Question 1

Faye makes it very clear to you that she only has the money for 15 sessions. After that, she couldn't get benefits for more therapy. When you propose a sliding scale, she balks at the idea as some kind of charity. Do you consider taking the case?

Accepted Answer

It may be a case that you have been looking forward to working with or have made certain room on your calendar for. What's more, insurance companies are beginning to limit more and more the number of sessions that they will authorize, but that doesn't mean you need to stop performing therapy with clients. Each will benefit in their own way if they are invested.

Question 2

If you used the Beck Depression Inventory and the Beck Anxiety Inventory to assess at the beginning of treatment, what tools would you use to assess progress in the middle of treatment?

Accepted Answer

In the interim or toward termination, you may feel more comfortable receiving feedback from the client about what a particular rating might mean so that you can tailor your efforts to any of her particular needs. Since no one is a better judge of how effective treatment has been, there may be a need to make changes before proceeding.

Question 3

Allison's mother is thrilled that she is receiving counseling. About eight weeks into treatment, her mother contacts you and wants Allison to stop counseling. When investigating her motives, you may discover that her mother:

Accepted Answer

When parents bring their children into counseling, or send them to the school counselor, they often have a different idea of what they will be allowed to know and what will be kept confidential. This can sometimes change a parent's view on the counseling process.

Question 4

A client was diagnosed with PTSD after two traumatic car accidents. He reported wanting to be able to drive again and has achieved much of his goal, but you recognize that he could go further. When coordinating around his treatment, it is important to consider:

Accepted Answer

With clients who have suffered from PTSD, it is often very important to consider how quickly the recovery process is moving for them. If the recovery process moves too quickly, the anxiety that exists for some PTSD victims can be too high, triggering relapse. A personalized timeline of recovery could be helpful.

Question 5

You're using CBT to work with a family that reports that the issues with their son are starting to dissipate. He's cleaning his room, finishing his dinner, and doing his homework. However, the couple is now noticing that there is more tension between them. How would you handle this?

Accepted Answer

As is often the case with couples, when there are no issues with the children, they begin to find issues with one another. In order to address this, you can continue doing some couples work with them, helping them to see what it is like to have a compliant son and educate them about the fact that they do not need to replace the problematic behavior.

Question 6

You have worked with a client for almost two years and the client has shown sufficient progress that she is ready to move on. As termination moves closer, she begins to decompensate, returning closer to her initial baseline. How do you proceed?

Accepted Answer

While it can sometimes be hard to let go of a therapist or client after two years, it is a very normal feeling. After all, therapists depend upon their skills with people in order to build and maintain those important relationships. Normalizing will also help the client to understand that she will return to a higher level of functioning.

Question 7

You have a client who is in denial regarding their mental illness. Progress in therapy is slow and the client's insight is not really improving. You begin viewing termination as imminent. Which is an important way you could go about building insight with the client?

Accepted Answer

Often, taking clients back to why they chose therapy (for those who chose) can have an especially large impact on what comes up for them and how willing they are to move forward. Since motivations change over time, more motivation might be present after a look back.

Question 8

Variable Victor can never quite decide which weeks he wants to come to therapy. Whenever there is what might be considered a breakthrough, Victor makes up what feels like an excuse the next week. When working with Victor, what might be your next step?

Accepted Answer

How ready is Victor to explore his resistance? You may not be sure, but exploring it openly can be an important piece of his recovery. If he is able to address it with you, it will be his way of moving forward and participating in his recovery more fully and completely by demonstrating a coping skill.

Question 9

Maggie Meds comes into therapy one day wanting to know if medication could be helpful for her. You refer her to a psychiatrist and point out that a medical evaluation could help determine if psychotropic drugs could be useful. She wants to know why she should pay to see you when a psychiatrist can perform therapy as well. You might suggest:

Accepted Answer

As an MFT, you are not in the business of bashing your colleagues, nor are you giving clients away. Really, it comes down to client expectations, comfort, and ability to relate to the doctor. You can give the best information possible in order to facilitate the most informed decision.

Question 10

Humanistic, or person-centered, therapy goes to great lengths in order to assist the client in feeling valuable in their own recovery. When coming to therapy, how might a person-centered therapist address therapy's progress?

Accepted Answer

Person-centered therapy is centered specifically on the person. Whether or not they are willing is an important part of how treatment is able to progress. If they are unwilling to address therapy further, a humanistic therapist might agree to terminate therapy. That said, it could benefit the client to increase their willingness if they see a more significant improvement in shorter periods of time.

Quiz 3: Ongoing