Treating Families: LCSW & MFT Exam Prep

By Bethany Vanderbilt on June 26, 2012

a child drawn house, parents, and childHappy Tuesday folks!  I know summertime doesn't exactly come with images of exam preparation...but the extreme heat in many places over the past few weeks can actually make it easier to stay indoors and study!  Remember not to do too much -- no more than 2 hours a day to make the best use of your brain (unless you're doing a mock exam, in which case you should sit through the whole thing in order to accurately simulate the real thing!).  This week we're moving onto the topic of Treating Families...oh the places we could go with this one! Let's get things going with a sample item.


A therapist in a family services agency begins an intake with parents and their two adolescent children.  They are seeking services due to their teen daughter's recent truancy and increasing arguments about homework and household chores.  A therapist using a structural approach would MOST likely use which of the following interventions to address the family's issues:

A. genogram

B. paradoxical directive

C. enactment

D. circular questioning

Structural Family Therapy is only one of several (or in the MFT's case, many) treatment modalities that you are likely to see on the exam.  This method was developed predominantly by Salvador Minuchin and focuses on, you guessed it, the structure of the family in both its conceptualization of problems and its approach to treatment.  Minuchin believed that all families have a structure that determines how members relate to one another, manage conflict and deal with family problems; he also focused on boundaries between family members and is responsible for the terms "enmeshed" and "engaged" that many therapists use, regardless of their orientation.  The terms that go with Structural Family Therapy sound structural to me -- they call forth images of something physical, like a building: alignment, hierarchy, inflexible, reframing.  If you can create associations like to this to help you absorb concepts and ideas, it will help you recall and apply them when you're sitting for the exam.


Well, I didn't choose one of the clearly "structural"-sounding interventions (gotta keep you on your toes!).  The answer to the above question is C -- enactment.  Enactment is an intervention technique used in structural therapy in which family members are asked to role-play relationship patterns so that maladaptive patterns can be identified and altered consciously.  Genograms are associated with  Extended Family Systems Therapy (Bowen); paradoxical directives are associated with Strategic Family Therapy (Haley/Erickson); and circular questioning is associated with Milan Systemic Family Therapy (Selvini-Palazzoli). There are likely some therapy modalities that you're more familiar with, so when you're studying, emphasize the modalities that feel trickier to you and consider focusing on no more than one modality per day in between other topics/tasks.  If I tried to study Structural Family Therapy, Strategic Family Therapy, Family Systems Therapy, and Milan Family Systems Therapy on the same day, my head would be swimming with "S" terms and I'd never be able to separate them!

Coming up next week: Elderly Issues

Think our straightforward, sensible approach could help you PASS your social work or MFT exam? If you're preparing for a social work exam, check out our Social Work Study Materials. If you're preparing for an MFT exam, check out our MFT Study Materials. Learn more about our offerings at The Therapist Development Center.

Looking for more practice questions and some study tips? Check out our new Social Work Exam Study Guide:

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