Using Systemic Thinking: MFT Family Therapy Cases

Family therapy is an integral part of Marriage and Family Therapy (MFT) practice, relying heavily on systemic thinking. Systemic thinking involves understanding the interactions and relationships within a family as interconnected and mutually influential, rather than isolated or linear. For therapists preparing for the MFT licensing exam, mastering systemic thinking through family therapy cases is essential.

What Is Systemic Thinking?

Systemic thinking in family therapy focuses on the family as a system, meaning each member’s behavior and emotional state affect and are affected by others. It emphasizes patterns, interactions, and the context rather than individual symptoms alone.

Example Case: The Smith Family

Consider a family presenting with a teenager, Alex, who is withdrawn and performing poorly in school. Systemic thinking encourages examining not just Alex’s behavior but how the entire family’s interactions might contribute to or maintain these issues. Perhaps Alex’s parents are experiencing marital stress, inadvertently increasing household tension, causing Alex to retreat emotionally and academically.

Applying Systemic Thinking

When applying systemic thinking in therapy, it’s important to consider several key aspects:

  • Identify Patterns: Notice repeated interactions. Is the withdrawn behavior a reaction to conflict? Are family members communicating effectively?
  • Explore Roles and Boundaries: How defined or rigid are the roles and boundaries within the family? Are there clear parental roles, or is there confusion creating anxiety and conflict?
  • Consider Family Narratives: Every family holds certain beliefs or narratives about themselves. Are these narratives contributing positively or negatively to the situation?
  • Contextual Influence: Examine how external contexts, like cultural expectations or socioeconomic status, influence family interactions and roles.

Systemic Interventions

Several systemic interventions can help strengthen family dynamics:

  • Reframing: Help the family view problems differently, fostering empathy and understanding.
  • Circular Questioning: Engage family members to consider how their actions affect others, promoting insight into their interconnectedness.
  • Boundary Setting: Guide families to establish healthier boundaries, reducing conflict and confusion.

3 Systemic Intervention MFT Practice Questions

MFT Practice Question 1

You are a structural family therapist working with Alicia (29) and her young daughter, Isla (5). Alicia states that she wants to feel closer to her daughter and feels terribly guilty that she works so many long hours. Isla seems disinterested and is sitting on the floor and focused only on playing with the crayons and stuffed animals in your office.

Given this information, how might you NEXT proceed with boundary making with Alicia and Isla?

A. Ask Alicia to sit next to her daughter on the floor while they talk about going to the beach this weekend
B. Ask Alicia to wait until Isla is done playing to continue the discussion
C. Ask Isla to keep playing but sit next to her mother on the couch while she plays
D. Continue honoring the autonomy that exists between Alicia and Isla by letting them remain where they are

Correct answer: A. Ask Alicia to sit next to her daughter on the floor while they talk about going to the beach this weekend.

This is the best strategy, as it focuses on building closeness. Encouraging Alicia to sit on the floor with her daughter can help to correct some of the disengagement in this family. This is a key strategy of structural family therapy. Boundary making entails taking an action, so allowing them to keep doing what they’re doing does not achieve that.

References
An Introduction to Marriage and Family Therapy, 2nd Edition. Pg 140.

MFT Practice Question 2

You are working with Noelle, a middle-aged woman who strongly dislikes her job and struggles with negative self-talk. At one point, she says, “I hate that I’m so stubborn.” You respond by saying, “Rather than stubborn, I see you as someone who clearly knows and lives according to her values.”

This intervention is known as:

A. Validating
B. Socratic questioning
C. Engaging in positive connotation
D. Reframing

Correct answer: D. Reframing

Reframing is when a therapist shifts a certain negative phrase into a more positive one. Socratic questioning would include thoughtful questions like, “What do you make of this stubbornness?” Engaging in positive connotation would be prescribing a positive motive to certain behavior. Validating might sound like, “I can see how hard this is for you.”

References
An Introduction to Marriage and Family Therapy, 2nd Edition. Pg 202.

MFT Practice Question 3

A therapist is meeting with a young girl and her parents for family therapy. The parents are contemplating divorce, and they want to provide a supportive environment for their child should they separate.

What early-phase goal would a family therapist applying Milan systemic theory have for this family?

A. Invite everyone to explore the system and share their thoughts on what could improve
B. Support family members in opening up to the therapist’s hypothesizing
C. Psychoeducate family members on the various dyads maintaining the family structure
D. Explore healthy solutions for creating systemic change

Correct answer: B. Support family members in opening up to the therapist’s hypothesizing.

Milan systemic therapists embrace therapist neutrality. They obtain information about the family’s goals and needs and often ask circular questions that help clients understand the best outcome for their situation. Engaging in hypothesizing is an early goal that invites families to open up to new perspectives and change the family’s usual “game.”

References
An Introduction to Marriage and Family Therapy, 2nd Edition. Pg 183-187.

Preparing for the MFT Licensing Exam

When approaching systemic therapy cases on your licensing exam, clearly identify the systemic principles at play and select interventions that enhance family system functioning. Practice regularly with case examples to sharpen your ability to think systemically.

Mastering systemic thinking prepares you not only to succeed on your MFT exam but also to effectively support families toward lasting positive changes in your professional practice.

Test Your Skills With Pocket Prep

Mastering systemic case scenarios is key to becoming a confident and effective Marriage and Family Therapist. By practicing with realistic, exam-style cases, you’ll sharpen your clinical judgment and reinforce the theories and interventions essential to MFT practice.

Ready to test your knowledge of everything from treatment planning to family systems theory? Pocket Prep’s MFT Exam Prep covers the core domains of the exam and includes six quiz types—like Weakest Subject quizzes and timed Mock Exams—to help you focus your study and build confidence. Start strengthening your systemic thinking today!