What Factors Affect Mental Health? LCSW & MFT Exam Prep

By Bethany Vanderbilt on May 16, 2012

A curved path in a forestThis week brings us to Factors Affecting Mental Health.  Most of these factors, including environmental and psychosocial factors, are recorded on Axis IV of the DSM Multiaxial Assessment.  You will see these factors in many test questions and will often be asked to prioritize interventions based on multiple stressors/factors. Let's look at an example:


A family contacts a social worker for help with an increase in conflict and fighting.  During the intake, the wife tells the social worker that her husband's mother recently moved in with the family after his father passed away.  She goes on to say that her husband wants the family "to all just bend to his mother's wishes."  The son and daughter, both adolescents, complain about the fact that they now have to share a room "because of grandma."  The husband sits silently while these exchanges are occurring.  What should the social worker do NEXT?

A. Provide the father with referrals for a bereavement support group

B. Help the family figure out how to set limits with the grandmother

C. Teach the family effective conflict resolution skills

D. Explore the father's feelings about his father's death and mother's arrival

At first, when you look at this question, you may think it's asking you about family therapy techniques, and it is, but it's also asking you to consider the environmental and psychosocial factors affecting this family and respond accordingly.  This happens on tests pretty frequently -- questions appear to be focused on therapeutic interventions but are actually testing your ability to identify and weigh the various factors that the stem presents.  And don't forget to pay particular attention to the word "NEXT" and use it as a prompt to put the answer choices in the order in which you would use them instead of trying to rule any of them out.


D is the best answer to the question above because it encourages the father to express his perspective and takes into account that he has recently lost his father, an additional psychosocial stressor.  A, B, and C may all be useful interventions, but hearing and understanding how the stressors have affected all family members is more important in this initial stage of treatment.  The entire family is experiencing the stressor of having the grandmother move in, but only the father is experiencing the additional stressor of losing a parent.  Without understanding how these stressors are affecting him, the therapist cannot proceed with additional interventions

Coming up next week: Stages of Development

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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