Assessment & Case Conceptualization
Define what is meant by a "multisystemic assessment" in marriage and family therapy.
A multisystemic assessment is a comprehensive evaluation that examines how problems develop and are maintained across interconnected systems.
Therapists should create goals that are SMART. What do the letters in the acronym SMART mean?
Specific, Measurable, Achievable, Relevant, Time-based
Identify two interventions commonly used in Structural Family Therapy.
Structural Family Therapy commonly uses: joining (to build therapeutic alliance and reduce resistance), and boundary making (to clarify and realign diffuse, rigid, or enmeshed subsystems).
What skills does a therapist utilize to help maintain cultural sensitivity?
Practice cultural humility
eliciting client explanatory models,
asking open, curious, non‑pathologizing questions
adapting language/techniques.
This process involves using standardized measures, client‑reported progress, and observable changes in interactional patterns to determine whether treatment goals have been met and whether the family is ready to transition to termination.
What is evaluating treatment outcomes?
When conducting a genogram-based assessment, what specific family patterns should clinicians look for to inform a treatment approach?
Look for intergenerational patterns: alliances, cutoffs, triangles, repeated roles, emotional distance, and transmission of trauma or conflict.
According to the Strategic model what does "Prescribing the symptom" mean?
A paradoxical intervention where the therapist instructs the client or family to intentionally engage in or exaggerate the behavior they identify as problematic in order to gain control over it.
What is enactment, and how can a therapist use it to identify maladaptive interactional patterns in a family session?
Enactment is a technique in which the therapist invites family members to interact with each other in session so their natural patterns emerge. The therapist observes the sequence, identifies maladaptive structures, and intervenes to shift boundaries or realign subsystems.
What ethical issues arise when treating families with conflicting wishes about treatment (e.g., one partner wants to continue, another wants to end)?
Ethical issues: autonomy, informed consent, confidentiality, competence, clarity of treatment goals, managing power imbalances, & therapist neutrality.
Therapists use this type of assessment at the beginning and end of treatment to compare baseline functioning with post‑treatment outcomes.
What is a pre‑post assessment?
Explain how circular questioning differs from linear questioning.
Circular questioning explores how each person’s behavior affects others in the system, while linear questioning focuses on cause‑and‑effect within an individual.
A Solution-Focused therapist might ask what type of question in order to track progress?
What is scaling questions?
This narrative therapy intervention invites clients to separate themselves from the problem by naming it and describing how it influences their lives, allowing them to identify moments when they resist its effects.
What is externalization?
A client discloses traditional healing practices that conflict with evidence-based recommendations. How should an MFT proceed in order to be ethically and culturally responsive?
Respect and inquire about the practice, assess for harm, negotiate integration (e.g., combining medical recommendations with safe traditional practices), obtain consent, consult cultural informants.
This termination task helps families anticipate future challenges and maintain gains by identifying strategies they can use without the therapist.
What is a relapse‑prevention plan?
When tension arises between two people and they join another person into system, which may prevent direct resolution of the problem. Also known as the smallest stable unit in a family.
What is Triangulation?
List the 3 EFT stages for a couple presenting with chronic conflict and low emotional attunement.
1. Early sessions focus on de‑escalation and establishing safety in communication, followed by identifying and interrupting negative interactional cycles. 2. Later sessions build emotional attunement through structured bonding exercises. 3. Final sessions consolidate new patterns and relapse‑prevention strategies.
This intervention from the Circumplex Model helps families shift toward balanced functioning by increasing flexibility or cohesion through structured tasks such as role‑switching, shared decision‑making, or planned family rituals.
What are balanced‑promoting interventions?
Discuss confidentiality limits in family therapy when multiple family members attend sessions. Provide an approach to informed consent that clarifies these limits.
Clarify at outset who the primary client(s) are, explain confidentiality limits (e.g., information may be shared in joint sessions), obtain signed informed consent that notes multiple-attendee complexities, offer individual sessions to protect privacy.
This ethical step is required when ending treatment, ensuring clients understand why therapy is concluding and what options are available next.
What is providing informed termination?
Provide one example of a circular question a therapist might ask to assess relational patterns
A circular question might be: “When ______ withdraws, how does ____ typically respond, and how does her response then affect him?”
What are the steps of risk management (e.g., imminent harm, abuse) that a therapist might incorporate into a treatment plan?
Document safety concerns, creating a clear safety plan, coordinating with appropriate protective or emergency services when needed, and integrating these steps into ongoing treatment without abandoning the couple or family.
This Imago intervention structures partner dialogue into intentional speaking and empathic listening, helping couples reduce reactivity, increase safety, and transform conflict into connection.
What is the Imago Dialogue?
This ethical principle guides therapists to decline or terminate treatment when overlapping roles could impair competence or create divided loyalties, even when cultural expectations encourage closeness.
What is non‑maleficence?
This type of measure tracks client‑reported changes in symptoms, functioning, or relationship satisfaction across sessions to determine treatment effectiveness
What are outcome measures?