Deck 12: Systemic Therapies

Question 1

According to systemic therapies,the key to meaningful change is:

A)controlled adaptation.
B)effective boundaries.
C)therapeutic double binds.
D)support multigenerational transmission.

Answer 1

A

Question 2

John and Nancy are married and have one child.According to systems theory,what is the minimum number of systems and subsystems present?

A)5
B)6
C)7
D)8

Answer 2

D

Question 3

When Donna yells at Bill,he tends to start drinking.These actions neither decrease nor increase their level hostility.According to systems theory,this is an example of:

A)a schism.
B)controlled adaptation.
C)a negative feedback loop.
D)a positive feedback loop.

Answer 3

C

Question 4

When communicating with his family,Claude usually omits how he feels about them.In their therapy sessions his wife is unable to reveal how she feels about his behavior.According to communication systems theory,Claude and his wife,respectively,would be examples of:

A)blamers,super reasonable communicators.
B)irrelevant communicators,placaters.
C)placaters,blamers.
D)super reasonable communicators,irrelevant communicators.

Question 5

For the past six months,a husband and wife have been fighting nearly every night before bedtime and typically end up sleeping in separate rooms.A strategic family therapist is most likely to tell the couple to:

A)continue to fight and sleep in separate rooms for the next two weeks.
B)schedule their fights for the morning instead of at night for the next two weeks.
C)develop more symmetrical communication patterns.
D)think as clearly as possible about how their own parents would fight.

Question 6

Studying the biological processes that lead to increasing complexity of organization of whole organisms is called:

A)complementarity.
B)cybernetics.
C)general systems theory.
D)multiple systems theory.

Question 7

The MRI's Brief Therapy would suggest all of the following EXCEPT:

A)communication changes are made primarily by changing behavioral interactions between system members.
B)patients are seen for a maximum of ten sessions.
C)treatment is necessarily oriented toward changing systems.
D)treatment often involves a single individual.

Question 8

According to communications systems theory,the most important initial objective for the therapist is to:

A)become more aware of who communicates to who,about what,and how.
B)clarify the family's rules for functioning.
C)look at the family's communication history.
D)understand the content of the family's communication.

Question 9

In family therapy,whenever a father makes a comment,the mother and teenage son criticize what he says and tell him that he should talk less because he doesn't know what he's talking about.A structural family therapist would most likely regard this process as an example of:

A)reframing.
B)a negative alliance.
C)triangulation.
D)a stable coalition.

Question 10

Which of the following is Structural Therapy most concerned with?

A)Pathological intrapsychic structures
B)What causes psychopathology
C)What maintains psychopathology
D)Which family members are symptomatic

Question 11

Communication systems therapy was originally developed with ___________ families.

A)manic-depressive
B)neurotic
C)obsessive
D)schizophrenic

Question 12

Hildegard refuses to allow her 42-year-old daughter to interact with her as an adult.This has disconfirmed her daughter's sense of self.Systems theory would suggest that this is a _____________ relationship.

A)complementary
B)disequilibrium
C)schismatic
D)symmetrical

Question 13

Which of the following has had the most important influence on the development of family therapy?

A)Psychoanalysis
B)Systems theory
C)The family life cycle
D)Functional analysis of behavior

Question 14

The central goal of communications family therapy is to:

A)increase family members' insight.
B)support the individuation of family members.
C)interrupt dysfunctional double binds.
D)prescribing the symptom.

Question 15

According to the text authors,the most important control mechanism in systems theory is:

A)boundaries.
B)controlled adaptation.
C)controlled growth.
D)feedback loops.

Question 16

A structural family therapist is most likely to view the presenting problem of a family in terms of:

A)faulty communication.
B)overly rigid or overly permeable boundaries.
C)a failure of complementarity.
D)dysfunctional mimesis.

Question 17

Similar to Freud's emphasis on self-analysis for the therapist's ability to conduct psychoanalysis,which family therapist viewed the therapist's resolution of emotional reactivity in their own family as critical to the effective application of his approach?

A)Salvador Minuchin
B)Murray Bowen
C)Donald Jackson
D)Virginia Satir

Question 18

Cybernetics involves the analysis of:

A)the flow of information in systems.
B)the family life cycle.
C)family structure.
D)differentiation of the self.

Question 19

The primary goal of Bowen family therapy is to:

A)increase the family's ability to solve everyday problems.
B)enhance each family members' ability to experience and express feelings.
C)increase the level of differentiation of self in family members.
D)improve the communication between each member of the family.

Question 20

Which of the following advocated studying the methods of communication and control that are common to living organisms and machines?

A)Nonlinear dynamics
B)Cybernetics
C)General systems theory
D)Multiple systems theory

Question 21

According to Minuchin,restructuring the family system involves the use of techniques intended to unbalance (or stress)the family's:

A)symptoms.
B)homeostasis.
C)communication.
D)boundaries.

Question 22

The structural therapist is most likely to first:

A)create a new therapeutic system.
B)join the system.
C)learn the rules of the system.
D)mark system and subsystem boundaries.

Question 23

According to structural theory,which of the following is LEAST likely to produce structural changes in the family system?

A)Being an authoritative leader in the therapeutic system
B)Causing disequilibrium to the family's homeostatic system
C)Confronting the family's homeostatic system
D)Providing accurate empathy and warmth to develop the therapeutic relationship

Question 24

The purpose of a genogram is to:

A)depict the relationships between family members.
B)produce a therapeutic triangle.
C)reverse an undifferentiated ego mass.
D)lower the level of family members' differentiation.

Question 25

By constructing a family genogram,you learn that the client's family is intensely close,much more so than might be expected for the family's cultural background.This family would be called:

A)enmeshed.
B)triangulated.
C)estranged.
D)joined.

Question 26

Strategic family therapists sometimes assign an unpleasant task that a client must perform when s/he shows symptomatic behavior.This is called:

A)metacommunication.
B)a detour.
C)an ordeal.
D)joining.

Question 27

Which of the following would NOT be considered a problem with research on the effectiveness of structural therapy?

A)Delineating its effects from those of behavior therapy
B)Lack of an alternative family therapy
C)Lack of controlled outcome research
D)Use of clinical survey studies
The following four questions refer to the following paragraph.
Tracy,her husband Tim,and their 14-year-old daughter Lucinda,the identified patient,are being treated by a Bowenian family systems therapist.Tracy and Lucinda have a symbiotic relationship.Tracy and Tim are less differentiated than either of their parents who,in turn,were less differentiated than either of their parents.

Question 28

If Bowen were working with this family,his first effort would be to increase:

A)Lucinda's differentiation.
B)Tim and Lucinda's differentiation.
C)Tim and Tracy's differentiation.
D)Tracy and Lucinda's differentiation.

Question 29

It is most likely that Lucinda developed her psychopathology through a multigenerational:

A)displacement process.
B)indifferentiation process.
C)schism.
D)transmission process.

Question 30

In the therapeutic relationship,a Bowenian family systems therapist is LEAST likely to:

A)maintain an objective "I" position to prevent a transference reaction.
B)not get triangled into the family.
C)not react emotionally.
D)provide unconditional positive regard.

Question 31

In a symmetrical relationship,the individuals are:

A)emotionally fused.
B)equal,but can escalate into a "one-upsmanship" communication pattern.
C)both seeking to establish an emotional triangle.
D)unequal but complementary in their communication.

Question 32

The belief that systems therapies are out of bounds when they try to construe every problem as a systems problem is a criticism from which theoretical viewpoint?

A)Cognitive therapies
B)Contextual therapies
C)Humanistic therapies
D)Integrative therapies

Question 33

When a structural therapist imitates important communication or behavior patterns of the family,he or she is performing:

A)blocking.
B)enactment.
C)mimesis.
D)reframing.

Question 34

Structural Therapy has been most often used with families in which the identified patient is a(n):

A)adult.
B)child.
C)parent.
D)spouse.

Question 35

The criticism that structural therapy is another in a long series of attempts to construct simple solutions to complex problems would be leveled by:

A)behavioral therapies.
B)humanistic therapies.
C)integrative therapies.
D)psychoanalysis.

Question 36

If two or more of these patients were present for a given session,the therapist's consciousness raising efforts would LEAST likely involve:

A)constantly questioning patients.
B)encouraging clients to communicate directly.
C)keeping the emotional system sufficiently toned down.
D)teaching clients about how family systems function and dysfunction.

Question 37

A triangle develops when any two-person system recruits another person into the system in order to:

A)engage in a complementary communication.
B)put together a genogram.
C)unconsciously resolve a double-bind.
D)reduce tension and increase stability.

Question 38

Freda feels as though her husband is exploiting her by having her be completely responsible for their home and for raising their children who are never around.While he is out drinking with his friends,she is at home developing an ulcer and feeling depressed.This scenario is most likely an example of a family which is:

A)diffuse.
B)disengaged.
C)enmeshed.
D)homeostatic.

Question 39

Which of the following is LEAST likely responsible for Lucinda becoming the identified patient?

A)She has a symbiotic relationship with her mother.
B)She is the least differentiated.
C)She is the most fused.
D)She is the youngest.

Question 40

In systems therapy,the technique used to interpret the role that symptoms play in maintaining homeostasis or balance within a family is called:

A)blocking.
B)enactment.
C)mimesis.
D)reframing.

Question 41

With respect to choosing,which of these statements would most likely be representative of a client's role in strategic therapy?

A)Enters into a contract specifying how often family will meet,who will attend,how long sessions will last,and the initial treatment goals
B)Liberates self from family system by choosing to respond in a more autonomous fashion
C)Responds from an "I" position based on what "I" observe to be factual
D)Chooses to follow the therapist's instructions or to chooses to rebel

Question 42

Evidence-based family therapies include each of the following EXCEPT:

A)functional family therapy.
B)communications/strategic family therapy.
C)multidimensional family therapy.
D)multisystemic family therapy.

Question 43

A highly directive,intensive family-based treatment derived in part from social-ecological theories and developed to treat youth with conduct disorder and substance abuse is:

A)multisystemic therapy.
B)structural family therapy.
C)family-focused therapy.
D)family psychoeducation.

Question 44

The belief that the therapeutic relationship initially includes accurate empathy,warmth and caring,but then the therapist relates as an authoritative leader is LEAST likely to be held by a:

A)Bowenian family therapist.
B)communication systems therapist.
C)Satir therapist.
D)structural therapist.

Question 45

Regarding choosing,the therapist's role in strategic therapy would most likely be to:

A)create a paradox that will help liberate the patient whether they choose to cooperate or refuse to cooperate with the therapist's directives.
B)help client clarify that the goal of autonomous responding is to differentiate self,not to blame or change others.
C)join family system as well as each subsystem to change it from within.
D)learn to speak the language of the family.

Question 46

Of the therapies listed,which would most likely view the therapist's role in catharsis as helping the patient become aware of whether their dysfunctional pattern is a blamer,placater,or irrelevant communicator?

A)Bowen family therapy
B)Communication systems therapy
C)Ordeal therapy
D)Structural therapy

Question 47

Which of the following statements about research on systems theory would be FALSE?

A)Bowenian therapy has received adequate research to qualify as evidence-based.
B)Outcomes for couples and family therapy are similar to those of individual therapies.
C)Most of the communication and strategic therapists have not been involved in systematic assessments of their treatments.
D)Systems therapy has been tested on a variety of specific disorders and problems.

Question 48

MST uses the five Ps to:

A)facilitate youth involvement with friends who do not participate in antisocial behavior.
B)resume contact with youth and families after missed sessions.
C)improve relations among family members and other social systems.
D)provide parent management training.

Question 49

The average length of a multisystemic therapy (MST)treatment is:

A)1-2 months.
B)3-4 months.
C)6-7 months.
D)10-14 months.

Question 50

The clinical populations that are typically mandated to MST include each of the following EXCEPT:

A)recurrently suicidal youth.
B)substance abusing youth .
C)serious juvenile offenders.
D)violent youth.

Question 51

Ordeal therapy would include all of the following EXCEPT:

A)an ordeal that causes less distress than that caused by the symptoms.
B)contingency management.
C)contracting.
D)extremely resistant patients.

Question 52

Which of the following statements would be LEAST consistent with a Bowenian family therapist's role in the therapeutic relationship?

A)The therapist maintains an "I" position.
B)The therapist relates in a genuine manner.
C)The therapist relies more on observation and objective thought rather than empathy to understand what is going on.
D)The therapist tries to establish unconditional positive regard toward the family.

Question 53

Multisystemic therapy was developed by which of the following?

A)James Alexander
B)Howard Liddle
C)Salvador Minuchin
D)Scott Henggeler

Question 54

Problem-solving therapy would include all of the following EXCEPT:

A)counterconditioning.
B)paradoxical directives.
C)straight directives.
D)the family retaining power.

Question 55

The contributions of Jay Haley have included all of the following EXCEPT:

A)long-term therapy.
B)communication systems therapy .
C)ordeal therapy.
D)problem-solving therapy.

Question 56

Which of the following therapies would most likely say that the therapist accommodates to the system,then challenges,confronts,and blocks and disrupts the homeostatic system?

A)Bowen family therapy
B)Communication systems therapy
C)Multigenerational family therapy
D)Structural therapy

Question 57

Bowen's family therapy would LEAST likely say which of the following about consciousness raising?

A)The therapist emphasizes observations rather than interpretations as a means to a more objective and differentiated level of consciousness.
B)The therapist encourages clients to communicate directly with each other.
C)The therapist keeps the emotional system sufficiently toned down to allow patients to process issues objectively without undue emotional reactions.
D)The therapist uses education to teach patients about how family systems function and dysfunction.

Question 58

Regarding consciousness raising,which of the therapies listed would most likely have the therapist NOT get blinded by the content of communications,and use relabeling,prescribing the symptom,and reduction ad absurdum techniques?

A)Bowen family therapy
B)Communication systems therapy
C)Multigenerational family therapy
D)Structural therapy

Question 59

What is it called when a structural therapist explicitly directs family members to engage in a particular activity?

A)Blocking
B)Enactment
C)Mimesis
D)Reframing

Question 60

The criticism that systems therapies are out of bounds when they try to construe every problem as a systems problem would be leveled by:

A)cognitive therapies.
B)humanistic therapies.
C)integrative therapies.
D)psychoanalysis.

Question 61

Randomized controlled trials of MST have shown:

A)favorable treatment effects that decrease over time.
B)favorable treatment effects that increase over time.
C)favorable treatment effects that are generally sustained.
D)favorable treatment effects but high dropout rates.

Question 62

Which of the following systems therapies has not been evaluated in controlled studies?

A)Bowen's family systems therapy
B)Multisystemic family therapy
C)Functional family therapy
D)Structural family therapy

Question 63

A recent meta-analysis of 24 studies involving the newer,evidence-based family therapies in the treatment of adolescent substance abuse and delinquency (Baldwin et al.,2012)documented that they:

A)are better than no treatment but equivalent to treatment as usual.
B)modestly outperformed treatment as usual.
C)are much better than treatment as usual.
D)produced highly variable outcomes,making average estimates of effects difficult to interpret.

Question 64

The addition of family therapy to the treatment of people with schizophrenia has been shown to reduce relapse rates by:

A)20%.
B)32%.
C)50%.
D)80%.

Question 65

Research-supported family-based therapies predominate treatment reviews of:

A)adults with addictions.
B)adolescents with eating disorders.
C)children and adolescents with externalizing problems.
D)youth anxiety and mood disorders.

Question 66

Among the most common MST youth and family engagement strategies is:

A)paying clients a small stipend each time they participate in therapy.
B)offers of a diversionary treatment program instead of a prison sentence.
C)visiting youth and family members where they live.
D)providing regularly scheduled weekly therapy sessions with pre-session reminders.

Question 67

The text authors offer which of the following concluding caveats about the nature of controlled research on systemic therapies?

A)Much of the research has been conducted on particular kinds of therapy systems,and not the family treatment format.
B)The majority of research has been conducted on the family treatment format,not on systemic therapy Itself.
C)MST is the only systemic therapy with any real evidence base.
D)Parents are too infrequently included in the treatment of child and adolescent disorders,thus limiting our understanding of the impact of parents on behavior change in youth.

Question 68

MST interventions target an adolescent's:

A)school and work role functioning.
B)entire system,including family,friends,school,and neighborhood.
C)parents' ability to manage their behavior.
D)extended family relations.

Question 69

According to the text authors,the therapeutic process of change in MST involves:

A)consciousness raising.
B)counterconditioning.
C)contingency management.
D)all of the above.

Question 70

A meta-analysis of eight controlled trials of family- and couple-based treatments for depression (Barbato & D'Avanzo,2008)showed that,compared to individual therapy,couples therapy:

A)was more effective in reducing depressive symptoms.
B)was less effective in reducing depressive symptoms.
C)was comparably effective in changing relationship satisfaction.
D)was more effective in improving relationship satisfaction.

Question 71

A recent meta-analysis of 24 studies on four of the new-generation,evidence-based family therapies (Baldwin et al,2012),including MST,revealed:

A)some family therapies were more effective than others.
B)each family therapy was comparable to the others.
C)insufficient evidence to determine the differential efficacy of the family therapies.
D)equivalent effectiveness of the family therapies,but differential dropout rates.