Clinical Practice SWES Practice Exam

What is the most important contraindication for marital therapy?

1. Paranoid reactions by a marital partner

2. The fragility of one partner's defenses

3. Actual violence threats between partners

4. One partner's acting out behavior

The correct answer is: Actual violence threats between partners

In the context of marital therapy, the most important contraindication is actual violence threats between partners. This is because situations involving threats of violence indicate a serious risk to the safety and well-being of one or both partners involved. When there is the potential for physical harm, the primary concern must be the safety of individuals before addressing relational dynamics. In cases where there are threats of violence, therapy could inadvertently place a partner in a situation where their safety is compromised. The focus in such cases should be on de-escalating potential violence, ensuring safety, and possibly involving legal or protective measures if necessary. Furthermore, engaging in therapy without addressing underlying violent behavior could exacerbate tension and lead to further harm. Other options, while significant to consider, do not present an immediate risk to safety like violence does. For example, paranoid reactions or the fragility of a partner's defenses may complicate therapy but do not imply an immediate danger. Similarly, acting out behavior indicates distress or dysfunction but lacks the urgency that accompanies threats of violence. Thus, prioritizing safety in the context of actual violence threats is paramount in deciding the appropriateness of marital therapy.