MFT National Exam flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Circular causality

A systemic view in which each person's behavior both triggers and is triggered by others' responses, forming a repeating loop rather than a single linear cause.

Negative feedback loop

A deviation-reducing interaction pattern in which the system responds to change by restoring its prior equilibrium, thereby maintaining homeostasis and stabilizing symptomatic behavior.

Second-order change

Change that alters the system's underlying rules or structure, in contrast to first-order change, which shifts behaviors within the existing rules without altering the pattern.

Triangulation

A process in which tension between two people is detoured through a third party, stabilizing the dyad while pulling the third person into the conflict.

Enmeshment and disengagement

Minuchin's continuum of boundary permeability: enmeshment describes overly diffuse boundaries with little autonomy, while disengagement describes rigid boundaries with little connection or support.

Miracle question

A solution-focused question asking the client to describe in concrete behavioral detail how life would differ the morning after a miracle solved the problem overnight.

Externalizing the problem

A narrative technique in which the problem is described as a separate entity outside the person, reducing blame and opening space to revise the dominant problem-saturated story.

Enactment

A structural technique in which the therapist asks family members to talk with each other in session about a conflict while coaching them toward new, clearer transactional patterns.

Genogram

A multigenerational family diagram, usually covering at least three generations, that maps structure, major events, illnesses, occupations, and relationship patterns to generate systemic hypotheses.

Olson Circumplex Model

A model describing family functioning along cohesion and flexibility dimensions plus communication, in which balanced levels on both dimensions predict healthier functioning than extreme levels.

Family Assessment Device

A self-report instrument based on the McMaster model measuring problem solving, communication, roles, affective responsiveness, affective involvement, and behavior control in families.

Major depressive disorder criteria

DSM-5-TR requires at least five of nine symptoms for two weeks, including depressed mood or anhedonia, plus clinically significant distress or impairment not attributable to another condition.

Z-code relational problems

DSM-5-TR codes for problems that are not mental disorders, such as Z63.0 relationship distress with spouse or intimate partner and Z62.820 parent-child relational problem.

Collateral versus individual interviews

Gathering information from family members separately and together lets the therapist compare perspectives, screen privately for violence, and test systemic hypotheses against multiple viewpoints.

Treatment plan elements

A written plan listing the relational problem, measurable goals, chosen model and interventions, session frequency and length, participant roles, and criteria for review and termination.

Pursue-withdraw cycle

An attachment-based negative cycle in which one partner presses for closeness while the other distances, each response escalating the other, typically targeted first in emotionally focused therapy.

Empirically supported family therapies

Treatments with replicated randomized trial support for adolescent problems, including multisystemic therapy, functional family therapy, brief strategic family therapy, and multidimensional family therapy.

No-secrets policy

A couple or family therapy rule disclosed during informed consent that specifies what the therapist will do with individually disclosed information, typically requiring disclosure or suspending conjoint work.

Contraindications to conjoint sessions

Ongoing violence or coercion, untreated severe substance use, active psychosis, or a secret that makes joint sessions unsafe or unworkable call for separate or sequenced treatment.

Measurement-based care

Administering brief standardized outcome measures at each session and using the scores to adjust treatment, which improves outcomes and flags clients who are deteriorating.

Planned termination

A collaborative ending when goals are met, involving review of gains, consolidation of skills, relapse-prevention planning, discussion of feelings about ending, and optional booster sessions.

Client abandonment

Terminating treatment without adequate notice, pretermination counseling, or referrals, which violates professional ethics and can harm clients who still need care.

Deterioration signal

A lack of measurable improvement by roughly six to eight sessions, or worsening scores, indicating the need to revise the hypothesis, change the model, consult, or refer.

Termination summary

A closing record documenting the presenting problem, course of treatment, outcome, client status at termination, referrals made, and follow-up recommendations for continuity of care.

Informed consent elements

Disclosure at intake of therapy's nature, risks, and benefits; confidentiality and its limits; fees; record policies; third-party involvement; and the right to withdraw or ask questions.

Tarasoff duty

A legal duty, adopted in varying forms by state laws, to take reasonable steps such as warning or otherwise protecting an identifiable third party threatened by a client.

HIPAA psychotherapy notes

Separately maintained process notes the therapist keeps apart from the medical record; they require a specific authorization for release and are excluded from general record disclosures.

Multiple relationships

Holding a second personal, financial, or professional role with a client or someone close to the client, permitted only when risks are documented and judgment is unlikely to be impaired.

Scope of competence

The ethical requirement to practice only within the boundaries of training, education, and supervised experience, obtaining consultation or referring when a case exceeds those boundaries.

Efficacy versus effectiveness

Efficacy trials test a treatment under controlled conditions with high internal validity; effectiveness trials test it in routine practice settings, emphasizing generalizability and real-world outcomes.

Dose-response effect

Findings that outcome improves with the number of sessions; classic estimates suggest about half of clients improve by eight sessions and about three quarters by twenty-six.

Common factors

Ingredients shared by all therapies, including client factors, therapeutic alliance, expectancy, and model techniques, estimated by Lambert to explain more outcome variance than specific techniques alone.