Chapter 7 Structural Family Therapy Exam Prep

Chapter 7: Structural Family Therapy

Multiple Choice

1. Structural family therapists map boundaries, hierarchies, and subsystems, which are all part of ________________________.
   1. the road home
   2. family Structure
   3. happiness
   4. mental Health

REF: Lay of the Land

1. After a structural therapist has assessed the family structure, the next goal for treatment might be to:
   1. make the family’s boundaries more rigid to promote a better structure.
   2. repair the emotional damage by encouraging more diffuse boundaries.
   3. realign the system’s boundaries and hierarchy to promote growth and resolve problems.
   4. introduce a new pattern of behavior to promote a “new dance” for the system.

REF: Lay of the Land

1. Which of the following is the best definition for a clear boundary?
   1. Families that do not make a clear distinction between members, creating a strong sense of mutuality and connection at the expense of individual autonomy.
   2. Autonomy and independence are emphasized at the expense of emotional connection, creating isolation that may be more emotional than physical.
   3. Boundaries that demand loyalty at the expense of individual needs.
   4. Boundaries that allow for close emotional contact with others while simultaneously allowing each person to maintain a sense of identity and differentiation.

REF: Lay of the Land

1. Which of the following is the best definition for disengaged or rigid boundaries?
   1. There is not a clear distinction between members, creating a strong sense of mutuality and connection at the expense of individual autonomy.
   2. Families with rigid or disengaged boundaries have excessive tolerance for deviation and often do not support or protect one another.
   3. Boundaries that allow for close emotional contact with others while simultaneously allowing each person to maintain a sense of identity and differentiation.
   4. Families with rigid boundaries have little tolerance for deviation and always mobilize support and protection for each other.

REF: Lay of the Land

1. When working with enmeshed and diffused boundaries, a structural therapist will primarily see which of the following in the family’s interactions?
   1. Significant freedom for most family members to do as they please.
   2. Few demands for, or expressions of, family loyalty and commitment.
   3. Family member’s lack of reaction and few repercussions, even to problems.
   4. Family members acting extremely protective or appearing to be over concerned.

REF: Lay of the Land

1. Minuchin used _______________ to see the family in action rather than simply relying on talking about interactions.
   1. reframes
   2. boundaries
   3. enactments
   4. one-way mirrors

REF: Lay of the Land

1. Enactments allow the structural therapist to do each of the following EXCEPT:
   1. discover the family’s rules and assumptions.
   2. discount the family’s strengths and resources.
   3. develop a hypothesis that maps the family’s boundaries.
   4. closely monitor content and process.

REF: Lay of the Land

1. According to structural family therapy, the process of joining refers to:
   1. the process after the work in therapy has been achieved and the family is “joined” together in their new patterns.
   2. the therapist illustrating a sense of openness to the roles of the family system.
   3. something the family must do in order to show that they are ready for therapy.
   4. the therapist adapting to the rhythm and style of the family.

REF: Lay of the Land

1. What is the best definition of therapeutic spontaneity?
   1. The therapist doing as they please with their clients.
   2. The therapist flowing naturally and authentically in a variety of contexts and situations.
   3. The therapist creating interventions spontaneously when working with clients.
   4. the therapist acting rigidly in clinical situations.

REF: Lay of the Land

1. When the family is ineffectual as the challenger of symptoms, the family __________________________________________.
   1. is aggressive and attempts to challenge the symptomatic member
   2. is assertive and challenges members in order to maintain homeostasis
   3. symptom performs a regulatory function in maintaining the family structure
   4. is passive, failing to challenge the symptomatic member

REF: Lay of the Land

1. Minuchin conceptualized a family as a single system that also had multiple subsystems. All of the following would be considered a subsystem, EXCEPT:
   1. couple
   2. parents
   3. sibling
   4. pets

REF: Lay of the Land

1. Which of the following best defines a cross-generational coalition?
   1. The children form an alliance against the parents.
   2. A subsystem formed between a parent and child against the other parent.
   3. A subsystem formed between members of one generation against members of another (i.e. grandparents vs. children).
   4. A conflict between the parents in the upbringing of their child.

REF: Lay of the Land

1. Claudia, a structural family therapist is working with a family. At one point in the session, she hears the mother tell her son, “Don’t tell your dad and step-dad about this.” The therapist is observing what?
   1. covert coalition
   2. overt coalition
   3. triangle coalition
   4. hierarchical coalition

REF: Lay of the Land

1. When parents set rules that are developmentally too strict and unrealistic with consequences that are too severe, this is considered what kind of hierarchy?
   1. effective
   2. insufficient
   3. excessive
   4. severe

REF: Lay of the Land

1. When the parents of a 13-year-old allow their daughter to have a cell phone, but put rules in place for its use, such as requiring homework to be completed before she can use the phone and requiring that she turn the phone off by 9:00 p.m. each night, this could be considered an example of what type of parental hierarchy?
   1. Effective
   2. Insufficient
   3. Excessive
   4. Rigid

REF: Lay of the Land

1. It is not uncommon for an insufficient parental hierarchy to lead to which of the following outcomes?
   1. Disengaged family boundaries
   2. Enmeshed family boundaries
   3. Appropriate family boundaries
   4. Invested family boundaries

REF: Lay of the Land

1. The over/underfunctioner, the good/bad child, the understanding/strict parent, the logical/emotional partner, are examples of what kind of patterns?
   1. symmetrical
   2. asymmetrical
   3. complementary
   4. adaptable

REF: Lay of the Land

1. At each state of __________, family members need to negotiate boundaries to support individual members’ growth needs.
   1. personality development
   2. psychosexual development
   3. family development
   4. faith development

REF: Lay of the Land

1. All of the following are examples of structural goals EXCEPT:
   1. establishing clear boundaries between subsystems.
   2. developing a family structure that promotes development and growth of the individual and the family.
   3. distinguishing between the marital/couple subsystem and the parental subsystem.
   4. repenting for an injustice and forgiving.

REF: Lay of the Land

1. Reframing from a structural viewpoint is seen as:
   1. a way to highlight dysfunctional relationships in the family and place blame on one person.
   2. piecing together each member’s description of the problem and restating it so that the broader systemic dynamic is revealed.
   3. a way of viewing a problem to determine how much each individual contributes to the conflict and then finding an agreeable solution.
   4. enforcing dysfunctional interactional patterns.

REF: Lay of the Land

1. When a structural therapist asks a family member to changes seats, has a separate session with individuals or subsystems, or asks one member of the family to remain silent during an interaction, the therapist might be doing what kind of intervention?
   1. Boundary making
   2. Challenging the family’s worldview
   3. Reframing
   4. Unbalancing

REF: Lay of the Land

1. Alexis, a structural family therapist, had been working with a volatile couple in family therapy for a few months. During one session, she verbally questioned the assumption of the couple: “that it is better for the children if we stayed married,” to determine if that belief was having the effect the couple thought it should. What intervention was Alexis using?
   1. Boundary making
   2. Challenging the family’s worldview
   3. Reframing
   4. Unbalancing

REF: Lay of the Land

1. Occasionally, when a structural therapist is having extreme difficulty realigning a hierarchy in a family or a particular family member is being scapegoated, the therapist might use which of the following interventions?
   1. Boundary making
   2. Challenging the family’s worldview
   3. Reframing
   4. Unbalancing

REF: Lay of the Land

1. Intensity is an intervention best described by which of the following statements?
   1. Intensity is a technique in which the therapist “turns up the heat” by using tone of voice, pacing, and word choice to break through a barrier.
   2. Intensity is a technique in which the therapist and the client hypothesize a “worst case scenario” therefore allowing the client to manage their own anxiety more effectively.
   3. Intensity is a technique in which the clients reenact the problem but to a heightened degree therefore highlighting the family interactional patterns.
   4. Intensity is technique in which the therapist allows the family to discuss what they would do in a hypothetical situation therefore realigning the boundaries in the system.

REF: Lay of the Land

1. Making compliments and shaping competence are used by a structural therapist in order to ______________________________________________________.
   1. make therapy more enjoyable to clients
   2. augment and reinforce the family’s natural positive interaction patterns and strengths
   3. encourage the client about the progress that they are making in their own self discovery
   4. help the family function in therapy

REF: Lay of the Land

1. Mikayla and Jenna have been married for six years, and have recently decided to try therapy because they find they argue incessantly and are drifting apart emotionally. They are no longer able to spend quality time together without fighting, and both would rather spend time with friends or by themselves than with each other. They state that their arguments tend to follow the same theme time after time, regardless of what they are fighting about. Mikayla sees Jenna as “overly emotional” and states that she always breaks down during their fights. Jenna states that Mikayla never tries to understand her, that she can’t share her emotions and that she’d rather be “logical” all the time. From a structural viewpoint, how might you describe this relationship pattern?
   1. The boundaries in their relationship are too diffuse.
   2. The boundaries in their relationship are rigid; the couple doesn’t want to change.
   3. The boundries in their relationship are complementary; their roles have become rigidly polarized.
   4. The boundries in their relationship are symmetrical; each partner tries to match the other’s role.

REF: Lay of the Land

1. Based on the previous vignette, Harold, the structural family therapist working with Mikayla and Jenna takes into account that all behavior has reciprocal antecedents and describes their pattern of interaction like this: M affects J’s response, which then affects M’s response, ad infinitum. Harold is doing what?
   1. Reframing the complementary relationship, removing blame from one person and describing how each person contributes to the problem dynamic.
   2. Boundary making to help the couple strengthen diffuse boundaries.
   3. Challenging the couple’s assumptions by overtly questioning whether they are actually having the effect the couple anticipated.
   4. Using crisis induction by bringing the symptom into the room.

REF: Lay of the Land

1. Which of the following statements about using structural family therapy with diverse populations is TRUE?
   1. The structural family therapy model was not developed to attend to the dynamics and needs of diverse families, especially those families with children having difficulties.
   2. Structural family therapy employs an active and engaged approach with which the therapist often takes an expert stance in relation to the family, an approach that often fits with the values of traditional cultures.
   3. Minuchin and his colleagues developed structural family therapy to work with wealthy, rural families.
   4. Structural family therapy employs a passive approach in which the therapist often takes a deferential stance in relation to the family.

REF: Tapestry Weaving: Working With Diverse Populations

1. In brief strategic family therapy, a model that draws on structural and strategic therapies to address drug abuse problems with African American and Hispanic populations, all of the following are principals of intervention EXCEPT:
   1. joining to connect with the family system.
   2. enactments to assess family functioning.
   3. reframing to promote caring and concern in the family.
   4. paradox to get family members to do something different.

REF: Tapestry Weaving: Working With Diverse Populations

1. Ecosystemic structural family therapy (ESFT), an empirically supported adaptation of structural family therapy was developed to treat which population?
   1. Children and adolescents with severe emotional or behavioral problems and their families within the context of their communities
   2. Adolescents with substance problems and their families within the context of their communities
   3. Couples with one member who is severely depressed and their extended families within the context of their communities
   4. Young adult men and women with severe eating disorders and their families within the context of their communities

REF: Tapestry Weaving: Working With Diverse Populations

1. Lesbian families are generally found to have highly egalitarian parenting practices.
   1. True
   2. False

REF: Tapestry Weaving: Working With Diverse Populations

Short Answer

1. List and describe the three types of boundaries defined in structural family therapy. Describe cultural considerations related to the assessment of “healthy” family boundaries.
2. Discuss the strengths and challenges of utilizing enactments in therapy.
3. How does a therapist join with a family according to structural family therapy?
4. How do symptoms relate to the family system according to structural family therapy?
5. Describe the typical goals used for families in structural family therapy.