MFT Child and Adolescent Therapy 3 — Questions and Answers
Question 1: A school-age child with ADHD frequently disrupts family sessions. Which systemic intervention is most appropriate to address this first?
- Remove the child from sessions until behavior improves
- Explore how the family system may be reinforcing the disruptive behavior (Correct answer)
- Refer immediately for a medication evaluation
- Use time-out in the waiting room as a consequence
Correct answer: Explore how the family system may be reinforcing the disruptive behavior
A systemic perspective examines how family patterns and responses may inadvertently maintain the child's disruptive behavior.
Question 2: A therapist notices a 10-year-old client's drawings consistently show adult figures with exaggerated genitalia. The therapist's priority action is to:
- Discuss the drawings openly in the next group session
- Conduct a structured assessment for possible sexual abuse (Correct answer)
- Normalize the drawings as age-appropriate curiosity
- Immediately notify the school principal
Correct answer: Conduct a structured assessment for possible sexual abuse
Sexualized content in a child's play or drawings is a recognized indicator that warrants a thorough clinical assessment for possible sexual abuse.
Question 3: Dialectical Behavior Therapy for Adolescents (DBT-A) differs from standard adult DBT primarily by:
- Eliminating the skills training component
- Including a family skills training module and adapting the skills for developmental level (Correct answer)
- Focusing exclusively on mindfulness without behavior chain analysis
- Using pharmacotherapy as the primary intervention
Correct answer: Including a family skills training module and adapting the skills for developmental level
DBT-A adds a family component and uses developmentally appropriate language and shorter skill modules while retaining the standard DBT structure.
Question 4: According to attachment theory, a child who seeks proximity when distressed but is not easily soothed and shows anger toward the caregiver upon reunion displays which attachment style?
- Secure attachment
- Avoidant (insecure-avoidant) attachment
- Anxious-ambivalent (resistant) attachment (Correct answer)
- Disorganized attachment
Correct answer: Anxious-ambivalent (resistant) attachment
Anxious-ambivalent attachment is characterized by heightened distress, difficulty being soothed, and ambivalent behavior (anger and clinging) toward the caregiver.
Question 5: A 16-year-old client tells the therapist she is planning to run away to avoid returning home but denies plans to harm herself. The MFT's most appropriate response is to:
- Immediately hospitalize the client under a psychiatric hold
- Explore the function of the plan and assess for underlying safety concerns (Correct answer)
- Inform the parents without any further assessment
- Document and take no immediate action
Correct answer: Explore the function of the plan and assess for underlying safety concerns
Running away is a safety concern requiring thorough exploration of triggers, risks, and home environment before determining next steps.
Question 6: Which play therapy technique involves the therapist actively joining the child's play and mirroring their actions to build rapport?
- Cognitive restructuring through play
- Tracking and reflection of play content (Correct answer)
- Limit setting
- Therapeutic storytelling
Correct answer: Tracking and reflection of play content
Tracking involves narrating and reflecting the child's play actions, demonstrating attention and attunement, which builds the therapeutic relationship.
Question 7: An MFT using a narrative therapy approach with a depressed adolescent would most likely employ which technique?
- Systematic desensitization to feared social situations
- Externalizing the problem by separating the adolescent's identity from depression (Correct answer)
- Identifying cognitive distortions using a thought record
- Prescribing paradoxical tasks to disrupt problem patterns
Correct answer: Externalizing the problem by separating the adolescent's identity from depression
Externalizing the problem is a core narrative technique that helps clients see the problem (e.g., 'Depression') as separate from their identity.
MFT Child and Adolescent Therapy 3
A school-age child with ADHD frequently disrupts family sessions.
Which systemic intervention is most appropriate to address this first?