Free MFT Practice Question: Crisis Interventions

Throughout your career as a Marriage and Family Therapist, there will be times when you are required to work with clients who are experiencing crises. In these situations, you will need to know how to manage their safety (and the public’s safety) by determining exactly which crisis interventions are most appropriate. The Board of Behavioral Services (BBS), whose mission is to, “Protect and serve Californians by setting, communicating, and enforcing standards for safe and competent mental health practice,” will test your knowledge of and ability to utilize crisis interventions. Let’s take a look at how this topic could be tested:

The test may ask:

• Assess a client’s risk to self or others
• Identify and provide referrals
• Identify legal mandates
• Engage support systems

There are many ways this topic could appear on your exam, so it is important to know how to navigate different types of crises and identify crisis interventions that align with the level of risk. 

Let’s test your knowledge of crisis interventions with the following FREE MFT exam question:

Practice Question:

A therapist working in private practice has been working with a 15-year-old girl with a history of non-suicidal cutting. The parents consented to their daughter’s treatment and have, on occasion, attended conjoint therapy sessions. The client appears for an individual session with tears streaming down her face. She tells the therapist that she had sent a nude picture of herself to her ex-boyfriend several months ago and now it is being circulated at school. She tells the therapist that she is so embarrassed and doesn’t know how she can face anyone ever again. The girl tells the therapist that she doesn't want her parents to know about this. Which of the following interventions should the therapist take to manage the situation presented in this case?

A. Inform client that her parents must be notified 

Make a child abuse report to the appropriate authorities

Assess client for potential risk to self

B. Inform client that her parents must be notified

Assess for child abuse and determine need to report

Process child abuse report with client

C. Explore client’s fears regarding parents learning of situation

Make a child abuse report and process with client

Safety plan with client and identify healthy coping skills

D. Explore client’s fears regarding parents learning of situation

Make a child abuse report and process with client

Assess client for potential risk of self-harm

(scroll down for answer and rationale…..)

The correct answer is D. 

This vignette is tricky because several issues require immediate attention. We see the issues of confidentiality of a minor, child pornography and mandated reporting requirements, and risk of self-harm. We want to find an answer that addresses all of the issues presented and interventions that align with the level of risk indicated in the vignette.

Answer A and B, based on the information we have so far, can be eliminated because we are not required to inform the client’s parents about the situation. Even if the parents consented to treatment, minors who are old enough to consent to their own treatment, have a right to confidentiality.  Answer B is also wrong because we do not need to assess for child abuse; distribution of child pornography, even if initially shared by the minor, is a mandated report. 

This leaves us choosing between answers C and D. As you can see, the first two parts of each answer are identical. We would absolutely want to understand why the client is scared of informing her parents, because this information would allow the therapist to determine how to proceed. This could lead to engaging in role play with the client to prepare her to tell parents, or possibly to conducting a conjoint session. We would also want to discuss the need for a child abuse report, and what this will mean for the client. 

The final part of answers C and D are quite different. Answer D, “ Assess client for potential risk of self-harm” would be the best crisis intervention to start. Safety planning will be appropriate if the assessment indicates a risk. However, safety planning prior to assessment would not make sense. 

Exam Preparation

To learn all about crisis intervention and more, sign up for one of TDC’s MFT exam study guides to help you prepare for your exam today! Amanda Rowan has helped thousands of Marriage and Family Therapists pass their MFT exams-are you our next success story?