What does it mean to think systemically? And how do you demonstrate systemic thought on an exam?

These questions come from a prior edition of the official handbook for the National MFT Exam. Both questions are derived from the same case vignette.

A couple has been married for 1 ½ years and have a newborn baby. They seek therapy to deal with behavioral problems involving the mother’s three children from a previous marriage. The father angrily says that the children, 9, 12, and 16, mouth back at him and do not respect their mother’s authority. The couple has started having serious fights.

The therapist decides to focus initially on the times when the father has thought that the children were respecting their mother’s authority. The purpose of this focus is to help the:

1. Parents unite the marital dyad.

Which of the following statements should the therapist make to help the family perceive their complaints from a systems perspective? 

1. “It is difficult to be a stepfather.”

Ben Caldwell Labs is now High Pass Education. Ben Caldwell's license exam prep programs are available here. 

Intro/outro music: "Swampy Lands" by Adam Saban, licensed via Soundstripe.

Exam developers work diligently to produce what they believe to be strong, accurate exams. But just like everyone else, they occasionally make mistakes. What should you do when you read a question and you think, none of these answers sound right?

This question comes from the current edition of the official California LPCC Law & Ethics Exam Plan, available here.

During an initial session, a client tells the counselor that she is currently seeing another counselor. She expresses angry feelings toward the other counselor and would like to get another perspective on her problems. What action should the counselor take?

1. Contract a set number of sessions with the client before sending her back to her current counselor

Ben Caldwell Labs is now High Pass Education. Ben Caldwell's license exam prep programs are available here. 

Intro/outro music: "Swampy Lands" by Adam Saban, licensed via Soundstripe.

What's your moral framework? That can heavily influence your clinical and ethical decision-making -- but it might not line up well with the approach you're being tested on. This episode is especially true to our title: In deciding right and wrong, to Think Like the Test means to think from a much more rule-based approach than how many clinicians actually work.

This question comes from prior edition of our book Preparing for the 2023 California Clinical Social Work Law & Ethics Exam.

Your client has health insurance, but the insurance carrier is refusing to cover the client’s therapy because she is seeing you for couple therapy and does not, in your assessment, qualify for a diagnosis of mental illness. You should:

1. Assess the client’s ability to advocate on her own behalf with the insurance company.

Ben Caldwell's license exam prep programs are available here. 

Intro/outro music: "Swampy Lands" by Adam Saban, licensed via Soundstripe.

Therapists and reality TV shows are often not a great mix. And yet, it turns out that both of your esteemed hosts have some history with Hollywood. Learn more about how to think about dual-relationship exam questions -- and Ben's dark secret.

This question comes from an older edition of one of our books.

A therapist is concluding short-term treatment with a casting director for a production company that is interested in developing reality television shows about therapists. The client asks whether the therapist might be willing to be considered for one of the company’s shows that will be casting in a few months. The client would not be involved in the casting decision, and would not inform others at the company that he had been in therapy with the therapist. The therapist should:

1. Politely refuse the offer, as the casting decision would be made less than two years after the conclusion of therapy.

Ben Caldwell's license exam prep programs are available here. 

Intro/outro music: "Swampy Lands" by Adam Saban, licensed via Soundstripe.

What happens when an ethics question -- produced by the actual test developer -- doesn't actually line up with what the relevant code of ethics says? In today's episode, even the "correct" answer isn't entirely correct. We discuss why, and talk about who you should think of as "the therapist" on exam items.

This question comes from the current California BBS exam handbook for the LPCC Law and Ethics Exam.

Which of the following situations would constitute an unethical dual relationship?

1. A current client begins to attend an AA meeting where the counselor serves as secretary

Ben Caldwell's prep program for the California LPCC Law and Ethics Exam is available here. For Ben's other exam prep resources, visit BenCaldwellLabs.com.

Intro/outro music: "Swampy Lands" by Adam Saban, licensed via Soundstripe.

Logic is one of the most important test-taking skills. If you can rule out even one part of a response choice, you can rule out that entire response choice. In today's question, Carrie ties herself in knots, as many examinees do. Ben explains how to focus your attention to answer complex questions quickly and correctly. 

This question comes from the current BBS handbook for the California MFT Clinical Exam. 

A 25-year-old client initiates therapy with complaints of chronic depression and lack of motivation. The client currently lives with his grandparents, does not have any money, and is attempting to finish graduate school. He discloses that his parents had a traumatic divorce several years ago and he fears he will become like his father, who had an emotional breakdown and abused his mother. The client currently has a girlfriend who lives in another state, and he says he feels alone without her. Which of the following actions should the therapist take to assess this client?

1. Gather family history, explore client’s strengths, identify coping mechanisms

Ben Caldwell Labs is now High Pass Education. Ben Caldwell's prep program for the California MFT Clinical Exam is available here. For Ben's other exam prep resources, visit highpass.com.

Intro/outro music: "Swampy Lands" by Adam Saban, licensed via Soundstripe.

[Content advisory: This episode includes discussion of sexual assault. Listener discretion advised.]

Crisis management questions will often include multiple answers that are good things to do in the situation described. But there's often a key word in the question that can help you know which of those good options is the right answer.

And speaking of safety, Ben starts asking whether clinical licensing exams actually do the thing they're supposed to do -- assess for safety in independent practice. 

This question comes from the current BBS handbook for the California MFT Clinical Exam. 

A 36-year-old client initiates therapy and reports that the previous night she went on a date with a man she had met online. After dinner he raped her and then dropped her off at home as if nothing happened. She tells the therapist that she spent the night in the emergency room, and is afraid to go home because her assaulter knows where she lives. Which of the following actions should the therapist initially take in this crisis situation?

1. Re-establish the client’s feelings of control to reduce her sense of victimization

Intro/outro music: "Swampy Lands" by Adam Saban, licensed via Soundstripe.

[Content advisory: This episode includes discussion of client suicidality. If you or someone you know is considering suicide, call 988.]

Exams have been criticized for how they treat information about a client's culture. Resisting stereotyping is an important clinical and test-taking skill, but race weighs more heavily on mental health licensing exams than you might expect.

This question comes from Preparing for the 2019 California Clinical Social Work Law & Ethics Exam. You can find the 2023 edition here.

A therapist is deeply concerned about her young adult client from Central America, who has been gradually weaning herself off of mood stabilizing medication. The client’s doctor advised against the change, and the client has begun exhibiting risk-taking behavior including high-stakes gambling, experimentation with psychedelic drugs, and running barefoot on a freeway. In session, the client says she is planning her suicide, and that she has bought a gun. The therapist should:

1. Assess the client’s history.

Intro/outro music: "Swampy Lands" by Adam Saban, licensed via Soundstripe.

Key words in a question can often help lead you to the correct answer. In this episode, we discuss some to attend to -- and some that you shouldn't give much weight to.

This question comes from the current California Board of Behavioral Sciences handbook for the LCSW Law & Ethics Exam.

A client discloses that he had a sexual relationship with a previous therapist. The client does not disclose the identity of the former therapist. Which of the following actions should the therapist take to address the legal obligation in this case?

1. Report the incident to the licensing board

Intro/outro music: "Swampy Lands" by Adam Saban, licensed via Soundstripe.

Remember the key lesson from childhood games like Simon Says and Mother May I -- always listen carefully to the instructions.

This question comes from Ben Caldwell Labs' program for the California LMFT Clinical Exam. (It's not from one of the full-length mocks, we wouldn't want to give the answer to one of those away.)

An MFT in a community mental health center receives a new client. The client reports that her family is having financial troubles because her husband recently was laid off, and they have been relying on her income from cleaning houses. Since the layoff, she has taken on five additional houses a week. She reports that her children have told her that she has become angry and mean, and she does not like the person she has become. She says that when she comes home from work, she is so irritable that she throws things. She also reports that she has been drinking more than usual. How should the MFT conceptualize her symptoms:

1. The client has repressed anger about her husband’s layoff

Intro/outro music: "Swampy Lands" by Adam Saban, licensed via Soundstripe.