MFT cards

32914 An 84-year-old man who you have been seeing in therapy for several months is taken by a neighbor to the emergency room at the hospital. The emergency medical technician calls you because she found your card in the patient's pocket. She requests information about your patient. What should you do?

a. Determine the nature of the emergency and provide only relevant information. b. Refuse to give the EMT any information under any circumstances. c. Maintain the client's confidentiality until you receive his authorization to release confidential information. d. Verify that the person is an EMT and, after doing so, give her information related to the emergency. Feedback Answer D is correct: It is unnecessary to obtain an authorization when protected health information (PHI) must be disclosed to avert a serious threat to the health or safety of a client. The correct answer is: Verify that the person is an EMT and, after doing so, give her information related to the emergency. Question 33 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32701 Your client, age 30, has just found out that he has an aggressive cancer. Which of the following is the client's MOST likely initial reaction to the news that he is terminally ill?

a. "No, it cannot be." b. "I hate the world." c. "There is no point in going on." d. "I might as well accept my fate and enjoy the time I have left." Feedback Answer A is correct: According to Elisabeth Kübler-Ross, the five stages that a terminally ill person goes through are denial, anger, bargaining, depression, and acceptance. Although the stages do not always appear in this order, the majority of people recently diagnosed with a life-threatening illness react with expressions of denial, such as that expressed in this answer. Answer B is incorrect: Anger might be experienced after the patient's denial erodes. Answer C is incorrect: This sounds like depression. Answer D is incorrect: This sounds like an expression of acceptance. The correct answer is: "No, it cannot be." Question 9 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32770 A clinician notices that her client, age 28, experiences frequent periods in which she is very irritable, sensitive, anxious, and self-deprecating; but that, between these times, the client seems to be fairly well-adjusted and even-tempered. When the clinician asks the client about these mood changes, the client says she has always become very moody during the week before her menstrual period. The client's symptoms are most suggestive of which of the following DSM-5 disorders?

a. Dysmenorrhea b. Cyclothymic Disorder c. Premenstrual Syndrome d. Premenstrual Dysphoric Syndrome Feedback Answer D is correct: More information would be needed to assign a diagnosis of Premenstrual Dysphoric Syndrome. However, of the diagnoses listed in the answers, this one is most consistent with the information provided in the question. Answer A is incorrect: Dysmenorrhea is a medical condition that is characterized by physical pain during menstruation. Answer B is incorrect: While the client's symptoms are cyclical, they do not meet the diagnostic criteria for Cyclothymic Disorder, which involves alternating periods of hypomanic and depressive symptoms. Answer C is incorrect: Premenstrual Syndrome is not a DSM-5 diagnosis. The correct answer is: Premenstrual Dysphoric Syndrome Question 18 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33408 Joanne and Robert come to therapy with issues around six-year-old Alan, their only child. Robert says Joanne babies Alan, encouraging him to avoid athletics because he might get hurt and buying him whatever he wants when he whines. Joanne replies that Alan is her major joy in life and that Robert is just trying to spoil the special time of early childhood. What would a structural family therapist say?

a. "You need to plan ahead for Alan's connection with his peers in school. Athletics will be a big factor in those relationships." b. "I'd like each of you to tell me more about your own early childhoods and the kind of parenting you got from your own mom and dad." c. "I know you are both loving parents, and I suggest that you both do more of whatever you believe expresses the most love for Alan." d. "It seems to me that every time you let Alan come between you, you are getting a temporary divorce. Is that really the best for him?" Feedback Answer D is correct: This response focuses immediately on the spousal subsystem and how it relates to the child and is consistent with a structural family therapy approach. Answer A is incorrect: This response sides with one parent, something any family therapist would be reluctant to do unless there were actual safety issues involved. Answer B is incorrect: This response focuses on the past, which is usually not relevant to a structural family therapist. Answer C is incorrect: This response is a strategic intervention that might actually increase spousal discord. The correct answer is: "It seems to me that every time you let Alan come between you, you are getting a temporary divorce. Is that really the best for him?" Question 93 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33146 Sally Sanchez is a licensed marriage and family therapist who serves as the supervisor for MFT associates and interns. Legally, Ms. Sanchez is required to complete a minimum of _____ hours of supervision training or coursework during each license renewal period.

a. 2 b. 4 c. 6 d. 8 Feedback Answer C is correct: CCR Section 1833.1 requires supervisors who are marriage and family therapists, licensed clinical social workers, or licensed professional clinical counselors to complete six hours of supervision training or coursework during every renewal period while providing supervision. The correct answer is: 6 Question 77 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32805 Mary, a 64-year-old widow, brings her 19-year-old grandson, Alex, to you for an evaluation. She reports that Alex, who lives with her, began having "strange problems" about eight months ago: He has trouble focusing and doing ordinary, day-to-day things, and she often has to monitor him. He is also often agitated and has a hard time sleeping. Mary says she knows that he used methamphetamines once but that he's now "clean." She thinks Alex is depressed about his parents who are recovering drug addicts and live out of state and can't take care of him. Alex tells you that voices in his head talk to him sometimes and he likes their company. He doesn't work or go to school, and he says he's not sure what he wants to do for a career. Which of the following requires immediate assessment in order to evaluate risk?

a. Alex's suicide potential; Mary's coping skills; Alex's need for inpatient care; whether Alex poses a danger to others b. Alex's ability to perform activities of daily living; Mary's mental status; Mary's social support system; Alex's suicide potential c. Alex's mental status; Alex's drug history; whether Alex poses a danger to others; Mary's coping skills d. Mary's well-being; Alex's suicide potential; Alex's mental status; Mary's social support system Feedback Answer D is correct: The vignette suggests that Mary is the only person caring for Alex and, as a result, may be feeling overwhelmed and physically and emotionally exhausted. Therefore, evaluating her well-being is a top priority. This would include determining if she has anyone she can turn to for support and evaluating her immediate support needs. In addition, suicide risk is always an important consideration for individuals with psychotic and/or depressive symptoms, and you'd want to obtain additional information on Alex's mental status to determine if he needs to be hospitalized at this time. Answer A is incorrect: Assessing Alex's suicide potential, Mary's coping skills, and Alex's need for hospitalization are all important. However, the vignette does not suggest that Alex poses a danger to others (e.g., it does not say he is currently aggressive or hostile or describe a history of violence). Although the use of methamphetamines is associated with an increased risk for violent behavior, you don't know that Alex is currently using drugs. Answer B is incorrect: This answer can be eliminated because evaluating Alex's ability to perform activities of daily living is not a top priority since he is not living alone. In addition, there's no reason to assume that Mary's mental status needs to be evaluated. Answer C is incorrect: This is not the best answer because, as noted above, there's no reason to believe that Alex is a danger to others. Also, the limited information given about Alex's drug use suggests that he's not currently using drugs, so this is not a factor that you'd assess first to evaluate risk. The correct answer is: Mary's well-being; Alex's suicide potential; Alex's mental status; Mary's social support system Question 29 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32989 Your client works as a cashier at a local discount store and does not make a lot of money. She has been in therapy for three months and has been paying your lowest fee. During her current session, she tells you she just got a large bill from the IRS and is unsure if she can continue therapy due to this development. The client asks if she can pay for treatment by working for you doing office work and cleaning. How do you handle this?

a. Bill the client in accordance with your regular fee schedule. b. Accept the client's offer with the understanding that it is a temporary arrangement. c. Decline the client's offer of work in exchange for therapy and discuss other options. d. Terminate therapy with the client. Feedback Answer C is correct: This situation is addressed in Principle 9.5 of the CAMFT Code of Ethics. It states that MFTs "ordinarily refrain from accepting goods, services, or other non-monetary remuneration from patients in return for professional services" because these arrangements can lead to conflicts and exploitation. Although Principle 9.5 doesn't complete prohibit barter, it implies that an MFT should consider other options and only agree to this type of arrangement when doing so is unlikely to lead to problems. Allowing a client to exchange services (e.g., office work and cleaning) would clearly be unacceptable since it could lead to problems, for example, if the client does not satisfactorily perform those services. The correct answer is: Decline the client's offer of work in exchange for therapy and discuss other options. Question 73 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32878 A therapist has been providing couples therapy to a 34-year-old man and his wife, age 36. After several months of therapy, the man arrives alone for a session and tells the therapist that he feels himself beginning to lose control. He worries that he may "lose it completely" one of these days. How should the therapist proceed?

a. Call the police. b. Have the client involuntarily admitted for inpatient mental health care. c. Make an agreement with the client that, if he feels out of control, he will notify her (the therapist) immediately. d. Have the client role-play a situation that has made him lose control in the past. Feedback Answer C is correct: Because this appears to be an emergency, the therapist must deal with the man's concerns even though her contract with the clients is for couples therapy. The key to selecting the best intervention is noticing that the man's statement is vague (e.g., it does not include a specific threat of harm to self or others). Of the four choices, making an agreement with the client that he will contact her if he feels out of control is the best course of action since it would provide the client with both support and structure. (An even better choice would be to assess the situation further before determining the best intervention, but that is not offered in any of the answers.) Answers A & B are incorrect: Based on the information provided in the question, this does not appear to be a situation in which a breach of confidentiality would be justified. The therapist could take the actions in answers A and/or B if the client were an imminent danger to himself or others. However, the question suggests that the man is still in control of himself at this time and that his concern is that he may lose control in the future. Answer D is incorrect: Role-playing could be a useful step later on, but answer C is better because it provides the client with structure and a sense of safety; i.e., with the reassurance that assistance will be available to him whenever he feels like he's losing control. The correct answer is: Make an agreement with the client that, if he feels out of control, he will notify her (the therapist) immediately. Question 32 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32751 Kim brings in Scott, her 16-year-old son, to begin family therapy. Kim states, "I don't know what's wrong with Scott. He is losing weight and has quit school. He used to have lots of friends but now he just spends all of his time in his room listening to music. Sometimes he seems like he can't stop talking but doesn't make sense when he talks." You notice that Scott appears agitated and somewhat confused and is sweating and has dilated pupils. What is the most likely diagnosis for Scott?

a. Cannabis Intoxication b. Schizophrenia c. Stimulant Intoxication d. Bipolar I Disorder Feedback Answer C is correct: Scott is exhibiting many symptoms that are consistent with Stimulant Intoxication -- e.g., dilated pupils, perspiration, agitation, confusion, and increased talkativeness. The correct answer is: Stimulant Intoxication Question 6 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32759 For nearly two years, a 30-year old woman has had several physical complaints that apparently do not have a physical cause. Her symptoms have changed over time and have included headaches and backaches, joint pain, and weakness in her hands and fingers. She says that she spends a lot of time worrying about her health and that her symptoms have made her miss work and that she's afraid she's going to get fired. This woman's symptoms are most suggestive of:

a. Factitious Disorder. b. Somatic Symptom Disorder. c. Generalized Anxiety Disorder. d. Conversion Disorder. Feedback Answer B is correct: The essential feature of Somatic Symptom Disorder is the presence of one or more somatic symptoms that cause distress or a significant disruption in daily life accompanied by excessive thoughts, feelings, or behaviors related to the symptoms. Answer A is incorrect: The diagnosis of Factitious Disorder requires falsification of physical or psychological symptoms that are related to deception but are not associated with an external reward. No information is provided in the question suggesting that this woman is intentionally producing or faking her symptoms. Answer C is incorrect: Generalized Anxiety Disorder involves excessive anxiety and worry about multiple events or activities. Answer D is incorrect: The diagnosis of Conversion Disorder requires the presence of at least one symptom that involves an alteration in voluntary motor or sensory function and is incompatible with known neurological and medical conditions. The correct answer is: Somatic Symptom Disorder. Question 21 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32849 You have determined that your new client's symptoms meet the criteria for a diagnosis of major depressive disorder. The presence of which of the following MOST suggests that he is at high risk for suicide?

a. He has a family history of suicidal behavior. b. He has a history of one or more suicide attempts. c. He reports that he takes no pleasure in previously enjoyed activities. d. He has recently experienced the death of a family member. Feedback Answer B is correct: The research has generally confirmed that a history of one or more suicide attempts is the strongest predictor of completed suicide. Answer A is incorrect: People with family histories of suicide are at increased risk, but one or more previous suicide attempts is a stronger predictor. Answer C is incorrect: This is a symptom of depression but is not considered a good predictor of suicide since many depressed individuals are not suicidal. Answer D is incorrect: A recent loss or death is associated with an increased risk for suicide, but one or more previous suicide attempts is a stronger predictor. The correct answer is: He has a history of one or more suicide attempts. Question 42 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32664 Which of the following diagnoses would you be most likely to assign to a client with the following symptoms: intense relationships characterized by over-idealization and then devaluation, a persistent sense of emptiness, unpredictable and intense anger, impulsivity, and recurrent suicidal threats?

a. Histrionic Personality Disorder b. Major Depressive Disorder c. Borderline Personality Disorder d. Antisocial Personality Disorder Feedback Answer C is correct: The essential feature of Borderline Personality Disorder is a pervasive pattern of instability in interpersonal relationships, self-image, and affects and marked impulsivity. Answer A is incorrect: Histrionic Personality Disorder is characterized by a pervasive pattern of emotionality and attention-seeking. Answer B is incorrect: While Major Depressive Disorder may involve suicidal ideation or a suicide attempt, it does not include the other symptoms this client has. Answer D is incorrect: Antisocial Personality Disorder is characterized by a pattern of disregard for and violation of the rights of others since the age of 15. The correct answer is: Borderline Personality Disorder Question 28 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32926 Which of the following is true about the use of hypnosis as a treatment technique by marriage and family therapists?

a. Hypnosis can be legally used only by therapists certified by the BBS or another licensing agency. b. Hypnosis can be legally and ethically used by anyone because licensing boards do not regulate or certify hypnosis practitioners. c. Hypnosis is legally and ethically used only by therapists who have the necessary competence based on training and experience. d. The use of hypnosis illegal because it is outside an MFT's scope of practice. Feedback Answer C is correct: Since the deregulation of hypnosis as a psychotherapeutic technique in 1991, MFTs, like other psychotherapists, can use hypnosis as long as they are competent to do so by reason of their education, training, and experience and as long as therapy is focused on relationship issues. The correct answer is: Hypnosis is legally and ethically used only by therapists who have the necessary competence based on training and experience. Question 67 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32722 During your first face-to-face meeting, a client reports feeling extremely guilty about taking supplies from his office to use at home. How would you proceed?

a. Identify whether the client's poor judgment is pervasive or related to only this area of functioning by assessing impulse control in other areas. b. Recognize that pervasive feelings of guilt may indicate a depressed mood and ask the client about other symptoms he has been experiencing. c. Allow the client to continue expressing himself and respond to him without judgment. d. Explain that people usually feel guilty about stealing in order to encourage the client's continued self-expression, normalize his feelings, and reduce his distress. Feedback Answer C is correct: During the first meeting with a client, you should focus on whatever the client considers important to talk about and avoid jumping to conclusions about his problems or concerns. Unless you need specific data, you should ask mostly open-ended questions and focus on giving the client an opportunity to explore and clarify his thoughts and feelings about his behavior in a safe way. You should also focus on conveying acceptance, as this can facilitate the development of trust. Answer A is incorrect: While it's possible that the client has a generalized problem with poor judgment or impulse control, it's too early for you to draw either of these conclusions. You need to test your assumptions and perceptions by continuing your interview with the client and obtaining information from other sources. Answer B is incorrect: It is too early to assume that the client's feelings of guilt indicate depression. Answer D is incorrect: Though normalizing a client's feelings or behaviors can often be useful, this client is probably aware that people who steal usually feel guilty about it. This answer also has a bit of a judgmental tone, which you would want to avoid. The correct answer is: Allow the client to continue expressing himself and respond to him without judgment. Question 19 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33021 John Doe, age 19, has chronic paranoid schizophrenia, lives in a group home, and has a conservator who was appointed by the court. Who should give consent to therapy for John?

a. John because he is an adult b. any officer of the court c. his caregiver at the group home d. his conservator Feedback Answer D is correct: Courts appoint conservators when a person is unable to manage his or her own affairs. John's conservator is essentially in charge of him, as though he were a minor, and will determine if John should receive mental health counseling. The correct answer is: his conservator Question 65 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32756 Your new client, Joseph, complains of problems at work. He says he's afraid to go to staff meetings due to a fear of being criticized and he hates giving presentations because he's afraid his co-workers will think he's stupid. Joseph also says that he doesn't like socializing with his co-workers and hasn't contacted any of his friends lately. The most likely DSM-5 diagnosis for Joseph is which of the following?

a. Panic Disorder b. Social Anxiety Disorder c. Agoraphobia d. Generalized Anxiety Disorder Feedback Answer B is correct: This case includes some symptoms that are not characteristic of any of the disorders listed in the answers (e.g., the client hasn't contacted any of his friends lately) However, Joseph's fear and anxiety are related to specific social situations and are due to concerns about being evaluated by others, which is consistent with a diagnosis of Social Anxiety Disorder. Answer A is incorrect: No information is provided in the question indicating that Joseph is experiencing unexpected panic attacks, which is a requirement for the diagnosis of Panic Disorder. Answer C is incorrect: The diagnosis of Agoraphobia requires the presence of marked fear or anxiety about at least two of five designated situations (e.g., using public transportation, being in enclosed spaces). The individual must fear or avoid these situations due to a concern that escape might be difficult or help will be unavailable in case he or she develops panic-like, incapacitating, or embarrassing symptoms. Answer D is incorrect: Generalized Anxiety Disorder involves excessive anxiety and worry about multiple events or activities. In contrast to Social Anxiety Disorder, anxiety associated with Generalized Anxiety Disorder is not related to a fear of being evaluated. The correct answer is: Social Anxiety Disorder Question 13 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32725 Your client sought therapy for help dealing with feelings of sadness and loneliness. You have completed a multidimensional assessment of the client and determined that he has major depressive disorder. How would you present this clinical diagnosis to the client?

a. Provide a general description without specific labels or details so that the client does not become upset. b. Have the client read about the disorder in the DSM or give him a written summary of the disorder. c. Explain each of the diagnostic criteria to the client and indicate those that apply to him. d. Explain how his behavior meets the diagnostic criteria for this disorder. Feedback Answer D is correct: What you tell a particular client about his diagnosis depends on several factors, including the client's capacity to understand. General guidelines for communicating a diagnosis to a client include providing an honest, clear, and fairly simple explanation (i.e., convey only what the client needs to know and leave out unnecessary details); avoiding jargon that could confuse or frighten the client; asking the client questions to verify his understanding; emphasizing positive information, such as a good prognosis; and acknowledging the client's feelings about the diagnosis. Of the answers given, this one is most consistent with these guidelines. Answer A is incorrect: There is no reason to withhold or obscure information about diagnosis from a client, except in the most unusual circumstances. Answer B is incorrect: It's better to explain in layperson's terms how the client's behaviors fit the diagnostic criteria for his disorder. Answer C is incorrect: This is better than the actions described in answers A and B, but answer D is even better. The correct answer is: Explain how his behavior meets the diagnostic criteria for this disorder. Question 20 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32768 Augustine, age 5, is in foster care and enrolled in a therapeutic nursery school. He and his older sister were removed from their home after they were found wandering in the park asking people for food and their parents were both found to have a drug problem. While observing Augustine at school, you notice that he impulsively approaches strangers, tends to be overly familiar with people he has just met, and quickly becomes attached to any adult who pays attention to him. Before assigning a DSM-5 diagnosis of ______________ to Augustine, you will want to confirm that his symptoms are attributable to ______________.

a. Reactive Attachment Disorder, disinhibited type; developmental delays b. Disinhibited Social Engagement Disorder; developmental delays c. Reactive Attachment Disorder, disinhibited type; early neglect or deprivation d. Disinhibited Social Engagement Disorder; early neglect or deprivation Feedback Answer D is correct: Disinhibited Social Engagement Disorder involves a pattern of culturally inappropriate and overly familiar behavior with unfamiliar people with evidence that the behavior is related to the experience of extremely insufficient care. Answer A is incorrect: The DSM-5 diagnosis of Disinhibited Social Engagement Disorder replaces the DSM-IV-TR diagnosis of Reactive Attachment Disorder, disinhibited type. Note that the presence or absence of developmental delays is not a diagnostic criterion for a diagnosis of Reactive Attachment Disorder or Disinhibited Social Engagement Disorder and, therefore, would not be useful for confirming either diagnosis, which is what this question is asking about. The correct answer is: Disinhibited Social Engagement Disorder; early neglect or deprivation Question 4 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33019 James, age 16, is brought to therapy by his mother who believes he may be depressed. In individual sessions, James reveals that he is unsure about his sexual orientation and is exploring sexually with a male friend. He begs the therapist not to disclose anything to his mother because she won't understand. What should the therapist do?

a. Reassure the client that all information conveyed in individual therapy is confidential, and remind him that this policy was explained to his mother before therapy began. b. Remind the client that certain kinds of information must be disclosed to authorities but not necessarily to his mother, and encourage him to be cautious about describing activities that might be reportable. c. Reassure the client that, in general, information disclosed in therapy is considered confidential but that certain kinds of information must be disclosed. d. Remind the client that, because he is a minor and his mother initiated the therapy, she has a right to receive regular progress reports in which significant information may not be omitted. Feedback Answer C is correct: This is the best answer of those given. Answer A is incorrect: It is incorrect because there are important exceptions to the general principle of confidentiality. Answer B is incorrect: It is incorrect because it encourages the client to avoid discussing clinically relevant issues that might involve dangerous behavior that needs to be reported. Answer D is incorrect: It is incorrect because minors are entitled to a confidential relationship and disclosure to parents or others depends on the situation. The correct answer is: Reassure the client that, in general, information disclosed in therapy is considered confidential but that certain kinds of information must be disclosed. Question 62 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32967 You are referred a client for marital counseling. The psychiatrist who referred this client to you diagnosed him with a specific condition that you have never treated before. What should you do?

a. Recognize that the case is outside your scope of practice and refer the client to another therapist. b. Research the client's condition, including how it might impact his marital problems. c. Ask the client to educate you about his condition. d. Recognize that this case is outside your scope of competence and refer the client to another therapist. Feedback Answer B is correct: This client has been referred for marital counseling so it seems clear that there are relationship issues to work on. However, it is not clear whether an MFT would have adequate knowledge, skills, or training since the question does not state what the client's "condition" is. For example, perhaps you have treated conditions similar to the client's condition (e.g., maybe he has Agoraphobia and you have dealt with other Anxiety Disorders) or maybe you have experience dealing with the specific marital problems that arise from his condition. Therefore, the best answer is to find out what effects his condition might have on his marital relationship and determine if you have the competence to handle them. Answer A is incorrect: Because the psychiatrist has referred this man for marital therapy, the issue is not scope of practice but whether you have the competence to deal with the ways in which his condition may be affecting his marital relationship. Answer C is incorrect: Having a client educate you about his condition is neither professional or advisable. Answer D is incorrect: Although you have never treated a client with this condition, it might be that consultation and your experience treating clients with similar conditions would qualify you to treat the client. In other words, this response assumes too much: It may not be true that you are not competent to treat this man. The correct answer is: Research the client's condition, including how it might impact his marital problems. Question 54 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32980 During his first therapy session, your new client tells you that his insurance covers only ten sessions and that he cannot afford your fee. He has a long history of relationship problems and has never been able to stay with a partner for more than a couple of months. Based on what he tells you, you conclude that the client probably needs long-term therapy. What should you do?

a. Reduce the client's fee after the ten sessions. b. Contact the insurance company and insist that it cover the necessary sessions. c. See the client for ten sessions, intervene on behalf of the client with the insurance company, and then refer to a low-cost clinic if the company declines to cover your fee. d. Refer the client to a low fee clinic. Feedback Answer D is correct: This would be in the best interests of the client. If the client needs long-term therapy, it would be better to have him begin with the therapist who will be able to see him long-term. Answer A is incorrect: Reducing the client's fee is an option, but fee reduction is not a legal or ethical requirement. Answer B is incorrect: This is not the best answer since the word "insist" is too strong. In addition, it doesn't address the possibility that the insurance company will continue to refuse to cover additional sessions. Answer C is incorrect: This is not the best answer because referring the client to another provider after ten sessions would not be in the client's best interests. The correct answer is: Refer the client to a low fee clinic. Question 51 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32700 A client who engages in binge-purge cycles has started experiencing hallucinations and other psychotic symptoms. He tells you that he was eating a Twinkie the other day and it spoke to him, instructing him to kill some innocent people. What would you do for this client?

a. Refer him to Overeaters Anonymous. b. Have him hospitalized and evaluated by a psychiatrist. c. Have him bring in his family for assessment and family therapy. d. Call the police and warn the possible victims. Feedback . Answer B is correct: This is the action you would want to take with someone who is experiencing psychotic symptoms, as it would take into consideration the safety of the client and others. Answer A is incorrect: Although a referral to OA might be useful for a client who engages in binge eating and purging, this is not a referral for someone with severe psychotic symptoms. Answer C is incorrect: This would not be the first intervention in a crisis situation. Answer D is incorrect: The client says he's been instructed to "kill some innocent people." This may have suggested a Tarasoff-type situation, but there is no reasonably identifiable victim to warn. The correct answer is: Have him hospitalized and evaluated by a psychiatrist. Question 16 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32869 A married couple came to therapy after being urged by their minister to do so when he learned that the husband physically abuses his wife. During the first therapy session, the husband acknowledges that he hits his wife when she annoys him. He says that he often loses control because she "pushes my buttons." The wife admits that he hits her at least two or three times a month. She says she never fights back but recognizes that her husband's behavior is wrong and wants it to stop. They tell the therapist that they want couples therapy so they can learn how to get along better. What should the therapist do?

a. Refer the husband to a group for batterers and give the wife referrals to groups for women who are victims of domestic violence and, if needed, to a shelter. b. Refer them both to support groups and see them as a couple as long as they commit to no violence or verbal threats. c. Refer them both to support groups, tell the wife about shelters, tell them that couples therapy is not appropriate at this time, and offer individual therapy to each of them. d. Refer the husband to a group for batterers and see the wife in individual therapy. Feedback Answer C is correct: Of the answers given, this is the best one. It includes interventions that will help ensure that the wife is safe, that allow the husband to be confronted directly by perpetrators with similar experiences, and that allow each partner to begin exploring the abuse in their relationship separately. Note that couples therapy is not indicated given the extent of the violence. Many experts believe that in cases of domestic violence, the partners should be treated separately in the initial stages of intervention, especially if the incidents of abuse are highly unpredictable and/or the batterer denies the abuse. Even though this man admits that he hits his wife, he blames her for his behavior and the abuse seems habitual. Seeing the couple together, even with a contract prohibiting abusive behavior, may just give the man further opportunities to control his wife and make it difficult for her to openly air her thoughts and feelings. The correct answer is: Refer them both to support groups, tell the wife about shelters, tell them that couples therapy is not appropriate at this time, and offer individual therapy to each of them. Question 44 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32729 Your new client is a 26-year-old man who complains of low self-esteem and feelings of shame about behaviors he engaged in while a college student. The client appears nervous during the session, but you observe that he is able to carry on a conversation with you and that his affect is appropriate. What does "appropriate affect" refer to?

a. The client's ability to express a full range of emotions. b. The client's ability to manage strong feelings that would otherwise interfere with his adaptive functioning. c. The client's emotional tone matches the idea, thought, or topic he is describing. d. The client is willing to talk about his feelings. Feedback Answer C is correct: This is a concise description of appropriate affect. Compared to mood, affect is more reactive and variable. In other words, affect is an emotional state of relatively short duration. Affect is considered to be "appropriate" when an individual is in touch with his emotions and can express them as he feels them in response to specific emotional or situational stimuli (e.g., when he cries while talking about something very sad). The correct answer is: The client's emotional tone matches the idea, thought, or topic he is describing. Question 22 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33051 You are a licensed marriage and family therapist who has just opened his own private practice. A 15-year-old boy walks into your office and tells you that he was born into the wrong body and really wants to see you to discuss his "mixed feelings". The boy says, "My parents do not understand me, and I really need to talk to someone without them knowing." What do you do?

a. Refuse to see him without parental consent since he is a minor. b. Refer him to a therapist who works with gay, lesbian, and transgender patients. c. Agree to see him without parental consent only if you believe his situation constitutes a crisis or emergency. d. Determine if it would be appropriate to see him without parental knowledge or consent. Feedback Answer D is correct: Health and Safety Code Section 124260 applies to this situation. It states that a "mental health professional" (which includes a marriage and family therapist and a marriage and family registered intern) may provide outpatient mental health treatment or counseling to a minor who is at least 12 years of age as long as the professional believes that the minor "is mature enough to participate intelligently" in those services. Note, however, that paragraph (c) of Section 124260 states that treatment "shall include the involvement of the minor's parent or guardian, unless the professional person ..., after consulting with the minor, determines that the involvement would be inappropriate." Also, note that Section 124260 does NOT apply to minors who are receiving benefits under the Medi-Cal program. The correct answer is: Determine if it would be appropriate to see him without parental knowledge or consent. Question 90 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33122 You are seeing an emancipated 15-year-old boy in therapy for relationship issues. He tells you he talked his 13-year-old girlfriend into having sex with him and wants to bring her in for a therapy session because he wants her to forgive him. What should you do?

a. Report the child abuse and inform the girl's parents of the crime. b. Agree to see the boy and his girlfriend in the next therapy session. c. Report the child abuse and continue seeing the boy in therapy. d. Contact the girlfriend to confirm the boy's story before reporting child abuse. Feedback Answer C is correct: This is the best answer because it addresses your legal mandate to report child abuse and the clinical issue of continuing to see the boy in therapy. (Sexual intercourse involving a 13-year-old and a 15-year-old is reportable abuse even when it is consensual.) Answer A is incorrect: You would be breaching the client's confidentiality by taking this action. You are legally mandated to make a report, but you have no mandate or ethical obligation to call her parents. Answer B is incorrect: Agreeing to see the girlfriend with the boy in the next therapy session may be acceptable, but this answer does not address the requirement to report child abuse. Answer D is incorrect: It is not necessary to confirm the story with the boy's girlfriend before making a report. The correct answer is: Report the child abuse and continue seeing the boy in therapy. Question 88 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32860 Over the past several sessions, a 23-year-old client has become increasingly depressed and has expressed suicidal ideation. During the current session, he tells his therapist that he is not happy with the progress of therapy and that he's not coming back. What should the MFT do?

a. Seek involuntary commitment of the client immediately. b. Encourage the client to continue therapy and attempt to have him sign a no-suicide contract. c. Call the client's family to discuss the situation with them. d. Acknowledge that the client has the right to terminate therapy when he wants to. Feedback Answer B is correct: The first concern with a suicidal client is to prevent a suicide attempt. Because you do not know if the level of risk is high, you should avoid answers that involve violating the client's confidentiality. Given the client's wish to leave treatment, this answer describes the best course of action: The MFT would want to try to deter the client from quitting therapy while he is suicidal. Having the client sign a no-suicide contract would also help protect the client without violating his confidentiality. Of course, if the client continued to insist on quitting therapy and his risk for suicide was relatively low, the MFT would probably want to refer him to another therapist for ongoing treatment of his depression. Answer A is incorrect: The question does not state that the client is at imminent risk for a suicide attempt. Therefore, this is not the best answer. Answer C is incorrect: The MFT should try encouraging the client to continue therapy first because calling the client's family would violate his confidentiality. If the client refused to continue in therapy or to see another therapist, the MFT might decide to contact his family, depending on his level of suicide risk. Answer D is incorrect: Although clients should be allowed to quit therapy when they want to, this situation requires special consideration. The correct answer is: Encourage the client to continue therapy and attempt to have him sign a no-suicide contract. Question 38 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32928 A client has asked an MFT to give her a summary of her file and is expecting to pick it up the next day. The MFT takes the file home to work on the summary. On her way home, she stops at the drugstore and, while in the store, her car is stolen.

a. The MFT must report the loss of the file to the police. b. The MFT is not responsible for the loss of the file as long as she locked her car. c. The MFT has jeopardized her client's confidentiality by placing the file in a non-secure place. d. The MFT will need to disclose this loss to the client and must reconstruct the file from memory. Feedback Answer C is correct: It is an unwise practice to transport client files because doing so can jeopardize client confidentiality. Client files should always be maintained in a secure location. Answer A is incorrect: Although the MFT will undoubtedly report her stolen car to the police, this does not address the ethical issue posed by this question. Answer B is incorrect: Whether the car was locked or unlocked is unimportant. The therapist should not have transported a client file in her car. Answer D is incorrect: This is not the best answer because the MFT will need to disclose the loss to the client, but she is not required to reconstruct the file from memory. The correct answer is: The MFT has jeopardized her client's confidentiality by placing the file in a non-secure place. Question 69 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33344 An 8-month-old child displays an intense fear reaction whenever she is approached by strangers. The child's behavior can be BEST explained by which of the following?

a. The child's previous negative experiences with strangers have conditioned her to respond to all strangers with fear. b. The child has not yet developed a schema for her mother's face and the alternate models are confusing. c. The face of a stranger represents an unfamiliar event that naturally elicits a fear response. d. The child's behavior is an abnormal reaction that is related an over-attachment to her mother. Feedback Answer C is correct: The child appears to be exhibiting stranger anxiety, which typically develops at about eight months of age and appears to reflect maturation of the infant's perceptual skills so that she is able to distinguish between familiar and unfamiliar individuals. The correct answer is: The face of a stranger represents an unfamiliar event that naturally elicits a fear response. Question 100 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

33107 During your first therapy session with Sue and Stan, you learn that she is 17 years old and pregnant and that Stan is 22 and the father of the child. Sue and Stan are thinking about getting married but "fight all the time" and came to see you to work on their relationship problems. You believe that Sue is sufficiently mature to participate in outpatient therapy. Assuming that Sue is not receiving benefits under the Medi-Cal program, which of the following is true about this situation?

a. You cannot see them in therapy without the permission of Sue's parent. b. You may see them in therapy without the permission of Sue's parent only if Sue is an emancipated minor. c. You may see them in therapy without the permission of Sue's parent if you determine that her parent's involvement is inappropriate. d. You may see them in therapy without the permission of Sue's parent but must file a report of child sexual abuse with the authorities. Feedback Answer C is correct: Since Sue is not receiving Medi-Cal, California and C Section 124260(b) applies to this situation. It permits a minor who is at least 12 years of age to consent to outpatient "mental health treatment or counseling services if, in the opinion of the attending professional person, the minor is mature enough to participate intelligently in the mental health treatment or counseling services." However, Section 124260(c) requires that treatment authorized under this section "shall include the involvement of the minor's parent or guardian, unless the professional person who is treating or counseling the minor, after consulting with the minor, determines that the involvement would be inappropriate." Answer D is incorrect: A report of child sexual abuse is not necessary since Sue and Stan fall outside the age range for reportable abuse. The correct answer is: You may see them in therapy without the permission of Sue's parent if you determine that her parent's involvement is inappropriate. Question 85 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

33320 Which of the following is NOT an example of paradoxical intervention?

a. You describe a pessimistic client's situation in even more dismal terms than he does. b. You tell family members that they shouldn't try to do anything about their problem because they're not ready to change. c. You tell a nagging mother to stop nagging her daughter because the girl never listens anyway. d. You tell an argumentative couple to practice arguing for at least two hours every evening. Feedback Answer C is correct: You are asking the mother to stop her problematic behavior and is not a paradoxical technique. Answer A is incorrect: This is an example of positioning, which is a paradoxical technique. Answer B is incorrect: This is an example of restraining, which is a paradoxical technique. Answer D is incorrect: This is an example of prescribing the symptom, which is a paradoxical technique. The correct answer is: You tell a nagging mother to stop nagging her daughter because the girl never listens anyway. Question 98 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33099 Which of the following minors meets the legal requirements for emancipation?

a. a minor who is legally married b. a minor who manages his or her own financial affairs c. a minor who lives apart from parents d. a minor who lives apart from parents and manages his or her own financial affairs Feedback Answer A is correct: Family Code 7002 defines an "emancipated minor" as a person under age 18 who is either legally married, on active duty with the armed forces, or has a legal declaration of emancipation. Answers B, C, & D are incorrect: Managing one's own affairs and living apart from one's parents are conditions the court considers when determining whether a minor qualifies for a legal declaration of emancipation but, by themselves, do not qualify a minor for emancipation. The correct answer is: a minor who is legally married Question 76 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

33308 You are a cognitive behavioral therapist who has been working with a depressed, middle-aged man. He is a successful businessman whose wife left him for a younger man. They have two children who are both in their twenties. The man feels that the divorce was his fault and, if he had paid more attention to his wife, they would still be married. In the middle stage of therapy, you will:

a. acknowledge his feelings and current beliefs. b. have him write down his automatic thoughts. c. encourage him vent his feelings. d. work on identifying, testing, and replacing his irrational beliefs. Feedback Answer D is correct: Cognitive behavioral therapists believe that, by changing your thoughts and attitudes, you can change the way you feel and behave. Identifying, testing, and replacing irrational beliefs (cognitive restructuring) is the primary goal of the middle phase of treatment. Answer A is incorrect: Some contemporary cognitive-behaviorists, such as David Burns, are interested in feelings, but the typical emphasis is on thoughts. In addition, changing maladaptive thoughts and behaviors (not just acknowledging them) is the focus of the middle phase. Answer B is incorrect: Cognitive behavioral therapists often have a client write down his or her automatic thoughts, but this is most often done in the early stage of therapy. Answer C is incorrect: Although cognitions are related to feelings, the emphasis is not on the expression of feelings for the sake of release. The correct answer is: work on identifying, testing, and replacing his irrational beliefs. Question 95 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32884 Luiz L. is 36 years old, Hispanic, recently divorced, and employed as a social worker. He has had epilepsy since his late 20s and received a diagnosis of diabetes mellitus three years ago. During the initial therapy session, Luiz seems hostile and very agitated, and he says he's been feeling very nervous lately. What information suggests that Luiz might be at high risk for completed suicide?

a. age (36), gender (male), and physical illness (diabetes mellitus) b. occupation (social worker), marital status (divorced), and physical illness (epilepsy) c. race or ethnicity (Hispanic), marital status (divorced), and occupation (social worker) d. race or ethnicity (Hispanic), age (36), and personality characteristics (agitation and hostility) Feedback Answer B is correct: An increased risk for suicide has been linked to marital status (a higher risk for those who are divorced, widowed, or separated); certain occupations including social worker, nurse, physician, and dentist; and certain physical disorders including epilepsy, Huntington's disease, malignancies, and multiple sclerosis. Answer A is incorrect: Suicide rates are highest for adolescents, young adults, and older adults; and diabetes mellitus has not been identified as a risk factor for suicide. Answer C is incorrect: At most ages (including age 36), the suicide rate is higher for whites than for members of racial or ethnic minority groups. Answer D is incorrect: Although agitation, impulsivity, and hostility are associated with an increased risk for suicide, the client's ethnicity and age are not. The correct answer is: occupation (social worker), marital status (divorced), and physical illness (epilepsy) Question 35 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

33008 You have been seeing Alfredo A. in therapy for over six months and believe he is no longer benefiting from therapy. However, when you discuss the possibility of terminating therapy, he says he's happy with his progress and wants to continue. As an ethical therapist, you:

a. agree to continue seeing Alfredo since he is satisfied with the progress of therapy. b. agree to continue seeing Alfredo for an additional period of time but, at the end of that period, insist on terminating therapy. c. explain to Alfredo that these are normal reactions to the end of therapy and set a date for termination. d. see if additional goals for treatment can be identified but, if not, set a date for termination and, if appropriate, provide him with referrals to other therapists. Feedback Answer D is correct: This answer is most consistent with ethical guidelines. Specifically, Principle 1.3.1 of the CAMFT Code of Ethics states that MFTs must terminate therapeutic relationships appropriately and provides examples of reasons for termination - e.g., the therapist is unable to continue providing treatment due to incapacity or the patient is not benefiting from treatment. In addition, Principle 1.7 requires MFTs to continue a therapeutic relationship only for as long as it is "reasonably clear" that the patient is benefiting from it. The correct answer is: see if additional goals for treatment can be identified but, if not, set a date for termination and, if appropriate, provide him with referrals to other therapists. Question 71 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32913 You are a therapist working in a small rural town. On Friday afternoon, you get a call from a very distraught man who says he has to be seen right away because "I don't know what's going to happen to me." You tell him that you can give him an appointment on Monday when you return to your office. He gets very angry and demands that you see him today. You:

a. agree to see him right away. b. give him your next available appointment next week. c. hospitalize him immediately. d. give him a local referral for an emergency service. Feedback Answer D is correct: A referral to emergency services makes sure this man will be taken care of by someone immediately. Because the man is not a current patient, you are not ethically obligated to see him right away. The standard of care in this situation is to provide him with an emergency referral if you are unable to see him immediately. Giving him the next available appointment next week (answer B) is not an option since he's already stated that he wants to see you today. Hospitalization (answer C) is not an option since the information in the question doesn't indicate that this is necessary. The correct answer is: give him a local referral for an emergency service. Question 39 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

33028 You are asked by one of the parents in a custody case to offer an opinion as to the best custody arrangement for the couple's 13-year-old child at an upcoming hearing. The parent making the request believes you are the best person to offer an opinion since you have been seeing the child in individual therapy since the parents separated six months ago. You should:

a. agree to the request and make sure that you base your opinion on the best interests of the child. b. agree to the request only if you believe you have sufficient information on which to base an opinion. c. agree to the request only if both parents sign an authorization. d. refuse to do so. Feedback Answer D is correct: This answer is most consistent with Principle 8.4 of the CAMFT Code of Ethics, which requires MFTs to "avoid providing both treatment and evaluations for the same clients or treatment units in legal proceedings," and with Principle 8.7, which requires MFTs to "only express professional opinions about clients they have treated or examined." The correct answer is: refuse to do so. Question 68 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32780 The DSM-5 requires which of the following for a diagnosis of Autism Spectrum Disorder?

a. an onset of symptoms prior to three years of age b. an onset of symptoms during the early developmental period c. apparent normal development for at least six months followed by a loss of previously acquired skills d. apparent normal development for at least two years followed by a loss of previously acquired skills Feedback Answer B is correct: For the diagnosis of Autism Spectrum Disorder, the DSM-5 requires that "symptoms must be present in the early developmental period." The correct answer is: an onset of symptoms during the early developmental period Question 31 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

33059 A new client presents with marital problems. You feel that a battery of tests would help you to better diagnose this client and create a treatment plan. What psychological tests can you, as an MFT, administer and interpret?

a. any tests related to interpersonal functioning b. all intelligence and personality tests c. any tests that have been validated for the purpose for which they will be used. d. any tests that you are competent to administer and interpret by virtue of your experience, training, and education. Feedback Answer D is correct: From a legal and ethical standpoint, this is the "rule of thumb": To administer any given psychological test, an MFT needs to have adequate experience, training, and education. The correct answer is: any tests that you are competent to administer and interpret by virtue of your experience, training, and education. Question 78 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33126 You are seeing a divorced mother and her children in therapy. The mother has sole legal custody. During sessions, the children talk a lot about how much they hate their father, and you document this in your notes. Later, the custody arrangement changes and the father contacts you, asking to see any psychotherapy notes containing information about his children. You:

a. are legally required to show him the notes since he now has legal custody. b. refuse to show him the notes if you determine that doing so would be psychologically harmful to the children. c. are legally allowed to show him the notes only if the mother signs an authorization. d. are legally required to show him the notes since the children are minors. Feedback Answer B is correct: This answer is most consistent with California law. Specifically, and C Section 123115(a)(2) states that a health care provider may refuse to provide a parent or guardian access to a minor's records when the provider determines that access "would have a detrimental effect on the provider's professional relationship with the minor patient or the minor's physical safety or psychological well-being." The correct answer is: refuse to show him the notes if you determine that doing so would be psychologically harmful to the children. Question 74 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32852 You work for a child abuse prevention agency and provide education to agencies throughout the area about child abuse. In one of your lectures, you explain that, compared with non-abusive parents, parents who physically abuse their children:

a. are more permissive with their children. b. rely on physical punishment more often. c. find their children's affective states more irritating. d. tend to be more overprotective or jealous of their children. Feedback Answer C is correct: One fairly consistent finding is that physically abusive parents are more easily irritated by their children, at least in part, because they tend to misinterpret their children's behaviors in a negative way and incorrectly identify their emotional state. Answer A is incorrect: This has not been found to be true about abusive parents. Answer B is incorrect: Contrary to what might be expected, abusive and non-abusive parents resort to physical punishment at about the same rate. The difference is that abusive parents rely on harsher physical punishment. Answer D is incorrect: Overprotectiveness and jealousy are associated more with sexual abuse than with physical abuse. The correct answer is: find their children's affective states more irritating. Question 45 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32717 Mrs. Bronstein is a White therapist who has extensive experience working with clients from diverse backgrounds. During her second session with Emily, who is African American, Emily states she would prefer to see an African American therapist. How should Mrs. Bronstein interpret the client's request?

a. as a manifestation of resistance b. as a function of racial identity c. as denial and avoidance d. in terms of locus of control Feedback Answer B is correct: A frequently discussed topic in the cross-cultural counseling literature is the impact of racial or ethnic identity on various aspects of the therapy process. For example, D.W. Sue and D. Sue (Counseling the Culturally Diverse: Theory and Practice, New York, John Wiley and Sons, 2015) note that "preference for a racially or ethnically similar counselor may really be a function of the cultural or racial identity of the minority person." Answer A is incorrect: The client apparently seems to feel that she can't identify with the therapist due to their racial difference. Resistance would more likely be the explanation for the client's stated preference if Mrs. Bronstein had worked with Emily for several months and they were getting into some difficult material that Emily wanted to avoid. Answer D is incorrect: While this may be true, it does not address the issue raised in the question (i.e., the racial difference between the therapist and client). The correct answer is: as a function of racial identity Question 5 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33167 You are seeing a Native American family that consists of the husband, wife, children, and the husband's father, who lives with them. You notice that the wife keeps referring to her father-in-law as "he" rather than using his name. You should:

a. ask the father-in-law his name. b. ask the family about their habits regarding names and relationships. c. accept the wife's language as a cultural norm. d. confront this as possibly indicative of disrespect. Feedback Answer B is correct: Your primary concern is to be sensitive to cultural differences that might exist between you and your clients. Asking the family about their habits allows you to discover the family's rules in a respectful way. Answer A is incorrect: Asking the father-in-law his name might be culturally insensitive if it is either a family or a cultural norm for younger family members not to use his name. In other words, you'd be breaking the rules. Answer C is incorrect: This would not provide you with any useful information. Answer D is incorrect: This is judgmental and confrontational and not the best course of action. The correct answer is: ask the family about their habits regarding names and relationships. Question 97 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32804 Jennifer, age 34, has been in therapy for nearly one year. Originally, her presenting problems were related to the break-up of a live-in relationship with her alcoholic boyfriend, but she's currently complaining of depression and low energy. Jennifer is a single mother of a nine-year-old boy. She and the boy have been living with her parents since the break up, and Jennifer is in constant conflict with her mother. Jennifer's 29-year-old brother is also living at home, but "he sits in his room and smokes a lot of marijuana." Jennifer's father is also an alcoholic, who alternates between passivity and angry outbursts. Jennifer's strongest memories of her childhood are of cowering on the couch (which is still in the living room) and watching her parents fight. Regarding Jennifer's depression and low energy, which of the following is least important?

a. asking Jennifer if she ever feels like killing or hurting herself b. asking Jennifer if she's had a physical exam lately c. drawing a genogram of Jennifer's family d. determining if Jennifer has experienced any changes in her eating or sleeping patterns lately Feedback Answer C is correct: Answers A, B, and D all represent responses to the immediate threat that Jennifer's depression presents and include the possibility that physiological factors may be involved. A genogram might be useful in identifying mood disorders elsewhere in Jennifer's family and/or in finding loss experiences to which she may be responding. However, the therapist must first assess the severity of Jennifer's depression and whether medical treatment is needed. The correct answer is: drawing a genogram of Jennifer's family Question 24 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32830 Your new client expresses a tremendous amount of anger during a therapy session. He slams his fist on the table and yells about his wife having an affair with the gardener. He just found out about this yesterday, and his wife "took off" after he confronted her. You should FIRST:

a. assess the client's lethality. b. defuse the anger and provide an alternative outlet. c. call a psychiatric emergency team (PET). d. contact the police. Feedback Answer A is correct: When a client displays extreme anger during a session, the therapist should immediately assess the level of danger posed by the anger. Then, if the client poses an imminent danger to self or others, hospitalization or other appropriate action should be taken immediately. Answer B is incorrect: It is sometimes appropriate for a therapist to attempt to diffuse a client's anger and suggest alternative outlets for it. This client, however, is described as expressing a "tremendous amount of anger"; therefore, you first need to determine whether he is currently dangerous. When a client is "expressing a tremendous amount of anger," attempting to diffuse his anger may not be sufficient or effective. Answer C is incorrect: If you determine that the client is dangerous, calling PET would be appropriate. However, assessing the client's level of dangerousness, not calling the PET, would be the first intervention. Answer D is incorrect: Unless the client needed to be committed to a psychiatric facility to protect himself or others, warning the police would improperly breach his confidentiality. The correct answer is: assess the client's lethality. Question 46 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32873 Crisis theory predicts that a crises involves a predictable sequence of events that begins when an individual encounters an emotionally hazardous event. This event then elicits which of the following?

a. avoidance of the situation through alcohol or drug use and/or sleep b. an increase in tension and attempts to use customary coping strategies c. a sense of apathy and withdrawal from the situation d. depression and suicidal ideation Feedback Answer B is correct: As defined by Golan (1978), a crisis involves a sequence of five events: a hazardous event, a vulnerable state, a precipitating factor, an active crisis state, and reintegration. The vulnerable state refers to the person's physical, emotional, cognitive, and behavioral responses to the hazardous event and involves an increase in tension and a sense of ineffectiveness that the person attempts to relieve by using his or her customary coping strategies. Answer A, C, & D are incorrect: These are too specific to be correct. Not everyone responds to a hazardous event by avoiding it through drug use or sleep, withdrawing from the situation, or becoming depressed and suicidal. The correct answer is: an increase in tension and attempts to use customary coping strategies Question 34 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32932 You get a phone call from Brian who complains that he's not making progress with his current therapist and wants to see if he will have better luck with you. He has been working with the other therapist for four months on issues related to abandonment by his father when he was six. Brian also tells you that he feels depressed a lot of the time and occasionally has panic attacks that seem to "come out of the blue." You are an expert in treating panic disorder. To be consistent with ethical requirements, you:

a. call the other therapist to assess what would be in Brian's best interest. b. ask Brian if he has terminated with his current therapist before making an appointment with him. c. urge Brian to clear up unfinished emotional business with his current therapist and then call you when he has done so. d. agree to see Brian a few times for evaluation. Feedback Answer B is correct: It is acceptable for you to see a patient who is also seeing another therapist if you and the other therapist are dealing with different treatment issues and working cooperatively. However, in this case, the client seems to be asking to see you for the same issues he is dealing with in his other therapy (e.g., he "wants to see if he will have better luck with you"). This situation is addressed in Principle 3.10 of the CAMFT Code of Ethics. It states that MFTs "do not generally provide professional services to a person receiving treatment or therapy from another psychotherapist, except by agreement with such other psychotherapist or after the termination of the patient's relationship with the other psychotherapist." Answer A is incorrect: This answer does not mention getting Brian's permission before calling the other therapist and, therefore, would breach confidentiality. Answer C is incorrect: This answer implies you would urge Brian to terminate with the other therapist but also suggests he would have to resolve the problems he's having with his therapist before you could treat him. However, this is not necessarily true. He could also give you permission to talk to the other therapist so that you can work cooperatively with him or her. Answer D is incorrect: This would be inappropriate. You would not want to start seeing Brian in therapy without addressing his relationship with the other therapist. The correct answer is: ask Brian if he has terminated with his current therapist before making an appointment with him. Question 72 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32693 An individual experiences hallucinations while intoxicated. This symptom suggests that this individual is LEAST likely to be intoxicated with which of the following?

a. cannabis b. cocaine c. heroin d. alcohol Feedback Answer D is correct: An intoxication syndrome is characterized by marked behavioral or psychological changes that are due to the effects of the substance on the central system, with the changes developing during or shortly after use of the substance. Although hallucinations may occur in alcohol withdrawal, they are not associated with alcohol intoxication. Signs of alcohol intoxication include slurred speech, incoordination, unsteady gait, nystagmus, impaired attention or memory, and stupor or coma. Answers A, B, & C are incorrect: Cannabis, cocaine, and heroin intoxication may include hallucinations. The correct answer is: alcohol Question 25 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32983 The parents of a 14-year-old girl bring her for therapy. She has developed bulimia and has been binging and purging for several months now. The girl is slightly thin and looks unwell. She says she does "not want to be here." The parents provided consent for their daughter's treatment and will be paying for it. As an ethical MFT, you should:

a. caution the girl that, since she is a minor, anything she says may be told to her parents. b. advise the parents that you are required to maintain confidentiality and will not be able to tell them anything the girl says. c. clearly establish with the parents and the girl prior to therapy what your policy will be with regard to sharing information with the parents. d. use your discretion with regard to what information to reveal and what information to keep confidential. Feedback Answer C is correct: When parents consent to a minor's treatment, they have a legal right to obtain information about their minor child's treatment. However, the therapeutic relationship would probably benefit most if your policy regarding confidentiality is established with the parents and the minor before the onset of therapy. Answer A is incorrect: The parents have a legal right to obtain information about their daughter's therapy when they provide consent, but answer C is a better course of action and is most consistent with ethical guidelines (see, for example, Principle 1.9 of the CAMFT Code of Ethics). Answer B is incorrect: This is not consistent with ethical guidelines or the law. Answer D is incorrect: While you will ultimately use your best judgment when deciding what information to share with the parents, you must also clearly establish your policy with the clients ahead of time so that all individuals know what to expect. The correct answer is: clearly establish with the parents and the girl prior to therapy what your policy will be with regard to sharing information with the parents. Question 64 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32745 You are seeing a 30-year-old woman who is very depressed after the breakup of a long relationship. After six weeks, she comes in very excited and tells you she has met a man online. "He could be the one!" she says. Your most appropriate response would be to:

a. change the treatment goals and work with her on developing a healthy relationship. b. invite her to bring the man in for conjoint treatment since this will help her begin a healthy relationship. c. suggest that she postpone any major decisions about the new relationship until the two of you have completed the work on the loss of her last relationship. d. warn her about the dangers of online dating and caution her to be mindful of personal safety. Feedback Answer D is correct: This is the best answer since it is not too directive and takes the client's welfare into account. Answer A is incorrect: This intervention seems inappropriate since it feeds into what is likely a fantasy - i.e., the woman's belief that "He could be the one!" Answer B is incorrect: This is clearly premature. Answer C is incorrect: This is too directive and may elicit resistance. The correct answer is: warn her about the dangers of online dating and caution her to be mindful of personal safety. Question 23 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32668 A client who is a member of a racial or ethnic minority group expresses negative feelings about her own culture and positive feelings toward the dominant (White) culture. From the perspective of the "racial or cultural identity development model," this client is in which stage?

a. conformity b. dissonance c. immersion d. denial Feedback Answer A is correct: Atkinson, Morten, and Sue's (1998) "racial or cultural identity development model" identifies five stages of identity development: conformity, dissonance, resistance and immersion, introspection, and integrative awareness. It provides a framework to help therapists understand the attitudes and behaviors of clients belonging to diverse ethnic, cultural, and racial groups by describing a client's identity in terms of how he or she views himself or herself and others of the same racial or ethnic group, members of other racial or ethnic groups, and members of the dominant (majority) group. A person in the conformity stage has positive attitudes toward dominant cultural values and depreciating attitudes toward his or her own minority culture. A client in this stage is likely to prefer a therapist from the majority group. The correct answer is: conformity Question 14 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32853 During the initial interview with a couple, you determine that the husband physically abuses his wife and that the abuse can be classified as instrumental. Consequently, the best initial approach is to:

a. ensure that the husband and wife are physically separated and provide them with separate therapy. b. have the husband and wife sign a "no-violence contract" and provide them with separate therapy. c. have the husband and wife sign a "no-violence contract" and provide them with conjoint therapy. d. provide combined individual and group therapy for both the husband and wife. Feedback Answer A is correct: In cases of instrumental abuse (which is violent, occurs without provocation, and is used primarily to control or coerce the partner), the woman is at risk for serious physical injury, and the best course of action is to make sure the husband and wife are physically separated and are provided with separate therapy. Answer C is incorrect: Conjoint therapy is usually the preferred treatment in cases of expressive abuse, in which the abuse is related to the emotional life of the couple and occurs within the context of escalating conflict. The correct answer is: ensure that the husband and wife are physically separated and provide them with separate therapy. Question 40 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

33062 Your new client, Mark, is a 16-year-old boy who was in an alcohol treatment center for the past three months. Upon discharge, Mark attempted suicide by mixing a large quantity of his father's barbiturates with alcohol. His father called you to set up an appointment for Mark after the suicide attempt. Several hours later, Mark's older sister called you and said that she and her husband actually raised Mark for the last several years and will be paying for therapy. She also suggested that their father is not competent to make decisions concerning Mark's welfare and explained that there is no mother in the family. In terms of your legal and ethical concerns, what would be a priority in the above case?

a. establishing who Mark's legal guardian is b. referring Mark to a psychiatrist for evaluation because his life-threatening behavior puts him outside the scope of MFT practice c. getting a signed no-suicide contract from Mark d. calling Child Protective Services Feedback Answer A is correct: Because Mark is a minor, it would be up to whoever is legally in charge of him to arrange for the further evaluation and hospitalization Mark may need. Thus, knowing whether Mark's father or sister is legally in charge would be an important first step. The correct answer is: establishing who Mark's legal guardian is Question 82 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

33027 A 40-year-old therapist becomes sexually attracted to a 38-year-old client and soon realizes that the feelings are mutual. They discuss the situation and agree to terminate therapy and begin dating immediately. This is:

a. ethical since they terminated therapy before beginning to date. b. ethical since the client is an adult and voluntarily agreed to stop therapy. c. unethical because the therapist began dating a former client immediately after terminating therapy. d. unethical unless the therapist and client received counseling related to this issue when they began dating. Feedback Answer C is correct: Sexual relationships with former therapy clients are addressed in California law and ethical guidelines. and C Section 4982(k) identifies "engaging in sexual relations with a client, or a former client within two years following termination of therapy" as unprofessional conduct and Principle 1.2.2 of the CAMFT Code of Ethics states that "sexual intercourse, sexual contact or sexual intimacy with a patient, or a patient's spouse or partner, or a patient's immediate family member, during the therapeutic relationship, or during the two years following the termination of the therapeutic relationship, is unethical." The correct answer is: unethical because the therapist began dating a former client immediately after terminating therapy. Question 55 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32909 During crisis assessment of a client who has just lost his job, a therapist would be likely to do all of the following EXCEPT:

a. explore how and to what extent social and cultural factors have influenced the client's response to the job loss. b. ask only closed-ended questions so that she can rapidly elicit information about the client's level of distress. c. assess actual or potential threats to the client's life. d. explore the client's problem-solving history and how well he has dealt with past stressful events in his life. Feedback Answer B is correct: Although closed-ended questions are useful for rapidly eliciting important details from a client, open-ended questions are also useful in crisis assessment for eliciting information about the client's feelings, thoughts, and behaviors. Answer A is incorrect: Because each client and each crisis is different, a therapist should focus not only on the client's current clinical condition but also on the social, cultural, and material factors that influence how people respond to stressful events. Answer C is incorrect: Because a crisis has the potential of overwhelming a person to such an extent that severe pathology results, every client in crisis should be assessed with regard to danger to self and others. Answer D is incorrect: A therapist should explore a crisis client's history of problem solving and success and failure in dealing with past stressful events and resolving past crises. This information is important for understanding and mobilizing the client's personal and social resources that will help him or her resolve the crisis in a positive way. The correct answer is: ask only closed-ended questions so that she can rapidly elicit information about the client's level of distress. Question 37 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

33255 A newly licensed MFT's new clients are a lesbian couple. The MFT has had very limited training and experience related to the treatment of gay and lesbian couples and should be aware that:

a. gay and lesbian couples have exactly the same problems as heterosexual couples. b. a therapist's comfort level with homosexuality can affect the therapeutic process. c. issues of confidentiality differ when clients are homosexual. d. exposure to homophobia is usually the most important issue for gay and lesbian clients. Feedback Answer B is correct: A therapist's attitude toward homosexuality can affect the therapeutic process when he or she is treating a homosexual couple. This is true about many client characteristics (e.g., clients with criminal records, clients engaged in extramarital or premarital sex). MFTs should always evaluate whether personal values will interfere with their ability to provide objective therapy. Answer A is incorrect: Due to exposure to prejudice and discrimination, gay and lesbian couples deal with issues that heterosexual couples do not ordinarily face. Therefore, although homosexual and non-homosexual couples deal with many of the same problems, they do not deal with "exactly the same" problems. In general, answers that contain absolutes (e.g., "exactly the same") tend to be wrong. Answer C is incorrect: Obligations related to confidentiality are essentially the same for all clients and do not vary based on a client's sexual orientation. Answer D is incorrect: Although dealing with homophobia may be a problem for many gay and lesbian clients, like all clients, they seek therapy for diverse reasons. The correct answer is: a therapist's comfort level with homosexuality can affect the therapeutic process. Question 94 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33100 Tanya, a college sophomore, comes to therapy for help with her fitness program. Despite the best of intentions and solemn resolutions, she has continued to procrastinate in joining a diet group and taking a physical education class. Before beginning treatment with Tanya you should:

a. have Tanya get a complete medical check up. b. research current literature on nutrition. c. seek consultation with a behavioral therapist. d. consider whether you should treat Tanya at all. Feedback Answer D is correct: This question asks what you should do before beginning treatment with Tanya, and your first priority is to consider whether you are the appropriate health professional to treat Tanya. Tanya's problem may be beyond the scope of your practice as defined in and C Section 4980.02 and, therefore, it may be illegal for you to treat her. The Code states that the practice of marriage and family therapy refers to services "performed with individuals, couples, or groups wherein interpersonal relationships are examined for the purpose of achieving more adequate, satisfying, and productive marriage and family adjustments." There is no mention of an interpersonal or family problem connected to Tanya's desire for self-improvement. It is possible, however, that you will discover relationship issues during your consideration of the scope of practice issue. Answer A is incorrect: A medical check-up would be an appropriate step after you have resolved the scope of practice issue. Answer B is incorrect: If Tanya becomes your patient, you may need to do research on nutrition but it would not be something you would do before considering your scope of practice. Answer C is incorrect: A behavioral approach may or may not be indicated after you have begun treatment. The correct answer is: consider whether you should treat Tanya at all. Question 75 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32732 Your client has sought therapy two weeks after being fired from a job that she held for five years. The client says she's having difficulty dealing with this stressful event, in part, because it was "completely unexpected." She thought that her job was secure because she recently received a positive performance evaluation. Of the following additional factors, which one is likely to have the greatest effect on the client's reaction to this stressful event?

a. her capacity to cope with stress b. her beliefs regarding her ability to cope with stress c. whether the client experiences a second stressful event d. the actual availability of reliable social support Feedback Answer B is correct: A person's perception of control and beliefs about her ability to cope are key determinants of her response to stress. When a person believes that she has no control over the situation or thinks she doesn't have the necessary coping mechanisms, stress will have a more detrimental effect. (See, e.g., R.B. Flannery, From victim to survivor: A stress management approach to treatment of learned helplessness. In B.A. van der Kolk, "Psychological Trauma," Washington, DC: American Psychiatric Press, 1987.) This finding is consistent with Bandura's self-efficacy theory, which predicts that a person's ability to achieve a goal depends on the person's beliefs about her ability to do so. Answer A is incorrect: As noted above, it is a person's beliefs about her ability to cope (rather than her actual ability to cope) that affects the person's reaction to a stressful event. Answer C is incorrect: The effects of additional stressors depend on several factors. For example, there is some evidence that the number of stressors has an impact on males but not on females. Answer D is incorrect: Research on the "buffering hypothesis" has found that perceived, not actual, social support is important. The correct answer is: her beliefs regarding her ability to cope with stress Question 17 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

33015 False and deceptive advertising of professional therapy services is:

a. illegal and unethical. b. illegal only. c. unethical only. d. not illegal nor unethical. Feedback Answer A is correct: The misrepresentation of professional services in advertisements violates legal and ethical requirements. Specifically, and C Section 4982(p) identifies "advertising in a manner which is false, misleading, or deceptive," as unprofessional conduct. And Principle 10.4 of the CAMFT Code of Ethics states that MFTs "do not use any professional identification, including but not limited to: a business card, office sign, letterhead, telephone, or association directory listing, Internet, or any other media, if it includes a statement or claim that is false, fraudulent, misleading, or deceptive." The correct answer is: illegal and unethical. Question 53 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32999 A client in need of crisis treatment is short on funds and asks his MFT to waive his insurance co-payment. He suggests that the MFT bill his insurance company at a higher hourly rate so that the reimbursement will cover her full fee. If the MFT agrees to this arrangement, she would be acting:

a. illegally and unethically. b. legally but unethically. c. legally and ethically. d. illegally but ethically. Feedback Answer A is correct: Misrepresentation of one's fees to an insurance company is fraudulent under all circumstances and, consequently, is both illegal and unethical. The correct answer is: illegally and unethically. Question 70 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

33081 The penalty for a therapist's first conviction for sexual exploitation of a therapy client is:

a. imprisonment in a county jail for no more than three months, a fine not exceeding $500, or both. b. imprisonment in a county jail for no more than six months, a fine not exceeding $1,000, or both. c. imprisonment in a county jail for no more than 14 months, a fine not exceeding $2,500, or both. d. imprisonment in a county jail for no more than 18 months, a fine not exceeding $3,000, or both. Feedback Answer B is correct: Sexual exploitation of a patient by a therapist is established as a crime by and C Section 729. For the first offense with a single victim, the charge is likely to be a misdemeanor; and, as established by and C Section 729(b)(1), the penalty is a sentence of up to six months in county jail, a fine not exceeding $1,000, or both. The correct answer is: imprisonment in a county jail for no more than six months, a fine not exceeding $1,000, or both. Question 87 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32692 When Loretta, age 29, comes to her first therapy session, you notice that she walks very slowly into your office and that she's wearing slacks and a high-necked sweater with long sleeves even though it's a warm spring day. Loretta sits at the end of the sofa, which is the seat farthest away from you, and she avoids making eye contact and answers your questions with few words. You have just taken a history and are about to begin your assessment of her current level of functioning. You should:

a. include her non-verbal communication in your assessment. b. ask her probing open-ended questions. c. help her construct a genogram. d. administer the MMPI-2. Feedback Answer A is correct: Evaluating nonverbal behavior is always important when conducting an assessment and is an aspect of a mental status exam, which is a tool used to assess current functioning. Of the answers given, this one is most connected to the information given in the question. Answer B is incorrect: This is possible, but answer A is more connected to the information provided in the question. In fact, Loretta's nonverbal behavior suggests that she might not be very forthcoming if you ask her probing questions. Answer C is incorrect: You may choose to construct a genogram with Loretta if that is one of your assessment or intervention tools. However, this question is looking for a more general answer, not one based on theoretical orientation. Answer D is incorrect: The MMPI-2 would not be the most useful way to assess Loretta's current level of functioning. Also, to use the MMPI-2, you need proper training and experience. The correct answer is: include her non-verbal communication in your assessment. Question 15 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32939 A licensed MFT has an M.A. in marriage and family therapy and a Ph.D. in art history. Her business card reads "Jane Doe, Ph.D., Individual and Relationship Therapy." This card is inappropriate according to CAMFT ethical standards because:

a. it misleads the public. b. it does not contain Jane's license number. c. it identifies Jane as a psychotherapist. d. it does not identify Jane as a licensed MFT. Feedback Answer A is correct: This is the best answer since because it's most consistent with ethical (and legal) requirements. Principle 10.4 of the CAMFT Code of Ethics states that "marriage and family therapists do not use any professional identification, including but not limited to: a business card, office sign, letterhead, telephone, or association directory listing, Internet, or any other media, if it includes a statement or claim that is false, fraudulent, misleading, or deceptive." The content of Jane Doe's business card is misleading because it does not identify her as a licensed MFT and lists her Ph.D., even though her doctoral degree is in a field unrelated to her professional practice as a therapist. Answers B & D are incorrect: While these answers are true, they are not the best answers because each identifies only one of the problems with the business card. Answer C is incorrect: An LMFT can identify him or herself as a psychotherapist. The correct answer is: it misleads the public. Question 61 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

33105 A client having a need for crisis treatment is short on funds and asks you to waive his insurance co-payment. He suggests that you bill his insurance company at a higher hourly rate so that the reimbursement will cover your full fee. If you do this, you will be acting:

a. legally and ethically since the client is in crisis. b. legally but unethically since the law permits this when clients are in crisis. c. illegally but ethically since the client is in crisis. d. illegally and unethically. Feedback Answer D is correct: According to and C Section 4982, "the commission of any dishonest . . . or fraudulent act . . ." is unprofessional conduct." If you are not collecting a co-payment, you must inform the insurance company. Overbilling to cover the co-payment is illegal and unethical behavior even when a client is in crisis. The correct answer is: illegally and unethically. Question 79 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32843 A 20-year-old woman comes to see a therapist at a crisis center a day after being raped while on a first date. The client reports that she was drinking heavily and is not sure if she blacked out or if something was "slipped into" her drink. She says she woke up during the attack but can't remember how the attack started. The woman is very upset and is unable to stop crying. In the interview with this client, the therapist should FIRST:

a. listen to the client and support her emotionally. b. help the client establish contact with significant others. c. obtain factual information about the rape. d. emphasize medical and legal procedures. Feedback Answer A is correct: Crisis intervention with an individual who has just been raped should include addressing emotional, medical, and legal considerations. However, this question is asking what the therapist should do first, which is to listen to the client and provide her with emotional support. Certain medical and legal procedures must be carried out after a rape (e.g., medical care, gathering of evidence for possible prosecution); however, these procedures should not be the focus of the initial interview. Answer B is incorrect: Helping the client obtain support from friends and family is very important, but the therapist should first allow the client to express herself and support the client emotionally. Answers C & D are incorrect: It is more important to listen to the client and provide her with emotional support in the initial interview than to obtain factual information about the rape or to emphasize medical and legal procedures. The correct answer is: listen to the client and support her emotionally. Question 49 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32925 You have found that, when working with difficult clients, it is often useful to make and review a video recording of therapy sessions. You would also like to use the recordings to illustrate therapeutic techniques in a graduate-level class that you teach. You can:

a. never use the recordings for educational purposes. b. avoid being sued for using the recording for educational purposes if you obtain verbal or written consent from the clients. c. use the recordings for educational purposes as long as doing so does not exploit the clients. d. use the recordings for educational purposes only if you obtain written authorization from the clients. Feedback Answer D is correct: CAMFT Ethical Principle 2.6 applies to this situation. It states: "Marriage and family therapists use clinical materials in teaching, writing, and public presentations only if a written authorization has been previously obtained ... or when appropriate steps have been taken to protect patient identity." Since the recordings are video recordings, it would not be possible to disguise the identities of the clients depicted in the recordings, so written authorization from them would be required. The correct answer is: use the recordings for educational purposes only if you obtain written authorization from the clients. Question 60 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33065 According to HIPAA regulations, the Notice of Privacy Practices (NPP) must be given to clients:

a. on or before the beginning of treatment. b. when you are required to breach confidentiality to protect the client or another person. c. before the termination of treatment. d. when requested by the client. Feedback Answer A is correct: HIPAA requires therapists to provide clients with a written Notice of Privacy Practices (NPP) on or before the beginning of treatment. The NPP informs clients of their rights and indicates how health information may be used and disclosed. The NPP must also be posted in a prominent place in the therapist's office, and the therapist must make a "good faith effort" to obtain the client's written acknowledgment of receipt of the notice. The correct answer is: on or before the beginning of treatment. Question 80 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32781 For a diagnosis of Separation Anxiety Disorder, the DSM-5 requires symptoms of fear, anxiety, or avoidance that have lasted for at least __________ in children and adolescents or about __________ in adults.

a. one week; six months b. four weeks; six months c. six weeks; eight months d. two months; eight months Feedback Answer B is correct: The DSM-5 specifies a minimum duration of symptoms for Separation Anxiety Disorder of "4 weeks in children and adolescents and typically 6 months in adults" (p. 191). The correct answer is: four weeks; six months Question 11 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32930 A couple is in counseling because they feel that they have "lost touch with each other." He is an airline pilot who is frequently out of town, and she is a third grade teacher. They want to improve their communication, and find ways to connect better when he is in town. She originally came to therapy by herself, but it quickly became apparent that the best unit of treatment was the couple, so you began couples therapy after the second session. If you were asked to release information to a third party, CAMFT Ethical Standards specify that, when a therapist is seeing clients conjointly:

a. only the client who initially requested the therapy must sign a release authorizing the therapist to disclose information b. either client may sign a release authorizing the therapist to disclose information c. all clients involved in the therapy who are legally competent to do so must sign a waiver for release of information d. all clients involved in the therapy must sign a waiver for release of information Feedback In conjoint family therapy, the question of who holds the privilege or which client may direct the therapist to break confidence can be complicated. However, the CAMFT Ethical Standards define what MFTs should do in these situations. Answer C is correct: CAMFT Ethical Standards specify that when an MFT is seeing clients conjointly, all clients who are legally competent to sign a waiver must do so before information can be released. Answer A is incorrect: This answer does not make sense since clients in conjoint therapy have often sought therapy together. Answer D is incorrect: This is missing the qualifier "who are legally competent to sign a waiver." The correct answer is: all clients involved in the therapy who are legally competent to do so must sign a waiver for release of information Question 52 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32792 The DSM-5 requires that which of the following be ruled out as the cause of an individual's symptoms before assigning a diagnosis of a sexual dysfunction?

a. other mental disorders, physiological or medical factors, and partner factors b. a nonsexual mental disorder, severe relationship distress, and the effects of a substance, medication, or other medical condition c. a nonsexual mental disorder, the effects of a substance or medication, and a lack of information about sexuality d. other mental disorder or condition, the effects of a substance or medication, and psychosocial factors Feedback Answer B is correct: The following is included as a diagnostic criterion for a DSM-5 diagnosis of Erectile Disorder, Premature Ejaculation, and other sexual dysfunctions: "The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance or medication or another medical condition." The correct answer is: a nonsexual mental disorder, severe relationship distress, and the effects of a substance, medication, or other medical condition Question 8 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32782 The core feature of the DSM-5 diagnosis of Gender Dysphoria is which of the following?

a. persistent preference for cross-gender roles b. strong desire to be treated as the opposite gender c. incongruence between assigned and experienced or expressed gender d. cross-gender identification Feedback Answer C is correct: The core feature of Gender Dysphoria is the presence of incongruence between assigned gender and experienced or expressed gender. Answer A is incorrect: A persistent preference for cross-gender roles in make-believe or fantasy play is one of the possible symptoms for children with Gender Dysphoria, but it is not the core feature. Answer B is incorrect: The DSM-5 lists "a strong desire to be treated as the other gender (or some alternative gender different from one's assigned gender)" (p. 452) as one of the possible symptoms of Gender Dysphoria for adolescents or adults. Answer D is incorrect: Cross-gender identification is the core feature of Gender Identity Disorder in DSM-IV-TR. The correct answer is: incongruence between assigned and experienced or expressed gender Question 12 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32844 Mike M., age 46, was a manager at a computer company but had to go on disability for work-related stress. When his disability ended, his company was in bankruptcy and he had no job. You have been helping Mike with stress reduction and relationship issues that developed with his wife as the result of his unemployment. Mike is diabetic, although insulin has kept his illness in check. One day, he makes an unscheduled visit to your office. He is shaking and sweating profusely and tells you he has been drinking about two pints of alcohol a day for the past week. You should:

a. refer him to AA. b. have him lie down on the floor and do deep breathing exercises. c. initiate a 5150 in order to hospitalize him. d. insist that he immediately seek hospitalization. Feedback Answer D is correct: This is the appropriate intervention. Mike needs immediate medical attention and no information is given in the question that suggests that he is unable to take action on his own. Answer A is incorrect: Mike is experiencing a crisis, and AA would not be helpful at this time. Answer B is incorrect: Mike needs medical help and asking him to do deep breathing exercises would not be helpful. Answer C is incorrect: This might be appropriate if Mike was unable to take any action on his own. However, he has come to your office on his own seeking help, implying that he will be able to follow through on your directive to seek immediate medical attention. The correct answer is: insist that he immediately seek hospitalization. Question 41 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33397 Bob is a gay male who has known he has been HIV positive for three years and has just been diagnosed with AIDS. He has not told his partner and says, "You are the first person I've told that I was even HIV positive." As his therapist, you should:

a. refer him to appropriate groups and community resources for support. b. tell him that you cannot see him in therapy unless he tells his partner or uses safe-sex practices. c. provide Bob with grief counseling and have him tell you his life story. d. explore his denial about his medical condition and ask him if he knows whether his partner is HIV positive. Feedback Answer D is correct: Exploring Bob's denial is the best answer of those given. He has gone from being HIV positive to having AIDS without the knowledge of his partner. This sounds like there is a very strong denial mechanism at work, which should be the initial focus of therapy. Answer A is incorrect: Support systems are not likely to be effective as long as Bob is in denial about his condition. Answer B is incorrect: While his partner's safety is certainly very important, bullying Bob may increase his resistance and denial. Answer C is incorrect: Providing Bob with grief counseling may be useful later. The correct answer is: explore his denial about his medical condition and ask him if he knows whether his partner is HIV positive. Question 99 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33247 An MFT is interviewing a lesbian couple. One of the women seems very uncomfortable. She says that she would feel better working with a lesbian therapist. She asks the MFT about her own sexual orientation. The MFT should do which of the following?

a. refer the clients to a lesbian therapist b. ask the client why she wants to know this c. ask the client what it would mean to her if she (the MFT) were a lesbian d. inform the couple that she has extensive experience working with gay and lesbian clients Feedback Answer C is correct: When a client asks you a question that seeks personal information, you can simply answer if you believe that the client is just curious and you feel comfortable providing an answer. However, when you suspect that a client may have an underlying reason for asking the question (e.g., unexpressed feelings), you should try to discover these reasons. While the response described in this answer is not a perfect response, it is a way of beginning to address the woman's question and explore any concerns that may underlie her question. Answer A is incorrect: While it may turn out to be in this couple's best interests to refer them to another therapist, the MFT should not do so without some discussion first, especially since the client has asked you a question. Answer B is incorrect: This sounds defensive and challenging. Answer D is incorrect: The MFT might tell the clients this (if it is true) but, by itself, this information is not all that useful. It neither answers the woman's question nor explores the concerns that may have prompted her to ask it. The correct answer is: ask the client what it would mean to her if she (the MFT) were a lesbian Question 92 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32955 James and Natalie are divorcing and come for therapy in the midst of a custody battle over Sal, their six-year-old son. Natalie insists that Sal live with her and have visitation with James and says she doesn't mind sharing legal custody. James states that he wants to share physical custody by having Sal spend every other week with each of them. Natalie insists this would be too difficult for Sal. James says that Natalie is just projecting her own insecurities onto Sal and that it's time for her to "let go" and "get a life." The MFT has no experience in custody matters. The MFT should:

a. refer the couple to a conciliation court. b. suggest that James and Natalie see a lawyer. c. see the couple but seek consultation. d. do his best to address the custody issue since it's the primary issue and the couple needs immediate help. Feedback Answer C is correct: The CAMFT Code of Ethics provides guidelines for this type of situation. Principle 1.11 of the Code states: "When appropriate, marriage and family therapists consult, collaborate with, and refer to physicians, other health care professionals, and community resources in order to improve and protect the health and welfare of the patient." The MFT can see the couple but, because of his lack of experience, should seek consultation regarding their custody concerns. Answer A is incorrect: Referring the clients to conciliation court is not the best choice since the legal system will do that automatically. Answer B is incorrect: This is not the best answer since it doesn't address what the MFT should do with regard to seeing these clients in therapy. Also, it is likely that, since the couple is getting divorced, they have already contacted an attorney. Answer D: Although the MFT should address custody because it's an immediate concern for the couple, this answer implies that he would do so without seeking consultation. Because the MFT lacks experience in custody matters, this would not be in the best interests of the clients. Answer D is incorrect: Although the MFT should address custody because it's an immediate concern for the couple, this answer implies that he would do so without seeking consultation. Because the MFT lacks experience in custody matters, this would not be in the best interests of the clients. The correct answer is: see the couple but seek consultation. Question 59 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

33070 A client asks you for a copy of her therapy record. You may provide the client with a summary of the record (rather than the complete record) if:

a. you explain your reasons for doing so to the client. b. the client's request was verbal rather than in writing. c. the client requested a summary and the request from the client was in writing. d. you believe it is in the best interest of the client to do so and the request from the client was in writing. Feedback Answer C is correct: Although California law permits a health care provider to determine whether to provide a client with a record summary or an entire record, HIPAA's Privacy Rule allows this only if the client agrees in advance to receiving a summary. Because HIPAA grants clients greater access to their records, it preempts California law. In addition, HIPAA and California law both require that a client's request for access to his or her records be in writing. The correct answer is: the client requested a summary and the request from the client was in writing. Question 86 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32982 Your new clients are Fred and Ethel who constantly bicker about almost everything. However, they are never too mean to each other, their feelings don't seem to get hurt, and the bickering almost seems habitual. After three sessions, Ethel calls and tells you that she recently had an affair. Ethically, you would:

a. refuse to talk to one of the clients without the other one present. b. have explained your secrets policy at the beginning of treatment and would act accordingly. c. encourage Ethel to disclose this information to Fred in the next therapy session. d. have explained to Fred and Ethel at the beginning of therapy that you can never "keep secrets" since they are both your clients. Feedback Answer B is correct: This issue is addressed in Principle 1.9 of the CAMFT Code of Ethics, which requires MFTs to "clarify, at the commencement of treatment, which person or persons are clients and the nature of the relationship(s) the therapist will have with each person involved in the treatment." To be consistent with this requirement, MFTs should establish a policy regarding "secrets" at the onset of therapy and adhere to that policy during the course of treatment. Answers A & D are incorrect: They aren't the best answers because your policy may or may not be to refuse to talk to one of the clients without the other one present or to never keep secrets. Answer C is incorrect: It is not the best answer because it may or may not be appropriate to encourage Ethel to disclose the information to Fred at this time. The correct answer is: have explained your secrets policy at the beginning of treatment and would act accordingly. Question 57 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33102 Your clients are two young children of a divorced couple. Their father sees the two children on the weekends. During one session, in which you are doing art therapy, the children draw pictures of a man driving while drinking beer. One child then says, "Daddy does this all the time!" You ask the other child if this is true and she answers, "Yes, it is." You should:

a. report to county welfare department for child endangerment. b. continue to see the children and gather more information. c. call the father in for an individual appointment to investigate this matter. d. call the mother and tell her. Feedback Answer A is correct: This question is difficult because two answers describe actions you could take. However, only answer A describes an action you must take, making it the correct choice. According to Penal Code 11165.2(a) "severe neglect also means those situations of neglect where any person having the care or custody of a child willfully causes or permits the person or health of the child to be placed in a situation such that his or her person or health is endangered." The father's drinking while driving places the children in a situation in which their physical well-being is endangered and, therefore, you must make a report of child abuse. Answers B & C are incorrect: There is enough information given for you to reasonably suspect severe child neglect and, therefore, must make a report. Answer D is incorrect: This is a mandated reporting situation and your responsibility is to call county welfare immediately. You may also call the mother, but that is not your legal responsibility. The correct answer is: report to county welfare department for child endangerment. Question 84 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33306 According to family systems theory, the family system differentiates and carries out its functions though subsystems (e.g., individual, spousal, parental and sibling), and the boundaries of these subsystems must be clear for proper family functioning. Enmeshed boundaries:

a. result in confusion and a lack of differentiation. b. result in excessively high levels of individual autonomy. c. allow only stereotyped and limited interactions between family members. d. facilitate communication and allow change to occur. Feedback Answer A is correct: Enmeshment occurs when there are diffuse psychological boundaries between subsystems and between individuals. In enmeshed families, autonomy is lost and there is a high degree of reactivity between individuals. Answer B is incorrect: Enmeshment does not lead to high levels of individual autonomy. Answer C is incorrect: This is associated with rigid boundaries, which result in disengagement. Answer D is incorrect: This is not true about enmeshed boundaries. Enmeshed and rigid boundaries both result in maladaptive behaviors. The correct answer is: result in confusion and a lack of differentiation. Question 96 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32850 Richard, age 10, is brought to therapy by his mother who was referred to you by Richard's elementary school principal because of his hostile, aggressive behavior on the school yard. When you meet Richard, he is extremely withdrawn and appears nervous. He continually bites his nails, and his conversation revolves around how awful school is, how he hates where he lives, and how likely it is that the world is going to "burn up." Richard describes himself as unlovable and worthless. What would you consider FIRST?

a. sexual abuse b. physical abuse c. child endangerment d. emotional abuse Feedback Answer D is correct: Richard's symptoms are most indicative of emotional abuse. Common indicators of this type of abuse include habit disorders (e.g., nail biting), conduct disorders, neurotic traits, regressive behaviors, over-concern about conforming to the instructions of authority figures, negativity, school problems, suicide attempts, and making derogatory statements about oneself. Answer A is incorrect: Common indicators of child sexual abuse include sudden changes in behavior, fear, night terrors, regressive behaviors, promiscuity, overly sophisticated knowledge about sex, social isolation, unwillingness to participate in physical activities, and suicide attempts. Answer B is incorrect: Common indicators of child physical abuse include extremes in behavior, school problems, avoidance of physical activity, hypervigilance, and wariness of physical contact. Answer C is incorrect: Any acts of commission or omission that put a child in danger constitute child endangerment. Neglect is the most common type of child endangerment, and common indicators of neglect include stealing or begging for food, falling asleep during school, missing school, vandalism, thievery, and statements that no one cares. The correct answer is: emotional abuse Question 47 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

33082 A therapist and her colleague share rented office space. Although they are not legally incorporated, they use the fictitious business name, "Main Street Counseling Associates." Legally, these therapists:

a. should not use the business name in advertisements because doing so would be misleading. b. may use the business name in advertising as long as the ads include their full names and licensure status. c. may use the business name in advertising only if the business is an LLC or other legal entity. d. may use the business name in advertising only if their liability insurance covers "Main Street Counseling Associates." Feedback Answer B is correct: Therapists may use a fictitious business name (which is also known as "doing business as" or DBA) as long as they file a Fictitious Business Name Statement with the registrar-recorder or county clerk in the county where the business is located. In addition, to meet the requirements of CCR Section 1811(a) and C Section 4980.45, all advertisements for the business must include the full names of the owners and their licensure status. Answer A is incorrect: It is not the best answer because the name "Main Street Counseling Associates" does not seem to be misleading. Answer C is incorrect: Therapists can use a fictitious business name without being an LLC (limited liability company) or other legal entity. Answer D is incorrect: Liability insurance would not cover a fictitious business. The correct answer is: may use the business name in advertising as long as the ads include their full names and licensure status. Question 89 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33041 You are an employee of a community counseling center where you also supervise MFT associates. One of your associates says she is quitting her placement because she needs to focus on her son who has just received a diagnosis of oppositional defiant disorder. She says everyone acknowledges you are the best therapist to treat this disorder, and she wants you to start seeing her son in therapy. You should:

a. suggest she ask her son's pediatrician for a referral. b. refer her to a competent colleague. c. agree to see her son since she is no longer going to be your associate. d. agree to see her son as long as you discuss the potential for conflicts with her before doing so. Feedback Answer B is correct: Ethical Principle 1.2 of the CAMFT Code of Ethics requires MFTs to avoid dual relationships when those relationships "are likely to impair professional judgment or lead to exploitation." Even though the associate is quitting, seeing her son in therapy is, at best, ethically questionable since problems could arise if she decides to continue her placement or you determine that seeing her in therapy with her son is the best treatment approach. Answer A is incorrect: This is not the best answer since you are probably more qualified than her son's pediatrician to offer an appropriate referral. Answers C & D are incorrect: As noted above, seeing her son in therapy may create an unacceptable dual relationship. The correct answer is: refer her to a competent colleague. Question 50 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32993 A client you have been seeing for several months suddenly tells you that she can no longer afford to see you. She says she has to end therapy but does not want to. You:

a. tell her you cannot see her for free but will refer her to a low fee clinic. b. tell her you will lower your fee for now and bill her for the difference when she can pay. c. respect her decision to terminate and invite her to come back when she can afford your fee. d. lower your fee and have her agree to increasing the fee when her financial situation improves. Feedback Answer D is correct: You are not ethically required to lower your fee for a client who cannot pay your full fee. However, of the answers given this is the best one. When taking the exam, keep in mind that the optimal answer may not be given and, for those questions, you'll have to choose the "best" one. Answer A is incorrect: The word "cannot" in this answer suggests that it would be unethical or illegal to see a client for free, which it isn't. This could be your policy, but don't expect exam questions to cover all the unique policies of individual MFT. When answering questions on ethical issues, look for answers that apply generally to the profession. Answer B is incorrect: This is not the best answer because allowing your client to accrue a large unpaid balance would not be in her best interests. Answer C is incorrect: The client prefers to stay in therapy, so terminating therapy at this time may not be in her best interests. In addition, terminating therapy without providing her with referrals would constitute abandonment. The correct answer is: lower your fee and have her agree to increasing the fee when her financial situation improves. Question 58 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32824 A 15-year-old client whom you've been seeing for several months says that he's been thinking about killing himself. In response to your concern, he says he's "just kidding" and asks that you not tell his parents. Your BEST course of action would be to:

a. tell the boy that you need to contact his parents and then do so. b. tell the boy that you won't tell his parents as long as he signs a "no suicide" contract. c. continue to discuss the matter to determine if the boy is, in fact, at risk for suicide. d. do nothing since he was "just kidding" but ask him about the issue during the next session. Feedback Answer C is correct: Suicide threats and ideation should always be taken seriously. However, before notifying the boy's parents, you'd want to determine how serious his thoughts about suicide are. The correct answer is: continue to discuss the matter to determine if the boy is, in fact, at risk for suicide. Question 36 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32706 A 30-year-old divorced female client says she feels angry, agitated, and "out of control" when her daughter returns from weekend visitations with her father and that she wants to have better control of her feelings. She says her father died when she was a baby and that her mother remarried when she was five. She states that she got along "okay" with her stepfather but has only scattered memories of day-to-day life as a child. What should the therapist be most concerned about?

a. unresolved issues with daughter's father b. issues of childhood sexual abuse c. the possibility that the client is dissociating d. what "out of control" means Feedback Answer D is correct: One of the first things an MFT must do in terms of clinical evaluation is to define the problem. In this situation, it would be important to know what behaviors and feelings are associated with being "out of control" for this client. Until this is determined, an MFT would not be able to identify an appropriate diagnosis or intervention. Answer A is incorrect: It may be true that this woman has unresolved issues with her daughter's father, but the more important issue is determining what "out of control" means. Answer B is incorrect: There is not enough information in this question to come to this conclusion. Answer C is incorrect: Although the client's feeling of being "out of control" might mean that she is dissociating, the feeling may be due to something else (e.g., an inability to control her anger). The correct answer is: what "out of control" means Question 3 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

33034 Your new clients are a Mexican American family that consists of a husband and wife and two daughters. They came for therapy because one of the girls has a shoplifting problem and the other has an eating disorder. You realize during the first session that you and the parents are members of the same country club. You should:

a. terminate therapy with this family immediately. b. ask the parents what they would like to do. c. determine whether you can maintain your objectivity with this family. d. not concern yourself because this situation presents no ethical dilemma. Feedback Answer C is correct: Not all dual relationships are prohibited by ethical guidelines. As stated in Principle 1.2 of the CAMFT Code of Ethics, MFTs "avoid dual relationships that are reasonably likely to impair professional judgment or lead to exploitation." The situation presented in this question is not a clear example of an unethical (harmful) dual relationship, so this answer is the best choice. You should consider the situation carefully to determine whether you will be able to maintain your objectivity (e.g., do you ever encounter the clients at the country club and, if so, how should you handle that situation?). Answer A is incorrect: As noted above, it may not be necessary to terminate therapy. Answer B is incorrect: This is not appropriate. It is your responsibility to determine whether this situation is likely to impair your professional judgment or lead to exploitation. Answer D is incorrect: This situation could present an ethical dilemma and, consequently, requires special consideration. The correct answer is: determine whether you can maintain your objectivity with this family. Question 56 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33137 A woman brings her 17-year-old daughter to therapy for issues related to anger. The daughter secretly married her boyfriend one year ago with her father's permission. When the mother found out, she had the marriage dissolved. The mother is paying for therapy sessions and wants to be kept informed. You should keep in mind:

a. the daughter is the holder of the privilege. b. the daughter is the client and is entitled to confidentiality. c. the mother is legally entitled to information about her daughter's sessions. d. the mother is the holder of the privilege since the marriage was dissolved. Feedback Answer B is correct: When a minor is legally married, even if the marriage is later dissolved, the minor is legally emancipated. Legally married means, among other things, the partners did not lie about their age, did not present an illegally executed parental consent form, etc. Since none of these conditions are presented as facts, in this case, you would accept that this 17-year-old is emancipated. Consequently, even though the mother is paying for her daughter's therapy, the daughter is entitled to confidentiality, and information should not be shared with the mother without authorization from the daughter. Answer A is incorrect: It is true that the daughter is the holder of the privilege, but privilege refers to the right to confidentiality in a legal proceeding and does not apply to this situation. Answer C is incorrect: The mother would not be legally entitled to information about the sessions since her daughter is an emancipated minor. Answer D is incorrect: The mother is not the holder of privilege. The correct answer is: the daughter is the client and is entitled to confidentiality. Question 83 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32763 When using the DSM-5, level of severity of Intellectual Disability is based on:

a. the individual's score on a standardized intelligence test. b. the individual's adaptive functioning in conceptual, social, and practical domains. c. the degree of discrepancy between the individual's cognitive and adaptive functioning. d. the degree of discrepancy between the individual's IQ and academic achievement. Feedback Answer B is correct: The DSM-5 distinguishes between four levels of severity for Intellectual Disability - mild, moderate, severe, and profound - and bases them on level of adaptive functioning in conceptual, social, and practical domains. Answer A is incorrect: IQ score was the primary determinant of severity for Mental Retardation in DSM-IV-TR. In DSM-5, Mental Retardation has been renamed Intellectual Disability and severity is based on adaptive functioning. The correct answer is: the individual's adaptive functioning in conceptual, social, and practical domains. Question 27 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32866 A person experiences a traumatic event. Which of the following factors is LEAST likely to play a role in determining whether this event will activate a crisis?

a. the person's problem-solving ability b. the person's cultural values regarding the event c. the person's current levels of social, material, and other support d. the actual nature of the traumatic event Feedback Answer D is correct: Crisis may stem from personal or material losses, transition states, and social and cultural factors, but events alone do not usually activate crisis. Instead, a crisis occurs when a person's interpretation of the event and available coping methods and social resources produce tension so severe that the person cannot find relief. Key determining factors include the person's cultural values regarding the event, the person's previous problem-solving ability, and the person's current levels of social, material, and other support. The correct answer is: the actual nature of the traumatic event Question 48 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33006 Your new client is a 23-year-old woman who is severely depressed. The woman is currently unemployed and is living on her savings, but her parents will be paying your fee. She takes care of all of her own daily needs, although she's been doing so with more effort since feeling depressed. In terms of confidentiality:

a. the woman's parents are the holders of the privilege since they are paying your fee. b. the parents should be given only general information about their daughter's progress since they are paying your fee and are, therefore, the "users" of your professional services. c. you should provide the parents only with information you believe they will understand. d. you should, at the onset of treatment, establish a policy about confidentiality jointly with the daughter and her parents. Feedback Answer D is correct: It is common for someone who is paying for therapy, such as a parent, to request information from the therapist and to assume that he or she is entitled to it. Therefore, it's always a good idea to reach an agreement with the payer and the client at the beginning of treatment that specifies whether and what information will be disclosed by the therapist to the payer. In the situation described in this question, the client is an adult, and the parents have no legal right to access information about her therapy. Answer A is incorrect: It is not true that the person paying the therapist's fee is the holder of privilege. Answer B is incorrect: The "user" of the services is the client. The client is entitled to a confidential relationship, regardless of who is the "payer" of the services. Answer C is incorrect: You are obligated to maintain the client's confidentiality. The correct answer is: you should, at the onset of treatment, establish a policy about confidentiality jointly with the daughter and her parents. Question 63 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32795 Your clients are a family consisting of the mother, the father, and two daughters, ages 9 and 14. The 14-year-old daughter is presented as the identified patient. The parents explain that she doesn't respect the family's values. When you ask what they mean by that, the mother says that the girl leaves the dinner table before others are finished eating, listens to hip-hop music, and dresses in a peculiar fashion. The girl gets fairly good grades and has no known history of drug or alcohol use. The father says, "I worry that she'll become a single parent." What should be your immediate short-term objective with this family?

a. to clarify the target problem by assessing whether the daughter's behavior is transient or reflects a more stable pattern b. to define the specifics about what needs to change in the daughter's behavior by having family members share their perceptions and feelings about her behavior c. to provide the family with an alternative idea of the problem by providing education about adolescent development d. to identify the strengths and weaknesses of the parents' parenting style by having the clients role-play a parent-child conflict Feedback Answer C is correct: This is the best answer because the information from the parents suggests that the girl's behavior while upsetting to them, is normal for her age group. Thus, you should provide education to the family about normal, or expected, adolescent behavior. You might also inform the parents about research showing that even though adolescents often follow their peers on issues such as music and fashion, they usually continue to conform with their parents on matters involving moral and social values. The correct answer is: to provide the family with an alternative idea of the problem by providing education about adolescent development Question 30 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32726 Your new client is a 35-year-old female who reports feeling anxious and unable to hold a job. In the initial phase of treatment, you perform a multidimensional assessment of the client in which you gather information from a variety of relevant sources and formulate that information into a coherent picture of the client and her circumstances. What is your primary purpose in performing this assessment of the client?

a. to identify a reliable means of evaluating the effects of treatment b. to facilitate the development of appropriate treatment goals and objectives c. To identify accurately what mental disorder she has d. To facilitate meaningful communication with other service providers and her insurance company Feedback Answer B is correct: This comes closest to defining the primary purpose of assessment. "Assessment is the thinking process by which a therapist reasons from the information gathered to arrive at tentative conclusions. During assessment, the available information is organized and studied to make sense of the client's situation and lay the foundation for a plan of action. When the assessment is complete, the therapist should be able to describe the problem accurately and identify what needs to be changed to improve the client's situation" [B.W. Sheafor and C.R. Horejsi, "Techniques and Guidelines for Social Practice" (6th Ed.), 2003, Boston, Allyn and Bacon, p. 244]. Answer A is incorrect: While evaluating the effects of treatment is important, identifying means for doing so is not the primary purpose of the initial assessment. Answers C & D are incorrect: Assessment is useful for these purposes but neither is the most important function. The correct answer is: to facilitate the development of appropriate treatment goals and objectives Question 26 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32744 Your client complains of feeling somewhat depressed and anxious. He tells you that his wife is a poor housekeeper and that their house often smells like rotting food. He also reports that he sometimes feels as though roaches are crawling on him at night, although he has never seen any roaches in their house. He tells you that his wife insists that their house is clean and that she has never felt any roaches crawling on her. What is your priority in working with this man?

a. to send the man to a psychiatrist because this case is outside an MFT's scope of practice b. to assess the pervasiveness of the client's thought disorder using the clinical interview and then refer him to a psychologist for psychological testing to further determine the nature and degree of his symptoms c. to complete a mental status exam to determine whether inpatient treatment in a psychiatric facility is immediately necessary d. to refer the man to a neurologist or psychiatrist for an evaluation because not to do so would be an ethical violation Feedback Answer D is correct: The man needs to undergo medical or neurological evaluations and may require medication. The man's symptoms -- kinesthetic and olfactory hallucinations and possible delusional thinking - may be due to a mental, probably psychotic, disorder due to a medical condition or the effects of a substance. A neurologist or a psychiatrist would be best equipped to evaluate and treat these symptoms. Don't let the extra verbiage about ethics throw you off from recognizing that the core of this answer is about medical evaluation. Answer A is incorrect: This answer starts out well because a psychiatrist would be able to evaluate this man and prescribe any needed medication. However, this is not the best answer because this case might not be outside an MFT's scope of practice. Answer B is incorrect: As noted above, this man needs medical attention first because his symptoms are suggestive of a mental disorder due to a medical condition or the effects of a substance. Answer C is incorrect: This man needs to be evaluated by a medical professional. In addition, inpatient treatment in a psychiatric facility is indicated for patients who, due to mental disorder, are a serious danger to themselves or others or gravely disabled. The question doesn't suggest that the man may be dangerous or gravely disabled. The correct answer is: to refer the man to a neurologist or psychiatrist for an evaluation because not to do so would be an ethical violation Question 10 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32810 Mrs. Smith comes alone to see a therapist, reporting some difficulties sleeping, a generally anxious mood, and a sense of feeling hopeless and lost. She has been married for ten years and has a 7-year-old and a 5-year-old child. Although Mrs. Smith talks freely about her children, she says very little about her husband other than that he is "moody." She says her symptoms are fairly long-standing but is unable to connect them to any events in her life and adds that her husband has told her she has a "weak character." One day, Mrs. Smith arrives for therapy with a large bruise on her arm and a black eye. When the therapist questions her about her injuries, Mrs. Smith first offers a long explanation about an "accident" and then confesses that her husband beat her up the night before. The therapist should:

a. try to convince Mrs. Smith to leave her husband. b. encourage Mrs. Smith to bring her children in to be evaluated for abuse. c. educate and inform Mrs. Smith about domestic violence and the community resources that are available to her. d. send Mrs. Smith to a physician. Feedback Answer C is correct: Of the answers given, this is the best one. You would want to give Mrs. Smith information and referrals, including referral to a physician. Answer A is incorrect: Ethically, an MFT cannot try to convince a client to leave her spouse. Answer B is incorrect: At this point, there is no indication that Mr. Smith is violent toward his children, and shifting the focus away from Mrs. Smith at this time would simply allow her to go back into denial of her own pain. Answer D is incorrect: This is not the best answer because a physician is only one of the individuals the therapist would want to refer Mrs. Smith to. In addition, the therapist would want to "urge her to see a physician" or "refer her to a physician," not "send her to a physician" since this implies that the therapist is accepting too much responsibility for Mrs. Smith's situation. The correct answer is: educate and inform Mrs. Smith about domestic violence and the community resources that are available to her. Question 43 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

33189 A husband and wife come to therapy. The wife says that her husband has become a workaholic and is rarely home. She also says that, when he's home, he frequently criticizes her and that they haven't had sex in nearly three months. As a strategic family therapist, one of the FIRST things you would do would be:

a. use strategies that help separate the husband and wife from their problems. b. identify strategies that would increase the couple's insight into the origins of their problems. c. identify techniques that would alter the couple's communication patterns and other interactions. d. use strategies that promote "problem-free" talk. Feedback Answer C is correct: As its name implies, strategic family therapy entails the use of specific strategies to induce behavior change. The focus of many of these strategies is on the family's communication patterns. Answer A is incorrect: Separating people from their problems is an initial strategy in narrative therapy and is used to foster a good therapeutic relationship. Answer B is incorrect: Strategic family therapists do not consider insight necessary for change. Answer D is incorrect: The use of strategies to promote problem-free talk is characteristic of solution-focused family therapy. The correct answer is: identify techniques that would alter the couple's communication patterns and other interactions. Question 101 Incorrect Mark 0.00 out of 1.00 Not flaggedFlag question Question text

32685 Lorna has been in therapy with you for 14 months, and you have assigned a diagnosis of Borderline Personality Disorder. Her suicidal behaviors and ideation have greatly diminished, but her basic way of relating to the world has changed very little. However, you feel that slow but sure progress is being made. Which of the following have you most likely encountered while working with Lorna?

a. violent outbursts b. flat affect c. agreement with your suggestions and cooperation with your interventions d. overt expressions of cooperation with covert resistance to treatment Feedback Answer D is correct: This answer best captures the "flavor" of the ambivalent and confusing interactions that often occur between individuals with Borderline Personality Disorder and their therapists. Answer A is incorrect: Though inappropriate rage and difficulty controlling anger are characteristic of individuals with Borderline Personality Disorder, answer D provides a better characterization of what typically occurs in the therapeutic setting. Answer B is incorrect: Individuals with Borderline Personality Disorder rarely have flat affect. In fact, affective instability due to marked reactivity of mood is a diagnostic criterion for this disorder. Answer C is incorrect: Individuals with Borderline Personality Disorder are often difficult to treat. They may be uncooperative, and they change therapists frequently and leave treatment prematurely without seeking alternative help. The correct answer is: overt expressions of cooperation with covert resistance to treatment Question 2 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33064 To be consistent with legal requirements, an MFT may deny a patient access to his or her own protected health information (PHI):

a. when access is reasonably likely to endanger the patient's life or physical safety. b. when access is reasonably likely to endanger the patient's mental health. c. when access is reasonably likely to endanger the patient's mental or physical health. d. under no circumstances. Feedback Answer A is correct: Because HIPAA provides greater access than does California law, HIPAA sets the standard for determining when access to PHI may be denied. HIPAA's Privacy Rule states that a provider may deny a patient access to his or her medical records when access is reasonably likely to endanger the life or physical safety of the patient or another person. The correct answer is: when access is reasonably likely to endanger the patient's life or physical safety. Question 91 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32673 The parents of an 11-year-old girl are going through a divorce. They have been married for 18 years, and the divorce has been a difficult one. The parents have been living apart for the past three months, and the daughter has been living with her mother. Most likely, the daughter:

a. will feel responsible for the divorce. b. will believe that the parent who left home no longer loves her. c. won't feel responsible for the divorce and will feel that her parent's marriage can be fixed. d. will feel abandoned by both parents. Feedback Answer C is correct: A child's age influences his or her perception of and reaction to divorce. Children aged nine to twelve usually recognize that their parents have changed and no longer love each other. However, they also tend to believe that whatever went wrong to cause the divorce can be remedied. Answer A is incorrect: Younger children, who are still egocentric, tend to believe the divorce is their fault. Answer B is incorrect: Three- to six-year-old children, who are extremely egocentric, not only often feel responsible for the divorce but also perceive that the parent who left home no longer loves them. Answer D is incorrect: Younger children (age 3 to 6) are less able to understand the reasons for divorce and, consequently, are more likely to blame themselves and to fear they will be abandoned by both parents. The correct answer is: won't feel responsible for the divorce and will feel that her parent's marriage can be fixed. Question 7 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

32931 You are a newly licensed MFT and are considering turning one of the bedrooms in your home into a therapy office. There is no problem with this arrangement, and it is considered safe and appropriate when:

a. you are mindful of the types of clients who may not be appropriately contained in this environment. b. you intend to move to a different office when it is financially feasible to do so. c. you have low fees that reflect your low costs. d. your theoretical orientation allows it. Feedback Answer A is correct: The use of one's home as a place to conduct therapy is not addressed by legal or ethical guidelines, so a good rule of thumb is to use sound clinical judgment and remain sensitive to the transference and boundary issues that might arise. This answer is most consistent with being alert to the possibility that some clients (e.g., those with attachment problems) may develop strong transference feelings when being seen in the therapist's home. Answer B is incorrect: This suggests that the only reason a therapist should have an office in his or her home is if he or she cannot afford to pay for office space elsewhere. That is not true. Answer C is incorrect: One's office space, whether it is in one's home or elsewhere, may or may not affect one's fees. Generally, you simply want your fees to be competitive and must make sure that they are fair to your clients. Answer D is incorrect: It's hard to think of a theoretical orientation that would specifically disallow a therapist to have a home office. Regardless of a therapist's approach to therapy, he or she would need to make sure that his or her office space is appropriate for the purpose of providing therapy and that he or she considers the needs of each client. The correct answer is: you are mindful of the types of clients who may not be appropriately contained in this environment. Question 66 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text

33142 Morgan, age 31, tested positive for HIV two months ago and, during a therapy session, reveals that he has not told his girlfriend about his condition and sometimes has unprotected sex with her. In this situation:

a. you must contact Morgan's girlfriend to inform her that Morgan is exposing her to HIV. b. you must contact Morgan's girlfriend to inform her that she may have been exposed to HIV but must not reveal Morgan's identity. c. you must contact Morgan's girlfriend to inform her that she may have been exposed to HIV but only if Morgan refuses to do so himself. d. you should maintain Morgan's confidentiality but inform him of the possible legal consequences of not telling his girlfriend about his HIV status. Feedback Answer D is correct: Whether you have a duty to protect in this situation is ambiguous, and, consequently, your best course of action would be to discuss the situation with a colleague or attorney to determine the best course of action. However, this is not given as a choice, so the best answer of those given is to maintain the client's confidentiality and inform him of the possible legal consequences of not telling his girlfriend about his HIV status: and C Section 120291 states that any person who exposes another person to HIV through unprotected sexual activity is guilty of a felony if that person knows he or she is infected, does not disclose his or her HIV-positive status, and acts with the intent to infect the other person with HIV. Answers A, B, & C are incorrect: Permission to inform the spouse or sexual partner of a person who has tested positive for HIV is granted in and C Section 121015. However, this statute applies to physicians and surgeons only, not to MFTs or other psychotherapists. The correct answer is: you should maintain Morgan's confidentiality but inform him of the possible legal consequences of not telling his girlfriend about his HIV status. Question 81 Correct Mark 1.00 out of 1.00 Not flaggedFlag question Question text