NCMHCE NCMHCE - National Clinical Mental Health Counseling Examination Family Systems and Couples Counseling 5

Question 1

A couples counselor is working with partners who fight constantly about household chores.
One partner states, 'You never appreciate anything I do.' According to the Gottman method, this is an example of:

Accepted Answer

Criticism

Answer

Contempt

Answer

Stonewalling

Answer

Defensiveness

Question 2

In contextual family therapy (Boszormenyi-Nagy), 'relational ethics' refers to:

Accepted Answer

The balance of fairness, obligations, and entitlements among family members across generations

Answer

The therapist's duty to maintain confidentiality with all family members equally

Answer

The ethical code governing co-therapy relationships

Answer

Rules about appropriate emotional boundaries in the therapeutic alliance

Question 3

A therapist working with a blended family notices that the stepparent attempts to discipline the biological children while the biological parent undercuts those efforts. The MOST systemic intervention is to:

Accepted Answer

Help the couple establish a unified parental alliance and clarify roles before enforcement

Answer

See the stepparent and biological parent separately to validate each perspective

Answer

Refer the children to individual therapy for adjustment issues

Answer

Educate the biological parent about the importance of consistent parenting

Question 4

During a couples session, one partner suddenly becomes silent, avoids eye contact, and gives monosyllabic answers. Gottman's research identifies this pattern as stonewalling, which physiologically is associated with:

Accepted Answer

Flooding—diffuse physiological arousal above 100 BPM

Answer

Parasympathetic dominance causing hypo-arousal

Answer

Vagal suppression causing emotional numbing

Answer

A dominant cortisol spike causing freeze response

Question 5

A family therapist using the Milan systemic approach introduces a question such as: 'If your mother were here, how do you think she would describe the relationship between your father and your sister?' This technique is called:

Accepted Answer

Circular questioning

Answer

Hypothetical future questioning

Answer

Reflexive questioning

Answer

Externalizing questioning

Question 6

A counselor assesses a couple using the PREPARE/ENRICH inventory. The PRIMARY purpose of this assessment is to:

Accepted Answer

Identify relationship strengths and growth areas to guide psychoeducation and skill-building

Answer

Diagnose relational disorders according to DSM-5 criteria

Answer

Determine whether the couple is appropriate for conjoint versus individual therapy

Answer

Measure attachment style to guide EFT treatment planning

Question 7

A Latino couple seeks therapy, and the husband states he makes all major family decisions as the head of the household. A culturally competent family therapist SHOULD:

Accepted Answer

Explore whether this structure is ego-syntonic for both partners and consistent with their cultural values

Answer

Challenge the patriarchal structure as inherently harmful to the wife's autonomy

Answer

Reframe the wife's deference as a trauma response requiring individual therapy

Answer

Apply structural family therapy to immediately realign the power hierarchy