Deck 7: Intergenerational and Psychoanalytic Family Therapies

Question 1

Differentiation is measured along a continuum that ranges from 1 to 100, with lower levels of differentiation represented by lower numbers. Bowen believed that the average person or people rarely reached higher than what on this scale?

A) 50
B) 95
C) 70
D) 65

Answer 1

C

Question 2

Object relations family therapy, family-of-origin therapy, and contextual therapy share several key concepts and practices. They include each of the following EXCEPT:

A) examining a client's early relationships to understand present functioning.
B) tracing transgenerational and extended family dynamics to understand a client's complaints.
C) promoting insight into extended family dynamics to facilitate change.
D) focusing on the nature of being human rather than families or family therapy.

Answer 2

D

Question 3

The greater the therapist's level of differentiation, the better able the therapist is to maintain a nonanxious presence with clients. A nonanxious presence refers to:

A) a therapist who does not overreact to strong emotion and is able to reflect before reacting.
B) a therapist who is free and clear from any and all mental problems.
C) a therapist who works better when his/her own emotions run high and who is aware of any countertransference.
D) a therapist who maintains a cold and detached stance that allows the clients to fully explore themselves without the influence of the therapist.

Answer 3

A

Question 4

Differentiation is one of the most useful concepts for understanding interpersonal relationships. Which of the following statements is true?

A) Differentiation refers to a person's ability to separate intrapersonal and interpersonal distress.
B) Differentiation is the ability to balance two life forces: the need for togetherness and the need for autonomy.
C) Differentiation is a lifelong journey that is colloquially referred to as "maturity" in the broadest sense.
D) All of these are correct.

Question 5

A key concept in Bowen's intergenerational theory is the therapist's use of which of the following?

A) Techniques
B) Self
C) Interventions
D) Coaching

Question 6

Intergenerational therapists focus squarely on a family's unique __________ rather than on environmental or general cultural factors, and they seek to identify the rules that structure the particular system.

A) interactive system
B) external system
C) self-esteem system
D) emotional system

Question 7

When working with a family, an intergenerational therapist can only accurately "see" what is going on in the family or clearly conceptualize family dynamics if they are:

A) anxious.
B) differentiated.
C) emotionally distant.
D) disengaged.

Question 8

A Bowenian therapist asks a client, "How do the struggles you are experiencing with your wife now compare to the struggles your own parents had? Are they similar or different?" The therapist is asking which type of questions?

A) Projection questions
B) Protection questions
C) Process questions
D) Proactive questions

Question 9

When an intergenerational therapist maintains an emotionally engaged stance that is nonreactive-meaning that the therapist does not react to attacks, "bad" news, and so forth without careful reflection-this is known as:

A) a detached presence.
B) a non-caring presence.
C) an emotional presence.
D) a nonanxious presence.

Question 10

When a family lacks sufficient differentiation, it may become emotionally fused. An undifferentiated family may become a(n):

A) ego mass.
B) mess.
C) cell.
D) nucleus.

Question 11

The father of a family in therapy complains that his wife is so involved with their children-always running them back and forth to school, sports practices, dance recitals, and attending PTA meetings-that he never sees her. When he does see his wife, they fight. According to a Bowen intergenerational therapist, this might be considered a classic example of:

A) differentiation.
B) emotional triangle.
C) emotional cutoff.
D) regression.

Question 12

In the hands of an intergenerational therapist, the genogram is used simultaneously as:

A) a way to help the family implement new patterns individually and as a family.
B) a way to map out family medical complications and how each affected the family.
C) an assessment instrument and intervention.
D) an intervention and tool for the closing phase of therapy.

Question 13

Which of the following refers to situations in which a person no longer emotionally engages with another in order to manage anxiety?

A) Differentiation
B) Emotional triangle
C) Emotional cutoff
D) Regression

Question 14

Which of the following does NOT accurately describe a differentiated person?

A) A person who is differentiated is better able to handle the ups and downs of life
B) A person who is differentiated has the ability to separate feelings and self from others
C) A person who is differentiated lacks emotion or emotional expression in emotional situations
D) A person who is differentiated does not immediately react in emotional situations

Question 15

Which of the following statements is TRUE about the intergenerational therapy goal to decrease emotional reactivity to chronic anxiety in the system?

A) As differentiation increases, anxiety decreases.
B) As anxiety increases, differentiation increases.
C) As emotional cutoff increases, differentiation increases.
D) As emotional cutoff increases, anxiety decreases.

Question 16

Intergenerational therapists focus on developing a therapeutic relationship that encourages all parties to further their differentiation process. What does this mean?

A) Intergenerational therapists believe that clients are in charge of the therapeutic process
B) Intergenerational therapists believe that clients can only differentiate as much as their therapists have differentiated
C) Intergenerational therapists believe that the differentiation of the client is the technique
D) Intergenerational therapists believe that they must take sides with the most differentiated family member

Question 17

From the perspective of an intergenerational therapist, which of the following is NOT true of a triangle?

A) A triangle is a stabilizing unit for the primary dyad
B) A triangle is a process in which a dyad draws in a third person or thing
C) A triangle is a healthy way to relieve tension
D) A triangle is a fundamental process in natural systems

Question 18

What is a genogram?

A) A genealogy covering the complete history of a family
B) A type of self report and discovery of family secrets
C) A type of family tree that specifically maps key multigenerational processes
D) A complete medical history of a family

Question 19

Like any theory with a definition of health, intergenerational therapy has clearly-defined, long-term therapeutic goals that can be used with all clients. Which one of the following fits for this theory?

A) Congruent communication for all family members
B) Effective parental hierarchy and the severing of cross-generational coalitions
C) Promote personal growth: support the completion of developmental tasks for all family members
D) Increase each person's level of differentiation (in specific contexts)

Question 20

Jordin, an intergenerational therapist, is working with a mom and daughter in therapy. The mom feels extremely guilty about her daughter's lack of social success in college. The mom, therefore remains very involved and emotionally reactive in her daughter's life, even though her daughter is living in the dorms in another town. How might Jordin view the mother's reactivity?

A) As low self-esteem
B) As chronic anxiety
C) As a paradox
D) As healthy

Question 21

Whether working with an individual, couple, or family, most therapists at some point will be "invited" by clients to triangulate with them against a third party who may or may not be present in the room. To be effective, the therapist must maintain therapeutic neutrality in order to interrupt a client's attempt to involve the therapist or someone else in a triangle. This ability to be neutral is also known as:

A) chronic anxiety.
B) regression.
C) differentiation.
D) validation.

Question 22

Nathan and Alexander, a couple who have been in a relationship for seven years, complain of a lack of communication and a dissatisfying intimate life. Nathan says he wants more emotional and physical intimacy with Alexander, but that Alexander is happy with cuddling on the couch or doing activities such as gardening together. Alexander complains that their closeness is never enough for Nathan and that he often feels pressured to do more to make Nathan happy. David, a Bowenian therapist, might use which type of intervention with this couple to promote Nathan and Alexander differentiating more and taking responsibility for their individual needs?

A) Teaching each person to self-soothe rather than demand that the other change
B) Hugging to relax and working with the couple to be "seen" by each other
C) Creating a genogram to identify patterns and alternative ways for relating to each other
D) All of these are correct

Question 23

According to Boszormenyi-Nagy, families use which system to maintain trustworthiness, fairness, and loyalty between family members (its breakdown results in individual and/or relational symptoms)?

A) Mechanical
B) Ethical
C) Electrical
D) Debt

Question 24

When therapists encourage clients to interact with family members while maintaining a clearer boundary between self and other, this is an example of what therapeutic technique?

A) Detriangulation
B) Relational experiments
C) Going home again
D) Genograms

Question 25

According to Framo, what are parental interjects?

A) The internalized negative aspects of parents
B) When clients defend against anxiety by projecting certain split-off or unwanted parts of themselves onto another person
C) Anxiety that is repressed when a child experiences separation from their primary caregiver
D) Transference from one family member to another family member

Question 26

A therapist works with a couple where partner A sees partner B as "perfect" in the early parts of the relationship. When partner B no longer conforms to expectations, however, partner B becomes the enemy. The therapist might call this:

A) interlocking pathologies.
B) self-object relating.
C) splitting.
D) projective identification.

Question 27

In psychoanalytic family therapy, when the therapist dismisses the symptomatic child from therapy and proceeds to work with the couple to address the issues that created the need for the child's symptoms, the therapist is doing what type of intervention?

A) Interpreting
B) Detriangulating
C) Working through
D) Eliciting

Question 28

Which therapist developed a three-stage model for working with couples that involved couples therapy, couples group therapy, and family of origin therapy?

A) Boszormenyi-Nagy
B) Framo
C) Ackerman
D) Sharff

Question 29

What does the concept of multidirected partiality in contextual family therapy mean?

A) The therapist must be accountable to extended family members not in the therapy room
B) The therapist must be accountable to monstrous family members
C) The therapist must be accountable to the youngest family members
D) All of these are correct

Question 30

Which of the following statements is TRUE about research and the evidence base for Bowenian and psychoanalytic therapies?

A) Research is needed on the outcomes and effectiveness of Bowen and psychoanalytic family therapies so that these models can be refined and further developed.
B) Research shows support for Bowen's assumption that people marry a person with a similar level of differentiation.
C) Research does not support the relation between differentiation and (a) chronic anxiety, (b) marital satisfaction, and (c) psychological distress.
D) Research does not support the therapeutic alliance and therapeutic outcome from the therapist's relationship with his or her parents, discrediting the Bowenian emphasis on the self-of-the-therapist.

Question 31

Which of the following is considered one of the main components of Schnarch's sexual crucible model of marriage?

A) Marriage functions as a vessel that physically contains a volatile transformational process
B) The contents of marriage must be let loose because they are unstable and explosive
C) Schnarch directs partners to soothe each other rather than retreat to accommodate their individual needs
D) All of these are correct

Question 32

In the Bowenian approach, how does the therapist address the pathologizing interpersonal pattern (PIP) to resolve issues among families?

A) The therapist asks how the lack of sibling hierarchy is expressing itself
B) Bowenian therapists would conceptualize not just the PIPs the couple presents as a problem, but also the PIPs in each family of origin
C) The focus is on how conflict is managed and the level of hierarchy in these cycles
D) All of these are correct

Question 33

Which of the following statements is TRUE about the nature of the therapeutic relationship in contextual family therapy?

A) Therapists are viewed as neutral blank screens.
B) Therapists keep their own feelings and expressions of empathy at bay.
C) Therapists are relationally-focused, creating a relationship they call the holding environment.
D) Therapists do not handle therapy arrangements; they leave that to the receptionist.

Question 34

Which classic psychoanalytic concept refers to when a client projects onto the therapist attributes that stem from unresolved issues with primary caregivers (therapists use the immediacy of these interactions to promote client insight)?

A) Countertransference
B) Transference
C) Protection
D) Centered holding

Question 35

Which of the following would NOT be considered a goal in psychoanalytic therapy?

A) Increase autonomy and ego-directed action by making conscious processes unconscious
B) Decrease interactions based on projections or a revolving slate of entitlements
C) Increase capacity for intimacy without loss of self (fusion with object)
D) Develop reciprocal commitments that include a fair balance of entitlements and indebtedness

Question 36

Which of the following statements is true regarding immigration and intergenerational conflict?

A) Intergenerational cultural conflict is correlated with acculturation mismatch between parents and children.
B) Intergenerational conflict related to acculturation is significantly correlated with internalizing symptoms.
C) Higher levels of perceived discrimination were associated with more intergenerational conflict among Asian immigrant families.
D) All of these are correct.

Question 37

Which intervention is designed to interrupt triangulation by increasing direct communication between the dyad experiencing problems or to reverse pursuer-distancer dynamics?

A) Relational experiments
B) Communication experiments
C) Acting "as if" experiments
D) Family attachment experiments

Question 38

Minority groups who prefer action and concrete suggestions from therapists may have difficulty with Bowen intergenerational and psychoanalytic therapies. Which one of the following reasons FALSELY reflects the risks?

A) These therapies are aimed at "thinking"-or psychologically-minded-clients, which minority groups are not
B) The therapist may use inappropriate cultural norms to analyze family dynamics, thereby imposing a set of values and beliefs that are at odds with the minority clients' culture
C) The therapist will assume that attachment in all cultures looks the same and the minority client may be inaccurately and unfairly evaluated
D) The therapist may expect minority clients to conform to common cultural norms

Question 39

Which of the following is true regarding sibling position within families?

A) The oldest child is generally the least likely to avoid responsibility in favor of freedom
B) More often, later born children identify with responsibility and authority
C) The more the family members exhibit expected characteristics of their sibling position, the lower the level of differentiation
D) The more the family members exhibit expected characteristics of their sibling position, the higher the level of differentiation

Question 40

The Women's Project was developed to promote a greater awareness of women's issues in the field of family therapy. Which of the following is one suggestion for how family therapists can reduce sexism in their work with couples and families?

A) Openly discuss the gender role expectations of each partner and parent and point out areas where the couple or family should increase those traditional roles
B) Encourage men to take time for themselves to avoid losing their individual identity to the roles of husband and father
C) Use the self-of-the-therapist to model an attitude of gender equality
D) Push women to take on equal responsibility in family relationships and the household, as well as for scheduling therapy, attending therapy with children, and/or arranging for babysitting for couples sessions

Question 41

Therapists should pay particular attention to the role of friendship relationships with LGBTQ clients, also known as:

A) extended kinship circles.
B) families of choice.
C) families of circumstance.
D) extended community ties.