MFT Couples Therapy 3 — Questions and Answers
Question 1: According to Gottman's Sound Relationship House theory, 'turning toward' bids for connection is most closely associated with which floor of the house?
- Shared meaning
- Trust and commitment
- Emotional bank account and fondness/admiration
- Responding to bids for emotional connection (Correct answer)
Correct answer: Responding to bids for emotional connection
Turning toward bids is the third floor of the Sound Relationship House, representing the habitual daily moments of emotional connection that build relationship trust.
Question 2: A couple reports low sexual frequency. One partner was raised in a religious household with shame around sexuality. The most clinically appropriate first step is:
- Prescribe sensate focus exercises immediately
- Conduct a thorough sexual history and explore each partner's sexual scripts (Correct answer)
- Refer to a sex therapist without further assessment
- Normalize the pattern as a common result of relationship aging
Correct answer: Conduct a thorough sexual history and explore each partner's sexual scripts
Before any intervention, the therapist must understand each partner's sexual history, values, and scripts — particularly shame-based beliefs — to tailor treatment appropriately.
Question 3: In Structural Family Therapy applied to couples, the concept of 'enmeshment' refers to:
- Rigid boundaries that prevent adequate emotional contact between partners
- Diffuse boundaries where partners have lost individual autonomy and identity (Correct answer)
- Hierarchical inversions where the couple defers to extended family
- Triangulation of children into marital conflict
Correct answer: Diffuse boundaries where partners have lost individual autonomy and identity
Enmeshment in Minuchin's structural model describes overly diffuse boundaries where individual identities merge, limiting healthy differentiation.
Question 4: A therapist notices that whenever one partner raises a complaint, the other immediately launches a counter-complaint. This pattern is best described as:
- Stonewalling
- Cross-complaining or counter-attacking (Correct answer)
- Belligerence
- Contempt
Correct answer: Cross-complaining or counter-attacking
Cross-complaining is a counter-productive conflict pattern where one partner deflects a legitimate complaint by immediately raising their own grievance, preventing resolution.
Question 5: Which approach to couples therapy uses 'enactments' as a primary in-session technique?
- Cognitive-Behavioral Couples Therapy (CBCT)
- Structural Family Therapy (Correct answer)
- Emotionally Focused Therapy (EFT)
- Gottman Method
Correct answer: Structural Family Therapy
Minuchin's Structural Family Therapy uses enactments — having the couple enact their typical interaction in session — so the therapist can observe and restructure the pattern directly.
Question 6: A couple in therapy discloses that one partner had an affair 2 years ago. The betrayed partner continues to bring it up during conflicts. The therapist's priority should be:
- Redirect the couple away from the affair to present-day communication skills
- Assess whether both partners are committed to rebuilding trust before proceeding (Correct answer)
- Immediately refer the couple for individual therapy before couples work
- Focus on the betraying partner's attachment wounds that caused the affair
Correct answer: Assess whether both partners are committed to rebuilding trust before proceeding
Before applying any specific treatment, the therapist must assess whether both partners genuinely want to repair the relationship, as commitment to recovery is foundational.
Question 7: In Integrative Behavioral Couples Therapy (IBCT), 'unified detachment' is a technique designed to:
- Help partners observe their conflict pattern from a calm, descriptive distance without blame (Correct answer)
- Teach partners to detach emotionally from each other to reduce dependency
- Increase acceptance of each other's negative behaviors through distancing
- Reduce emotional reactivity by suppressing emotional expression during conflict
Correct answer: Help partners observe their conflict pattern from a calm, descriptive distance without blame
Unified detachment helps couples step outside their conflict pattern and describe it objectively together, transforming a divisive 'you vs. me' issue into a shared problem to solve.
MFT Couples Therapy 3
According to Gottman's Sound Relationship House theory, 'turning toward' bids for connection is most closely associated with which floor of the house?