The MFT exam, the national LMFT licensing test

A couple argues in session about whose turn it was to pay a bill. The therapist says, "I notice that when you raise your voice, she goes quiet, and then you get louder." The therapist is focusing on

1. process rather than content
   Naming the sequence (he raises his voice, she goes quiet, he gets louder) is attention to process: how the couple interacts, regardless of the topic.
2. content rather than process
   Content would be the bill itself, whose turn it was to pay; the therapist's remark says nothing about the bill.
3. a positive connotation of the conflict
   Positive connotation (Milan) ascribes a benevolent purpose to each person's behavior; the therapist here only describes the sequence and assigns no motive.
4. an exception to the problem
   An exception is a solution-focused search for times the problem did not happen; this remark describes the problem pattern while it is happening.

A therapist is formulating a hypothesis about a 9-year-old's disruptive behavior in class. Which statement BEST illustrates circular causality?

1. The divorce reduced supervision, which lowered his grades, which then led to more classroom outbursts.
   Divorce, then less supervision, then grades, then outbursts is a longer chain, but it never feeds back to its first link, so it remains linear causality.
2. Inconsistent discipline at home is directly causing his outbursts in the classroom.
   Blaming inconsistent discipline as the direct cause is a single cause producing a single effect: a textbook linear explanation.
3. His outbursts bring teacher criticism, which upsets his parents, whose tension fuels more outbursts.
   This loop returns to its start: outbursts bring criticism, criticism raises parental tension, and that tension feeds the next outburst, which is what circular causality means.
4. His impulsive temperament causes outbursts, which in turn cause criticism from his teacher.
   Temperament causing outbursts that cause criticism runs one way only; the criticism is never shown to feed back into more outbursts, so the chain stays linear.

At the final session with a family who came in because of their 10-year-old's tantrums, the therapist's closing remarks should MOST emphasize:

1. the techniques that worked in therapy.
   Highlighting the techniques credits the therapist's tools rather than the family, which weakens the family's ownership of the change.
2. each member's part in the changes made.
   Crediting each member's part treats the change as a property of the whole family system, which makes it more likely to hold after therapy ends.
3. the child's improved self-control.
   Focusing on the child's self-control puts him back in the identified-patient role, as if the change happened only inside him.
4. the parents' improved discipline skills.
   Praising only the parents' discipline narrows the change to one subsystem and leaves out the child's and other members' contributions.

A therapist's primary aim is to help each family member raise self-esteem and communicate congruently, using sculpting and family reconstruction. This therapist is MOST likely following:

1. Bowen family systems theory
   Bowen therapy aims at differentiation of self and lower anxiety through calm, coached work on the family of origin, not experiential sculpting.
2. The MRI brief therapy model
   The MRI brief model targets the attempted solutions that keep a problem going; self-esteem and family reconstruction are not part of it.
3. Minuchin's structural approach
   Minuchin's structural therapy aims at boundaries, subsystems and hierarchy through joining, enactment and unbalancing, not self-esteem or sculpting.
4. Satir's human validation model
   Raising self-esteem, congruent communication, sculpting and family reconstruction are signatures of Virginia Satir's human validation process model.