What does it mean to think systemically? And how do you demonstrate systemic thought on an exam?

These questions come from a prior edition of the official handbook for the National MFT Exam. Both questions are derived from the same case vignette.

A couple has been married for 1 ½ years and have a newborn baby. They seek therapy to deal with behavioral problems involving the mother’s three children from a previous marriage. The father angrily says that the children, 9, 12, and 16, mouth back at him and do not respect their mother’s authority. The couple has started having serious fights.

The therapist decides to focus initially on the times when the father has thought that the children were respecting their mother’s authority. The purpose of this focus is to help the:

1. Parents unite the marital dyad.
2. Father accept his role as a stepparent.
3. Parents feel hopeful about the situation.
4. Mother perceive her part in the interaction.

Which of the following statements should the therapist make to help the family perceive their complaints from a systems perspective?

1. “It is difficult to be a stepfather.”
2. “The children are having difficulty adapting to the new baby.”
3. “The marital relationship is being affected by your wife’s children.”
4. “You are experiencing a normal adjustment to becoming a stepfamily.”

Ben Caldwell Labs is now High Pass Education. Ben Caldwell's license exam prep programs are available here.

Intro/outro music: "Swampy Lands" by Adam Saban, licensed via Soundstripe.

Exam developers work diligently to produce what they believe to be strong, accurate exams. But just like everyone else, they occasionally make mistakes. What should you do when you read a question and you think, none of these answers sound right?

This question comes from the current edition of the official California LPCC Law & Ethics Exam Plan, available here.

During an initial session, a client tells the counselor that she is currently seeing another counselor. She expresses angry feelings toward the other counselor and would like to get another perspective on her problems. What action should the counselor take?

1. Contract a set number of sessions with the client before sending her back to her current counselor
2. Inform the client that she needs to terminate her ongoing therapy before the counselor can provide treatment
3. See the client until she makes up her mind which counselor she wants to have for therapy
4. Call the current counselor to inform him about the client’s desire to change counselors

Ben Caldwell Labs is now High Pass Education. Ben Caldwell's license exam prep programs are available here.

Intro/outro music: "Swampy Lands" by Adam Saban, licensed via Soundstripe.

What's your moral framework? That can heavily influence your clinical and ethical decision-making -- but it might not line up well with the approach you're being tested on. This episode is especially true to our title: In deciding right and wrong, to Think Like the Test means to think from a much more rule-based approach than how many clinicians actually work.

This question comes from prior edition of our book Preparing for the 2023 California Clinical Social Work Law & Ethics Exam.

Your client has health insurance, but the insurance carrier is refusing to cover the client’s therapy because she is seeing you for couple therapy and does not, in your assessment, qualify for a diagnosis of mental illness. You should:

1. Assess the client’s ability to advocate on her own behalf with the insurance company.
2. Offer to include an “insurance diagnosis” on the client’s paperwork to facilitate coverage.
3. Work with the client to develop an alternative plan for payment.
4. Discontinue therapy.

Ben Caldwell's license exam prep programs are available here.

Intro/outro music: "Swampy Lands" by Adam Saban, licensed via Soundstripe.