Mastering Competencies Family Therapy 2nd Edition By Gehart – Test Bank

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Mastering Competencies in Family Therapy

Chapter 5: Structural Family Therapy

According to the author of the text, structural family therapists map which of the following?

The road home

Family structure

Happiness

Mental health

ANS: B

REF: Lay of the Land (p. 125)

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

Make the family’s boundaries more rigid to promote a better structure.

Realign the system’s boundaries and hierarchy.

Repair the emotional damage by encouraging more diffuse boundaries.

Introduce a new pattern of behavior to promote a “new dance” for the system.

ANS: B

REF: Lay of the Land (p. 125)

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 clear boundary?

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.

Autonomy and independence are emphasized at the expense of emotional connection, creating isolation that may be more emotional than physical.

Boundaries allow for close emotional contact with others while simultaneously allowing each person to maintain a sense of identity and differentiation.

None of the above.

ANS: C

REF: The Juice: Significant Contributions to the Field (p. 125-126)

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

There is not a clear distinction between members, creating a strong sense of mutuality and connection at the expense of individual autonomy.

Autonomy and independence are emphasized at the expense of emotional connection, creating isolation that may be more emotional than physical.

Boundaries allow for close emotional contact with others while simultaneously allowing each person to maintain a sense of identity and differentiation.

None of the above.

ANS: B

REF: The Juice: Significant Contributions to the Field (p. 125-126)

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

Family members insisting on high levels of protectiveness or appearing to be over concerned

Significant freedom for most family members to do as they please

Few demands for — or expressions of — family loyalty and commitment

Family member’s lack of reaction and few repercussions, even to problems

ANS: A

REF: The Juice: Significant Contributions to the Field (p. 125-126)

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. 

reframes

boundaries

enactments

one-way mirrors

ANS: C

REF: The Juice: Significant Contributions to the Field (p. 126-128)

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

To discover the family’s rules and assumptions

To develop a hypothesis that maps the family’s boundaries

To closely monitor content and process

To discount the family’s strengths and resources

ANS: D

REF: The Juice: Significant Contributions to the Field (p. 127)

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

Joining the family, mapping the structure, and transforming the structure

Boundary-making, establishing hierarchy, and creating subsystems

Joining the family, boundary-making, and creating subsystems

Mapping the structure, family reenactment, and processing outcome

ANS: A 

REF: The Big Picture: Overview of Treatment (p. 129)

When a structural family therapist joins the family system, they are doing which of the following?

Becoming member of the family

Agreeing with the family

Accommodating the family’s style

Processing the family’s problems

ANS: C

REF: Making Connections: The Therapeutic Relationship (p. 129)

The process of joining refers to which of the following?

The process after the work in therapy has been achieved and the family is “joined” together in their new patterns

The therapist illustrating a sense of openness to the roles of the family system. 

Something the family must do in order to show they are ready for therapy

The therapist demonstrating adapting to the rhythm and style of the family. 

ANS: D

REF: Making Connections: The Therapeutic Relationship (p. 129)

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

The therapist doing as they please with their clients

The therapist “flying by the seat of their pants” when working with clients

The therapist flowing naturally and authentically in a variety of contexts and situations

The therapist avoiding being natural in clinical situations

ANS: C

REF: Making Connections: The Therapeutic Relationship (p. 130)

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?

Rigid

Selfless

Permeable

Flexible

ANS: D

REF: Making Connections: The Therapeutic Relationship (p. 130)

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

The family is aggressive and attempts to challenge the symptomatic member.

The family is assertive and challenges members in order to maintain homeostasis.

The family is passive, failing to challenge the symptomatic member.

The symptom performs a regulatory function in maintaining the family structure.

ANS: C

REF: The Viewing: Case Conceptualization and Assessment (p. 131)

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?

Couple

Parents

Sibling

Pets

ANS: D

REF: The Viewing: Case Conceptualization and Assessment (p. 131)

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

The children form an alliance against the parents.

A subsystem is formed between a parent and child against the other parent.

A subsystem is formed between members of one generation against members of another (i.e., grandparents vs. children).

A conflict is formed between the parents in the upbringing of their child.

ANS: B

REF: The Viewing: Case Conceptualization and Assessment (p. 131-132)

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 what?

Covert coalition

Overt coalition

Triangle coalition

Hierarchical coalition

ANS: A

REF: The Viewing: Case Conceptualization and Assessment (p. 131-132)

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

Effective

Insufficient

Excessive

All of the above

ANS: C

REF: The Viewing: Case Conceptualization and Assessment (p. 132)

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?

Effective

Insufficient

Excessive

All of the above

ANS: A

REF: The Viewing: Case Conceptualization and Assessment (p. 132)

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

Disengaged family boundaries

Enmeshed family boundaries

Appropriate family boundaries

Invested family boundaries

ANS: B

REF: The Viewing: Case Conceptualization and Assessment (p. 132)

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?

Symmetrical

Asymmetrical

Complementary

 Adaptable

ANS: C

REF: The Viewing: Case Conceptualization and Assessment (p. 132)

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. 

personality development

psychosexual development

family development

faith development

ANS: C

REF: The Viewing: Case Conceptualization and Assessment (p. 132-133)

All of the following are examples of structural goals EXCEPT?

Establishing clear boundaries between subsystems

Promoting development and growth of the individual and the family

Distinguishing between the marital/couple subsystem and the parental subsystem

Repenting for an injustice and forgiving

ANS: D

REF: Targeting Change: Goal Setting (p. 133)

Reframing from a structural viewpoint is seen as:

a way to highlight complementary relationships in the family and often involves removing blame from one person and spreading it evenly.

piecing together each member’s description of the problem and reframing it so that the broader systemic dynamic is revealed.

a way of viewing a problem to determine how much each individual contributes to the conflict and then finding an agreeable solution.

Both A and B.

ANS: D

REF: The Doing: Interventions (p. 133-134)

When a structural therapist asks family members to changes 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?

Boundary making

Challenging the family’s worldview

Reframing

Unbalancing

ANS: A

REF: The Doing: Interventions (p. 134)

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?

Boundary making

Challenging the family’s worldview

Reframing

Unbalancing

ANS: B

REF: The Doing: Interventions (p. 134)

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?

Boundary making

Challenging the family’s worldview

Reframing

Unbalancing

ANS: D

REF: The Doing: Interventions (p. 135)

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

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.

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.

It is a technique in which the clients reenact the problem to a heightened degree, therefore highlighting the family interactional patterns.

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 in the system.

ANS: A

REF: The Doing: Interventions (p. 135)

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

Make therapy more enjoyable to clients

Augment and reinforce the family’s natural positive interaction patterns and strengths

Encourage the client about the progress that they are making in their own self discovery

Help the family function in therapy

ANS: B

REF: The Doing: Interventions (p. 135-136)

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?

The boundaries within their relationship are too diffuse.

The boundaries are rigid, and the couple doesn’t want to change.

Complementary — their roles have become rigidly polarized.

Symmetrical — each partner tries to match the other’s role.

ANS: C

REF: The Viewing: Case Conceptualization and Assessment (p. 132)

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 doing which of the following?

He is reframing the complementary relationship and removing blame from one person and describing how each person contributes to the problem dynamic. 

He is boundary making to help the couple strengthen diffuse boundaries. 

He is challenging the couple’s assumptions by overtly questioning whether they are actually having the effect the couple anticipated.

He is using crisis induction by bringing the symptom into the room.

ANS: A

REF: The Doing: Interventions (p. 133-134)

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

The structural family therapy model was developed to attend to the dynamics and needs of diverse families, especially those families with children having difficulties.

Structural family therapy employs an active and engaged approach with which the therapist often takes an expert stance in relation to the family, an approach that often fits with the values of traditional cultures.

Both A and B are correct.

Neither A nor B are correct.

ANS: C

REF: Tapestry Weaving: Working with Diverse Populations (p. 140-141)

Brief strategic family therapy, 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 EXCEPT?

Joining to connect with the family system

Enactments to assess family functioning

Reframing to promote caring and concern in the family

Paradox to get family members to do something different

ANS: D

REF: Clinical Spotlight: Brief Strategic Family Therapy (p. 142-143)

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

Children and adolescents with severe emotional or behavioral problems and their families within the context of their communities

Adolescents with substance problems and their families within the context of their communities

Couples with one member who is severely depressed and their extended families within the context of their communities

Young adult men and women with severe eating disorders and their families within the context of their communities

ANS: A

REF: Clinical Spotlight: Ecosystemic Structural Family Therapy (p. 143-144)