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MFT Comprehensive Exam Graded A+
*Blended Family - ANSWER-a) Divorce b) Step-families. Separate families united by marriage or coupling which face non- normative developmental challenges of redefining/merging roles, rules, and rituals for a new family structure c) Redefining the role of parenting a new step-dad will have with his new step-children. *Complementarity - ANSWER-a) structural b) Reciprocity that defines every relationship. The exchanges are logically opposite: pursuer-distancer, active-passive, dominant-submissive, accuse-deny c) In a pursuer - distance relationship, the more one pursues, the more the other distances, inviting further pursuit. *Cross Generational Coalition - ANSWER-a) Structural b) A triadic structure detailing the alignment of a person from one generation with another from a different generation against a 3rd family member. c) A father and son are disrespectful toward the mother. *Double-Bind - ANSWER-a) Communications theory, Bateson b) Theory has to have all three of:
- An intense relationship from which individual cannot withdraw
- Two messages that contradict each other
- An injunction that must be obeyed or disobeyed but neither response is appropriate c) A wife says tells her husband she wants him to want to do the dishes *DSM-5 - ANSWER-a) APA Diagnostic and Statistical Manual of Mental Disorders, 5th edition 2013 b) Standardized classification of mental disorders for the purpose of diagnosis and treatment planning c) A set of symptoms for a certain amount of time can indicate a DSM diagnosis for third party reimbursement *Emotional Cutoff - ANSWER-a) Bowen b) An individual emotionally and physically remove themselves from the family system to manage anxiety c) A son that is fused with his mother moves across the country to go to college to severely limit contact and avoid reactivity 2nd law of thermodynamics - ANSWER-a) Law of Physics b) As all entities get more complex they tend toward a state of entropy or total chaos c) All mountains will eventually crumble. Relevant to MFT in that families temporarily subvert this law and tend toward maximum order - or negentropy. AAMFT Clinical Fellow - ANSWER-a) AAMFT
b) A credentialed member of the AAMFT; Has met the standards for independent clinical practice. c) 1.Clinical membership (licensure) Eligible to apply if you have a license and reside in an accepted state.
- Clinical membership (evaluative) Eligible to apply if you live in a state that doesn't license mat's or does but the license isn't accepted by the AAMFT. Accreditation - ANSWER-a) Program Standards b) Certification granted to an educational institution that meets performance standards of an institution of accreditation. Enables the consumer to know the quality of the program. c) The MFT program at FU is accredited by COAMFTE Boundaries - ANSWER-a) Structural Therapy b) Invisible lines that regulate closeness and distance and exchange of information among family members, and between families and the environment. Diffuse - enmeshed, Rigid - disengaged, Clear - firm but flexible c) A Father who distances himself from a feuding Mother/daughter and does not get involved = Rigid Caring Day Technique - ANSWER-a) Strategic (Richard Stuart) b) A therapist tasks a problem couple to generate a list of small positive things that they can do to show each other that they care. c) Each member of a couple has to come up with a list of no more than 5 concrete things they want the other to do. Has to be small and specific things (buy flowers, give a hug, make the bed), has to be something the other can do, and has to be positively framed to do something, not to not do something. Cloe Madanes - ANSWER-a) Strategic Family Therapist b) Together with Jay Haley, founded the Family Therapy Institute in Washington DC. Uses playfulness, benevolent interpretation of symptoms, humor, and metaphor in therapy. c) A wife's reluctance to have sex with her husband is a benevolent way to protect him from experiencing performance anxiety. Co-dependency - ANSWER-a) Substance Abuse and Addiction b) The problem is not only the addict but also the family and friend network. The non- addicted family member/friend enables the addict - inadvertent contributor to the maintenance of the problem. c) A wife calls in to work for her hungover husband lying and telling them that he has the flu. Coaching - ANSWER-a) Bowenien b) Therapist guides the process of change but does not do the work; self-differentiation must be self-motivated and achieved.
Detriangulation - ANSWER-a) Bowen b) The process by which an individual removes themselves from the emotional field of two others c) A therapist not taking sides with any one member of a dyad remains detriangled. Differentiation of self - ANSWER-a) Bowen b) The ability to separate the emotional and intellectual systems and self from others. Level exists on a continuum. Allows a variety of responses in the face of intense anxiety rather than reacting immediately. c) My less differentiated client is quicker to react when faced with situations that provoke anxiety. Divorce Mediation - ANSWER-a) Legal model of dispute resolution (Alternative to the more adversarial legal model). b) A trained specialist enables cooperative, self-determined divorce agreement. c) An MFT trained in mediation works with a couple to agree on mutually acceptable arrangements for time with children Ecosystem Approach - ANSWER-a) Brofrenbrenner b) Approach that takes into account all systems that affect family functioning: neighborhood, relatives, religious affiliation, the therapist himself c) Therapist learns that the church a couple belongs to offers marital retreats and suggests they go on one to strengthen the spousal subsystem Enmeshment - ANSWER-a) Structural b) Characterized by: -Over-involvement -Lack of autonomy -Low levels of differentiation with high reactivity -Rapid transfer of information c) A mother who repeatedly answers for her son in therapy session, or constantly tells him what to say or how to say it, is likely enmeshed with her son. Equipotentiality - ANSWER-a) General Systems Theory b) The same input leads to different outcomes c) Spanking a misbehaving child can result in more misbehavior, less misbehavior, no change in behavior Externalization - ANSWER-a) Narrative Therapy b) A listening and questioning technique. Redefines problems not as internal deficits, but as an external influence. Personifies the problem. c) When did anxiety show up vs. when were you anxious? Family Life Cycle (McG & Carter) - ANSWER-a) McG & Carter b) Normal developmental changes that can cause stress and the need for structural change. Families must adapt.
-Leaving home -Joining families through marriage -Adults with young children -Adults with adolescents -Launching and moving on -Families in later life c) Many couples encounter problems in the 5th stage, when children leaving home force them to focus on their marriage rather than parenting. First Order Change - ANSWER-a) Cybernetics b) Temporary or superficial change that occurs within the threshold of the system and does not require structural change. c) A wife replaces fighting with her husband with ignoring him completely Gender Dysphoria - ANSWER-a) DSM-5 Diagnosis b) Emotional and psychological identity to be opposite to one's biological sex c) A child born as a girl may express a desire to be a boy, not want to get her period or wear dresses, insist on being called by a boy's name, and want to grow up to be a man. Genogram - ANSWER-a) Bowen b) A generational map of a family that highlights important information such as divorce, substance use, mental health, etc. c) A therapist may use a genogram to highlight patterns of abuse in a family. Hierarchy - ANSWER-a) Structural b) Part of the family structure that determines who is in charge, how decisions are made, and the power balance in the system. c) In a patriarchal society it is common for men to be at the top of the hierarchy Homeostasis - ANSWER-a) General Systems Theory b) A system's tendency to regulate itself regardless of external influence. c) A mother calms her children during a storm, to restore balance. Incongruous Hierarchy - ANSWER-a) Strategic, MRI b) The idea that the problem is both a source of power and a weakness that maintains the power balance of the system c) An alcoholic Fater has power because he is able to organize the family around his needs. His alcoholism is also a weakness because he is unable to take care of himself. Informed Consent - ANSWER-a) Legal and Ethical b) A therapists responsibility to inform clients about purposes, policies, procedures, and potential risks. c) An Mft's informed consent will cover topics such as confidentiality, fees, etc. Internalized Racism - ANSWER-a) Social justice b) When racist attitudes and prejudices are felt about ones own race
A child takes on or is assigned responsibilities that are beyond their emotional and developmental capabilities. The child has been elevated in the hierarchy to become an equal (or even a superior) in the parental subsystem. c) A single parent relies on the oldest child to take responsibility for helping with her siblings and treats her as a confidant/friend without any generational boundaries. Patterns of Interaction - ANSWER-a) General Systems Theory b) Patterns that, over time ,establish a families roles and rules. Repetitive and predictable. c) A wife feels ignored by hubby. She argues with him. He pays attention to her. She feels lonely again. Positive Feedback Loop - ANSWER-a) Cybernetics b) Escalating deviations away from homeostasis that eventually lead to structural change. c) Constant conflict between a couple eventually leads to their separation. Pretend Technique - ANSWER-a) Cloe Madanes/Strategic b) Therapist asks the family to pretend to have the symptom so the pretend replaces the actual having of the symptom c) Telling parents to pretend to make their child have a tantrum, and asking their child to play along. Qualitative Research - ANSWER-a) Research methods b) Research that cannot be quantified with numbers but is better described with words. Explores the meaning attributed to experiences. c) Focus groups and In-depth Interviews Racism - ANSWER-a) Social Justice b) Belief that characteristics or abilities are attributable to all members of a race; Belief that one race is superior to another. Also, prejudice toward someone of a different race based on the belief that one's own race is superior. c) Attributing terrorism to Muslims is a racist attitude. Raising intensity - ANSWER-a) Structural b) A therapist blocks negative feedback patterns in an attempt to alter the family's boundaries, move them away from homeostasis, and towards systemic change. c) A therapist continues to ask the same question until the family answers it. Reframing - ANSWER-a) Constructivist, used in Structural/Strategic b) Shifts the way clients experience their situation in a way that fits the facts; makes it more amenable to change/alternate ways of responding. c) A therapist may reframe an arguing couple as passionate Restraint from Change - ANSWER-a) Strategic, H & M
b) A therapist tells a client or family that they are not ready to change with the hopes they will resist the instruction and change, or take a new position relative to the symptom. c) A therapist tells a family they may not be ready to change how they speak to each other because they're better at arguing than talking calmly. Sculpting - ANSWER-a) Experiential b) An intervention where the therapist physically positions family members during session based on attitudes, roles, or space to represent a behavior interaction. c) A therapist using this technique may put family members in opposite corners of the room to represent emotional distance. Second Order Change - ANSWER-a) Cybernetics b) Change in the structure & function of the system. c) A couple getting divorced and separating Sexual Orientation - ANSWER-a) Social Justice b) The desire for intimate emotional and/or sexual relationships with people of the same gender/sex, another gender/sex, or multiple genders/sexes. c) Gay, lesbian, straight, bisexual Sexual Response Cycle (Master my Johnson) - ANSWER-a) Masters and Johnson b) 4 stages of sexual response: Excitement, Plateau, Orgasm, Resolution c) During the excitement phase a person would experience muscle tension, increased heart rate. Situational Sexual Dysfunction - ANSWER-a) DSM-5 Diagnosis b) A sexual disorder or problem that only occurs in some contexts c) A woman feels hypoactive desire with her husband, but is attracted to other men. Stages of Divorce - ANSWER-a) Ahrons b) 5 stages of predictably consistent experiences through the process of divorce c) Decision, Announcement, Separation, Formal Divorce, Aftermath. Strategic Therapy - ANSWER-a) Haley/Madanes, Ericsson, MRI, Milan Group b) A model that focuses on the symptom in the pattern of interactions and how to interrupt those patterns to alleviate the symptom and change the system c) A paradoxical prescription is a common strategic method System - ANSWER-a) General Systems Theory b) Dynamic ordering or parts and processes which exist in mutual interaction. Interrelated elements exhibiting coherent behavior as a whole. c) In FT, a family is viewed as a system, where the behavior of one affects the entire family. Therapist's use of self - ANSWER-a) Structural
Wrong solution Cycle - ANSWER-a) MRI b) How a family's "solution cycle" maintains symptoms rather than alleviating them, by doing the same things over and over. c) 3 WSCs: Action taken but not necessary, action necessary but not taken, taken action at the wrong level. A wife nags her husband to do the dishes and he withdraws and does not. She continues this every night, hoping for a different outcome.
