Free MFT Exam Practice Question: Working with Elderly Clients Answer and Rationale

By Robin Gluck on May 1, 2018

Free MFT Exam Practice Question Image

This week, our free MFT exam practice question is going to focus on the topic of working with the elderly. It’s quite possible you have not worked with elderly clients during your traineeships or internships, and yet the BBS still wants to know that you are aware of the unique issues that arise when working with this population. Regardless of how much or how little you already know about this subject, the Therapist Development Center’s exam prep, will ensure you know everything you need to correctly answer questions on this topic.

What to Expect on the Exam:

Whether you are taking the Law and Ethics Exam, the California Clinical Exam or the National MFT Exam, you will see a substantial number of questions focused on issues specific to working with the elderly. So how could this subject appear on your exam?

You could see questions that test your ability to:

  •    Balance self-determination vs. safety concerns
  •    Assist clients navigating challenges adjusting to new life stages
  •    Identify and properly address cognitive changes and/or disorders
  •    Identify and act on legal obligations
  •    Identify and act on ethical obligations

Let’s see how you do on this week’s FREE MFT practice question regarding working with the elderly.

Practice Question:

A therapist meets with an 83-year-old woman who is brought for individual therapy by her son and daughter. The son explains that he, his sister and their other sibling who lives out of state are becoming increasingly concerned for their mother’s safety. The daughter explains that their mother still lives in their childhood home and continues to drive, but all of the siblings agree that she needs to move to an assisted living facility and should stop driving. The woman brushes off her children’s concerns and states, “I might be old, but I’m not useless. My kids are confused and think they are the parents now. I told them I’m fine on my own and they persist. I told them I don’t want to see a therapist, and yet here I am.” Which of the following actions should the therapist take based on the case presented?

A. Acknowledge children’s concerns for their mother and explore mother’s resistance to changes

B. Validate the mother’s feelings and determine appropriateness of continuing therapeutic services

C. Determine appropriateness of continuing therapeutic services and assess for safety concerns

D. Validate the children’s concerns and identify appropriate treatment goals


The correct answer is C.

  • Answer A can be eliminated because the client in this vignette is the mother, not her children. In addition, the therapist is aligning with the children to the detriment of building a therapeutic alliance with the woman and respecting her right to self-determination. This answer choice ignores the woman’s statement that she does not want to see a therapist, something that must be addressed.
  • Answer B seems like a really good answer and is likely one of the two you narrowed your answers down to--in fact, you may have picked this answer. However, the children indicate safety concerns, and this answer does not address them.  All parts of this answer are technically correct, but it is not the strongest option available to you.
  • Answer D, similar to answer A, also overlooks the woman’s expressed lack of interest in receiving therapy and takes on the children’s agenda. Ethically, the therapist should honor the woman’s decision of whether or not she would like to engage in treatment.
  • Answer C is the strongest answer choice available to you. It allows us to assess possible safety concerns, something that is noted in the vignette when the children say they are “becoming increasingly concerned for their mother’s safety.” In addition, it honors the mother’s right to self-determination and whether or not she would like to engage in the therapeutic process.

Exam Preparation

Which answer did you choose? Does the rationale fit with your understanding of the topic and how you would apply it in a clinical setting? Or did you learn something new with this scenario? If you have any further questions feel free to check in with a TDC coach. We are here to support you all along the way. And if you came up with the same answer-great job! You are on the right track to getting licensed.

Still haven’t signed up for an exam preparation program? Or have you already passed the exam and need to complete your continuing education requirements? Our structured, straightforward approach will provide you with exactly what you need!



Commenter Name
December 25, 2018

I chose feelings (B) over safety (C). After rereading the Stem, I realized that the safety concerns of the children are much more prevalent than the feelings of the client.

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