What Do You Need to Know About Treating Couples for the LCSW & MFT Exam?

By Bethany Vanderbilt on June 20, 2012

It’s Tuesday, and even though I have a wicked case of the sniffles, it’s time for another Hot Topic.  We’re headed into pretty juicy territory here: Treating Couples.  Not everyone will work with couples directly, but even if both partners aren’t in the room with you, couples issues will impact your work and need to be addressed. Here’s a sample question…

Sample:

After 10 years together, a couple decides to seek treatment for increasing tension and feelings of disconnection and anger.  They meet with a therapist and decide on a course of treatment that includes weekly sessions and homework.  After several sessions, one partner calls the therapist and admits to having a long-term affair; the partner pleads with the therapist not to say anything and states a plan to end the affair to focus on the relationship.  What should the therapist do NEXT?

A.   Explore the partner’s reasons for telling the therapist about the affair now

B.   Validate the partner’s feelings and encourage the partner to disclose the information before the next session

C.  Remind the partner of the therapist’s no-secrets policy and the need to address this issue in session

D.  Clarify the partner’s plan to end the affair and explore the impact on the current relationship

This is not the most creative question I’ve ever written – in fact, it’s aclassic question that might get asked on an exam.  The famous “no-secrets policy” is a concept that you should be very familiar with, as well as the ethical response to a situation like the one described above. Contrary to it’s name, a no-secrets policy doesn’t mean that everything shared in an individual session or phone call will be shared with the other partner – that would be pretty wild!  What it does mean, is that the therapist won’t keep a secret on behalf of one partner that has the potential to damage the couple’s relationship or ability to benefit from treatment.  In some cases, this may mean facilitating a disclosure at the next session, and in other cases, it may mean working with the individual over time to work up to a disclosure.  NASW, AAMFT, and CAMFT all address this issue (directly or indirectly) in their ethical standards.

Answer:

The answer to the question above is C; this is the ethical response and ensures that the therapist doesn’t get pulled into a conflict that has the potential to completely derail treatment.  A is a pretty good answer, but would not occur before C; likewise, the therapist might at some point do D, but not as a first step.  B is not the best answer because encouraging the client to disclose the information before the next session may cause harm and result in abrupt termination. Knowing your discipline’s code of ethics and really understanding its application can give you a huge advantage on the exam – and make you a better therapist (which is what we’re really here for, right?).

Coming up next week: Treating Families

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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