to your client that you have a Masters Degree in counseling from an accredited university, you are licensed in the state in which you practice, and describe the certifications you hold that qualify you to provide counseling. You discuss your theoretical orientation, procedures and goals of therapy, potential harms or risks and potential reasonable benefits expected for the client from therapy, discuss the limits of confidentiality and ability to terminate therapy at any time to the client. It is appropriate to follow all of the above practices __________________. Correct answer: At the outset of therapy Explanation: It is appropriate at the outset of therapy to discuss your qualifications, credentials and areas of expertise to your client. It is further appropriate, at the outset of therapy to discuss your theoretical orientation, procedures and goals of therapy, counseling policies, potential risks and harms that could derive from therapy, reasonable benefits that the client may expect from therapy, the limits of confidentiality, mandatory reporting, and the ability of the client to terminate therapy at any time. The above should be discussed with clients before proceeding with therapy. EXISTENTIAL GROUPS Existential group work focuses on the subjective aspects of a member's experiences. The central issues in existential group therapy and therapy are: Freedom, Responsibility, and the anxiety that accompanies being both free and responsible. Some of the concepts of existential therapy in a group setting are: 1. The meaning of death is a productive focus for group sessions, for from the concept of death do we realize the meaning of living. 2. "We have to learn to stand alone before we can stand beside anyone." 3. "If it does not kill me, it can only make me stronger." 4. People become what they choos...