Deck 5: Structural Family Therapies

Question 1

When a structural family therapist joins the family system, they are:

A) becoming member of the family.
B) agreeing with the family.
C) accommodating the family's style.
D) processing the family's problems.

Answer 1

C

Question 2

According to Minuchin, therapists must use themselves to relate to the family, varying from being highly involved to professionally detached. Which of the following words best fits with this description?

A) Rigid
B) Selfless
C) Permeable
D) Flexible

Answer 2

D

Question 3

When working with enmeshed and diffused boundaries, a structural therapist will primarily see which of the following in the family's interactions?

A) Family members insisting on high levels of protectiveness or appearing to be over concerned
B) Significant freedom for most family members to do as they please
C) Few demands for - or expressions of - family loyalty and commitment
D) Family members' lack of reaction and few repercussions, even to problems

Answer 3

A

Question 4

It is not uncommon for an insufficient parental hierarchy to lead to which of the following outcomes?

A) Disengaged family boundaries
B) Enmeshed family boundaries
C) Appropriate family boundaries
D) Invested family boundaries

Question 5

The parents of a 13-year-old girl allow their daughter to have a cell phone. They put in place certain rules for its use such as her homework must be done before using it, and it must be turned off by 9:00 p.m. This could be considered an example of what type of parental hierarchy?

A) Effective
B) Insufficient
C) Excessive
D) All of these are correct

Question 6

The over/underfunctioner, the good/bad child, the understanding/strict parent, the logical/emotional partner, and so forth are examples of what type of patterns?

A) Symmetrical
B) Asymmetrical
C) Complementary
D) Adaptable

Question 7

Minuchin preferred __________ to talking about interactions because often people describe themselves as one way but behave quite differently. This allowed Minuchin to see the family in action.

A) reframes
B) boundaries
C) enactments
D) one-way mirrors

Question 8

Minuchin conceptualized a family as a single system that also had multiple subsystems . Some subsystems can be found in almost every family. Which of the following would NOT be considered a subsystem?

A) Couple
B) Parents
C) Sibling
D) Pets

Question 9

Boundaries are rules for managing physical and psychological distance between family members, and defining the regulation of closeness, distance, hierarchy, and family roles. Which of the following is the best definition for a boundary?

A) Families with overly diffuse boundaries do not make a clear distinction between members, creating a strong sense of mutuality and connection at the expense of individual autonomy.
B) Autonomy and independence are emphasized at the expense of emotional connection, creating isolation that may be more emotional than physical.
C) Boundaries allow for close emotional contact with others while simultaneously allowing each person to maintain a sense of identity and differentiation.
D) None of these is correct.

Question 10

Minuchin describes three main phases of structural therapy. What are they?

A) Joining the family, mapping the structure, and transforming the structure
B) Boundary-making, establishing hierarchy, and creating subsystems
C) Joining the family, boundary-making, and creating subsystems
D) Mapping the structure, family reenactment, and processing the outcome

Question 11

Which of the following best defines a cross-generational coalition?

A) The children form an alliance against the parents
B) A subsystem is formed between a parent and child against the other parent
C) A subsystem is formed between members of one generation against members of another (i.e., grandparents vs. children)
D) A conflict is formed between the parents in the upbringing of their child

Question 12

Structural therapists strive to cultivate therapeutic spontaneity. What is this referring to?

A) The therapist doing as they please with their clients
B) The therapist "flying by the seat of their pants" when working with clients
C) The therapist flowing naturally and authentically in a variety of contexts and situations
D) The therapist avoiding being natural in clinical situations

Question 13

After assessing the family structure, what is the goal for structural therapists?

A) Make the family's boundaries more rigid to promote a better structure
B) Realign the system's boundaries and hierarchy
C) Repair the emotional damage by encouraging more diffuse boundaries
D) Introduce a new pattern of behavior to promote a "new dance" for the system

Question 14

According to the author of the text, structural family therapists map:

A) the road home.
B) family structure.
C) happiness.
D) mental health.

Question 15

Enactments allow the structural therapist to do each of the following EXCEPT:

A) to discover the family's rules and assumptions.
B) to develop a hypothesis that maps the family's boundaries.
C) to closely monitor content and process.
D) to discount the family's strengths and resources.

Question 16

When parents set rules that are developmentally too strict and unrealistic with consequences that are too severe, this is considered what kind of hierarchy?

A) Effective
B) Insufficient
C) Excessive
D) All of these are correct

Question 17

Which of the following is the best definition for disengaged or rigid boundaries?

A) There is not a clear distinction between members, creating a strong sense of mutuality and connection at the expense of individual autonomy.
B) Autonomy and independence are emphasized at the expense of emotional connection, creating isolation that may be more emotional than physical.
C) Boundaries allow for close emotional contact with others while simultaneously allowing each person to maintain a sense of identity and differentiation.
D) None of these is correct.

Question 18

The process of joining refers to which of the following?

A) The process after the work in therapy has been achieved and the family is "joined" together in their new patterns
B) The therapist illustrating a sense of openness to the roles of the family system
C) Something the family must do in order to show they are ready for therapy
D) The therapist demonstrating adapting to the rhythm and style of the family

Question 19

Claudia, a structural family therapist, is working with a family in therapy. At one point in the session, she hears mom tell her son, "Don't tell your dad and step-dad about this." The therapist is observing:

A) covert coalition.
B) overt coalition.
C) triangle coalition.
D) hierarchical coalition.

Question 20

Structural family therapists examine the relationship between the symptom and the family system. What does family as ineffectual challenger of the symptom refer to?

A) The family is aggressive and attempts to challenge the symptomatic member.
B) The family is assertive and challenges members in order to maintain homeostasis.
C) The family is assertive and challenges members in order to maintain homeostasis.
D) The symptom performs a regulatory function in maintaining the family structure.

Question 21

All of the following are examples of structural goals EXCEPT:

A) establishing clear boundaries between subsystems.
B) promoting development and growth of the individual and the family.
C) distinguishing between the marital/couple subsystem and the parental subsystem.
D) forgiving and repenting for an injustice.

Question 22

Giving compliments and shaping competence are used by a structural therapist in order to do which of the following?

A) Make therapy more enjoyable to clients
B) Augment and reinforce the family's natural positive interaction patterns and strengths
C) Encourage the client about the progress that they are making in their own self discovery
D) Help the family function in therapy

Question 23

Based on the previous vignette, Harold, the structural family therapist working with Mikayla and Jenna, takes into account that all behavior has reciprocal antecedents and describes their pattern of interaction like this: M affects J's response, which then affects M's response, ad infinitum. Harold is:

A) reframing the complementary relationship, removing blame from one person and describing how each person contributes to the problem dynamic.
B) boundary making to help the couple strengthen diffuse boundaries.
C) challenging the couple's assumptions by overtly questioning whether they are actually having the effect the couple anticipated.
D) using crisis induction by bringing the symptom into the room.

Question 24

Which of the following statements about using structural family therapy with diverse populations is TRUE?

A) The structural family therapy model was developed to attend to the dynamics and needs of diverse families, especially those families with children having difficulties.
B) Structural family therapy employs an active and engaged approach in which the therapist often takes an expert stance in relation to the family, an approach that often fits with the values of traditional cultures.
C) The structural family therapy model was both developed to attend to the dynamics and the needs of diverse families-especially those families with children having difficulties-and also employs an active and engaged approach in which the therapist often takes an expert stance in relation to the family-an approach that often fits with the values of traditional cultures.
D) None of these is correct.

Question 25

Ecosystemic structural family therapy (ESFT), an empirically supported adaptation of structural family therapy, was developed to treat which population?

A) Children and adolescents with severe emotional or behavioral problems and their families within the context of their communities
B) Adolescents with substance problems and their families within the context of their communities
C) Couples with one member who is severely depressed and their extended families within the context of their communities
D) Young adult men and women with severe eating disorders and their families within the context of their communities

Question 26

At each state of __________, family members need to negotiate boundaries to support individual member's growth needs. It is when families do not do this that problems occur.

A) personality development
B) psychosexual development
C) family development
D) faith development

Question 27

Occasionally, when a structural therapist is having extreme difficulty realigning a hierarchy in a family, or when a particular family member is being scapegoated, the therapist might use which of the following interventions?

A) Boundary making
B) Challenging the family's worldview
C) Reframing
D) Unbalancing

Question 28

Intensity is an intervention best described by which of the following statements?

A) It is a technique in which the therapist "turns up the heat" by using his or her tone of voice, pacing, and word choice to break through a barrier.
B) It is a technique in which the therapist and the client hypothesize a "worst-case scenario," therefore allowing the client to manage their own anxiety more effectively.
C) It is a technique in which the clients reenact the problem to a heightened degree, therefore highlighting the family interactional patterns.
D) It is a technique in which the therapist allows the family to discuss what they would do in a hypothetical situation, therefore realigning the boundaries of the system.

Question 29

Which of the following are potential missteps when working with Asian American families according to Epstein and colleagues?

A) Accounting for the couple-focused mindset of Chinese parents, who are not used to focusing their attention solely on the child
B) Avoiding mislabeling the collectivist values of closeness as a form of enmeshment
C) None of these is correct
D) Accounting for the couple-focused mindset of Chinese parents who are not used to focusing their attention solely on the child and avoiding mislabeling the collectivist values of closeness as a form of enmeshment

Question 30

When a structural therapist asks family members to change seats, has separate sessions with individuals or subsystems, or asks one member of the family to remain silent during an interaction, the therapist might be doing what kind of intervention?

A) Boundary making
B) Challenging the family's worldview
C) Reframing
D) Unbalancing

Question 31

Which of the following is NOT one of the four fundamental concepts of intensive structural therapy (IST)?

A) Social environment
B) Asymmetric relations
C) Homeostatic maintainer
D) Crisis induction

Question 32

Alexis, a structural family therapist, had been working with a volatile couple in family therapy for a few months. During one session, she verbally questioned the assumption of the couple that it "is better for the children if we stayed married" to determine whether that belief was having the effect the couple thought it should. What intervention was Alexis using?

A) Boundary making
B) Challenging the family's worldview
C) Reframing
D) Unbalancing

Question 33

Which of the following is NOT considered to be a protective factor in families according to FFT?

A) Clear limits and consistent enforcement of discipline
B) Lack of involvement in conventional activities
C) Parental involvement in a child's life
D) Supportive parenting that meets the social needs of the child

Question 34

When assessing families, FFT therapists attend to the family's cultural and community contexts. Which of the following BEST defines the term "community contexts?"

A) The family's social influences
B) The family's regional culture
C) The family's local community
D) The family's adoption of global societal norms

Question 35

What is the typical order of problem solving steps in FFT's mutual problem solving strategy?

A) Identify the problem, reevaluate outcomes, agree on how to accomplish the goal, identify potential obstacles, identify the desired outcome
B) Reevaluate outcomes, agree on how to accomplish the goal, identify the problem, identify potential obstacles
C) Identify the desired outcome, identify the problem, identify potential obstacles, agree on how to accomplish the goal, reevaluate outcomes
D) Identify the problem, identify the desired outcome, agree on how to accomplish the goal, identify potential obstacles, reevaluate outcomes

Question 36

Mikayla and Jenna have been married for six years. They have recently decided to try therapy because they find they argue incessantly and are drifting apart emotionally. They are no longer able to spend quality time together without fighting, and both would rather spend time with friends or by themselves than with each other. They state that their arguments tend to follow the same theme time after time, regardless of what they are fighting about. Mikayla sees Jenna as "overly emotional" and states that she always breaks down during their fights. Jenna states that Mikayla never tries to understand her, that she can't share her emotions and that she'd rather be "logical" all the time. From a structural viewpoint, how might you describe this relationship pattern?

A) The boundaries within their relationship are too diffuse
B) The boundaries are rigid, and the couple doesn't want to change
C) Complementary - their roles have become rigidly polarized
D) Symmetrical - each partner tries to match the other's role

Question 37

Brief strategic family therapy is a model that draws on structural and strategic therapies to address drug abuse problems with African-American and Hispanic populations. All of the following are principles of intervention in brief strategic family therapy EXCEPT:

A) joining to connect with the family system.
B) enactments to assess family functioning.
C) reframing to promote caring and concern in the family.
D) using paradoxical directives to get family members to do something different.

Question 38

The IST scorecard is designed to enable clinicians to:

A) work with conduct disorder and delinquency.
B) aggregate outcome data scores to track a positive direction from baseline.
C) determine the degree to which a child may be triangulated into a couple relationship.
D) track their outcomes using clear measures and benchmarks.

Question 39

Reframing from a structural viewpoint is seen as:

A) a way to highlight complementary relationships in the family, which often involves removing blame from one person and spreading it evenly.
B) a way of piecing together each member's description of the problem and reframing it so that the broader systemic dynamic is revealed.
C) a way of viewing a problem to determine how much each individual contributes to the conflict and then finding an agreeable solution.
D) as a way to highlight complementary relationships in the family and a way of piecing together each member's description of the problem and reframing it so that the broader systemic dynamic is revealed.

Question 40

Which of the following is NOT considered a major difference between heterosexual couples and LGBT couples?

A) The basic structure and dynamics of gay and lesbian families differs from those of heterosexual couples
B) Lesbian families are generally found to have highly egalitarian parenting practices
C) Gay male couples must acknowledge that the development of their family structures are more complex and unique to each couple
D) None of these is correct