MFT Couples Therapy 5 — Questions and Answers
Question 1: In sensate focus (Masters and Johnson), the initial phase specifically requires couples to:
- Engage in sexual intercourse with mindful awareness
- Take turns giving and receiving non-genital touch without performance expectations (Correct answer)
- Communicate sexual preferences verbally before physical contact
- Practice synchronized breathing to build nervous system co-regulation
Correct answer: Take turns giving and receiving non-genital touch without performance expectations
Early sensate focus deliberately removes performance pressure by banning intercourse and focusing on non-genital touch, allowing partners to rediscover pleasure without anxiety.
Question 2: A couple presents where one partner experienced childhood emotional neglect. In session, they frequently intellectualize and minimize their partner's emotional expression. The EFT therapist would most likely:
- Challenge the intellectualization as a cognitive distortion
- Use evocative responding and heightening to access underlying primary emotions beneath the defense (Correct answer)
- Assign a homework exercise requiring emotional journaling between sessions
- Reframe the intellectualization as a strength that balances the couple's dynamic
Correct answer: Use evocative responding and heightening to access underlying primary emotions beneath the defense
EFT therapists use evocative questioning and heightening to bypass secondary responses (like intellectualization) and access the primary attachment emotions underneath.
Question 3: According to Gottman, which of the Four Horsemen is the BEST predictor of relationship dissolution?
- Criticism
- Defensiveness
- Contempt (Correct answer)
- Stonewalling
Correct answer: Contempt
Gottman's longitudinal research identified contempt — which communicates superiority and disgust — as the single strongest predictor of divorce.
Question 4: A therapist is working with a couple from a collectivist cultural background. The partners prioritize family harmony over individual expression. The culturally competent therapist should:
- Educate the couple about the importance of direct communication for healthy relationships
- Adapt the therapeutic framework to honor collectivist values rather than imposing individualistic norms (Correct answer)
- Refer to an ethnic-specific therapist as the only appropriate option
- Focus exclusively on structural interventions to avoid cultural bias
Correct answer: Adapt the therapeutic framework to honor collectivist values rather than imposing individualistic norms
Cultural competence requires adapting therapeutic models to fit the couple's values — collectivist couples may communicate indirectly, and this is a cultural strength, not a deficit.
Question 5: During a couples session, a husband discloses that his wife physically hit him last month. The wife denies it. The therapist's FIRST responsibility is to:
- Maintain neutrality and gather more information from both sides equally
- Conduct a safety assessment and determine whether conjoint therapy is appropriate to continue (Correct answer)
- Ask the couple to complete a violence screening tool together at home
- Reframe the incident as mutual conflict and work on de-escalation skills
Correct answer: Conduct a safety assessment and determine whether conjoint therapy is appropriate to continue
Disclosure of physical violence requires immediate safety assessment; the therapist must determine risk level and whether continuing conjoint sessions is safe and appropriate.
Question 6: The 'demand-withdraw' pattern in couples research is most strongly associated with:
- Increased relationship satisfaction when one partner is highly motivated
- Poor conflict resolution outcomes and reduced relationship satisfaction (Correct answer)
- Secure attachment in both partners seeking closeness in different ways
- Cultural differences in communication style rather than relational dysfunction
Correct answer: Poor conflict resolution outcomes and reduced relationship satisfaction
Research consistently links demand-withdraw patterns to lower relationship satisfaction, higher distress, and reduced intimacy over time.
Question 7: A couple reports they have 'tried everything' and are considering separation. The therapist notices they still laugh together and show occasional positive affect. Clinically, this is most relevant because:
- It indicates the couple is minimizing the severity of their problems
- Residual positive sentiment and humor are associated with better prognosis in couples therapy (Correct answer)
- It suggests one partner is avoiding honest disclosure of dissatisfaction
- Positive affect in distressed couples is typically a defense mechanism
Correct answer: Residual positive sentiment and humor are associated with better prognosis in couples therapy
Gottman's research shows that couples who retain capacity for humor and positive interaction, even during distress, have better prognosis and are more responsive to intervention.
MFT Couples Therapy 5
In sensate focus (Masters and Johnson), the initial phase specifically requires couples to: