MFT Exam Study – Strategic + Structural Therapy

🎧 Strategic Therapy (Core Concept)

  • Focus: Change behavior directly

  • Time focus: Present (not past)

  • Goal: Solve problems quickly by interrupting patterns

  • NOT about insight, emotions, or childhood

🧠 Strategic Therapy – Key Question

  • “What is keeping this problem going right now?”

🛠 Strategic Therapy – Techniques

  • Directives: Therapist gives clear instructions

  • Paradoxical interventions: Client is told to do the problem

  • Reframing: Change meaning of behavior

⚠ Strategic Therapy – Exam Traps

  • NOT insight-based

  • NOT focused on emotions

  • NOT focused on childhood

  • YES → action-based, present-focused

💡 Strategic Memory Hook

  • Strategic = Strategy = Action

🎧 Structural Therapy (Core Concept)

  • Focus: Family structure

  • Looks at organization, power, roles, and patterns

  • Problems come from unhealthy structure

🧱 Structural Therapy – Boundaries

  • Rigid: Too distant, disconnected

  • Diffuse: Too close, enmeshed

  • Healthy: Balanced

👨‍👩‍👧 Structural Therapy – Key Concepts

  • Subsystems: Parental, sibling

  • Hierarchy: Parents should be in charge

  • Coalitions: Two members team up

🚨 HIGH-YIELD

  • Cross-generational coalition = parent + child vs other parent

🛠 Structural Therapy – Techniques

  • Joining: Build trust, enter system

  • Enactment: Family acts out interactions

  • Boundary making: Adjust closeness/distance

  • Unbalancing: Shift power temporarily

⚠ Structural Therapy – Exam Clues

  • Boundaries

  • Hierarchy

  • Subsystems

  • Family structure

💡 Structural Memory Hook

  • Structure = Boundaries + Hierarchy + Subsystems

❓ QUIZ MODE

Q: Therapist gives instructions to change behavior.
A: Strategic Therapy

Q: Client told to stay awake on purpose.
A: Paradoxical intervention (Strategic)

Q: Focus on present behavior only.
A: Strategic Therapy

Q: Child has too much control in family.
A: Structural Therapy (Hierarchy issue)

Q: Parent + child vs other parent.
A: Cross-generational coalition

Q: Too much closeness, no privacy.
A: Diffuse boundaries

Q: Emotional distance, disconnection.
A: Rigid boundaries

Q: Family acts out conflict in session.
A: Enactment

Q: Therapist shifts power in session.
A: Unbalancing

Q: Mentions boundaries, hierarchy, subsystems.
A: Structural Therapy

🔥 HARD SCENARIO QUESTIONS (EXAM STYLE)

Question 1:

A couple reports frequent arguments that escalate quickly. The therapist instructs them to argue every evening at 7 PM for exactly 15 minutes and stop after that time.

What is the BEST answer?

A. Structural Therapy – Enactment

B. Strategic Therapy – Directive

C. Bowen Therapy – Differentiation

D. CBT – Behavioral activation

Answer:

B. Strategic Therapy – Directive

Question 2:

A client struggles with insomnia. The therapist instructs the client to try to stay awake as long as possible each night.

What is the therapist using?

A. Reframing

B. Enactment

C. Paradoxical intervention

D. Boundary making

Answer:

C. Paradoxical intervention

Question 3:

During a session, a therapist notices that a mother constantly speaks for her teenage son and does not allow him to answer questions. The therapist asks the mother to step back and directs questions to the son.

What is the BEST answer?

A. Strategic Therapy – Directive

B. Structural Therapy – Boundary making

C. Bowen Therapy – Differentiation

D. Narrative Therapy – Externalization

Answer:

B. Structural Therapy – Boundary making

Question 4:

A therapist asks a family to demonstrate how they typically handle disagreements during the session.

What technique is being used?

A. Joining

B. Reframing

C. Enactment

D. Paradoxical intervention

Answer:

C. Enactment

Question 5:

A child refuses to follow rules at home and makes most of the decisions. The parents report feeling “out of control.”

What is the MOST accurate conceptualization?

A. Diffuse boundaries

B. Rigid boundaries

C. Hierarchy problem

D. Enmeshment

Answer:

C. Hierarchy problem

Question 6:

A therapist aligns with a quieter parent during a session to help shift the power dynamic in the family.

What technique is this?

A. Joining

B. Unbalancing

C. Directive

D. Reframing

Answer:

B. Unbalancing

Question 7:

A family presents with emotional distance. Members avoid discussing feelings and rarely interact.

What type of boundary issue is MOST likely?

A. Diffuse boundaries

B. Rigid boundaries

C. Cross-generational coalition

D. Enmeshment

Answer:

B. Rigid boundaries

Question 8:

A mother and daughter consistently side together against the father during conflicts.

What is the BEST answer?

A. Enmeshment

B. Diffuse boundaries

C. Cross-generational coalition

D. Hierarchical balance

Answer:

C. Cross-generational coalition

Question 9:

A therapist focuses on identifying and interrupting the pattern that maintains a couple’s conflict, without exploring their past.

What therapy is being used?

A. Structural Therapy

B. Strategic Therapy

C. Bowen Therapy

D. Psychodynamic Therapy

Answer:

B. Strategic Therapy

Question 10:

A therapist spends the session reorganizing family interactions, ensuring the parents take leadership roles and children are not in control.

What is the BEST answer?

A. Strategic Therapy

B. CBT

C. Structural Therapy

D. Narrative Therapy

Answer:

C. Structural Therapy

🔥 BONUS TRICK QUESTION

Question 11:

A therapist explores how a client’s childhood experiences shaped their current relationship patterns.

What is the BEST answer?

A. Strategic Therapy

B. Structural Therapy

C. Psychodynamic Therapy

D. MRI Therapy

Answer:

C. Psychodynamic Therapy

🧠 FINAL TEST YOURSELF

If the question focuses on:

• “What should the therapist DO right now?”

→ Strategic Therapy

• “Family roles, boundaries, hierarchy”

→ Structural Therapy

• “Past experiences, insight, childhood”

→ PsychodynamiC