MFT National Practice Questions (2026) — Free Sample Questions with Answers

Answer: A

access the attachment fear beneath her reactive anger.: Correct. In emotionally focused therapy (Johnson), the therapist moves past the reactive secondary emotion (anger) to the primary attachment emotion (fear of being abandoned) to soften the pursue-withdraw cycle.

practice a gentle start-up when raising complaints.: Gentle start-up is a Gottman Method skill; the question is not skill-building.

identify the cognitive distortion behind her criticism.: Identifying distortions is cognitive-behavioral work; the question explores emotional experience, not thoughts to be corrected.

connect her reactions to her family of origin.: The question stays in the present moment of the cycle; it does not trace intergenerational patterns.

EFT de-escalates a couple's negative cycle by accessing the attachment emotions beneath reactive anger or withdrawal and helping partners express them.

Answer: D

The parents extend each grounding from one week to two: More of the same solution; a change in amount within the existing rules is first-order change.

The son keeps his curfew for two weeks after a warning: Temporary compliance within the unchanged parent-control/son-resistance structure is first-order change, and the old cycle can easily return.

The parents replace grounding with taking away his phone: Swapping one punishment for another keeps the same rule (parents escalate control, son resists), so it is still first-order change.

The family renegotiates how its rules get made: Correct. Changing the rules about how rules are made (the system's meta-rules) alters the structure that produced the escalating cycle; that is second-order change.

First-order change alters behavior within a system's existing rules (often "more of the same"); second-order change alters the rules themselves (Watzlawick, Weakland and Fisch).

Answer: D

disruptive mood dysregulation disorder.: DMDD requires symptoms for at least 12 months in at least two settings.

conduct disorder, childhood-onset type.: Conduct disorder requires repeated violations of others' rights or major rules over 12 months, such as aggression or theft; tantrums alone do not qualify.

oppositional defiant disorder, mild.: ODD requires a pattern lasting at least six months; this has lasted five weeks.

an adjustment disorder.: Correct. The symptoms began within three months of an identifiable stressor (the separation) and cause clinically significant problems at home. A systems lens adds that the behavior appears in only one household, pointing to the relational context of the transition.

Recent onset after an identifiable stressor points to an adjustment disorder; check the duration rules (6 months for ODD, 12 months for DMDD) before choosing a disruptive behavior diagnosis.

Answer: D

a clear boundary around the parental subsystem.: Only the father side is clear; the diffuse boundary and the coalition show the parental subsystem is not protected.

a disengaged father–daughter subsystem.: The line between Father and Daughter is a clear boundary, not a rigid one, so disengagement is not shown.

conflict detoured through the daughter.: Detouring would be drawn as parents united against or around a child; the daughter has no line to either parent here.

a cross-generational coalition of mother and son.: Correct. The bracket joins Mother and Son across the parent–child line, the boundary between them is diffuse, and the parents are in conflict: the classic picture of a cross-generational coalition that weakens the parental subsystem.

In Minuchin notation, a bracket linking a parent and child across the generational line, with conflict between the parents, signals a cross-generational coalition.

Answer: C

Note the comment and revisit it at the next session: Delays risk assessment; a statement about others being better off without him is a recognized warning sign that needs attention now.

Refer the husband for a medication evaluation: Out of sequence; a referral may follow, but the level of risk has to be assessed first.

Ask him directly about suicidal thoughts and plans: Correct. A possible suicide warning sign calls for direct, nonjudgmental questions about ideation, plan, intent and means before anything else. Asking directly does not increase risk, and his minimizing does not rule it out.

Ask the wife to watch his mood at home this week: Hands the assessment to a family member and leaves the current risk unknown.

When a possible suicide warning sign appears, in any modality, the first step is a direct assessment of ideation, plan, intent and means.

Answer: A

“What do you notice about fathers and sons across these generations?”: Correct. The genogram shows a cutoff between father and son in each of the last two generations, and conflict now between Ivan and Nikolai. A curious, open question helps Ivan see the multigenerational transmission and lowers his reactivity (McGoldrick; Bowen).

“Your father’s cutoff from you is what causes this conflict.”: This gives a linear, blaming cause. Bowen-informed genogram work invites the family to notice patterns; the therapist does not hand down a verdict.

“Nikolai needs firmer limits now that he is almost an adult.”: This moves to linear advice about the son and ignores the multigenerational pattern that the genogram shows.

“Let’s set the genogram aside and focus on this week’s argument.”: Dropping the genogram wastes the intervention just when it could link the current conflict to a repeating pattern.

Used as an intervention, a genogram helps the family discover repeating multigenerational patterns through curious questions. The therapist does not supply causes.

Answer: D

prescribing the pursue–withdraw pattern.: Prescribing the symptom is a strategic and paradoxical move; EFT names the cycle in order to de-escalate it.

teaching speaker–listener skills.: Structured communication skills come from behavioral and skills-based couple approaches, not from EFT.

promoting the withdrawer’s re-engagement.: Withdrawer re-engagement is a Stage 2 task. It comes after the cycle has been de-escalated, so it is out of sequence here.

tracking the negative interaction cycle.: Correct. In EFT Stage 1, de-escalation (Johnson), the therapist tracks and reflects the pursue–withdraw cycle and the feelings under it. This casts the cycle, not either partner, as the enemy.

EFT Stage 1 de-escalation tracks the negative cycle and the attachment feelings under it, so the couple sees the cycle as the shared enemy.

Answer: B

“Lorna, how do you see what Kenji just said?”: This passes Kenji’s concern about the therapist to his partner, which risks confirming that the therapist and Lorna are aligned.

“Thank you for saying so. What did I do that felt that way?”: Correct. Kenji is signalling a split alliance. The therapist names the rupture without defending, asks for specific feedback and stays accountable, which repairs the alliance with the partner who feels less supported (task 03.01).

“I stay neutral, so I’m not taking either side.”: A defensive answer dismisses Kenji’s experience and leaves the rupture in place.

“Let’s meet individually until you feel more comfortable.”: Switching to individual sessions before the rupture is explored splits the couple system and avoids the alliance issue.

When one partner feels less supported in conjoint therapy, address the rupture openly and without defensiveness, and ask for that partner’s feedback.

Answer: C

are improving faster than expected.: Clients who are already on track gain little from the feedback; their outcomes are good either way.

are seen by the most experienced therapists.: The feedback effect does not depend on therapist experience.

are not progressing as expected.: Correct. Feedback works mainly by alerting therapists to clients who are not on track (Lambert and colleagues). In couple therapy, Anker, Duncan and Sparks (2009) also found better outcomes with feedback.

complete measures only at their final session.: A single end-point measure cannot guide treatment while it is happening.

Routine outcome monitoring helps most by flagging clients who are not on track so that the therapist can change course early.

Answer: D

Ending therapy now, since all treatment goals have been met: Ignores the two predictable stressors ahead; an abrupt stop gives the family no chance to practice its new skills under strain.

Continuing weekly sessions until the schedule change happens: Continues treatment beyond clear benefit (AAMFT Code 2026, 1.8) and implies the family cannot cope without the therapist.

Referring the family to a parenting group and closing the case: A referral is not a termination plan and does not consolidate the family's own gains.

Tapering sessions and planning for the upcoming changes together: Correct. A termination plan to maintain gains spaces out the final sessions and has the family anticipate the school change and the new parenting schedule, rehearsing how they will use their new structure.

When goals are met but known stressors are ahead, taper sessions and plan with the family how it will handle them.

Answer: A

Propose couple sessions and revise the goals with them: Correct. Task 04.04 asks the therapist to keep evaluating whether the modality fits. Nell’s presenting problem has improved and the parents are asking for couple work, so the therapist proposes couple sessions and renegotiates goals and the contract with them (including routine separate screening for partner violence and how information from the family work will be handled), which also moves the marital conflict out of Nell’s hearing.

Keep meeting as a family, since Nell’s goals came first: Holding to the original format ignores that the clients’ needs have changed and keeps Nell exposed to her parents’ marital conflict.

Refer the parents elsewhere and end the family’s treatment: Ending treatment and transferring the parents disrupts an established alliance without a clinical reason; the modality can change within the current therapy.

Ask Nell how the arguments affect her at home: Asking Nell to report on her parents’ fights draws her into the marital conflict (triangulation) instead of moving it to the couple subsystem.

When the presenting problem resolves and a different relational need emerges, revisit the modality and contract with the clients, and move marital conflict to the couple subsystem.

Answer: D

Email her the number of a crisis line: Far too passive for a medical emergency in progress.

End the video call and phone emergency services: Ending the call loses contact with Yara and the chance to monitor her condition.

Tell Yara to drive herself to the nearest emergency room: She has taken an overdose and is drowsy; driving is dangerous.

Stay connected while emergency services are sent to her apartment: Correct. The therapist keeps the connection open and sends emergency services to the location confirmed at the start of the session (by a second phone or a colleague), then uses the emergency contact as needed. This is why identity, location and safety are confirmed at every teletherapy session (task 06.10).

In a teletherapy emergency, stay connected and dispatch help to the client's confirmed location; the session-start location check makes this possible.

Answer: B

hide them where Kai is unlikely to find them.: Teens often know where firearms are hidden; hiding does not reliably limit access.

store them outside the home until the crisis passes.: Correct. Lethal means counseling favors temporary storage away from the home (with a trusted relative, a gun shop or law enforcement, as local law allows). Suicidal crises are often brief, so removing access to a highly lethal method lowers the risk of death.

keep them at home as long as Kai denies a plan.: Ideation can escalate quickly; denying a plan today does not make access safe.

teach Kai safe firearm handling to prevent accidents.: Handling skills address accidents, not deliberate suicidal use.

Lethal means counseling is part of every suicide safety plan; for firearms, temporary storage outside the home is the most protective option.

Answer: A

prohibited, however much time has passed.: Correct. AAMFT Code 1.4 prohibits all forms of sexual behavior with current and former clients and with known members of the client's family system, with no time limit. The sister was known to the therapist through Philippa's sessions.

permitted, because more than two years have passed.: The Code sets no waiting period; the prohibition has no time limit.

permitted, if the therapist first consults a colleague.: Consultation cannot make prohibited conduct acceptable.

permitted, because she was never a client.: Code 1.4 extends the ban beyond clients to known members of the client's family system.

Sexual or romantic involvement with current or former clients, or with known members of their family system, is never permitted.

Answer: D

Check that the recording feature is turned on: Recording requires prior written authorization (Code 1.11) and is not a routine first step.

Review the homework assigned last session: Reviewing homework is useful but comes after the session-start check.

Ask each partner to rate the week's conflict: Routine outcome monitoring is valuable but not the first step of a teletherapy session.

Confirm the couple's identity, location and safety: Correct. Task 06.10 calls for confirming identity, current location and safety at the start of every teletherapy session. Location matters for emergency response and for whether the therapist may legally practice there (Code 6.6).

Open every teletherapy session by confirming who is present, where they are, and whether they are safe.

Answer: A

Written authorization from both Simone and Teodoro: Correct. In couple treatment, AAMFT Code 2.2 and 2.3 require written authorization from each competent individual before records are released or accessed. Simone's request alone is not enough, because the record also holds Teodoro's information.

Simone's written request, since she is a client: One partner's request is insufficient in conjoint treatment; each competent member must authorize the release (Code 2.3).

A verbal agreement from each partner: Verbal authorization is sufficient only in emergencies (Code 2.2); a records request from an attorney is not one.

A written request from Simone's attorney: An attorney's request is neither client authorization nor a court order; it does not permit release.

Releasing or giving access to couple or family records requires written authorization from every competent member of the treatment unit.