AMFTRB MFT National Exam cheat sheet

Systems thinking holds that circular causality, not linear cause-effect, explains family interaction patterns; a symptom is maintained by feedback loops among members.

Bowen's differentiation of self is the capacity to stay emotionally connected while maintaining separate thinking; low differentiation predicts reactivity and fusion under stress.

Minuchin's structural model organizes families by subsystems (spousal, parental, sibling), boundaries (clear, diffuse, rigid), and hierarchy; enmeshment and disengagement are boundary extremes.

The identified patient is the family member carrying the presenting symptom; systemic practice reframes the symptom as serving a function in the family system.

Strategic and MRI models use directives, reframing, and paradoxical tasks to interrupt attempted solutions that maintain the problem.

Solution-focused therapy assumes clients already possess strengths; the miracle question, scaling, and exception questions build on prior success.

Narrative therapy externalizes the problem as separate from the person and uses unique outcomes to thicken preferred storylines.

Satir's experiential model emphasizes communication stances (placater, blamer, super-reasonable, irrelevant, congruent) and family sculpting to raise awareness.

Intergenerational transmission: unresolved family-of-choice issues, triangles, and multigenerational patterns recur across at least three generations in Bowen theory.

DSM-5-TR requires clinically significant distress or impairment for most disorders; a diagnosis is not made from a single symptom or a single session.

Cultural formulation interview (CFI) domains include cultural identity, cultural conceptualizations of distress, psychosocial stressors, and clinician-client relationship.

The Global Assessment of Functioning was removed from DSM-IV-TR onward; DSM-5-TR uses the WHODAS 2.0 for disability assessment.

Relational distress is coded under Z codes or the relational problem categories; V-code/Z-code conditions are not mental disorders.

A genogram maps at least three generations of family structure, medical and mental health history, and relationship quality; standard symbols denote gender, death, and closeness.

Substance use screening commonly uses AUDIT or CAGE; CAGE items are Cut down, Annoyed, Guilty, and Eye-opener.

Suicide risk assessment should document ideation, plan, intent, means access, protective factors, and a safety plan; no instrument alone predicts suicide.

Differential diagnosis requires ruling out medical conditions and substance effects before attributing symptoms to a psychiatric disorder.

Mandated reporting and confidentiality limits are disclosed before assessment; minors' assent and guardians' consent apply depending on state law.

Treatment plans include presenting problem, measurable goals, specific interventions, timeline, and evaluation criteria; goals are written in behavioral terms.

Emotionally focused therapy (EFT) proceeds through de-escalation, restructuring negative interaction cycles, and consolidation; it targets attachment injuries and cycle patterns.

Cognitive behavioral family therapy targets maladaptive cognitions and behavioral contingencies; homework and behavioral rehearsal are core components.

Motivational interviewing uses OARS (open questions, affirmations, reflections, summaries) and attends to change talk while rolling with resistance.

Structural interventions include joining, enactment, boundary making, and unbalancing to shift family organization and hierarchy.

Therapeutic alliance in couple therapy is triadic; the therapist must manage split alliances and avoid coalition with one partner.

Relapse prevention plans identify high-risk situations, coping strategies, and a written response plan; they are developed collaboratively.

Informed consent for treatment specifies modality (individual, couple, family), fees, confidentiality limits, and risks and benefits.

Termination is planned when goals are met or progress stalls; a summary of gains and referral options supports ethical closure.

Confidentiality is limited by duty to warn/protect, suspected child or elder abuse, court order, and client consent; state law defines specific duties.

Tarasoff v. Regents (1976) established a duty to protect identifiable third parties from serious threats of violence; implementation varies by jurisdiction.

Multiple relationships are avoided when they could impair objectivity or exploit the client; not all dual roles are unethical, but risk must be documented.

Informed consent must be obtained before treatment and documented; for minors, guardian consent plus minor assent is standard practice.

Records are retained per state statute and professional guidelines; HIPAA protects PHI, and clients generally have access to their records.

Boundary crossings require clinical rationale and documentation; sexual relationships with current clients are always prohibited.

Competence requires practicing within training and experience; new areas require supervision, consultation, or additional training.

Mandated reporting of suspected child abuse is required regardless of confidentiality; reporters are protected from liability when reporting in good faith.

Fees, bartering, and gifts are addressed in the treatment agreement; bartering is discouraged when exploitation or confusion is likely.

Supervision is a gatekeeping and evaluative role distinct from therapy; supervisors document supervisee competence and fitness for practice.

The supervisory working alliance includes agreement on goals, tasks, and bond; ruptures are addressed directly and documented.

Informed consent for supervision discloses evaluation methods, confidentiality limits, and the supervisor's reporting obligations to the licensing board.

Supervisors must hold the required license and supervision credential; supervision hours and formats are set by state licensing boards.

AAMFT supervision standards require supervisors to maintain competence in supervision models and to monitor supervisee ethical practice.

Consultation differs from supervision: consultants advise without direct evaluative authority or legal responsibility for the consultee's cases.

Parallel process describes supervisee dynamics mirroring client dynamics; supervisors use it diagnostically to understand the case.

Continuing education requirements vary by state; licenses renew on defined cycles with documented CE hours in ethics and clinical topics.

Self-care, burnout, and impairment are professional obligations; impaired clinicians must seek remediation and may need to limit practice.