AATBS PXAM B

Question ID #13302: The label "primary," when applied to a sexual dysfunction, means which of the following? A. The person is extremely distressed by his or her sexual dysfunction. B. The person's sexual dysfunction began following a psychosocial stressor. C. The person's sexual problem has been present since his or her first sexual experiences. D. The person's symptoms of sexual dysfunction are attributable to the effects of a substance, medication, or medical condition.

C. The person's sexual problem has been present since his or her first sexual experiences. **Sexual dysfunctions are considered "primary" when they have existed since the onset of the person's sexual functioning (his or her first sexual experiences). Sexual disorders that are considered "secondary" develop after a period of relatively normal sexual functioning. These terms are used by many authors in the field (e.g., Masters and Johnson), but DSM-5 uses the word "lifelong" for primary sexual dysfunctions, and the term "acquired" for secondary sexual dysfunctions. Answer A: See C. Answer B: This would be a secondary, or acquired, sexual dysfunction. Answer D: Sexual dysfunctions are considered "primary" when they have existed since the onset of the person's sexual functioning (his or her first sexual experiences).

Question ID #13129: Once pharmacological treatment has been initiated, intervention for a client in the acute phase of schizophrenia should usually emphasize which of the following goals? A.Reducing stressful relationships, events, and environments and promoting relaxation B.Improving the client's adaptation and minimizing the likelihood of relapse C.Sustained symptom control, establishing medication compliance, and preventing relapse D.Addressing functional impairments in activities of daily living

A .Reducing stressful relationships, events, and environments and promoting relaxation **The primary goals of treatment during the acute phase of schizophrenia are to reduce stressful or overstimulating relationships, events, and environments and to promote relaxation (American Psychiatric Association, 2004). This includes providing the client with clear and simple communications and expectations, a structured and predictable environment, low performance requirements, and a non-demanding and supportive relationship with the therapist. The client and their family should also be offered information on the nature and management of schizophrenia as appropriate to the client's capacity to understand the information. The family should also be provided information about community resources and organizations. Answer B: This would be a goal of treatment after the client is stabilized on medications with a reduction in stressful events/relationships. Answer C: This would be a future goal in treatment after initial stabilization of medications and stress management has occurred. Answer D: This could be an individualized goal for clients but may not be applicable for all clients with this diagnosis. The question is asking about the acute phase of treatment.

Question ID #13308: A social worker has noted in a client's record that the client has been diagnosed with paranoid personality disorder. Which of the following would this client be MOST likely to display, based on his diagnosis? A. Jealousy B. A pervasive fear of being perceived as inadequate C. Magical thinking D. A desire to exploit others

A. Jealousy **The essential feature of paranoid personality disorder (PPD) is a pervasive pattern of distrust and suspiciousness that entails interpreting the motives of others as malevolent. Individuals with PPD may be pathologically jealous: they often suspect, without sufficient justification, that their spouse or sexual partner is unfaithful and may gather supposed "evidence" to support their jealous beliefs. To maintain complete control and avoid being betrayed in intimate relationships, they may constantly question or challenge the whereabouts, actions, intentions, and fidelity of their spouse or sexual partner. Answer B: A pervasive fear of being perceived as inadequate is more characteristic of individuals with avoidant personality disorder. Answer C: Magical thinking is associated with schizotypal personality disorder. Answer D: A desire to exploit others is associated with antisocial personality disorder. Individuals with PPD sometimes engage in antisocial behavior, but their motivation for doing so is usually revenge, rather than a desire to exploit others.

Question ID #13793: Immunization programs, prenatal nutrition programs, Meals on Wheels, and public education programs on drug and alcohol abuse are all examples of what type of preventions? A.Primary prevention B.Secondary prevention C.Tertiary prevention D.Community organization

A. Primary prevention ***Primary preventions are aimed at reducing the prevalence of mental and physical disorders by decreasing the incidence of new cases. This is accomplished by making an intervention that promotes mental or physical health available to all members of an identified group or population. Answer B: Secondary preventions are used as an attempt to decrease the prevalence of mental and physical disorders by reducing their duration through early detection and intervention.Answer C: Tertiary prevention programs are designed to reduce the duration and consequences of mental and physical disorders.

Question ID #13633: Susan is a school social worker and has been assigned to meet with Hugh after his father passed away due to a workplace accident. Hugh is 11-years-old. Susan knows that children's reactions to and understanding the death of a parent differ depending on their age. She should expect to see some of the following reactions exhibited by Hugh EXCEPT _______________. A. believing death is temporary or reversible B. understanding death is final and may worry about his own death C. May experience denial and not want to talk about what happened D.wanting to ask a lot of questions about death

A. believing death is temporary or reversible **This is more commonly seen from a child that is 2-5 years of age. During these ages, a child's understanding of death is limited, and may believe that the death is temporary or reversible. Answer B: Understanding the finality of death is a typical reaction among 8-12 years of age. Answer C: Experiencing denial and not wanting to talk about what happened is a typical reaction of 8-12 year old children after experiencing the death of a parent. Answer D: 8-12 year old children are likely to ask many questions about the death, such as "What happened to the body?"

Question ID #13622: Which of the following children is MOST likely to have been sexually abused? A.A 7-year-old who frequently masturbates at school B.A 7-year-old who is fearful and has severe behavioral problems C.A 7-year-old who performed oral sex on a 9 year old D.A 7-year-old who wears clothing in a manner that hides her body as much as possible

A.A 7-year-old who frequently masturbates at school **This child "frequently" masturbates at school, and inappropriate masturbation that has a compulsive or driven quality is an indicator of sexual abuse. Answer B: This might indicate sexual abuse, but these indicators are more commonly found in children who have been physically abused. Answer C: This is the second-best answer. Atypical sexual play and an unusual level of knowledge about sexual activity are indicators of sexual abuse. In this answer, however, it's not clear which child initiated this activity. In addition, sexually abused children who engage in aggressive or forced sexual activity with other children usually do so with younger children. Answer D: This may be an indicator of sexual abuse (to protect one's body). However, children who have been physically abused may also use clothing to hide their bodies-in particular, their injuries.

Question ID #13197: A woman makes an appointment for counseling at the recommendation of her physician after sharing some traumatic life experiences with him. The woman tells the social worker that a friend of hers suggested she look into treatment using Eye Movement Desensitization and Reprocessing (EMDR) and she wants this same treatment method. About two years ago, the social worker took a course in graduate school on different treatments that covered EMDR, but he hasn't used this yet in his practice or been formally trained. What should the social worker do? A.Admit his lack of expertise with EMDR as a treatment method and refer the woman to a different social worker B.Advise the woman that her traumatic life experiences can be addressed by using other methods of treatment that the social worker is qualified to useIncorrect C.Accept the woman for treatment and begin utilizing EMDR after reviewing his class notes and current literature on this treatment method D.Accept the woman for treatment and begin utilizing EMDR, but seek consultation or supervision if he has any problems during the course of treatment

A.Admit his lack of expertise with EMDR as a treatment method and refer the woman to a different social worker **The social worker would be acting unethically (and illegally) if he provided a treatment that he is not competent to use. One class on EMDR two years ago is not sufficient education, training, or professional experience to make the social worker competent to use this technique. Therefore, it is in the client's best interests for him to refer her to a social worker who is qualified to use this technique. Answer B: It would be unethical for the social worker to try to persuade the client to choose a different course of treatment just because he is not qualified to provide the treatment she wants. Answer C: Reviewing class notes and current literature on EMDR would not provide adequate training, education, or professional experience to make the social worker competent to use EMDR with a client. Answer D: This is also inadequate. In addition, it implies that the social worker would seek consultation or supervision only if he encountered problems while treating the client rather than getting guidance right from the beginning.

Question ID #13580: Which of the following is NOT included as an alcohol-related disorder in the DSM-5? A.Alcohol dependence B.Alcohol intoxication C.Alcohol withdrawal D.Alcohol-induced major neurocognitive disorder

A.Alcohol dependence **The DSM-IV-TR diagnoses of alcohol abuse and alcohol dependence have been replaced in the DSM-5 by alcohol use disorder. Answer B: Alcohol intoxication is included as a diagnosis in the DSM-5 and involves maladaptive behavioral and psychological changes with at least one characteristic symptom (e.g., slurred speech; unsteady gait; nystagmus; impaired attention or memory). Answer C: The DSM-5 describes alcohol withdrawal as involving the development of at least two characteristic symptoms within several hours to a few days following cessation or reduction of alcohol consumption (e.g., autonomic hyperactivity, hand tremor, insomnia, transient illusions or hallucinations, seizures). Answer D: Alcohol-induced major neurocognitive disorder is described in the DSM-5 as involving a significant decline in one or more cognitive domains that interferes with independence in everyday activities. The DSM-5 provides two specifiers for this disorder - nonamnestic-confabulatory type and amnestic-confabulatory type. The amnestic-confabulatory type is also known as Korsakoff syndrome, and it is characterized by anterograde and retrograde amnesia and confabulation (attempts to compensate for memory loss by fabricating memories), and has been linked to a thiamine deficiency.

Question ID #13319: An adolescent with a history of aggressive behavior has been referred to a social worker from a juvenile detention facility. The client also has a history of alcohol use and school truancy. In a session with the social worker, the client says, "I can't stand this kid I know, Kevin. He's a total dork, and I'm going to get him." What should the social worker do FIRST in this situation? A.Explore what the client means by his statement B.Contact the police and try to locate Kevin C.Clarify why the client "can't stand" Kevin D.Either warn Kevin of the danger he is in or notify law enforcement officials of the client's threat

A.Explore what the client means by his statement **Exploring what the client means by his statement should be the social worker's first step. This question is difficult because the social worker lacks specific information that would help clarify this situation and the level of danger. For instance, does the client have contact with Kevin these days? What does the client mean by the words "get him"? Having this information would help the social worker determine if the other boy is in serious danger of being harmed by the client. Whether or not this situation warrants the duty to protect/warn, however, it would be appropriate for the social worker to inform, or remind, the client about the limitations to his right of confidentiality, and the social worker's related legal obligations. Answer B: From the information in the question, the social worker can't conclude that the client poses a serious threat to Kevin, so it is premature to contact the police or try to locate Kevin. First, the social worker needs to clarify what "get him" means. Answer C: Clarifying why the client "can't stand" Kevin, on the other hand, is not a priority at this time. Answer D: It's possible that the client's statement contains a threat of serious harm against Kevin. The 1974 Tarasoff decision established a psychotherapist's "duty to warn" the intended victim of a client when a client communicates a serious threat of violence against a reasonably identifiable victim; in a rehearing of the case in 1976, this was changed to a "duty to protect" the intended victim by warning him or her, notifying the police, and/or taking other reasonably necessary steps. The duty to protect, however, applies only in cases where the therapist believes that the client poses a clear and imminent (serious) danger against an identifiable victim. In this particular situation, the social worker does not know enough information yet to draw this conclusion. Therefore, she should explore the statement further with her client first. (NOTE: Even in states without a "duty to warn" law, the duty to protect/warn applies as a general principle. Many authorities recommend that social workers follow this principle.)

Question ID #13653: A social worker is assessing a family who is very worried about one of their 4-year-old twin sons. They say that one boy, Kyle, is "normal," but that the other, Luke, insists that he is a girl and throws tantrums if they try to make him dress like a boy. He likes to play with dolls, while his brother prefers trucks. Luke wants to change his name to Lisa and refuses to respond to anyone who calls him Luke. The parents are confused about this behavior and don't know what to do. They say that he started calling himself a girl when he was 2 years old. They are most worried about him being bullied at school if he shows up in a dress. What should the social worker recommend that the parents do? A.Allow Luke to wear girl clothes and adopt the name of Lisa B.Work with a specialist in gender dysphoria to help Luke become accepting of his identity as a boy C.Allow Luke to wear girl clothes and call him Lisa at home but insist that he dress like a boy and go by Luke when at school or on playdates D.Insist that Luke dress like a boy, as this is just a phase that he will grow out of

A.Allow Luke to wear girl clothes and adopt the name of Lisa **Most clinicians are increasingly supportive of the idea that children who insist that they are a different gender should be supported in socially transitioning to that gender. Children who are forced to live a gender they don't identify with have significantly more mental health issues such as depression, anxiety, and suicide. Answer B: It is increasingly viewed as unethical to do conversion therapy, i.e., therapy aimed at trying to change a person's gender identity and expression to become more congruent with the sex assigned at birth. Answer C: This would only lead to confusion and suggest to Luke/Lisa that s/he is unacceptable to outsiders. Answer D: See above answers.

Question ID #13340: While conducting the first interview, the social worker sees that his client is overwhelmed. The client is having difficulty sharing any information about her situation. What technique should the social worker use to bring focus and direction to this interview? A.Ask closed-ended questions B.Ask open-ended questions C.Self-disclose D.Narrow the focus

A.Ask closed-ended questions **Closed-ended questions (those that limit how the client can respond) are useful when there is a need for specific information or when a client is so overwhelmed or confused that a high level of structure is needed in order to maintain focus and direction in the interview. An example would be, "How long have you and your husband been married?" Answer B: Asking open-ended question would not help bring focus or direction to the interview. These questions give clients the opportunity to say whatever they think is important. An example would be, "Tell me about your husband." Answer C: Appropriate self-disclosure on the part of the social worker can make it easier for a client to talk about sensitive topics and help a client feel more comfortable. As a rule, though, self-disclosure should be avoided in the early stages of helping and should be used sparingly in the later stages. Answer D: This answer isn't bad, but A is better because this client is having difficulty sharing any information with the social worker. Narrowing the focus ("funneling") involves asking a series of questions designed to assist the client in describing her situation or concerns. These questions may be open-ended or closed-ended, and each question should follow up on (e.g., seek more information or clarification about) what the client has just said.

Question ID #13085: A couple comes in for counseling because of arguments over how much time to put into childcare and household chores. They both work at full-time jobs. The wife states that her husband isn't helpful with the kids and that it is completely up to her to take care of them. Her mother, who lives next door, pitches in way too much and often complains to the wife about it, which makes her feel like she is caught in between the two of them. If the social worker were to use circular questioning to assess this case, what would be a typical question? A.Ask the husband how he thinks the grandmother feels about helping out B.Ask the husband how he feels about what his wife is saying C.Ask the husband to ask the grandmother herself how she really feels D.Ask the clients to pretend the grandmother is in the session and role play what she would say about the situation

A.Ask the husband how he thinks the grandmother feels about helping out **Asking the husband to speak for what he perceives the grandmother's feelings to be requires him to shift from a first-person position to a third-person observer. This enables the clients to get out of their own heads and view the problem from a different perspective. This is a common strategic approach originally developed by the Milan Group. Answer B: This is a linear question that does not invite the husband to step out of his first-person perspective. Answer C: This is a linear question that does not invite the husband to step out of his first-person perspective. Answer D: This does invite a third-person perspective, but it is not a circular question.

Question ID #13165: After exploring a client's concerns with him, the social worker determines that she should refer the client to a local agency for a service he needs. When she suggests the referral, the client agrees that it would be useful for addressing his needs. Which of the following would NOT be appropriate to do when making this referral? A.Assuring the client that he is eligible for the service if he asks her about this B.Letting the client know about the limitations of the service C.Accompanying the client to the agency if he is too afraid to go on his own D.Helping the client gather the information and documents he will need in order to show his eligibility for the service

A.Assuring the client that he is eligible for the service if he asks her about this **All agencies have their own procedures, policies, and eligibility criteria. Unless the social worker has the authority to make eligibility decisions (which is unlikely in this case), they should not assure a client that he is eligible for a service. Answer B: The social worker should explain both the advantages and limitations of the service. If the client is fearful, confused, or very dysfunctional, however, the social worker should avoid focusing too much on the limitations, as this might create an additional barrier to his use of the service. Answer C: The social worker should generally encourage a client to take on as much responsibility as he can for deciding to receive a service he wants. However, when a client is fearful, overwhelmed, or immature, it is appropriate to do whatever is needed to establish the linkage, especially if the referral is an important one. The social worker may accompany the client to the agency or find family members or friends who can do this. Answer D: The social worker could assist the client with finding the correct documentation and information to ensure eligibility is met for this referral.

Question ID #13390: A social worker begins working in individual therapy with a 35-year-old client who has a promising career, has been happily married for 10 years, and has a 6 year-old daughter. The client sought therapy to resolve unsettled issues concerning his parents, who have never been supportive and continue to treat him like a child. In a session during the fifth month of therapy, the client discloses that he had a very upsetting dream in which he sexually abused his daughter. The client is visibly distressed as he discloses the dream and tells the social worker that he doesn't understand what it means. What should the social worker do? A.Be reassuring and supportive and help the client understand his feelings and the dream B.Shift the focus so that she can gather information to determine if a child abuse report is required C.Validate the client's openness, but explain that a child abuse report must be filed, and then file the report

A.Be reassuring and supportive and help the client understand his feelings and the dream **The client has taken a risk and confessed a disturbing dream to the social worker. Incestuous dreams (as well as homoerotic and sadomasochistic dreams) are not uncommon, although few people are willing to discuss them. The best intervention at this time is to provide a safe atmosphere in which the client can feel comfortable exploring the meaning of his dream. Answer B: This would not address the client's need for immediate support, and at this time there is no reasonable suspicion of child abuse. Answer C: Validating the client's openness would be helpful, but a child abuse report does not need to be filed based on this dream alone. The correct answer is: Be reassuring and supportive and help the client

Question ID #13232: A mother seeks help because her 6-year-old son resists when she tries to get him ready for school. He claims that he feels sick and cries when she leaves him at school. The social worker suspects that the boy may have school phobia. Which of the following MOST likely underlies this? A.Being separated from his mother B.Academic difficulties C.Anaclitic depression D.Stranger anxiety

A.Being separated from his mother **This is correcteither separation anxiety or a traumatic school experience usually underlies school phobia. Answer B: Academic difficulties can make school unpleasant for a child, but they don't usually rise to the level of a "traumatic school experience." Answer C: Anaclitic depression may develop in some children who are separated from their mother during the second half of the first year of life. This syndrome is marked by developmental delays, unresponsiveness, and withdrawal (Spitz, 1945). Answer D: In stranger anxiety, a child becomes very fearful and anxious in the presence of strangers. Stranger anxiety is considered to be a normal part of development and usually begins at age 6 to 8 months, lasts until about age 2, and then diminishes.

Question ID #13470: A social worker is beginning individual therapy with a client who has been a heavy cocaine user for a year and continues to use despite losing his job two weeks ago. He was referred to the social worker by his physician. He appears to be aware that he has a problem but does not appear to be committed to change. Which of the following Stage of Change does the client appear to be in? A.Contemplation B.Maintenance C.Pre-contemplation

A.Contemplation **The member appears to be in the Contemplation Stage of Change. He is aware that there is a problem but does not appear to be committed to change, which reflects this stage accurately. Answer B: The Maintenance Stage of Change is when a client has a sustained change and new behavior replaces the old. Answer C: The Pre-contemplation Stage of Change is when a client has no intention of changing the behavior and may not have an awareness that a problem exists

Question ID #13159: A social worker is meeting with a 50-year-old man whose wife died 10 weeks ago. The client reports feeling depressed and lonely. After conducting an assessment, the social worker concludes that the man would benefit from attending a bereavement support group. What should be the social worker's FIRST step in providing this referral? A.Discuss with the client how joining the group can help address his concerns, needs, and objectives B.Provide the client with all of the information he needs in order to contact the group leader so that he feels comfortable with the referral process C.Explain to the client how support groups differ from individual therapy

A.Discuss with the client how joining the group can help address his concerns, needs, and objectives **An effective way of preparing a client to use a resource is to explain how the resource relates to his expressed needs and concerns and the treatment goals. Answer B: If a client is not ready to use a resource, there is a good chance that he will not follow through on it. This is not the right first step in making a referral. Answer C: This would be important but is not the first step in making the referral

Question ID #13089: Which of the following is a way to implement trauma-informed care practice within a service agency? A.Engage clients in determining discussion topics for future group therapy sessions. B.Avoid using peer support systems consisting of fellow trauma survivors. C.Decrease staff training to only allow for individual supervision on the effects of adverse childhood reactions. D.Focus on medication management.

A.Engage clients in determining discussion topics for future group therapy sessions.

Question ID #13521: A social worker is working in individual therapy with a 10-year-old boy. The guidance counselor at the boy's school calls the social worker, requesting advice on how to deal with a recent incident at school in which the boy was involved. What is the social worker's BEST course of action? A.Explain that she cannot discuss any client until she has written permission from the client or the client's parents B.Ask the counselor to describe the school incident and then offer general suggestions for dealing with the problem C.Provide minimal information about the client, limited to areas that are specifically relevant to the school incident D.Offer to visit the school to talk over the incident with the client and school personnel

A.Explain that she cannot discuss any client until she has written permission from the client or the client's parents **Although there are some exceptions to a client's confidentiality rights, this situation is not one of them. Therefore, permission from at least one of your client's parents would be required before you could speak to the school counselor about the boy. In this option, the social worker is not confirming or denying that she works with the boy. Answer B: Continuing the conversation and asking the school counselor for a description of the incident would imply that the boy is a client of hers and would therefore be a violation of confidentiality. Answer C: Providing any information would be in violation of the boy's right to confidentiality. Answer D: Offering to visit the school would be acknowledging that the boy is working with the social worker. The social worker would first need to get written permission from the boy's parent before visiting the school, discussing the client with anyone, or even acknowledging that she is working with him.

Question ID #13216: Which of the following characteristics is LEAST relevant to consider when assessing a client's ego functioning? A.Gender B.Age C.Impulse control D.Culture

A.Gender **Ego functions include reality-testing capacity (e.g., judgment, accurate sense of reality), self-control and self-regulation (e.g., impulse control, frustration tolerance), capacity for interpersonal relationships (object relations), cognitive functioning (e.g., intelligence level, logic, memory), integrative functioning (e.g., the ability to adaptively integrate conflicting attitudes, behaviors, values, affects, etc.), and defense mechanisms. There are some gender-based differences in ego functions, but differences based on age and culture are more significant. Answer B: There are considerable differences in ego functioning depending on the person's developmental stage. Answer C: Impulse control is an ego function. Answer D: Ego functioning as it pertains to thought, emotion, attachment, and social norms develops differently due to cultural expectations.

Question ID #13435: A gay client tells a social worker that he has sought therapy because he is afraid to disclose his sexual orientation to his family and doesn't know what to do. In addressing the presenting problem in this case, what should the social worker do FIRST? A.Help the client compare the potential consequences of coming out to those of continuing to hide his homosexuality B.Help the client identify the potential benefits of telling his family C.Support secrecy and the client's reluctance for now in order to build trust

A.Help the client compare the potential consequences of coming out to those of continuing to hide his homosexuality **Even after coming out to themselves, some gay people struggle with a decision about whether and how to disclose their sexuality to others. When treating a client who is struggling with this decision, a social worker should avoid taking a position that is comfortable for them but inconsistent with the client's situation or needs. Answer B: Often, clients are most worried about consequences and negative reactions to coming out to family. The first thing the social worker should address would be the client's concerns and potentially the benefits after the negative. Answer C: A social worker should neither collude with a client's worries about the negative consequences of disclosure nor advocate disclosure merely on principle if a client is not ready to tell others that he is gay. Instead, the social worker's role is to help the client identify and evaluate the actual and imagined consequences of disclosing his sexuality and compare these to the negative effects that may result from continuing to hide his sexual orientation.

Question ID #13143: A client reports that he is being discriminated against at his job because of a physical disability. The social worker believes that this allegation is true based on events the client has described. As this client's advocate, what should the social worker do NEXT? A.Identify what steps the client wishes to take. B.Schedule a meeting with the clients employer after getting the client's permission. C.Arrange to meet with the client and his attorney. D.Help the client fight the apparent discrimination.

A.Identify what steps the client wishes to take. **An advocate's actions must always be based on the client's wishes. Therefore, the first step should be to meet with the client and plan the action. Answer B: This may be a future action, but first the social worker and client should meet to determine what actions the client wishes to take in the situation. Answer C: The client may want to meet with an attorney but first the social worker needs to determine what the client's wishes are and how she can help advocate for him. Answer D: The question asked what should the social worker do next, which indicates an action step. Helping the client fight against discrimination is the overarching goal.

Question ID #13644: The World Health Organization advocates for providing psychological first aid (PFA) for people who have experienced a trauma. The approach is ordered around which three principles? A.Look, listen, and link B.Ethical practice, supportive services, professionalism C.Assess, support and refer D.Professionalism, ethics and comprehensiveness

A.Look, listen, and link **Psychological first aid (PFA) has three overarching components: 1) Look to ensure that the situation is safe, and identify who is in pressing need; 2) Listen to the client(s), ask about needs, project acceptance; and 3) Link, or refer for relevant services, information, and support.

Question ID #13409: A client in need of case management services immigrated to the United States from Mexico two years ago. He is uncomfortable speaking English and asks the social worker to provide her services in Spanish. The social worker speaks some Spanish, but recognizes that her Spanish-language skills may be insufficient for interacting effectively with this client. What should the social worker do? A.Make an appropriate referral B.Offer to bring in a translator with cultural knowledge C.Use a trained paraprofessional who speaks Spanish D.Encourage the client to speak English and use her Spanish-language skills to assist him when he has difficulty communicating with her

A.Make an appropriate referral **This client would like the social worker to provide the services in Spanish. The social worker should interact in the language requested by the client. If this is not possible, ideally, the social worker will be able to make an appropriate referral to a provider (a qualified case manager, in this case) who is competent to interact in the language of the client. If this is not possible, then the social worker should offer the client a translator with cultural knowledge and an appropriate professional background. If no translator is available, then a trained paraprofessional from the client's culture may be used as a translator/culture broker. Answer B: Offering to bring in a translator with cultural knowledge may be an option if the first requestfor the social worker to provide services in Spanishis not able to be fulfilled. Before pursuing this option, though, the social worker should try to refer the client to a Spanish-speaking social worker. Answer C: Using a trained paraprofessional who speaks Spanish could be an option for consideration if the request made by the client is not possible and bringing in a translator is not possible. Only if the paraprofessional has the appropriate credentials and requirements necessary to work with this client is this an acceptable solution. Answer D: Encouraging the client to speak English would ignore the client's request for a Spanish-speaking social worker.

Question ID #13451: A client resists the social worker's efforts to draw him out during the initial phase of therapy, and she hypothesizes that this is because he is angry that he had to wait a long time to get an appointment with her. The client never says he is angry, but he talks at length about his efforts to schedule an appointment and tells the social worker many times how frustrated he felt about having to wait. Which of the following strategies should the social worker use to address this client's resistance? A.Mirror his feelings B.Redirect him to a more productive topic C.Allow him to continue venting his feelings D.Explore whether his defensive behavior is part of a long-term pattern

A.Mirror his feelings ***The social worker needs to intervene to address this client's resistance and the feelings that underlie it. Mirroring (or empathic mirroring) is an attempt on the social workers part to reflect, repeat, or represent, through imitation, a client's verbal pace and nonverbal behavior, with the goal of helping the client see some aspect of himself more accurately. In this case, mirroring can be used to help the client identify and articulate his true feelings of anger. This process can eliminate his need to maintain his defenses, thereby reduce his resistance.***

Question ID #13641: The parents of a 12-month-old boy report that he has no vocabulary of his own. They add that he can understand some of what other people say. What should the social worker advise the parents to do about this? A.Not worry because it reflects normal development B.Consult with a speech pathologist C.Speak to the child's pediatrician D.Have the child screened for autism spectrum disorder

A.Not worry because it reflects normal development **These parents should relax. While lots of children begin to talk at around their first birthday, first words may be spoken at any time from age 10 months to age 15 months. Any age within this range reflects "normal" development. Answer B: The child's speech development is well within the normal range. Answer C: See A. Answer D: If the child was avoiding eye contact with the parents, not attempting to engage with them, not responding or exhibiting appropriate facial expressions, etc., then it would be appropriate to have the child screened for autism spectrum disorder.

Question ID #13431: A gay man presents for individual therapy shortly after coming out to his pastor. The client has attended this church for five years and had a good connection with his pastor, but now the pastor avoids him. The client adds that he feels alienated at his church now and that this experience is making him question his faith. In addressing the presenting problem in this case, what should the social worker do FIRST? A.Offer the client referral to a local church where he will find acceptance and be more comfortable B.Discuss with the client the pros and cons of disclosing his sexual orientation C.Further assess the client's religious needs and explore his beliefs with him D.Encourage the client to break away from his church and find support elsewhere

A.Offer the client referral to a local church where he will find acceptance and be more comfortable

Question ID #13667: Regarding the physical changes that accompany growing older, which is the following is true? A.Physical activity can help prevent the frailty that may come with old age. B.By age 75, the majority of adults have experienced notable hearing loss. C.Older adults need less sleep than younger adults. D.Diabetes is the most common chronic health condition among adults over age 65.

A.Physical activity can help prevent the frailty that may come with old age. **Regular physical activity in late adulthood is associated with many benefits including a lowered risk of coronary heart disease, colon cancer, diabetes, high blood pressure, and osteoporosis; a reduced risk of falling; less anxiety and depression; a greater ability to maintain joint strength and mobility; and better cognitive functioning. In addition, maintaining lean muscle helps to prevent frailty and disability. Answer B: Prior to age 75, the majority of adults do not experience significant hearing loss. Among adults age 75 to 79, however, 50 percent or more have hearing deficits that interfere with daily functioning. The biggest problem is a decreasing ability to perceive high-frequency sounds, which makes it difficult to understand human speech, especially when there is a competing noise. Answer C: Older adults do not require less sleep than younger adults; however, they do have more trouble falling asleep, awaken more often during the night, and experience a shift in the timing of sleep that involves going to bed and waking up earlier. Answer D: The most common chronic health conditions among people over age 65 are hypertension and arthritis, followed by heart disease, sinusitis, and diabetes.

Question ID #13190: A social worker begins assessment of a new client, and after one session with her, realizes that she needs long-term psychotherapy. The client has insurance that covers only 10 sessions. Beyond that, she can't afford to pay the social worker's lowest fee. What is the social worker's BEST course of action? A.Refer the client to a low-fee community-based clinic. B.See the client and intervene with the insurance company on her behalf. C.See the client, intervene with the insurance company on her behalf, and refer her only if the company refuses to continue paying. D.See the client for 10 sessions and then refer her to a low-fee clinic.

A.Refer the client to a low-fee community-based clinic. **The social worker's best action would be to refer the client to a low-fee clinic now so that she can begin treatment with a social worker who will be able to see her for the full course of the treatment she needs. Generally, in situations in which a managed care company refuses to authorize payment for services that are believed to be necessary, the social worker should appeal the managed care (MC) company's decision and make a plan with the client to address this issue in the event that the MC company denies the appeal. This plan can include continuing treatment at a lower cost, reducing the frequency of sessions, or referring the client to a lower-fee provider. While referral should be avoided after treatment is underway and a therapeutic relationship has developed, in this case, the social worker and the client have met only once. Answer B: The social worker should not see this client for treatment as it creates the possibility that services will be interrupted. Answer C: The social worker shouldn't see this client for therapy. Doing so would create the possibility that her treatment will need to be interrupted if the appeal to the managed care company ends up being denied. Answer D: It would be unethical to treat a low-income client until her insurance runs out and then refer her to a low-fee community clinic.

Question ID #13196: In the first interview, an adult client reports several vague symptoms but has difficulty identifying a specific problem. The social worker conducts a thorough assessment over the course of three sessions and, after studying the collected data, discovers that he is not qualified to treat the disorder that the client turns out to have. Specifically, he determines that the client would benefit most from a type of intervention with which he has no prior experience or training. What is the social worker's BEST course of action? A.Refer the client to a social worker who is qualified to provide this intervention. B.Advise the client of his limitations regarding the intervention and let the client decide whether or not to continue services with him. C.Continue treating the client if a therapeutic relationship has developed, but use only interventions that he is qualified to use.

A.Refer the client to a social worker who is qualified to provide this intervention. **To properly handle this situation, the social worker must consider the client's welfare and the ethical responsibility and legal obligation to work only within the scope of his competence. Even though he has had three sessions with this client and might have a therapeutic relationship with him, the social worker can't provide him with therapy if his problem and the intervention he needs are outside the scope of his competence. For this reason, this option of referring to another social worker is the best answer offered. According to NASW's Code of Ethics, "The social worker who anticipates the termination or interruption of service to clients should notify clients promptly and seek the transfer, referral, or continuation of service in relation to the clients' needs and preferences. "Answer B: A social worker should not burden a client with this type of decision. When a social worker knows that a specific treatment would be most effective for a client and that treatment is outside the scope of his competence, an appropriate referral is the right course of action. Answer C: It would not be in the best interests of this client to use an alternative treatment simply because the social worker is not qualified to provide the more appropriate treatment.

Question ID #13505: An adult client would be MOST likely to give which of the following reasons for leaving group therapy prematurely? A.Scheduling conflicts B.Feeling fearful of intimacy C.Feeling that he "doesn't belong" with the other group members D.Feeling unsure about the group leader's competence

A.Scheduling conflicts

Question ID #13067: Which of the following statements is untrue? A.Schizophreniform disorder is somewhat less severe than schizophrenia. B.Schizophreniform disorder has identical symptoms as schizophrenia. C.The only difference between schizophreniform disorder and schizophrenia is the time frame. D.Schizophreniform disorder is somewhat less severe than schizophrenia, but the time frame for the two disorders is different.

A.Schizophreniform disorder is somewhat less severe than schizophrenia. **This is an untrue statement. Schizophreniform disorder has identical symptoms as schizophrenia and there is no difference in severity. The only difference is the time frame. Schizophreniform disorder episodes last from one month to six months. If the symptoms are still present at six months, the diagnosis is changed to schizophrenia. Answer B: This is a true statement. Schizophreniform disorder has identical symptoms as schizophrenia. Answer C: This is a true statement. Schizophreniform disorder episodes last from one month to six months. If the symptoms are still present at six months, the diagnosis is changed to schizophrenia. Answer D: Although it is true that the time frame for the two disorders is different, schizophreniform disorder can be just as severe as schizophrenia.

Question ID #13067: Which of the following statements is untrue? A.Schizophreniform disorder is somewhat less severe than schizophrenia. B.Schizophreniform disorder has identical symptoms as schizophrenia. C.The only difference between schizophreniform disorder and schizophrenia is the time frame. D.Schizophreniform disorder is somewhat less severe than schizophrenia, but the time frame for the two disorders is different

A.Schizophreniform disorder is somewhat less severe than schizophrenia. **This is an untrue statement. Schizophreniform disorder has identical symptoms as schizophrenia and there is no difference in severity. The only difference is the time frame. Schizophreniform disorder episodes last from one month to six months. If the symptoms are still present at six months, the diagnosis is changed to schizophrenia. Answer B: This is a true statement. Schizophreniform disorder has identical symptoms as schizophrenia. Answer C: This is a true statement. Schizophreniform disorder episodes last from one month to six months. If the symptoms are still present at six months, the diagnosis is changed to schizophrenia. Answer D: Although it is true that the time frame for the two disorders is different, schizophreniform disorder can be just as severe as schizophrenia.

Question ID #13420: A social worker could use which of the following techniques to clarify the emotional distance or closeness between family members? A.Sculpting. B.Mimesis.Incorrect C.Psychodrama. D.Reframing.

A.Sculpting. **In family sculpting (or family sculpture), family members position themselves (or objects that represent them) in a physical space in a way that reflects their relations and roles within the family system. The process usually involves having each family member, one at a time, create his or her own "sculpture." Sculpting can be useful for revealing family members' differing perceptions and feelings, and each member's view of the emotional closeness or distance between family members. Although sculpting is a very subjective technique, it often provides insight into how family members perceive their own and one another's roles and positions within the family. Answer B: Mimesis is associated with structural family therapy, in which the therapist's first task is to develop a therapeutic system by joining (entering) the family in a position of leadership. Joining can be divided into three types: 1) Joining from a distant position: The therapist teaches and gives directive advice. 2) Joining from a median position (tracking): The therapist serves as an active, neutral listener, and uses techniques such as summarizing, observing, and commenting on processes. 3) Joining from a close position (mimesis): The therapist imitates (mimics) the affective range, style, and/or the content of the family's communications in order to build kinship with them and solidify the therapeutic alliance. Answer C: Psychodrama involves the use of dramatic techniques (such as role-reversal) through which clients are asked to act out past, present, or anticipated situations (usually socially stressful situations), and roles in order to gain new and deeper understanding and achieve catharsis. Answer D: Reframing is a verbal technique used to help clients change the meaning they give to an event, behavior, or experience by gently persuading them that it can be viewed in a different and more positive light

Question ID #13104: A social worker is meeting with a family of three, including the father, mother, and a 13-year-old son. The parents report that the son has been acting out ever since he became a teenager (failing to do chores, talking back to them, etc.) and that all of their efforts to discipline him have failed. He used to "shape up" when they took away his Internet privileges or allowance, but now he continues to disobey them. The boy says he wants more freedom to manage his own time and doesn't want his parents to regiment his life so much. The social worker observes that the parents are highly involved in the details of the boy's life, bicker a lot, and seem reluctant to change the way they've been managing their son. What approach to family therapy would be MOST useful in this case? A.Structural B.Solution-focused C.Humanistic D.Psychodynamic.

A.Structural **The question suggests that the parents are having difficulty adapting to their teenage son's demands for more autonomy. It also appears that the boundaries in this family are diffuse. Structural family therapists view family dysfunction as the result of an inflexible family structure that prohibits the family from adapting to maturational and situational changes. Answer B: Solution-focused therapy focuses on the de-emphasizing the causes of problems, and, instead, focuses on solutions to helping clients become unstuck. Answer C: Humanistic is an intervention that emphasizes the importance of being your true self in order to lead the most fulfilling life. It's based on the principle that everyone has their own unique way of looking at the world. Answer D: Psychodynamic is more focused on a client's thoughts and feelings than social and environmental factors.

Question ID #13084: A new client comes to see the social worker. He is very quiet and sallow looking. He states that he has tried therapy a lot of times, but it has never worked. When the social worker asks why he thinks this is, he says, "they just never get me. I doubt if you will either." What is the best response? A.Tell the client that it is possible that he will have a similar experience here. B.Tell the client that the social worker feels sure that they can work things out here. C.Ask the client what it is about him that leads to this happening over and over again. D.Reassure the client that they can work together to have a different outcome.

A.Tell the client that it is possible that he will have a similar experience here. **The social worker should try to meet the client where he is at, which in this case is to reflect the client's hopelessness honestly. Of course, there is more discussion to follow, and the social should ask what happened in the client's previous experiences that have disappointed him, etc. Answer B: This is overly optimistic and the client will likely not feel seen by the social worker. Answer C: Immediately throwing the problem back on the client will probably feel like blaming. The key in the first few sessions is to establish a connection with the client. Answer D: This ignores the client's experiences and fails to meet the client where he is at.

Question ID #13536: Generally speaking, the psychological adjustment of children with chronic illness is MOST dependent on which of the following? A.The child's level of functional impairment B.Peer acceptance C.Family attitudes toward the illness

A.The child's level of functional impairment **If you're unfamiliar with research in this area, the best approach is to select the most general response. A number of studies have linked severity of the illness to adjustment outcomes. Some authors argue that it is not so much illness severity, however, but the level of functional disability. Other factors predictive of good adjustment include higher socioeconomic status, a two-parent family, little visible disfiguration, and healthy parental adjustment. Answer B: Peer acceptance is important but is not the most important factor here. Answer C: A factor that is predictive of good adjustment would include healthy parental adjustment, but degree of functional impairment is the most predictive factor.

Question ID #13646: A mixed-race couple brings their family in for counseling regarding the youngest child's developmental issues. The mother is Chinese, and the father is Caucasian. They have three children, 15, 10, and 6. What is the most likely scenario regarding social acceptance for this family? A.The children are more likely to be accepted in the white community and rejected in the Chinese community. B.The children are more likely to be accepted in the Chinese community and rejected in the white community. C.There should essentially be no difference in how the ethnic communities view the family. D.The children probably feel that they don't really belong in either community.

A.The children are more likely to be accepted in the white community and rejected in the Chinese community. **The Chinese community tends to isolate the interracially married Chinese and look down upon mixed-race children. The Chinese community has resisted ethnic blending, despite the fact that China has been occupied by foreign invaders several times in its recent history. Answer B: See A. Answer C: See A. Answer D: It is likely that the children feel more acceptance in the Caucasian community than in the Chinese community.

Question ID #13728: A social worker is preparing to use a single-subject design to evaluate changes in her client's behavior. In this situation, the dependent variable is which of the following? A.The client's behavior B.The intervention C.The therapeutic setting D.The final outcome of the intervention

A.The client's behavior ***Direct practice evaluation involves assessing your interventions and their impact on a specific client. When using a single-subject design for this purpose, the client's functioning (behavior, emotions, etc.) is considered the dependent variable.

Question ID #13072: A social worker has been referred a family that fled from violence in their home country. The family consists of a father, mother and two children. A third child was killed by landmines just before the family fled their home. All four members of the family are showing significant stress, and the father has started drinking, although he swears that he did not drink before. The mother was a doctor, but can now only find work as a janitor in a hospital. She complains of nightmares almost nightly and says the children often wake up frightened, but can't say of what. How BEST should the social worker respond to help bridge the cultural gap? A.Use a traditional healer from the family's home culture; help the family to connect with others from their culture who have re-settled before them; encourage each of them to tell their story; assess and treat PTSD and refer to a substance abuse program. B.Connect the family with ethno-cultural community organizations and religious institutions, help the client get involved with community resources and make vocational training referrals C.Focus on the father's drinking initially, followed by reviewing the family's migration trajecto

A.Use a traditional healer from the family's home culture; help the family to connect with others from their culture who have re-settled before them; encourage each of them to tell their story; assess and treat PTSD and refer to a substance abuse program. **The question asks about how to bridge the cultural gap, and three out of the four elements in this answer do just that. Working with a traditional healer, at least in the beginning, from the family's home culture (if available) can help bridge the cultural divide, by beginning with a framework the family knows and understands. Connecting the family to others who have resettled, especially those who have been here a while and are doing well, can lessen the impact of dealing with a foreign culture. Encouraging the family members to tell their stories can help them process what they have gone through before they emigrated, during the immigration process, and during resettlement. The fourth non-cultural element is nevertheless a very good one as it addresses PTSD and substance abuse issues, which are both pervasive in the clinical presentation. Answer B: All of these responses are good, but none of them actually involve working with the social worker. All the work is being done by others (except the referrals) outside of the therapy room. Answer C: While the father's drinking is certainly an issue of concern, the question is about bridging the cultural gap. The family may feel that the social worker is missing the point (of the tremendous stress caused by the immigration process and traumas preceding it) by focusing on father's drinking initially.

Question ID #13020: What is one of the most common reasons of intergenerational conflict when a family immigrates to another country? A.Younger generations tend to adapt more quickly to the dominant culture and reject many of their cultural traditions. B.Younger generation tend to try to maintain the traditional family relationship patterns and are more unaccepting of the dominant culture's patterns. C.The parents and older adults have a better understanding of the language and dominant culture. D.Both the older generations and younger generations tend to reject the dominant culture making it hard to be accepted into mainstream culture.

A.Younger generations tend to adapt more quickly to the dominant culture and reject many of their cultural traditions. **Most often by the third generation, immigrants and refugees have adopted and internalized many of the dominant culture's patterns. Younger generations such as children and adolescents within the family, tend to adapt much more quickly and reject many of their cultural traditions. This can lead to family problems and conflict. Answer B: This is not a true statement. The younger generation tends to adapt to the new culture more quickly while rejecting many cultural traditions. Answer C: This is not a true statement. Research has shown that often times it is more difficult for older generations to adapt to the dominant culture due to language barriers and cultural differences. Answer D: Although both generations may struggle with the transition, younger generations tend to adapt more quickly than the older generation when immigrating to a new country and way of living.

Question ID #13366: The client is a 30-year-old single dad who reports feeling bored at his job and at a "dead end" socially. He is interested in dating and has completed online profiles, but he never gets around to making connections with women who respond. The client reports that he is "in a rut" and would like help getting out of it. The social worker decides to use a brief therapy model with this client. The assumptions of this model include all of the following EXCEPT: A.a client lacks resources for change and a social worker's key role is to provide skills and knowledge to facilitate change. B.problems are a normal part of life rather than signs of dysfunction or pathology. C.the purpose of therapy is to find solutions rather than meaning or insight. D.a social worker should believe that change is possible and convey this expectation to the client.

A.a client lacks resources for change and a social worker's key role is to provide skills and knowledge to facilitate change. **Social workers using a brief therapy model adopt a strengths perspective, which means that they recognize that both the social worker and the client have resources that can be used during treatment to facilitate change. The client is presumed to have resiliency, knowledge, abilities, and problem-solving and coping skillshe is temporarily stuck or overwhelmed and unable to fully use his own strengths. The social worker's role is to help him access and use these resources so that he can move forward and find solutions. This assumption has been described by the term "utilization," which refers to conducting the work with what the client brings. Answer B: A brief therapy model works to help clients understand that problems are normal and not a sign of dysfunction and pathology. Answer C: Measurable goals are the key focus of brief therapy. Goals should be small steps toward an end and must be meaningful to the client, and measures should be used before, during, and at the end of treatment to document progress. Answer D: This refers to "expectancy," which is a key part of the brief therapist's stance. The objective is to set the client up for a self-fulfilling prophecy.

Question ID #13282: While assessing a client who immigrated to the United States from India three years ago, a social worker identifies the client's degree of acculturation into the mainstream culture in this country. According to contemporary models, "acculturation" is BEST defined as: A.a process of adopting the traits of the dominant culture with or without abandoning the traits of one's native culture. B.a process of adopting the traits of the dominant culture without abandoning the traits of one's native culture.Incorrect C.a process of adopting the traits of the dominant culture and rejecting the traits of one's native culture. D.a process of psychosocial and biological adjustment to living in a new cultural environment.

A.a process of adopting the traits of the dominant culture with or without abandoning the traits of one's native culture. **"Acculturation" refers to a process of change that occurs when two cultures come into contact. For an individual, acculturation occurs when he adopts the cultural traits (e.g., beliefs, attitudes, values, language) of his new culture. Most contemporary models of acculturation emphasize that it is an ongoing process involving both adopting the traits of the mainstream society and giving up the traits of one's indigenous culture, but that these aspects of acculturation are not necessarily correlated: Answer B: An individual can adopt the traits of the dominant culture and may or may not abandon the traits of his native culture. Answer C: An individual can adopt the traits of the dominant culture without abandoning the traits of his native culture. Answer D: Acculturation is a psychosocial process, but not really a biological one.

Question ID #13178: A case manager in an agency notices that many of her clients live in a certain area of the city in which public transportation is not offered. These clients report this as a problem getting to and from their meetings with the social worker, and many of them don't show up at all. The social worker begins a macro change process, calling attention to this problem by notifying important people in that area who can bring about change. The role that the social worker has undertaken by doing this is: A.an initiator. B.an educator. C.a mediator. D.a negotiator.

A.an initiator. **As an initiator, the social worker starts a macro change process by calling attention to a problem, need, or situation that can be improved in a community or organization. In this situation, the social worker realized that public transportation was not offered in a certain area of her community and undertook efforts to improve an existing service. Answer B: An educator gives information and teaches skills. Answer C: Mediators help factions within an organization or community resolve differences or disagreements. Answer D: In the role of negotiator, the social worker acts as an intermediary who attempts to settle disputes and/or resolve disagreements between various parties.

Question ID #13610: The two most prominent negative symptom features in schizophrenia are: A.avolition and diminished emotional expression. B.anhedonia and alogia C.avolition and anhedonia. D.asociality and diminished emotional expression.

A.avolition and diminished emotional expression.

Question ID #13848: A client says that she sometimes feels as though she is in a dream-as though she is outside of herself, observing her own thoughts, body, and actions. This sensation is referred to as: A.depersonalization. B.derealization. C.disorientation. D.dissociation

A.depersonalization.

Question ID #13021: Psychologist Jeffrey Arnett proposes that there should be an additional life-cycle stage for young adults that should be considered. He calls this stage: A.emerging adulthood. B.extended adolescence. C.transitional adulthood.

A.emerging adulthood. **Arnett (2000) proposed a new stage between adolescence and adulthood (roughly between 18 and 25), calling it emerging adulthood, which has become common over the past half-century in industrialized countries. Instead of leaving home after adolescence and marrying, starting a family, and entering into full-time employment, young adults are pursuing secondary education, marrying, and achieving financial independence at a later age. Young people tend to be dependent on their parents for longer, and they take longer to become full contributing members of their societies. However, when they do make commitments to career and family, they have a tendency to be more mature in their judgment. Answer B: Most people in the stage of emerging adulthood no longer see themselves as adolescents, but not quite fully as adults either. Answer C: This terminology is incorrect.

Question ID #13187: A client with no money to pay for case management services offers a social worker food from his family farm in exchange for services. The social worker knows that other providers in her rural community have agreed to such arrangements and determines that the client will not be able to receive services if she doesn't accept these goods as payment. If the social worker accepts this arrangement, she will be engaging in behavior that is: A.neither illegal nor unethical. B.unethical. C.illegal and unethical.

A.neither illegal nor unethical. Bartering is not illegal. And, under certain circumstances, it is ethical. NASW's Code of Ethics says the following about bartering: "Social workers should avoid accepting goods or services from clients as payment for professional services. Bartering arrangements, particularly involving services, create the potential for conflicts of interest, exploitation, and inappropriate boundaries in social workers' relationships with clients. Social workers should explore and may participate in bartering only in very limited circumstances when it can be demonstrated that such arrangements are an accepted practice among professionals in the local community, considered to be essential for the provision of services, negotiated without coercion, and entered into at the client's initiative and with the client's informed consent. Social workers who accept goods or services from clients as payment for professional services assume the full burden of demonstrating that this arrangement will not be detrimental to the client or the professional relationship." Answer B: When bartering is in accordance with the NASW Code of Ethics, it is not considered to be unethical. Answer C: Bartering is not illegal and is not considered to be unethical when performed only in very limited circumstances, following guidelines outlined from the NASW Code of Ethics.

Question ID #13734: The client is a 50-year-old man who has been battling cancer for several years. He is very ill and weak and unlikely to recover. He and his family ask the social worker about the possibility of hospice care for the man and wonder if he is eligible. The social worker, who is familiar with hospice care, tells them that most hospices accept: A.patients who have a life expectancy of six months or less and who are referred by their personal physician. B.only patients with private insurance who have a life expectancy of six months or less. C.only patients with private insurance who are referred by their personal physician. D.patients who have a life expectancy of six months or less and who are referred by a mental health care professional.

A.patients who have a life expectancy of six months or less and who are referred by their personal physician. **Hospice care is an interdisciplinary approach to caring for individuals with terminal illness when recovery is unlikely. Most hospices accept patients who have a life expectancy of six months or less and who are referred by their personal physician. In fact, one of the first things a hospice program will do is contact the patient's physician to make sure the physician agrees that hospice care is appropriate for the patient at this time. Most hospices have medical staff available to help patients who have no physician. Answer B: Private health insurance is not the only option that a hospice accepts; typically, Medicaid, Medicare, and private insurance cover hospice care if criteria is met. Answer C: Private health insurance, Medicare, and, in some states, Medicaid cover hospice care for individuals who meet eligibility criteria. Answer D: The client would need a referral from a primary care physician.

Question ID #13825: A social worker is given two days to prepare and submit a report to the court about a client's progress. The social worker has a demanding caseload and obligations to meet with clients that have been previously scheduled. The social worker's supervisor also needs to review the client's record before the report can be sent to the court. The social worker's BEST course of action is to: A.request an extension. B.meet her obligation to submit the report on time. C.notify the client that she didn't receive the information in time. D.encourage her supervisor to meet the deadline.

A.request an extension. **Because two days is a short period of time to prepare such a report, especially if the supervisor needs time to review the records, it would be appropriate for the social worker to request an extension. Answer B: By meeting her obligation to submit the report on time, it sounds like the social worker will have to cancel some previously scheduled meetings and appointments with her clients. Requesting an extension would be the best option to try first. Answer C: By itself, this solution does not adequately address the problem. Answer D: The supervisor will need adequate time to review the records to make sure the report is accurate and submitted correctly.

Question ID #13591: A teenage boy is brought to therapy by his parents because he has recently started acting very strangely. He complains of ghosts bothering him and headaches. The parents say that at times he makes no sense and at other times cries uncontrollably. The social worker can conclude that: A.the boy is suffering from a serious emotional disturbance. B.the boy may be developing schizophrenia. C.the boy may be having a medical crisis. D.he may be using drugs

A.the boy is suffering from a serious emotional disturbance **The only thing the social worker can be sure of is that the boy is suffering from a serious emotional disturbance. Answer B: While the boy may indeed be developing schizophrenia, the one thing that the social worker can be sure of is that he has a serious disturbance. Answer C: While the social worker should definitely refer the boy for a medical evaluation immediately and the disturbance may be medical in nature, the question is not asking about what the social worker should do it is asking about what the social worker thinks might be going on. Answer D: While the boy may be using drugs, the symptom picture does not point in this direction.

Question ID #13192: The purpose of peer review is: A.to monitor practices. B.to settle disputes among consumers, practitioners, and third-party payers. C.to determine whether patient services meet predefined standards. D.to receive informal feedback about professional conduct and practices.

A.to monitor practices. **According to Barker (2003), in social work and other professions, peer review refers to "a formal periodic process in which professional standards of intervention have been spelled out and practices are monitored by colleagues." In other words, peer review is a formal evaluation by a relevant peer group of a professional's specific actions or general competence. Answer B: Peer review committees are used to control abuse of third-party reimbursement by unethical/incompetent practitioners and often serve as an alternative to the legal system for settling disputes between practitioners, consumers, and third-party payers; however, this answer is too narrow. Answer C: This option describes the primary purpose of quality assurance. Quality assurance is used to verify that services and programs are effective, efficient, and available. It involves comparing services rendered to the accepted standards of quality in the professional field. Peer review is often used for quality assurance, but its purpose is broader than that. Answer D: Peer review is a formal process.

Question ID #13752: Guidelines for appropriate self-disclosure include all of the following EXCEPT: A.using self-disclosure as an intervention to build rapport. B.limiting self-disclosure to statements that are likely to support the treatment goals and objectives. C.only revealing information that has a clear connection to the client's concerns. D.immediately shifting the attention back to the client after self-disclosing

A.using self-disclosure as an intervention to build rapport. **As a general rule, social workers should avoid self-disclosure in the early stages of a helping relationship. Social workers normally do not self-disclose until rapport has developed. Answer B: Social workers should self-disclose only when doing so is likely to increase the client's comfort or promote growth in some way. Answer C: This is a guideline for appropriate self-disclosure. Answer D: Immediately shifting the attention back to the client is important so that the primary focus remains on the client's needs.

Question ID #13599: Which of the following features would cause the social worker to consider other specified obsessive-compulsive and related disorder over a diagnosis of body dysmorphic disorder? A.The person is excessively preoccupied with perceived defects or flaws in their own physical appearance, and this preoccupation does not cause significant impairment or distress. B.The person is excessively preoccupied with actual defects or flaws in their own physical appearance, and this preoccupation causes significant impairment or distress. C.The person is excessively preoccupied with perceived defects or flaws in their own physical appearance, and has performed repetitive behaviors or mental acts in response to their appearance concerns. D.The person is excessively preoccupied with a desire to have a limb amputated to correct an experience of mismatch between their sense of body identity and actual anatomy, and this preoccupation causes significant impairment or distress.

B. The person is excessively preoccupied with actual defects or flaws in their own physical appearance, and this preoccupation causes significant impairment or distress. **In body dysmorphic disorder, there is no actual flaw in the person's appearance. One of the disorders discussed under the heading of other specified obsessive-compulsive and related disorder is similar to body dysmorphic disorder, but there actually is a flaw in the person's appearance. The person is overly preoccupied with that flaw and this preoccupation causes significant impairment or distress. Answer A: In both other specified obsessive-compulsive and related disorder, and body dysmorphic disorder, the preoccupation must result in significant impairment or distress. Answer C: Both of these criteria are present (note perceived defects or flaws) in body dysmorphic disorder. Answer D: This is a description of body integrity disorder, which is not in the DSM-5. The preoccupation does not have to do with the limb's appearance (as it would in body dysmorphic disorder), but is instead focused on the feeling that the limb is wrong and/or does not belong to the person and needs to be removed.

Question ID #13816: Which of the following BEST describes a "functional community"? A.A collection of people coping with a shared problem. B.A category of people who share common goals, purposes, and professional interests. C.A group of people who share common values, interests, services, institutions, or geographic proximity. D.A setting that supports reliable patterns and maintains social control.

B.A category of people who share common goals, purposes, and professional interests. **Barker (2003, p. 170) defines a functional community as, "A class of people or organizations that has common purposes, goals, or orientations toward their achievement. Examples are the education, military, business, religious, or medical communities. Social workers and others belong to the welfare or human services functional community." Answer A: This is a very limited perspective and does not correctly define a functional community. Answer C: This is a more general definition of the term "community." Answer D: These are two characteristics of integrated (adaptive) communities or ones that promote the mental health of their residents. Integrated/adaptive communities have the following characteristics: they support reliable patterns (which allows residents to acquire the goods and services they need), they maintain social control (which supports the reliability of the community and provides residents with a sense of security), they permit residents to find and obtain assistance when they need it, they support a way of life (culture), which provides residents with a sense of relationship to others in the community and with a model for organizing their own behaviors, and they allow residents to develop a sense of identity and social worth. Individuals denied such opportunities may resort to maladaptive behavior such as crime and substance use.

Question ID #13341: A client is in individual therapy with a social worker to get help adapting to increased stress in her life after a job promotion. Without calling to cancel, the client doesn't show up for a therapy session. Although the client has never done this before, the social worker is upset. What technique should the social worker use to address this issue with the client? A.ConfrontationIncorrect B.An I-statement C.Interpretation D.Pointing out negative consequences

B.An I-statement **A social worker may share her feelings with a client when it is believed that doing so will increase the client's comfort or promote her growth. In this case, it would be appropriate for the social worker to let the client know how she was affected by her failure to show up for therapy without canceling beforehand. An effective way of doing this would be to use an I-statement. An I-statement sends a clear and direct message and, thereby, reduces the likelihood that the person receiving the message will be put on the defensive. An I-statement has three parts: a brief, clear description of a specific behavior (in this case, the client's failure to show up for the appointment), the feeling experienced as a result of that behavior (for example, upset or disappointed), and a description of the tangible impact the behavior has had on her (for example, the social worker's schedule was disrupted). Answer A: Confrontation would not be appropriate and could cause harm to the therapeutic relationship and/or cause the client to react defensively. Answer C: An interpretation is an explanatory statement that responds to something about a client's behavior or thinking that the client is not aware of. Offering relevant and timely interpretations is an important way of facilitating insight. In this case, however, it doesn't seem as though the client's failure to show up should be interpreted or explained. The question says this is the first time the client failed to show up for a scheduled appointment. Answer D: This approach is likely to place the client on the defensive. Using a I-statement would be sufficient for this situation.

Question ID #13120: The client is a divorced woman with one young child. Her husband deserted her over a year ago. The client was employed as an assistant buyer for a small manufacturing company, but lost her job two months ago when the company went bankrupt. Since that time, she has stayed home with her son. She reports being a little depressed and very anxious about her failure to find a new job because she is the sole source of support for her son. She has come in to get advice on how to handle her stress, because she's concerned that she might become a bad mother. What would be the BEST way for the social worker to help this client manage her stress? A.Empathize and clarify her feelings of anger toward her ex-husband. B.Arrange for her to join a support group for single mothers so that she can share her fears, reduce her isolation, and do some practical networking. C.Help her modify negative automatic thoughts about herself and her future so that she feels able to take action to change her life. D.Provide referrals to assist her in resuming a more active social life as a strategy to reduce her isolation.

B.Arrange for her to join a support group for single mothers so that she can share her fears, reduce her isolation, and do some practical networking. **This answer is the most likely one to provide this client with some immediate relief for her stress. A support group has the potential to provide several benefits that could help fulfill some of this client's needs and, thereby, reduce her stress. Answer A: The client may be angry at her ex-husband, but she does not mention this in her report. Answer C: Although many clients can benefit from being exposed to cognitive restructuring techniques, this client's presenting concerns seem to be based in the reality of her current situation (rather than a product of negative self-talk), and she has presented with a number of concrete needs. Answer D: This intervention doesn't address any of the primary needs the client has described. She wants help with reducing her stress and also needs help with finding a job to support herself and her son.

Question ID #13157: Which of the following BEST describes the goal of permanency planning? A.To reunite families B.To provide continuity in the care of dependent children C.To identify children in temporary foster care who need alternative placement D.To improve the quality of foster care for dependent children

B.To provide continuity in the care of dependent children **Permanency planning seeks to provide alternatives to temporary foster care placement through organized efforts to provide long-term continuity in the care of dependent children. Several strategies are used in permanency planning, including helping a child's family become able to care for the child, assisting with adoptions, and clarifying foster care guidelines. Answer A: This answer is too limited. Answer C: This answer is too limited. Answer D: This answer is too limited

Question ID #13336: A social worker is meeting for the first time with a client who has sought therapy shortly after breaking up with his girlfriend of three years. The client blames himself for the break-up, saying that he has trouble expressing himself to loved ones. The social worker observes that the client seems passive, and he comes off as needy and whiny in the interview. To establish rapport with the client, it is MOST important for the social worker to do which of the following? A.Be congruent in her words and actions B.Be aware of her personal biases C.Be authentic and self-disclose D.Always empathize with the client

B.Be aware of her personal biases **The question is presented as a scenario, but the correct answer is one that applies to all clients, and not just the one in this question. If social workers are not aware of their personal biases, they can inhibit the conditions required for rapport to develop. For instance, subjective, rather than objective or unbiased, thoughts and feelings about a client can interfere with the ability to be authentic, congruent, accepting, empathetic, etc. Answer A: Although being congruent with words and actions is important, it does not address the issue here of establishing rapport with this client. Answer C: There is no need to self-disclose in this situation, as this issue is about the social worker and not about the client. Making sure the social worker is aware of her personal biases is what is most important for establishing rapport with the client. Answer D: Demonstrating empathy is very important, but it's difficult, if not impossible, to "always" empathize with a client. Forcing herself to come off as empathetic when this social worker doesn't feel that way could come off as insincere which would inhibit, rather than facilitate, the development of rapport.

Question ID #13819: A social worker involved in an episode of macro change has analyzed the problem, developed a working hypothesis about the causes of the problem, created a working hypothesis of intervention, and selected an approach to change (s/he has decided to use a program approach). Their NEXT major step is MOST likely to be which of the following? A.Conducting a needs assessment B.Building support for the program C.Identifying what resources they need D.Identifying objectives and activities and creating an action plan

B.Building support for the program **In sequence, the major steps taken in an episode of macro change include the following: a) analyze the problem, population, and arena; b) develop a working hypothesis of etiology about the problem; c) develop a working hypothesis of intervention; d) select an approach to change (policy, program, project, practice, or personnel); e) build support for the change; f) estimate the probability of success; g) decide whether to pursue the change effort; h) select strategies and related tactics to get the change approved by decision-makers and others; i) plan the intervention; j) prepare to implement the intervention; k) monitor the intervention; and, l) evaluate the effectiveness of the intervention. Answer A: Needs assessment is a common way of identifying the incidence, prevalence, and nature of a problem within a community and may be used by change agents when they are analyzing the problem. Answer C: Identifying needed resources is just one of the things that change agents may do when attempting to build support for a proposed program. Answer D: Once the social worker has gotten support for the program, s/he can start identifying objectives and activities and creating an action plan.

Question ID #13293: A client who has been taking antipsychotic medication for years begins experiencing tightness in his jaw and involuntary arm and tongue movements. If the client has developed tardive dyskinesia (TD), what medication could be used to alleviate its symptoms? A.Haldol B.Clonazepam C.Prozac D.Clozaril

B.Clonazepam **Tardive dyskinesia (TD) is a medication-induced movement disorder that can develop in individuals who have been taking an antipsychotic drug (especially a typical, or traditional, antipsychotic) for a long period of time. Its symptoms include involuntary, rhythmic movements of the jaw, lips, tongue, limbs, and trunk. TD is the most serious of the extrapyramidal side effects associated with antipsychotic drugs and must be addressed immediately by a qualified medical professional. Treatments for TD include taking the patient off the medication and may also include giving the patient clonazepam (a benzodiazepine). Answer A: Haldol is an antipsychotic drug. Answer C: Prozac is an SSRI antidepressant. The SSRIs exert their effects by blocking the reuptake of serotonin (5-HT). Answer D: Clozaril is the trade name for clozapine, which is an antipsychotic drug.

Question ID #13563: A gay couple, Bob and Joseph, come in to therapy to discuss whether they want to go through the process of surrogacy in order to be able to become parents. The social worker notices that Bob seems to be dominant over Joseph, in that Joseph tends to yield to Bob even when he has a different opinion. How would a social worker using an MRI approach describe this relationship? A.A symmetrical feedback loop B.Complementary communication C.Pursuer-distancer D.A non-egalitarian relationship

B.Complementary communication **Mental Research Institute (MRI) theory would see this type of relationship as complementary. In a healthy complementary style of relationship, the pattern of one persons behavior fits the other, or one person tends to take the supportive role to the more dominant partner. In an unhealthy complementary relationship one person dominates and controls the other and the other responds by being passive and victimized. Answer A: In a healthy symmetrical relationship MRI theory would say that the partners mirror each other. Each person is equal to the other. An unhealthy symmetrical relationship would be characterized by competition. Answer C: When one partner feels there is too much distance between them and a partner, they pursue. If the distancers feel they are being crowded, they distance in order to get some space, which causes the pursuer to pursue even more. Answer D: This might be one way to describe this relationship (where Joseph defers to Bob) but it is not how the MRI theorist would describe it.

Question ID #13258: A social worker meets with an 82-year-old woman at the request of the woman's son. The son is concerned that his mom has Alzheimer's disease because she has become increasingly forgetful. During the interview, the social worker notices that the woman sometimes gets confused when trying to describe recent events in her life. Based on this observation, what should the social worker do NEXT? A.Refer for projective testing to identify thinking patterns. B.Conduct a mental status exam. C.Get a medical history from her. D.Evaluate her activities of daily living (ADLs).

B.Conduct a mental status exam

Question ID #13828: A 25-year-old client recently immigrated to the United States from Southeast Asia. In working with this client, which of the following will be MOST important? A.Providing counseling to accelerate his acculturation process B.Connecting him to community programs for immigrants and refugees that offer resources C.Helping him deal effectively with discrimination, racism, and xenophobia

B.Connecting him to community programs for immigrants and refugees that offer resources **Because we have no details about this client's situation, we should answer the question by applying basic knowledge about working effectively with clients who are immigrants or refugees. Clients who are recent immigrants or refugees usually have few social contacts, may need help with the basic necessities of life, and usually benefit from being connected to programs that provide culturally relevant services and resources. For example, the client may benefit from being connected to a program that offers interpreters, language classes, and other assistance with learning about American culture, as well as contact with other immigrants and individuals who share his cultural background. Answer A: A social worker can provide a variety of services to facilitate the client's adaptation but he or she wouldn't attempt to "accelerate" the acculturation process. For an individual, acculturation is an ongoing process in which he adopts the cultural traits (beliefs, attitudes, values, language, etc.) of his new culture. Answer C: Without knowing any detail about this client's situation, we should rule this out as being too narrowly focused on one issue.

Question ID #13038: The political parties in the United States have differing philosophies on social welfare and the role of the government. Which of the following statements is the MOST accurate? A.Democrats favor expanding social welfare programs, support the existing Social Security system structure, and support government-guaranteed universal medical care rights, while Republicans seek to restrict social welfare spending and leave decisions regarding social welfare to private and state entities. B.Democrats favor expansive social welfare programs, support the existing Social Security system structure, and have a long-term goal of government-guaranteed universal medical care rights, while Republicans seek to restrict and limit social welfare spending, seek to modify the current Social Security system structure, and prefer to leave access to medical care to the private sector (except for Medicare and Medicaid programs). C.Democrats seek to restrict and limit social welfare spending and prefer leaving access to medical care to the private sector (except for Medicare and Medicaid programs), while Republicans favor affirmative action laws, raising the minimum wage, and government roles

B.Democrats favor expansive social welfare programs, support the existing Social Security system structure, and have a long-term goal of government-guaranteed universal medical care rights, while Republicans seek to restrict and limit social welfare spending, seek to modify the current Social Security system structure, and prefer to leave access to medical care to the private sector (except for Medicare and Medicaid programs). **All three statements about Democrats and Republicans in this answer choice are true and accurately compare the parties to one another. In other words, both statements accurately address social welfare spending, social security, and medical care. Answer A: Parts of this answer are false. Answer C: All the statements in this answer are false. Answer D: Parts of this answer are incomplete as Democrats do support affirmative action.

Question ID #13057: A social worker is meeting with a 16-year-old client with the consent of his parents. The client discloses that he wishes to transition and is considering sex reassignment surgery. To be an ethical social worker, what is the best response? A.Tell the client that he is mandated to discuss transitioning with his parents as they consented for treatment. B.Encourage the client to invite his parents into a session to discuss further. C.Begin helping the client research doctors to conduct the surgery. D.Discuss concerns that this option is risky and that the client should reconsider.

B.Encourage the client to invite his parents into a session to discuss further. **Since the client is a minor and he would need consent by his parents for the surgery, it is best to encourage that the minor and the parents have a session together. Answer A: Although the client is a minor, the social worker is not mandated in this case to tell his parents what is discussed in session. Answer C: A possible intervention may be necessary to help the client process his decision, however the question asks for best ethical response. Answer D: While the surgery may be risky, and it is a good idea to discuss those risks with the client, the social worker will want to be careful not to forward their own views by telling the client to reconsider.

Question ID #13049: A school social worker observes a student who consistently comes to school dirty, tired, and hungry. When asked who helps him get ready for school in the morning, the boy says his mom helps him. The next day the social worker approaches the boy's mother. She reports that she recently lost her job and is having difficulty with providing meals for her and her son. As an ethical social worker, what is the BEST response? A.Trust the mother's report and do nothing B.File a child abuse report on suspicion that the child is being neglected C.Offer to help the mother set up a routine for her son in the mornings to make getting ready easier and more manageable D.Help the mother find resources in the community to obtain food

B.File a child abuse report on suspicion that the child is being neglected **Based upon the information, it's important to assess further and file a child abuse report on suspicion of neglect. Answer A: Doing nothing is not a possibility in this case after hearing what the mother has said, and consistently seeing the boy with these issues at school. Answer C: It would be helpful for the social worker to help the mother develop a more structured morning routine, but there are larger issues here that need to be addressed first. Answer D: The social worker will want to help the mother locate resources in the community to obtain food and other services, but first the child's safety and welfare needs to be addressed with a mandated report.

Question ID #13145: A social worker has been working for several months with an elderly woman when it becomes apparent that she can no longer take care of her personal or financial needs adequately. The client's daughter is also closely involved in the woman's treatment sessions. What type of intervention should the social worker advise the client's daughter to take in order to legally assist her mother? A.Contact Adult Protective Services B.Guardianship C.Initiate long-term care for the client D.Offer the daughter respite care resources

B.Guardianship **Guardianship may need to be established when an elderly person can no longer adequately take care of their personal needs or finances. A judge would appoint a person, or sometimes an organization, to take care of the elderly person's personal needs and/or financial matters. This person is usually called a legal guardian or court-appointed guardian. Appointing a legal guardian does require a court proceeding. Answer A: Adult Protective Services are social services provided to abused, neglected, or exploited older and/or disabled adults. This answer does not appear to apply to the needs of the client in the question. Answer C: Long-term care placement may need to be initiated in the future, but first, the daughter of the client should seek legal appointment to assist with decisions legally for the client. Answer D: The daughter may benefit from respite care services, which provide caregivers with temporary relief from continuous support and care for their elderly parent. However, the question is focused on the client's inability to care for herself, which would be covered under guardianship.

Question ID #13683: A client reports experiencing a great deal of stress at work that is affecting him at home. He and his wife are expecting their second child and their first child is a toddler. The client wants to learn relaxation techniques so that he can prevent a build up of stress during the day and be more available to help his wife with things at home. Which of the following factors, if true about this client, is MOST likely to have a negative effect on his response to the stress in his life? A.His self-efficacy beliefs are high. B.He has an external locus of control. C.He sometimes engages emotion-focused coping and problem-focused coping at the same time.

B.He has an external locus of control. **People's responses to stress are typically determined by certain moderating factors, including their social resources and personal characteristics. Here, you're looking for something that would have a negative impact on this client's response to the stress in his life. Individuals are better able to tolerate and cope with stress when they have an internal locus of control - i.e., when they believe they have a degree of control over the causes or consequences of stress. Answer A: This would have a positive effect. When a person believes that he has control over a situation and/or has the necessary coping skills or mechanisms, stress will have a less negative effect. This is consistent with Bandura's self-efficacy theory, which proposes that a person's belief about his own self-efficacy is the most significant mediator of his adjustment. Answer C: Usually a person must first deal with his emotional reactions to stress (or a stressor) before moving on to problem-solving, but emotion-focused and problem-focused coping often occur simultaneously and that's okay (it doesn't necessarily diminish the person's ability to cope). "Emotion-focused coping" is coping used to manage one's emotional and cognitive responses to stress or a stressor; and "problem-focused coping" (a.k.a. task-focused coping) involves determining what one can or should do in response to stress or a stressor - i.e., using strategies to deal directly with the source of the stress.

Question ID #13162: While living at a transitional shelter, a 22-year-old man attempts suicide twice. A week before his discharge date, the man tells his social worker that he doesn't want to move back into his parents' house after he is released. What should the social worker do to respond to the client's need? A.Arrange other housing for him. B.Help him find needed resources in the community. C.Establish a contract in which he agrees to call her if he has suicidal thoughts after returning home. D.Call his parents to find out whether they are supportive of him.

B.Help him find needed resources in the community. **This action has several benefits. In addition to taking seriously the client's reluctance to go back home by helping him with housing alternatives that may feel safer to him, it also allows the client to participate in helping himself. Answer A: Although this answer choice offers the client alternatives to moving back home, it does not allow him to participate in the process. Answer C: The social worker should not dismiss the client's reluctance to go home. This arrangement might be appropriate if, for some reason, moving back home were the client's only alternative, but the question does not state that the client has no choice but to return to his parents' home. Answer D: This action would violate the client's confidentiality. Moreover, regardless of what the parents might say to the social worker. the primary concern should be how the client feels about returning home

Question ID #13215: A client seeks therapy two weeks after being fired from a job that she held for five years. The client says she's "stressed out" and having difficulty dealing with this event, in part because it was completely unexpected. Of the following factors, which one is MOST likely to affect the client's response to the stress she is under? A.Her capacity to cope with stress B.Her beliefs regarding her ability to cope with stress C.The availability of reliable social support, as confirmed by the social worker's assessment

B.Her beliefs regarding her ability to cope with stress **A person's perception of control and beliefs about her ability to cope are key determinants of her response to stress. When a person believes that she has no control over the situation or thinks she doesn't have the necessary coping mechanisms, stress will have a more detrimental effect (see, e.g., R.B. Flannery, From victim to survivor: A stress management approach to treatment of learned helplessness. In B.A. van der Kolk, "Psychological Trauma," Washington, DC: American Psychiatric Press, 1987). This finding is consistent with Bandura's self-efficacy theory, which emphasizes changing a person's beliefs about her ability to control events or outcomes and proposes that a person's belief about her own self-efficacy is the primary mediator of her adjustment. Answer A: A person's capacity to cope with stress is mediated by her belief in her ability to cope. Answer C: Research on the buffering hypothesis has found that perceived, not actual, social support is important.

Question ID #13404: A social worker conducting the first interview with a client finds herself feeling angry at the client. What is the social worker's BEST course of action? A.Refer the client to a colleague B.Identify the source of her anger C.Set aside her negative feelings

B.Identify the source of her anger **The question says nothing specific about the client's behavior or attitude, and the social worker and the client are meeting for the first time. The implication is that the social worker's feelings toward this client stem from her own unresolved issues (i.e., they are probably a "gut" response to something the client said or did in this meeting). In other words, this sounds like a case of countertransference. Social workers who experience countertransference should monitor and attempt to understand their feelings so that they don't impede their therapeutic effectiveness or objectivity and also so that they learn about themselves as helpers and how they can improve. This process should occur outside the therapeutic setting (e.g., in supervision or consultation). One way of identifying the source of feelings would be to seek consultation. Social workers should seek consultation before feelings begin to affect the therapeutic effectiveness or objectivity. Answer A: This isn't the correct answer because the development of countertransference doesn't necessarily, or even usually, require referral of the client to a different therapist, at least not right away. Answer C: The social worker could try this, but it may be difficult to do. The social worker needs to address this problem more actively.

Question ID #13296: The social worker is seeing a new client, Lisa, who states that she is "tired of everyone telling [her] what to do all of the time" and wishes "everyone would just leave [her] alone." She says that sometimes she doesn't feel like getting up in the morning to go to school. If the social worker were to do a functional analysis in Lisa's case, what would be involved? A.Establish a baseline of functioning. B.Note the antecedents and consequences of a behavior, and analyze the context of the behavior and the reinforcement patterns that sustain it. C.Assess the frequency, intensity, duration, and function of Lisa's problem.

B.Note the antecedents and consequences of a behavior, and analyze the context of the behavior and the reinforcement patterns that sustain it **These are the correct components of a functional analysis. Answer A: This answer is too simplistic. It would simply define how the client is functioning without giving any additional information. Answer C: Establishing a baseline for a problem includes assessing the frequency, intensity, and duration of the problem. In order to understand the function of the problem, one would have to do a functional analysis

Question ID #13182: A school social worker is in a meeting with the principal and a student. During the meeting, it becomes obvious that the social worker needs to file a child abuse report based on what the student is telling them. After the meeting, the principal informs the social worker that he does not want her to make the report, stating that "the family will know that [they] made the report." What should the social worker do? A.Agree with the principal since he is in a position of authority and can determine the policies and procedures of the school B.Inform the principal that her code of ethics requires her to file a child abuse report C.Lie to the principal and file the child abuse report anyway D.Give it some time to see if anything else raises her suspicions about this student's risk

B.Inform the principal that her code of ethics requires her to file a child abuse report **When a social worker encounters a situation in which the ethical responsibilities conflict with the policies and procedures of the work setting, the social worker must make a good-faith effort to resolve the conflict, according to the Social Work Code of Ethics. The resolution must be consistent with the principles and standards of the code of ethics. Informing the principal of the mandate to report when there is reasonable suspicion of abuse or neglect is the best and only option in this situation. When a conflict like this one arises, the best first action is usually to discuss one's concerns directly with the other involved professional. Answer A: While the principal is in a position of authority, it does not mean that the social worker must go against the code of ethics when instructed to do so. She would need to inform the social worker of her mandate to report in this situation. Answer C: Lying to the principal would not be appropriate. The principal also, most likely, needs to be made aware of the report, since Child Protective Services will likely visit the school if they determine an investigation is appropriate. Disclosing this information to the principal or other school personnel would be on a "need-to-know" basis under compelling professional reasons. Answer D: The social worker has a legal requirement to file a report when there is reasonable cause or suspicion that child abuse or neglect has occurred.

Question ID #13154: A social worker begins working in individual therapy with a client who is suffering from a depressed mood after her divorce. The client has been referred by her primary care physician, and her HMO has authorized ten visits. After meeting five times with the client, the social worker realizes that the client needs more than ten sessions of therapy to address her depressed mood and adjustment to life post-divorce. The social worker contacts the managed care program to get authorization for additional sessions, but the program refuses this request. What should the social worker do NEXT? A.Refer the client to a low-fee clinic B.Initiate an appeal with the managed care program on behalf of his client to challenge the denial C.Explain to the client the limitations imposed on him by her managed care planIncorrect D.Explore alternative treatment options for the client, such as working with a psychiatrist who can provide antidepressant medication

B.Initiate an appeal with the managed care program on behalf of his client to challenge the denial **The social worker's ethical responsibility to the client supplants any limitations imposed by the client's managed care plan or insurance coverage. Therefore, when a decision made by a managed care program impacts the quantity or quality of care that the social worker can provide for a client, he has a duty to serve as the client's advocate. This includes initiating an appeal on behalf of the client to challenge the denial and argue for the provision of the treatment that the social worker has determined that the client needs. Answer A: This answer doesn't address the obligation to advocate on behalf of the client by filing an appeal. In addition, referring the client isn't a good option because therapy is underway, and the social worker and client probably have a therapeutic relationship by now. A better option with this client would be to continue treatment at a lower cost that she can afford out-of-pocket. Answer C: This suggests that the social worker would simply accept the managed care program's decision, which would be inappropriate. In addition, the social worker should discuss with a client the limitations imposed by her managed care plan in the first treatment session, not after a request for additional sessions has been denied. The first treatment session should also include a discussion of what steps will be taken if the managed care program denies the client's needed services. Answer D: The social worker is obligated to provide the client with treatment that is consistent with the standard of care he or she would normally provide for a client. In other words, the social worker shouldn't change the treatment plan or recommend a less complete or effective form of treatment just because the managed care program has denied the request. Instead, the social worker is obligated to file an appeal.

Question ID #13412: A social worker has been working in individual therapy with a client who recently relapsed on alcohol after a 10-year period of sobriety. The client continues to have frequent relapses throughout the week despite intervention by the social worker. The client is medically stabilized and does not appear to need detoxification, but struggles to maintain abstinence. The client reports drinking 3 nights a week, 1-3 drinks. The social worker offers the client a referral to a higher level of care to facilitate the recovery. What is the most appropriate next level of care based on the information provided? A.Outpatient care B.Intensive outpatient care C.Non-hospital residential care D.Inpatient care

B.Intensive outpatient care **The client has been attending outpatient care with the therapist and does appear to need a higher level of care with more frequent visits to attempt sobriety. Intensive outpatient care is more highly structured than regular outpatient care and is recommended for individuals who require daily, rather than weekly or bi-weekly, support. Answer A: The client has been attending outpatient care. Answer C: Non-hospital residential care includes short-term halfway houses and long-term therapeutic communities. This is for individuals who have failed to make progress in less intensive levels of care. The client may require this in the future, however, they would first benefit form a lower level of care. Answer D: Inpatient care is generally recommended only for individuals who have not made progress in less intensive levels of care, or have serious problems or impairment. Patients are given 24-hour medical monitoring and nursing attention. This client does not appear to be medically impaired yet, and would benefit first from a lower level of care such as intensive outpatient.

Question ID #13307: An individual with schizoid personality disorder is MOST likely to display which of the following? A.Eccentric behavior B.Isolation C.Suspiciousness D.Excessive emotionality

B.Isolation **The essential feature of schizoid personality disorder is a pervasive pattern of detachment from interpersonal relationships and a restricted range of emotional expression in social settings. Answer A: Eccentric behavior is more associated with schizotypal personality disorder. Like schizoid personality disorder, schizotypal personality disorder is associated with social and interpersonal deficits; however, the latter disorder also includes cognitive and perceptual distortions - peculiarities in behavior, thinking, communication, and appearance - that are not found in schizoid personality disorder. Answer C: Suspiciousness is more associated with paranoid personality disorder. Answer D: Excessive emotionality is more associated with histrionic personality disorder. Schizoid personality disorder is marked by a restricted range of emotional expression in social settings.

Question ID #13676: The social worker is working with two different clients - one client immigrated from China one year ago and the other client is 5th generation Asian-American. What would not be expected of the latter? A.The 5th generation Asian-American family would expect the social work not to be formal and directive with them. B.The 5th generation Asian-American family would be very concerned with maintaining linkage to historical values. C.The 5th generation Asian-American family would respond better to a structured approach than an unstructured one. D.The 5th generation Asian-American family would not have acculturation issues.

B.The 5th generation Asian-American family would be very concerned with maintaining linkage to historical values.

Question ID #13148: Two sisters, ages 76 and 78, live together in a small apartment. One sister never married and the other has been a widow for nearly 20 years. Neither woman ever had children. The sisters have no friends or other support nearby and mostly keep to themselves. They have adequate access to medical care and recently had check-ups. The sisters have recently begun having some difficultly managing certain day-to-day living tasks, such as grocery shopping and keeping track of their finances. What is the BEST action for the social worker to take? A.Refer for medication evaluations B.Offer homemaking services C.Refer to a support group D.Recommend a nursing home

B.Offer homemaking services **The most significant issue in this case is the sisters' difficulties with performing activities of daily living. The case indicates that the women are having "some" difficulty in this area and that the difficulties emerged recently. Homemaking services, which include help with daily living chores (cooking, shopping, cleaning, etc.) and providing transportation and some nursing services, are designed to allow individuals to remain in their own homes for as long as possible. Answer A: Recommending additional physical evaluations by a doctor could be appropriate, but there is no reason to refer the women for medication evaluations. Answer C: This referral would be useful for expanding the sisters' support network; in terms of their welfare and safety, however, homemaking services are more important. Answer D: The question does not give information to support a nursing home currently. It may be a consideration in the future if homemaking services do not meet the clients' needs.

Question ID #13581: Joanne has been referred to therapy by her pastor, and tells the social worker that she has been feeling extremely anxious and worried for the last week. Under questioning, she states that she has had fantasies of ending it all because she simply cannot stand feeling this way. She complains of an inability to sleep or eat, difficulty concentrating, and feeling excessively guilty for things she knows are not under her control. What is the most appropriate diagnosis for Joanne? A.Major depressive episode with anxious distress B.Other specified depressive disorder: short-duration depressive episode C.Generalized anxiety disorder D.Disruptive mood dysregulation disorder

B.Other specified depressive disorder: short-duration depressive episode

Question ID #13709: A client says, "I don't want to get so wrapped up in my relationship with my boyfriend that I lose my ability to make my own decisions." The social worker responds by saying, "Your independence is important to you." What skill has the social worker used? A.Interpretation B.Paraphrase C.Accent response D.Seeking concreteness

B.Paraphrase ***This response is basically a more concise version of what the client has just said. A paraphrase restates the essence of a client's message - it is a selective restatement of the main idea that resembles the client's statement but is not identical to it. Particularly when they are used with responses that highlight the client's feelings (such as empathic responses), paraphrases are effective for encouraging the client to continue expressing herself. They are also useful for bringing focus to an idea or a situation that the client should consider.

Question ID #13827: A client reports feeling anxious since starting a new job three months ago. He feels inadequate and irritable on most days because it's been hard to juggle working more hours with his other obligations. His girlfriend has been accusing him of ignoring her. He wants to please her but he also wants to succeed at work, and this is making him feel tired all the time. He says he wants to feel like himself again - like someone who "has it together." How should the social worker approach treatment in this case? A.Refer the client to couples therapy. B.Provide stress management training. C.Help the client express his anger using I-language. D.Teach progressive muscle relaxation.

B.Provide stress management training. **This client is experiencing a lot of stress and is seeking help for coping with the extreme stress. People under stress may demonstrate anxiety, feelings of inadequacy, irritability, and fatigue like the symptoms this client is expressing. Strategies for comprehensive stress management focus on the client's belief system and attitudes, his ways of dealing with stress, and his eating, sleep, and exercise habits. Answer A: The client has come in by himself complaining of stress and its effects on him. While he may decide that he wants couples therapy at some point, the social worker's intervention should be directed at what the client wants to work on now. Answer C: This is an element of anger management training. The client reports being irritable, therefore, the social worker has no evidence at this point that he has a problem with anger management. Answer D: Progressive muscle relaxation can be effective as a part of stress management training, but is only one technique in the training. The regular use of relaxation techniques (such as progressive muscle relaxation) are highly effective for preventing cumulative stress, which is associated with high levels of anxiety that make it more difficult to deal with everyday stressors

Question ID #13723: A social worker meets with a client who is disabled and unemployed. The client has never had a job and has almost no money. Based on this information, the social worker should recommend that the client apply for which of the following? A.SSDI B.SSI C.TANF D.Unemployment insurance

B.SSI **This client is disabled and has never had a job. Supplemental Security Income (SSI) is a federal income supplement program funded by general tax revenues (not Social Security taxes) and designed to help aged, blind, and disabled people who have little or no income by providing cash to meet basic needs for food, clothing, and shelter. Answer A: Social Security Disability Insurance (SSDI) pays benefits to individuals and certain members of their family if they are insured, meaning that they have worked long enough and paid Social Security taxes. Answer C: TANF (Temporary Assistance to Needy Families) provides cash aid, services, and work opportunities to eligible needy families. Answer D: Unemployment insurance provides partial income replacement to regularly employed members of the labor force who become involuntarily unemployed. This client has never had a job.

Question ID #13384: A social worker begins working with a family on behavioral problems involving the children. Instead of exploring the family's problems in detail, the social worker asks, "When is this problem not a problem?" What is the purpose of this intervention? A.To reframe the situation in a more positive way B.To identify exceptions as a resource for positive change C.To re-author the family's dominant story D.To restructure the family's cognitions

B.To identify exceptions as a resource for positive change ***The fact that the social worker has asked the clients this question indicates that they are probably using solution-focused therapy. A solution-focused therapist asks, "When is this problem not a problem?" in order to find exceptions to the clients' problem. When clients can identify situations in which things go well for them, these situations can become resources or models for positive change. That is, when clients can identify and describe times or situations when their problem does not exist or is less serious, this often reveals things they can do to create more frequent "non-problem" experiences.

Question ID #13477: A social worker provided short-term therapy to a client who was experiencing a high level of job-related stress and whose HMO authorized only six sessions. In the sixth session, the client expressed a desire to begin long-term therapy to address childhood issues that emerged during their sessions. The social worker gave the client three referrals for long-term therapy. Two weeks after termination, and before the client has had a chance to begin seeing a new provider, she calls the social worker, saying that a terrible crisis has occurred and she needs to talk to him. What is the social worker's BEST course of action? A.Schedule an appointment for the client with a social worker on the referral list B.Schedule an appointment and see the client until the crisis has abated C.Give the client contact information for a 24-hour suicide helpline so that she has support in place until she can see a new social worker

B.Schedule an appointment and see the client until the crisis has abated **It's important to remember to always act in the best interests of the client. Although it's likely that the social worker will not be reimbursed by the HMO, this action is clearly the right thing to do to care for the client.Answer A: Since the client already has an established therapeutic relationship with this social worker, it would be better to see the client than to schedule an appointment for her with a new social worker.Answer C: There is nothing in the question to indicate that the crisis is about suicide; therefore, the mention of suicide in this answer is a reason to eliminate it right away.

Question ID #13817: A health social worker at a hospital conducts an evaluation to assess the psychological and social concerns of a patient who needs heart surgery. In doing so, the social worker asks the patient questions about his financial resources. What is the primary reason the social worker would evaluate the patient's financial well-being? A.The patient might be eligible for entitlement programs. B.Socioeconomic factors impact access to services and resources, and this may need to be addressed in the intervention. C.Having limited financial resources is a psychosocial stressor that would impact the patient's health. D.The social worker needs information about the patient's health insurance.

B.Socioeconomic factors impact access to services and resources, and this may need to be addressed in the intervention.

Question ID #13088: A man goes to the casino, and over the course of the evening, he ends up losing thousands of dollars yet continues to still gamble throughout the night. What decision-making principle MOST applies here? A.Gambler's fallacy B.Sunk cost fallacy C.Positive recency D.Overoptimistic probability bias

B.Sunk cost fallacy **The sunk cost fallacy refers to the fact that the more one sinks resources into something, the more they need to continue putting resources into it so that at least the previous costs count for something. For example, the more you put money into a car that is a lemon, the more likely it is that you'll continue putting money into it because you've sunk so much into it already. In other words, it is very hard to walk away from something you've invested in, despite the fact that it is not working.Answer A: The gambler's fallacy is the erroneous belief that if a particular event occurs more frequently than normal during the past, it is less likely to happen in the future (or vice versa). In Roulette, if the wheel has landed on black 10 times in a row, people will bet that the next time it will land on red (even though the probability for either result is the same).Answer C: Positive recency refers to overvaluing the thing or event that occurred the most recently (the hot hand fallacy).Answer D: Overoptimistic probability bias (or the optimistic bias) is a cognitive bias that causes someone to believe that they themselves are less likely to experience a negative event than someone else.

Question ID #13005: While working with a couple on communication issues, the social worker decides to have a session alone with each one of them. In her session, the wife tells the social worker that she has a serious illness that she may die from. She hasn't told her husband about her illness because, she notes, he would just worry constantly and he has enough on his mind already. How should the social worker respond? A.Tell the client that, with her permission, the social worker will gently bring the issue up in the next couples session B.Tell the client that she needs to tell her husband about her illness for couples therapy to continue C.Agree to keep the client's secret since she feels so strongly about it D.Suggest that maybe individual therapy would be more appropriate at this time

B.Tell the client that she needs to tell her husband about her illness for couples therapy to continue **A major issue like this in the clients life needs to be brought into the couples session. It would be unethical for the social worker to continue providing therapy to them as a couple while holding such a major piece of information that could affect them both on so many levels. The social worker should gently encourage and coach the wife on how to tell her secret during a session with the both of them. If the wife is unwilling to do this, the social worker should discontinue couples therapy and offer the woman individual therapy. Answer A: This information should come from the wife, not the social worker. Answer C: It would be unethical for the social worker to continue providing therapy to them as a couple in this situation. Answer D: This would be the second-best answer, but B is more complete.

Question ID #13775: A social worker is hired by a private, non-profit agency that works with the HIV/AIDS population. The primary responsibility of the social worker's unit is to educate sexually active individuals about the disease, helping them understand the importance of testing, medication compliance, treatment options, and lifestyle changes. What is the BEST way to describe the agency's type of prevention? A.Crisis intervention B.Tertiary prevention C.Secondary prevention D.Primary prevention

B.Tertiary prevention **Tertiary prevention efforts focus on people affected by the disease and attempt to reduce disability and restore/maintain functionality. These types of programs improve the quality of life for people with various diseases and involve actual treatment for the disease. Answer A: Crisis intervention is a type of intervention that is specific to circumstance and is not limited in scope. A client in crisis is typically overwhelmed and needs specific intervention to manage the crisis. Answer C: Secondary prevention refers to measures that detect disease before it is symptomatic. The goal is to identify and detect disease in the early stages to help treat it successfully Answer D: Primary prevention is used to prevent the disease before it occurs.

Question ID #13019: The social worker has been seeing a woman for about a year, who has several severe, life-threatening conditions. She is in constant pain, with only occasional relief from medication. She has been told several times that she has only months to live, but has always rallied back. One day, she comes in and tells the social worker that she has had enough, and that she has decided to stop taking all of her medications, except pain pills. The social worker points out that the medications seem to be what have been keeping her alive these past few years. The client acknowledges this, and states, "I don't want to live any longer. I'm done." How should the social worker respond? A.The client plans to attempt suicide and the social worker must intervene. B.The client is exercising her right to make a decision and the social worker should support her in that decision. C.The social worker should call the Psych. Emergency Team and ask them to institute an involuntary hold on the client. D.The social worker should strongly encourage the client to talk with her doctor about what will happen if she goes off her medication.

B.The client is exercising her right to make a decision and the social worker should support her in that decision **The client is exercising her right to determine what is best for her and the social worker should support her decision. This client is fully aware of the implications of her decision to go off of her medication, and has decided to face her inevitable death on her own terms. Answer A: The client is not taking her own life, for example, by telling the social worker that she plans on taking an overdose. Given the situation, the client is bowing to the inevitable, and making an effort to exert some control over her life and death. Answer C: The client is not suicidal, so this would not be appropriate. Additionally, this action would be unnecessarily traumatizing. Answer D: This is a strong second-best answer. The social worker should definitely encourage the client to talk her decision over with her doctor. However, ultimately, the client is exercising her self-determination and her caregivers should support her decision.

Question ID #13047: A social worker's client is looking for extra work to help pay some of his bills. In session he mentions that he used to be a house painter and asks if the social worker if he know anyone in need of his services. The social worker does have a friend looking to have his home repainted and provides his friend's number to the client. Which of the following statements BEST represents the social worker's behavior? A.The social worker acted ethically and was looking out for the best interests of his client. B.The social worker acted unethically by taking advantage of his relationship with his client to further personal or business interests. C.The social worker breached privilege by connecting his client and friend. D.The social worker provided a service to his client in exchange for helping his friend and acted unethically.

B.The social worker acted unethically by taking advantage of his relationship with his client to further personal or business interests. **In this situation, the ethical principle of avoiding conflicts of interest is being exploited. The social worker acted unethical in offering his client work through a personal relationship. The code of ethics (Standard 1.06) says that social workers should not take unfair advantage of any professional relationship or exploit anyone to further personal, religious, political, business interests. Answer A: The social worker is going against standards set by the Code of Ethics with regard to conflicts of interest. Answer C: Privilege is a word used in court related settings so is not accurate in this situation. The social worker did not breach confidentiality (or privilege) in this situation because he gave his friend's number to the client, allowing the client to make the choice whether or not to call. However, it is still not an appropriate action. Answer D: There is no mention that this is in exchange of something. However, it is still considered unethical since it is a conflict of interest that could be avoided.

Question ID #13081: The social worker is employed in an agency with a large immigrant population. She is most familiar with immigrants from Latin American countries. Lately, she has taken on a female client who immigrated from the middle east and is Muslim. The client complains of depression and anxiety, and feels alienated from Allah since moving to the United States. The social worker has researched Islamic culture and its views on mental health, and knows that there is an emphasis in Islam of the value and cohesion of the community. She runs a group for people with depression and anxiety and recommends that the client attend. The client agrees, and never returns. Which of the following BEST represents the error the social worker made? A.The social worker should have inquired as to whether this client would feel comfortable in a mixed-gender group B.The social worker did not take into account that some Muslims, although comfortable with groups within their own culture, may feel uncomfortable in group settings with people from different cultures. C.The social worker should have assessed the place that Islam has in the life of this client. D.The social worker should have realized tha

B.The social worker did not take into account that some Muslims, although comfortable with groups within their own culture, may feel uncomfortable in group settings with people from different cultures. **This client may not feel comfortable in a group setting with people from diverse cultures. And, it is unclear if the group is mixed-gender, but if it is, it may not be appropriate for this particular client due to her religious background, although different branches of Islam approach the issue of how men and women relate in differing ways. Answer A: While it may very well be true that this client may not feel comfortable in a mixed-gender group, we do not know if the group is indeed mixed-gender. Answer C: While this is true, it is not immediately apparent that this is the problem. Answer D: Working in a group setting is not necessarily in violation of this client's belief system.

Question ID #13082: The social worker is seeing Dave, who has bi-polar disorder. Dave has a long history of manic episodes that have, at times, gotten him in trouble with the law. He is currently stable on his medications and is able to hold down a full-time job as a bus driver for the local transit district. What is the social worker's role as far as managing a client's medication? A.The social worker has no role in medication management. B.The social worker should monitor the client's medication compliance. C.The social worker should monitor the client's medication compliance, and report any problems to the prescribing physician D.The social worker can recognize when there are problems with medication, such as side-effects and help the client manage them.

B.The social worker should monitor the client's medication compliance. **There is growing recognition that social workers play a vital role in medication management. While a psychiatrist may only see a client once every few months or so, the typical social worker is seeing the client at least once a week. The social worker is in a better position to monitor compliance and to spot problems such as side-effects. Of course, the social worker is not allowed to give advice about how to deal with side-effects, but can play an active role in facilitating communication between the client and the prescribing physician. Answer A: Social workers should play an active role in medication management, within certain constraints. Answer C: Report sounds somewhat punitive. The social worker should encourage medication compliance, and, in some situations, report issues to the prescribing physician. In other cases, it would be more appropriate to encourage the client to bring up issues with the psychiatrist themselves. Answer D: Helping the client manage side-effects may be crossing the scope of practice line.

Question ID #13422: A social worker begins working with a family who has presented with parenting difficulties and acting out by the adolescent children. If the social worker were using structural family therapy with these clients, which of the following techniques would he use first? A.Reframing B.Tracking and mimesis C.Constructing a family map D.Enactment

B.Tracking and mimesis **The three steps in structural family therapy, in sequence, are: joining, evaluating the family structure, and restructuring the family. Tracking (identifying and using the family's values, life themes, and significant life events in conversations) and mimesis (adopting the family's affective and communication style) are methods used to join the family. Answer A: Reframing (relabeling behaviors so that they can be viewed in more positive ways) is a restructuring technique. Answer C: A family map is used when evaluating the family structure. It enables the therapist to make a structural diagnosis from which the specific goals of therapy can be derived (e.g., strengthening boundaries in an enmeshed family). Answer D: Enactment (having family members role-play their relationship patterns so that they can be identified and altered) is a restructuring techniques

Question ID #13670: A boy is able to tell that dogs are mammals and therefore related to cats. He also knows cats are related to horses, and concludes that dogs are related to horses as well. How would Piaget describe this process? A.Deductive reasoning B.Transitivity C.Concrete operational D.Formal operations

B.Transitivity **Transitivity is the ability to recognize relationships among various things in a serial order, in other words, the understanding that if A is related to B, and B is related to C, then A must be related to C. Answer A: Deductive reasoning is premised on the idea that if there is on accurate information, the outcome will be accurate as well. Answer C: The concrete operational stage spans approximately from 7 to 11 years, and is characterized by the development of logical thought. The child has not yet moved on to the ability to understand abstract ideas. Answer D: The formal operational stage usually begins around the age of 12, and continues through adulthood. The person is able to understand abstract ideas and theoretical concepts, and can come up with creative, outside the box solutions to complex problems.

Question ID #13062: The client is a 28-year-old female who has sought therapy for depression. She discloses that she's been taking sleeping pills every night for months and thinks she might be addicted to them. You encourage the client to stop taking the sleeping pills because you think doing so might help her feel better during the day. The client stops taking the pills without seeking medical advice or support, and she experiences a seizure. Which of the following is the most significant ethical issue presented in this situation? A.You inappropriately limited your client's right to make her own decisions. B.You gave advice on a matter that is outside your scope of competence. C.You failed to inform the client of the risks associated with your recommendation. D.You failed to confer with the client's doctor before advising her about her medication.

B.You gave advice on a matter that is outside your scope of competence **The most significant ethical issue is that you acted outside your scope of competence by advising the client to stop taking a medication. NASW Ethical Standard 1.04(c) states that social workers should exercise careful judgment and take responsible steps (including appropriate education, research, training, consultation, and supervision) to ensure the competence of their work and to protect clients from harm. As a social worker, you are not qualified (i.e., competent) to advise clients on matters related to starting or stopping medication or changing their dosages. You should have referred this client to a medical doctor to discuss her concerns about the sleeping pills. Answer A: This option doesn't fit with the issue at hand. You should have referred this client to a medical doctor. Answer C: Whether you informed the client of the risks associated with your recommendation or not, it is still out of your scope of competence to advise on medication. Answer D: Whether you conferred with her doctor beforehand is less relevant because, as a social worker, you should not advise a client to stop taking a medication in the first place.

Question ID #13033: The client has had numerous episodes of major depression. She has been hospitalized twice and has tried to commit suicide once. She was raised by an alcoholic mother and a periodically absent, abusive father. Mindfulness-based Cognitive Therapy (MBCT) would consider the client's depression as consisting of: A.a lack of self-acceptance. B.a downward mood spiral that can be caused by high standards. C.an inability to be present in the moment. D.internalized anger.

B.a downward mood spiral that can be caused by high standards. **MBCT teaches clients how to stop the downward spiral that begins with a bad mood or thoughts about painful memories. MBCT teaches clients to accept negative emotions or thoughts without judgment and to shift gears to a more self-accepting, less judgmental mental space. Answer A: While a lack of self-acceptance is part of what MBCT addresses, this answer is incomplete. Answer C: An inability to be present is only part of what MBCT addresses. Answer D: The idea of internalized anger originated with Freud.

Question ID #13661: A 30-year-old client reports feeling self-conscious around other people and worrying that they are judging her in negative ways. She is acutely aware of other people's reactions to her behavior and tries to adapt what she says and does to other people's expectations in order to avoid their ridicule or censure. She says she's been this way for years and years. Erikson would predict that this problem first developed when the client was: A.an infant. B.a toddler. C.a school-age child. D.a teenager.

B.a toddler. **This question requires you to apply your knowledge and understanding of Erikson's "Eight Stages of Man." This client is excessively concerned about how other people are perceiving and judging her, which suggests a high level of shame and self-doubt and a low level of autonomy. According to Erikson, toddlerhood is associated with the psychosocial crisis of 'autonomy vs. shame and doubt. In this stage, a sense of self (autonomy) develops out of positive interactions with one's parents or other caregivers.Answer A: Erikson would say that the developmental task of an infant is trust vs. mistrust. An adult who did not meet the challenge of this stage would likely be suspicious, anxious, or even paranoid.Answer C: Initiative versus guilt is the stage the school-age child must negotiate. Children begin to initiate activities with their peers and, hopefully, develop a sense of initiative and a security in their ability to interact with others.Answer D: According to Erikson, the teenager is working on identity vs. role confusion, where they search for a sense of self and personal identity.

Question ID #13737: A social worker is sued by a former client who is alleging that the social worker's therapeutic methods harmed him. The social worker receives a deposition notice informing her of an upcoming deposition that is part of the lawsuit. The social worker should _____________. A.claim the privilege B.attend the deposition C.not attend the deposition unless she is subpoenaed D.refuse to attend the deposition or to release any information at all until she has a signed waiver from the former client

B.attend the deposition **The social worker should attend the deposition. Depositions are part of the legal process called "discovery." During discovery, one party in a lawsuit discovers facts and information from another party in a lawsuit. The facts and information obtained during discovery allow the parties to identify the issues that will be addressed during the trial. Depositions consist of oral questions and answers (an "interrogatory" is the written equivalent of a deposition). Testimony at a deposition takes place under oath and is recorded by a court reporter. Note that this social worker, because she is the defendant in this case, should have an attorney of her own present with her at the deposition. Answer A: There is no privilege in this situation because the client has brought a legal action against the social worker alleging that her therapeutic methods harmed him. Answer C: Because the social worker is named in the lawsuit, a deposition notice is the only document necessary to require her attendance. Answer D: There is no privilege in this situation because the client has brought a legal action against the social worker alleging that her therapeutic methods harmed him. Confidential information may be necessary to the social worker's defense, so the social worker can disclose relevant confidential information during the legal proceeding, and the client can't invoke the privilege to prevent the information from being admitted into the legal proceeding. Malpractice cases are civil suits that require a plaintiff (e.g., the client) to prove his claim by a "preponderance of the evidence." In other words, the plaintiff must establish a standard of care and show that the therapist did not meet it.

Question ID #13781: The geographic region that is served by a social agency is known as the agency's: A.mission statement. B.catchment area. C.functional community. D.claimed domain.

B.catchment area. ***A catchment area is the geographic region that an agency serves (i.e., all the agency's potential clients located in that region)***

Question ID #13615: A person's ability to self-regulate their own emotional states depends in large degree on: A.genetic susceptibilities. B.early attachment experiences. C.upbringing. D.self-soothing and calming capabilities.

B.early attachment experiences. **A person's ability to self-regulate their own emotional states depends in large degree on their early attachment experiences. Children learn to recognize and manage their internal states when they are reflected, and adequately responded to, by an empathic and attuned caregiver. If the caregiver is overly focused on their own needs rather than those of the child, or are indifferent or abusive to them, the child will not get the mirroring that helps them learn how to regulate their own emotional states. Answer A: Genetic susceptibilities can affect how the caregiver's responses influence the child, but the primary determinant is the caregiver's attunement. For example, a parent who has a child that is predisposed for shyness, may provide support and encouragement that will allow the child to learn to tolerate and thrive in relationship to others. On the other hand, a shy child whose caregiver is punitive or neglectful does not help the shy child learn how to be successful in relationships. Answer C: This is a broad answer that is generally correct, however, Answer Choice B is more specific. Answer D: The child learns to self-sooth (emotionally regulate) by being in an attuned relationship with primary caregivers.

Question ID #13496: A client seeks therapy because she is feeling inadequate and unable to change her life for the better. The social worker helps her change from having an external locus of control over the circumstances in her life to having an internal locus of control. This is an example of: A.confrontation. B.empowerment. C.clarification. D.reframing.

B.empowerment. **The empowerment approach is a way of working with clients to help them acquire the personal, interpersonal, and political power they need to take control of their lives and bring about changes in policies, organizations, and public attitudes that are impacting their lives and the lives of their families in negative ways. Applying an empowerment strategy with a client involves, among other things, helping the client shift from believing that she is powerless to change her life and at the mercy of impersonal societal forces (external locus of control) to believing that she has the power to take control of her life and bring about the changes she wants (internal locus of control). Answer A: Confrontation is used to help a client recognize that she is using distortions, deceptions, denials, avoidance, or manipulations that are getting in the way of desired change. When using confrontation, you gently challenge the client to examine a thought or behavior that is self-defeating or harmful to others and to take action to change it. Answer C: Clarification is a response to a vague or confusing statement by a client that enables you to check out what the statement means or verify that you have understood the client. Answer D: Reframing is used to help a client change the negative meaning she gives to an event, behavior, or life experience through gently persuading her that it can be viewed in a different and more positive light.

Question ID #13483: The overall goal of social worker authenticity with a client is to _______________. A.improve the chances that the client will like the social worker B.facilitate client growth C.elicit information from the client D.facilitate rapport in the early stages of treatment

B.facilitate client growth **As a social worker, conveying authenticity (genuineness) to clients is shown by being open, nondefensive, and spontaneous, matching words and actions, and making statements that are consistent with thoughts and feelings (the latter two skills are also known as being congruent). To be nondefensive, for example, the social worker takes responsibility for his or her own feelings (i.e., avoid blaming a client for them) and are willing to admit when they have made a mistake. In turn, these behaviors provide the client with a model for relating authentically with the social worker and others. Another important skill for demonstrating authenticity is appropriate self-disclosure, or authentic responding, in which the social worker makes statements to a client that reveal some of his or her own thoughts, feelings, or life experiences. During all phases of intervention, the social worker self-discloses selectively and only when doing so is likely to increase the client's comfort or promote his or her growth in some way. Answer A: Facilitating client growth is a better choice as it is more about the best interest of the client, rather than the social worker "being liked" by the client. Answer C: Although being authentic with a client will help to elicit information from the client, it is one part of the overall goal of facilitating client growth, making Answer Choice B a better answer. Answer D: While this option is not a bad answer, it suggests that authenticity is primarily important in the initial phases of treatment, when, in fact, a social worker should be authentic in all phases of treatment.

Question ID #13672: A social worker is meeting with a family that has been referred by the adolescent son's school. She observes that the parents are very warm in their interactions with their two children but also discovers that they almost never discipline or correct them. Children coming from homes where the parents use this parenting style ("indulgent-permissive") tend to display behavior that is: A.aggressive and dependent. B.impulsive and self-centered. C.socially withdrawn and submissive D.moody and aggressive.

B.impulsive and self-centered. **You might have made an "educated guess" if you didn't know the right answer: it "makes sense" that children of indulgent and permissive parents would tend to be impulsive and self-centered; these children also tend to be easily frustrated and low in achievement and independence. Answer A: The offspring of "authoritarian" parents are often aggressive, dependent, and irritable and have a limited sense of responsibility and low levels of self-esteem and academic achievement. Authoritarian parents exhibit high demandingness and low responsivity. They impose absolute standards of conduct, stress obedience, and use power-assertive techniques (e.g., physical punishment, threats, and deprivation) to gain compliance. Answer C: Socially withdrawn and submissive children tend to have hostile and controlling parents. Answer D: The offspring of "rejecting-neglecting parents" tend to have low self-esteem and are often moody, aggressive, and impulsive. Rejecting-neglecting parents exhibit low levels of responsivity and demandingness, minimize the time and effort they spend with their children, and may be overtly hostile toward their children.

Question ID #13013: The social worker is seeing a Chinese-American woman for therapy. She states that she has been sad a lot lately, but doesn't know why. The social worker is feeling stuck because she cannot get the woman to say more about this sadness, or to tell her about how emotions were handled in the woman's family. She wonders if perhaps she should refer the woman out. The social worker would do best to keep in mind that: A.in Chinese families, emotional expression is shameful and reflects badly on the family. B.in Chinese families, emotional expression is considered harmful to one's health and relationships, and children are encouraged to avoid it. C.the woman may have a bio-chemical imbalance that needs to be addressed with medication. D.the reason that the woman may not be saying any more about her sadness could be because she is suicidal.

B.in Chinese families, emotional expression is considered harmful to one's health and relationships, and children are encouraged to avoid it. **In Chinese families, emotional expression is considered harmful to one's health and relationships, and children are encouraged to avoid it.Answer A: Answer choice B touches on two beliefs about emotional expression the effect it has on 1) the individual, and 2) on the family. This answer only touches on one of those beliefs, and therefore is not quite as strong as B. Answer C: This might be true, but there is a theme centering around culture in the question that would lead to a culture-related answer. Answer D: While the social worker should assess for suicidality, there do not seem to be obvious signs pointing to imminent danger.

Question ID #13815: The client is a 20-year-old immigrant from Turkey who came to the U.S. with his family when he was 16. The client says he's becoming more like his American friends and is uneasy about that. He wants to fit in but doesn't want to lose his own customs and values. He acts one way when he's with his family and another way when he's with his friends. He asks the social worker what she thinks about that. Based on her familiarity with contemporary models of acculturation, the social worker is MOST likely to tell the client that efforts to function well within both one's culture of origin and the mainstream culture: A.may produce overwhelming levels of stress. B.may be associated with better adaptation. C.often produce confusion and identity crises. D.lead to social isolation

B.may be associated with better adaptation **Some experts have suggested that the best possible outcome of acculturation is the ability to function well in both one's culture of origin and the dominant (mainstream) culture. In order to become "biculturally competent," immigrants need knowledge of the new culture's beliefs and values, a positive attitude toward both cultures, the belief that they can live happily and successfully in both groups without compromising their sense of cultural identity, supportive and reliable social networks in both groups, a broad range of culturally and situationally appropriate behaviors and roles, and communication competency. Answer A and C: The opposite is true. Answer D: Being biculturally competent will likely lead to more friendships, rather than fewer.

Question ID #13310: The key components of creating a trauma-informed care practice are: A.training staff in trauma-specific treatment approaches and creating a safe environment. B.patient empowerment, choice, collaboration, safety and trustworthiness. C.communication, safety, education and patient empowerment.

B.patient empowerment, choice, collaboration, safety and trustworthiness. **Patient empowerment, choice, collaboration, safety, and trustworthiness are the key components to creating a trauma-informed care practice. Answer A: These are important specific aspects contained in the key components of patient empowerment, choice, collaboration, safety and trustworthiness. Answer C: Communication is a broad term encompassed within patient empowerment, choice and collaboration.

Question ID #13315: State legislators can be involved in decisions related to: A.confidentiality. B.privilege. C.anonymity. D.self-determination

B.privilege. **Among the four choices, only privilege is a legal matter that can be affected directly by state legislators. Privilege refers to an individual's right to prevent (or attempt to prevent) confidential information from being revealed in a legal proceeding without his or her consent. State laws, however, define certain limits to this right. In many states, for example, privilege is waived when a social worker is acting in a court-appointed capacity (e.g., has been appointed to evaluate a defendant), when a client has introduced his or her mental capacity as a defense in a civil or criminal suit, when a client initiates a malpractice case or other lawsuit against a social worker, and when a social worker learns about child abuse in her or her professional capacity. Note that many exceptions to privilege are not automatic, however. Rather, when an exception may apply, a judge must review the relevant material and determine whether an exception to privilege will allow the information (i.e., testimony, records) to be disclosed in the legal proceeding. The judge will order that the information be released only when the information falls under an exception to privilege. Answer A: Protecting a client's confidentiality is an ethical, not legal, obligation, and the limits to confidentiality (including those affected by state laws) are defined in a profession's code of ethics. Answer C: The ethical principle of anonymity requires professionals engaged in research to prevent disclosure of the identity of subjects who respond to questionnaires by not revealing their names or any other identifying data. Answer D: Self-determination is also an ethical principle. It recognizes the client's right and need to be free to make his or her own decisions and choices.

Question ID #13035: A social worker is working in family therapy with a single mother of a 10-year-old child. The client reports frustration with her child because he refuses to complete any assigned household chores. The social worker suggests the mother take the child's television privileges for a period of three days as punishment. What technique is the social worker recommending? A.overcorrection B.response cost C.time-out from reinforcement D.flooding

B.response cost **Response cost is an application of negative punishment that involves removing a specific positive reinforcer each time a negative behavior is displayed. This technique can be used whenever the control of positive reinforcers is possible. Answer A: Overcorrection is a form of positive punishment that entails applying a penalty following an undesirable behavior in order to eliminate it. An example would be asking a client to write apology letters to his teacher when he yells at his friends in class. Overcorrection encompasses restitution and positive practice. Answer C: Time-out involves removing all sources of positive reinforcement for a brief, prespecified period following a behavior in order to decrease the behavior. An example of time-out would be a teacher placing a student in a partitioned corner of the room for five minutes each time he is disruptive. Answer D: Flooding is used to eliminate an anxiety response by exposing a client to high-anxiety-arousing stimulus for a prolonged period of time (usually 30 to 60 minutes).

Question ID #13074: A treatment center focuses on clients with serious mental health challenges. The goal is to stabilize clients and provide ongoing support to enable them to live functional, meaningful lives in the community. This kind of care is known as: A.primary prevention. B.tertiary prevention. C.relapse prevention. D.secondary prevention

B.tertiary prevention. **Tertiary prevention helps people manage ongoing illness and aims to prevent a worsening of symptoms. Answer A: Primary prevention aims to prevent problems from occurring in the first place. Universal primary prevention is aimed at large groups of people without regard to risk. Selective primary prevention targets individuals who have elevated risks. Indicated primary prevention serves people who have indications of a problem but do not meet the full criteria for a diagnosable disorder. Answer C: Relapse prevention aims specifically to prevent a return of the problem symptoms, so it would be part of the broader term of tertiary prevention. Answer D: Secondary prevention aims to intervene in the early progression of an illness to prevent it from becoming severe.

Question ID #13649: A child living in the United States is exposed to both English and a second language between the ages of six months and 3 years and, as result, becomes fluent in both languages. If the child had not been exposed to the second language until after the age of 4 or 5, she would have had more trouble acquiring the second language. This provides evidence for: A.the concept of critical periods. B.the concept of sensitive periods. C.the theory of information processing. D.the notion of imprinting.

B.the concept of sensitive periods. **Although some authors use the terms "critical period" and "sensitive period" interchangeably, they actually mean two different things. A critical period refers to a time when, if certain developmental events don't happen, later aspects of development will not occur. A sensitive period refers to an optimal period rather than a necessary period. The situation described in this question suggests there is a sensitive period for dual language learning. Answer A: A critical period refers to a time when, if certain developmental events don't happen, later aspects of development will not occur. Answer C: The theory of information processing likens the brain to a computer with information taken in through the sense, placed into short-term memory, encoded into long-term memory and then retrieved when needed. Answer D: The term "imprinting" describes phase-specific learning (learning occurring at a particular age or life stage) that is rapid and apparently independent of the consequences of behavior. Imprinting is believed to have a critical period. "Filial imprinting," in which a young animal acquires some of its behavioral characteristics from its parent, was described and studied by Lorenz, among others. Working with geese, Lorenz demonstrated how incubator-hatched geese would imprint on the first suitable moving stimulus (including Lorenz himself) they saw during a "critical period" between 13 and 16 hours after hatching. In human development, the term "filial imprinting" is used to describe the process by which a baby learns who his or her mother and father are. The process is believed to begin in the womb, when the unborn baby starts to recognize his or her parents' voices.

Question ID #13078: Suppes and Wells (2013) named five levels of intervention for generalist social work practice. The five levels are: A.individual, micro, family, mezzo, and macro. B.the individual, family, group, organization, and community. C.the individual, family, group, community, and organization.

B.the individual, family, group, organization, and community **From narrowest to broadest focus, these are the five levels of intervention proposed by Suppes and Wells (2013). Answer A: The three major areas of social work are micro, mezzo, and macro practice. Answer C: This answer has all of the correct elements of Suppes and Wells' five levels of intervention, however, they are in the wrong order of narrowest to broadest. Community intervention is a broader term than organization.

Question ID #13377: Ego psychology emphasizes all of the following EXCEPT: A.the development of ego functions and processes. B.unconscious forces. C.development during adulthood. D.the social environment.

B.unconscious forces. **Although Freud's psychoanalytic theory underlies ego psychology, the latter stresses the growth and development of ego functions and processes independent from the unconscious drives that Freud emphasized. Answer A: Ego analysts do emphasize the development of ego functions and processes. "Ego autonomous functions" for example, include memory, language, judgment, decision-making, and other reality-oriented functions. Answer C: Ego psychology focuses on adulthood development and the individual's capacity to resolve problems and deal with social realities. Answer D: Ego analysts are concerned with the role played by the social environment in either helping or preventing people from mastering developmental tasks that are important for healthy functioning.

Question ID #13116: A client presented for therapy complaining of anxiety and recurrent thoughts about being contaminated by touching other people. He says he can't control these thoughts and "hates them" because he knows they're "ridiculous and unreasonable." After completing an assessment of this client, the social worker determines that he has obsessive-compulsive disorder. As part of the treatment plan, she refers the client to a psychiatrist for a medication evaluation. Which of the following kinds of medication would be MOST useful for reducing this client's obsessions? A. Lithium B. An anxiolytic C. An antidepressant D. An antipsychotic

C. An antidepressant **Pharmacotherapy combined with behavioral or cognitive-behavioral techniques is currently considered the treatment of choice for OCD. Of the drugs listed, antidepressants (i.e., a tricyclic, such as clomipramine, or an SSRI) have been most consistently been found to be useful for reducing obsessions associated with OCD. Answer A: Lithium is a mood stabilizer most commonly used for mania. Answer B: An anxiolytic, such as Valium, might reduce the client's anxiety, but the risk of addiction is high. Antidepressant medications usually help reduce anxiety, along with their antidepressant effects. Answer D: An antipsychotic would be inappropriate in this situation.

Question ID #13576: The client is a young woman who is a recent immigrant from El Salvador. The client discovered a week ago that her mother, who is still in El Salvador, is seriously ill. Two days after getting this news, the client began crying, trembling, and shouting uncontrollably while at the grocery store. The client's behavior is MOST likely attributable to which of the following? A.Panic disorder B.Uncomplicated bereavement C.A cultural syndrome

C.A cultural syndrome **In the DSM-5, "cultural concepts of distress" are defined as the "ways that cultural groups experience, understand, and communicate suffering, behavioral problems, or troubling thoughts and emotions" (p. 758). Three types of cultural concepts are described: "Cultural syndromes" are clusters of symptoms and attributions that co-occur among individuals from a particular culture and are recognized by members of that culture as coherent patterns of experience; "cultural idioms of distress" are used by members of different cultures to express distress and provide shared ways for talking about personal and social concerns; and "cultural explanations" refer to the explanatory models that members of a culture use to explain the meaning and causes of symptoms, illness, and distress. The DSM-5's Glossary of Cultural Concepts of Distress describes a number of different cultural syndromes, including "ataque de nervios." This syndrome is recognized by the members of certain Latino cultures and is characterized by intense emotional upset (acute anxiety, anger, or grief), screaming or shouting uncontrollably, attacks of crying, trembling, verbal and physical aggression, heat in the chest rising into the head, and an overall sense of being out of control. Some attacks may also include dissociative experiences, seizure-like or fainting episodes, and suicidal gestures. These attacks often occur as a direct result of a stressful event involving the family. Answer A: To diagnose panic disorder, we'd need more information about panic-attack-related symptoms (shortness of breath, dizziness, heart palpitations, numbness, intense fear, etc.). In addition, to receive this diagnosis, a person must experience recurrent (at least two) unexpected panic attacks. Answer B: In the DSM-5, uncomplicated bereavement is defined as a normal reaction to the death of a loved one that primarily involves feelings of emptiness and loss.

Question ID #13263: A client has been diagnosed with schizophrenia. Her family asks the social worker about the client's prognosis. In response, the social worker could tell them that a better prognosis for individuals with schizophrenia is associated with which of the following? A.A family history of a mood disorder, an early onset of symptoms, and male gender B.The presence of a mood disturbance, a later age of onset, and male gender C.A family history of a mood disorder, a later age of onset, and female gender D.An absence of mood symptoms, an early onset of symptoms, and female gender

C.A family history of a mood disorder, a later age of onset, and female gender **A better prognosis for schizophrenia is associated with several factors including an acute onset of symptoms, a later age of onset, female gender, precipitating events, a brief duration of active phase symptoms, an associated mood disturbance, and a family history of a mood disorder. Answer A: Early onset and male gender are often associated with a poorer prognosis in schizophrenia. Answer B: Males with schizophrenia often have a poorer prognosis. Answer D: An associated mood disturbance if often associated with a better prognosis in schizophrenia.

Question ID #13301: Unlike bipolar I disorder, bipolar II disorder MUST include which of the following? A.A manic episode B.More than one manic episode C.A major depressive episode D.Both major depression and mania

C.A major depressive episode

Question ID #13213: A 26-year-old client complains of low self-esteem and feelings of shame about behaviors he engaged in while he was a student in college. The client appears nervous in the interview, but he is able to carry on a conversation and his affect is appropriate. What does "appropriate affect" refer to? A.The ability to express a full range of emotions B.The ability to manage strong feelings that would otherwise interfere with adaptive functioning C.An emotional tone that matches the idea, thought, or topic that one is describing

C.An emotional tone that matches the idea, thought, or topic that one is describing

Question ID #13354: During a session, a 15-year-old therapy client says, "This guy has been stalking me." She then begs the social worker to keep this information from her parents because she's afraid that they'll get mad and think she somehow provoked the behavior. What should the social worker do FIRST in this situation? A.File a child abuse report B.File a child abuse report and call the client's parents C.Assess the situation further to determine what the client needs D.Maintain confidentiality and address the client's feelings about this

C.Assess the situation further to determine what the client needs **Because this girl may be in danger, the social worker must first gather more information from her so that she can better understand the situation and what she needs to do. The social worker needs to know what the "stalking" consists of, so she should clarify what the client means when she uses this word, who is doing the stalking, and what danger, if any, the girl is in. Answer A: Being stalked, by itself, doesn't constitute a form of child abuse. A report may turn out to be necessary, but more information is needed first. Answer B: Being stalked, by itself, doesn't constitute a form of child abuse. Depending on what else is learned about this situation, however, a report may turn out to be necessary, as well as notifying the client's parents. Answer D: This answer might be tempting because it includes addressing the girl's feelings. However, while the social worker may turn out to have no legal basis for breaching confidentiality in this situation, the social worker can't know if this is true until she has clarified what's going on. At the very least, if the client is in danger at all, then she would want to inform her parents about this situation and discuss options, such as contacting the police, with the family.

Question ID #13283: A social worker is working in the first stage of therapy with a 35-year-old African American man who sought treatment because he was feeling depressed and dissatisfied at his job. Why would it be useful for the social worker to discuss issues related to race and racism with this client? A.To demonstrate her concern. B.Because the client may be reluctant to bring it up himself. C.Because it may have a bearing on the problem definition. D.Because she has an ethical responsibility to work to reduce racism.

C.Because it may have a bearing on the problem definition. **As a social worker, you are concerned with a client's entire person-in-situation configuration. Because this client is African American, it's possible that his problems, needs, or concerns are related in some way to experiences he has had with racism. Answer A: This is a very broad answer, whereas answer choice C is more specific. Answer B: This may be true, but answer choice C is better because it explains how discussing these issues can facilitate the treatment process. Answer D: This is a truism, but it doesn't offer a reason why discussing these issues can facilitate treatment.

Question ID #13269: The client is a 25-year-old transgender person who recently started hormone therapy. The client has sought help because he has been feeling very anxious lately. What should be the social worker's FIRST step in approaching this case? A.Assess the client's understanding of hormone therapy and provide him literature about this medical treatment and its potential side effects. B.Discuss the client's feelings about undergoing hormone therapy and normalize his anxiety symptoms under the circumstances. C.Clarify the source of the presenting problem by consulting with the client's doctor. D.Assess the intensity of the client's symptoms of anxiety and provide coping skills that he can use immediately.

C.Clarify the source of the presenting problem by consulting with the client's doctor. **The question doesn't offer much information about the client. You do know, however, that he recently started hormone therapy (hormonal gender reassignment) and now feels anxious. These facts suggest that the social worker's priority at this time would be to consult with the client's physician in order to find out if the medical treatment may be causing his anxiety symptoms. Answer A: This is something the social worker should do, but first the social worker should consult with the client's physician in order to find out if the medication may be causing his anxiety symptoms. Answer B: Some patients undergoing hormone therapy for gender reassignment become anxious because they realize that the treatment will lead others to discover their "secret." This may or may not be true about this client, however. However, it would be important to consult with the physician before attributing the client's symptoms to this or any other psychological cause. The physician would also be able to perform a medication evaluation to determine whether the client would benefit from taking an antianxiety agent. Answer D: These are important suggestions, but getting some clarity about the role of medication in the problem is the FIRST thing the social worker should do.

Question ID #13327: A social worker has been hired by the court to conduct an evaluation of two divorcing parents and to prepare a report that will be used in determining how to award custody of the couple's children. Both parents call the social worker, telling him they don't want him to submit the report. What should the social worker do? A.Check with the court and ask them what he should do B.Contact the attorneys C.Complete the report and submit it to the court D.Comply with the parents' wishes

C.Complete the report and submit it to the court **The court is the "client" in this situation. The court has hired/appointed the social worker to prepare and submit the report, and, therefore, he must do so. Answer A: The question clearly states that the social worker has been hired by the court to conduct an evaluation. There is no need to check in with the court. Answer B: There is no mention of attorneys in this situation. The social worker has been hired by the court and therefore must complete his evaluation. Answer D: The divorcing parents are not the clients. Therefore, if they have a complaint or wish about this situation, they should contact the court.

Question ID #13792: Which of the following activities would occur FIRST in the policy process? A.Identifying key decision makers. B.Determining resources needed to implement a new policy. C.Conducting a needs assessment. D.Making specific policy recommendations

C.Conducting a needs assessment. **A needs assessment is commonly performed as the policy problem is being defined (i.e., planners survey the community and establish indices of its needs). The other answer options would all take place during the first stage of the policy process, but only after a needs assessment. In the first stage of the policy process, policy managers identify and seek to understand the specific policy problem or issue. Important tasks performed in the initial stage of the policy process are performed in this sequence: determine the existence of a policy problem or issue, define the nature of the policy problem and its socioeconomic context. Answer A: The results of the needs assessment allow policy planners to determine the community's needs and establish priorities for service by Identifying factors contributing to the problem, defining important policy issues and their implications, evaluating current policies and programs., examining previous efforts to resolve the problem, and Identifying key individuals and other decision-making entities. Answer B: The activity in this answer choice is associated with the second stage of the policy process when an approved policy is translated into practice. Important tasks include: operationally define the policy and the resources needed to carry it out, define the levels at which the policy will operate, list and analyze legislative, administrative, and judicial considerations, develop political strategies, select monitoring strategies and criteria for evaluating the intervention, and monitor and evaluate the outcome or results achieved by the intervention and make recommendations about the continuation of the intervention or its modification. Answer D: Making policy recommendations would only occur after you define, assess, rank, and recommend policy alternatives and calculate costs and benefits; and estimate the effects of the recommended policies.

Question ID #13133: A middle-aged man comes to a community mental health clinic and is displaying slurred speech, unsteady gait, and impaired attention. A social worker who meets with him smells alcohol on his breath, and when she questions him about this, he admits to drinking "now and then" but denies being intoxicated at the time of the interview. Of the following findings about this man, which one is LEAST likely to contribute to a decision that he should be referred for acute hospital care (inpatient detoxification)? A.He lacks social support. B.Several previous attempts at outpatient treatment for his alcoholism have failed. C.Despite clear evidence to the contrary, he has denied being intoxicated during the interview. D.In addition to severe alcohol use disorder, he has significant depression.

C.Despite clear evidence to the contrary, he has denied being intoxicated during the interview.

Question ID #13137: A client with a physical disability is referred to a social worker for case management services. What should the social worker do FIRST? A.Connect the client to needed medical services to address her disability. B.Work with the client to formulate an appropriate case plan to address immediate needs stemming from her physical condition C.Gather information to identify the client's needs and concerns.

C.Gather information to identify the client's needs and concerns. **The only concern mentioned in this question is the client's physical disability; it does not give any information about her specific needs. The work of a case manager usually begins with engaging the client and identifying the kind of help she needs. For these reasons, answer choice C is correct - none of the other answer choices mention engaging the client, but C recommends identifying her needs. Answer A: The question does not give information about what type of needs the client may have, so the social worker will need to first identify the client's needs and concerns. Answer B: This answer would be appropriate after it the case manager identifies the needs to address as stated in correct answer choice C.

Question ID #13452: A social worker has been working in individual therapy with a client for five months. Near the end of a session, the client begins to cry and states, with a great deal of emotion, that therapy has helped him a lot. In the next session, the client seems embarrassed and becomes uncomfortable when the social worker asks him how he is feeling. What should the social worker do FIRST? A.Avoid focusing on the client's feelings for now B.Resolve the transference C.Discuss what happened in the last session

C.Discuss what happened in the last session **Even without knowing what the client is working on in therapy, this situation presents an opportunity to help him grow. The social worker should use her therapeutic skills to emotionally support the client and help him talk about and understand what happened in the last session and why he has reacted this way to what happened. Answer A: This would overlook an opportunity to help the client grow. Answer B: The client's behavior in the last session may have been a transference reaction; however, if the social worker simply "resolves the transference" without discussing with the client what happened, the client won't benefit much from the intervention. Plus, it is unclear what the social worker would actually do in this session to "resolve the transference."

Question ID #13818: A client reports that her 4-year-old son was found showing his genitals to a classmate at his preschool. The client is not upset by this but she is curious about what it means. What should the social worker do FIRST? A.Remind the mother of the limitations to confidentiality and file a child abuse report. B.Provide education about sexual behavior in children. C.Elicit more information to determine if this is normal sexual exploration. D.Refer the child to a pediatrician.

C.Elicit more information to determine if this is normal sexual exploration. **The social worker's first action should get more information about the boy's sexual play. Generally, "typical" sexual exploration and play by children is infrequent, spontaneous, and voluntary on the part of both children and involves children who know each other well and are of about the same age and size. Conversely, sexual play by children can signal a problem (e.g., perhaps that one of the children has been sexually abused) when it includes behavior that is well beyond the child's developmental stage; causes anxiety, anger, or other strong emotions in one or both children; involves threats, force, or aggression; and/or involves children of very different ages (e.g., a 4 year old and a 10 year old) (NCTSN, 2009). Answer A: This behavior can be a normal part of a boy's sexual development. The social worker should get more information about the boy's sexual play to make sure that it can be considered typical (i.e., not a sign of a problem). If more information develops that indicates child abuse, the social worker would then discuss reporting issues with the mother before making a report. Answer B: We're looking for the social worker's first action. The social worker should get more information about the boy's sexual play to make sure that it can be considered typical (i.e., not a sign of a problem). After that, if there is no sign of a problem, the social worker would provide education about sexual behavior in children. Answer D: The social worker's first action should get more information about the boy's sexual play.

Question ID #13096: A social worker is working in family therapy with two parents and their teenage children, a girl, age 16, and a boy, age 15. The presenting problem was frequent arguing in the family, and the focus of treatment has been on identifying and altering the family's maladaptive communication patterns. After the family has been in treatment for six weeks, the father suddenly admits to the social worker that he drinks heavily. He manages to go to work and functions fairly well at his job, but he always drinks at night when he gets home--usually enough to become intoxicated. He says that he drinks at home because he can't stand all the fighting. Under these circumstances, what should the social worker do? A.Clarify how dysfunctional interaction patterns in the family have played a role in maintaining the father's drinking problem. B.Educate the clients about alcohol addiction and recovery. C.Establish a therapeutic contract for abstinence with the family. D.Continue working to resolve the original presenting problem because this is what the family sought treatment for and it influences the father's drinking pattern

C.Establish a therapeutic contract for abstinence with the family. **The social worker must change the focus of treatment to address the father's alcohol abuse. This answer is the best of four interventions listed. No matter their theoretical orientation, most therapists working with alcohol or drug addicted individuals believe that it is critical to establish abstinence early in treatment so that meaningful therapeutic work can proceed. When providing family therapy, the therapist will usually seek an agreement from all family members on this goal and then structure treatment so that control of the user's problematic alcohol use is the top priority. Typically, the therapist will begin by establishing a therapeutic contract for abstinence with the user and his family members. This intervention in is the only one that comes close to addressing the fact that the father's excessive drinking could be endangering his health and should stop. Answer A: This intervention would be appropriate later, after the family enters the recovery stage of treatment. Answer B: This intervention would be appropriate after the abstinence contract is established. Answer D: This would be easy to rule out as the social worker should change the focus of the treatment to address the alcohol abuse by the father before moving forward.

Question ID #13160: A client informs her social worker that she doesn't want any confidential information about her to be discussed at an upcoming interdisciplinary team meeting. How should the social worker handle this? A.Inform the other team members that the client doesn't want any confidential information to be discussed B.Explain to the client that, to best serve her needs, he has to share confidential information about her at the meeting C.Explain to the client relevant issues related to confidentiality and how information is shared at team meetings D.Respect the client's wishes and disclose as little confidential information as possible at the meeting

C.Explain to the client relevant issues related to confidentiality and how information is shared at team meetings **The client's request suggests that she may misunderstand what goes on at an interdisciplinary team meeting. Therefore, among the four choices, the most appropriate and useful response would be to clarify relevant confidentiality issues for the client and how information is shared at team meetings. For example, the social worker could explain that only information directly related to the provision of services to the client is discussed at these meetings and that this information is shared exclusively with individuals who are directly involved in her case. Answer A: Telling the other team members this implies that the social worker may be complying with the client's request. A failure to share relevant confidential information about the client at a team meeting would, in all likelihood, prevent the social worker and the team from fully serving the client's needs. Answer B: While this answer includes a true statement, this approach is dismissive because it doesn't address the concerns that may underlie the client's request. Answer D: There are several problems with this answer: First, this client doesn't want any confidential information at all shared at the meeting. Second, this action doesn't explore or address the concerns that may underlie the client's request. And, last, the social worker would always share as little confidential information as possible at a team meeting (i.e., only information directly related to the delivery of services to the client).

Question ID #13356: A social worker has been working in individual therapy with a male client who was divorced six months ago. The social worker receives a phone call from a person she does not know. The person says he is a friend of the client's and that the client has recently stated that he's going to "teach his ex-wife a lesson." What should the social worker do? A.Ask the caller for more information about the client's statement B.Refer the client for a psychiatric evaluation C.Explore this statement with the client D.Report this to the police and, if possible, to the ex-wife

C.Explore this statement with the client **The social worker has learned from someone claiming to be a friend of the client's about a threat allegedly made by the client. The social worker should take this information seriously but, because it has come from a friend of the client's rather than from the client himself, it doesn't invoke a duty to protect (a.k.a. duty to warn). Even if the social worker didn't know this, the threat, as described by the caller, is too vague to meet the standards set by the Tarasoff decision. Does it even involve a threat of physical violence? Therefore, the responsibility in this situation is to explore the statement with the client so that the social worker can determine whether it constitutes a serious threat to physically harm his ex-wife. Answer A: While this is tempting, there is no valid reason to breach the client's confidentiality at this time. The social worker would need a written release of information from the client before having any conversation at all with this person about the client. In fact, the social worker shouldn't even acknowledge to this caller that he or she is treating the client. Answer B: The social worker might consider doing this, but, by itself, it doesn't address the potential danger in a direct enough way. Answer D: The limited information does not invoke a duty to protect. The threat has also come from someone other than directly from the client.

Question ID #13570: A client has been diagnosed with pedophilic disorder. Which of the following is MOST likely to be true about this client? A.He has been willing to disclose his pedophilic impulses or behaviors. B.He denies his pedophilic impulses or behaviors. C.He sometimes experiences depression about his pedophilic impulses or behaviors. D.He is not sexually attracted to adults

C.He sometimes experiences depression about his pedophilic impulses or behaviors. **Pedophilic disorder is diagnosed when, for at least six months, the person has experienced recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger); the person has acted on these urges or the urges or fantasies cause marked distress or interpersonal difficulty; and the person is at least 16 years and at least five years older than the child(ren). Some individuals with pedophilic disorder maintain (whether true or not) that their pedophilic impulses or behaviors cause them no distress and that their only problem is the reactions of other people. Others, however, report experiencing shame, guilt, and depression about their pedophilic impulses or behaviors. Answer A: In the DSM-5, the diagnostic criteria for pedophilic disorder can apply both to persons who disclose this paraphilia and to persons who deny sexual attraction to prepubertal children despite significant objective evidence to the contrary. With regard to persons who disclose, they may be diagnosed with pedophilic disorder if they also report that their sexual attraction to prepubertal children is causing psychosocial difficulties (such as marked distress or interpersonal difficulty); on the other hand, if they report feeling no guilt, shame, or anxiety about their paraphilic impulses, are not functionally impaired by their impulses, and have never acted on their impulses (as indicated by self-report and legally recorded history), then they have a pedophilic sexual orientation but not pedophilic disorder. Answer B: Those who deny their sexual experiences, impulses, or fantasies involving children may also deny feeling distressed. Therefore, as long as there is evidence of recurrent behaviors for six months and evidence that they have acted on their sexual urges or experienced interpersonal difficulties as a result of the disorder, they may be diagnosed with pedophilic disorder even in the absence of self-reported distress. Answer D: This may or may not be true about this client. Some, but not all, persons with pedophilic disorder are attracted to ch

Question ID #13492: Samuel is referred to a social worker by his priest. He is worried that he may not be able to hold onto his job any longer, as he has missed so many days from work because he was just too depressed to go in. Which of the following is the strongest indicator that Samuel might be a suicide risk? A.Depression B.Family history of suicide C.Hopelessness

C.Hopelessness **A number of studies (e.g., Beck's early studies of patterns of responses on the Beck Depression Inventory) have identified hopelessness as the aspect of depressive affect associated with the highest suicide risk Answer A: Depression is certainly a risk factor for suicidality, but the risk increases substantially when the client is expressing hopelessness. Answer B: Family history of suicide is a risk factor for suicidality, but the risk increases substantially when the client is experiencing hopelessness.

Question ID #13556: It is often difficult to distinguish between major and mild neurocognitive disorder, delirium, and major depressive disorder in older adults. However, the presence of which of the following suggests that delirium is the appropriate DSM-5 diagnosis? A.Deficits in memory B.Fatigue or loss of energy C.Impaired attention and awareness D.Flight of ideas

C.Impaired attention and awareness

Question ID #13424: In group therapy, when is the group leader MOST active? A.When the members ask questions B.When conflicts arise in the group C.In the first stage

C.In the first stage ***Group leaders are typically most active during the first stage of group therapy. In the first stage, group members are tentative about becoming involved in the group and their communications are directed primarily toward the leader. Some members may even demand that the leader adopt a "take charge" approach. The group leader's role is primary in this stage: he or she is highly active, initiates and directs group discussion, and encourages participation.

Question ID #13675: A couple is working on intimacy issues in couples therapy. He is Caucasian and she is Chinese-American. She was raised and subscribes to her traditional, Chinese heritage. They have been married for a year, and at first, things seemed to be fine. Now, he says he thinks that she doesn't love him as much as he loves her. She says that this is not true, but seems puzzled by what he wants from her. The social worker should help them understand that: A.They may be using different social cues with each other that are culturally derived. B.He is expecting something from her that she is unable to give, because of her Chinese cultural background. C.In traditional Chinese culture, it is believed that verbally expressing love is not only unnatural, but is often considered artificial. D.She is unable to read his social cues to understand what he wants

C.In traditional Chinese culture, it is believed that verbally expressing love is not only unnatural, but is often considered artificial **In traditional Chinese culture, it is believed that verbally expressing love is not only unnatural, but is seen as fake or artificial. Chinese are more inclined to using non-verbal expressions of love. They are less physically and emotionally demonstrative in expressing warmth and love to their children than mainstream American parents. It is best to help the husband understand his wife's cultural background and help the couple find ways to communicate their love that work for them both. Answer A: This is probably true, but it is a very broad answer that doesn't give us any more information. Answer B: While he may be expecting something from her that she has difficulty giving, one cannot assume that she is incapable of giving the kind of affection he needs. She may need to learn how to. Answer D: This may be true, but answer choice C offers a more specific answer for the problem

Question ID #13777: A social worker involved in policy management relies on a model that emphasizes efforts to engage community members as much as possible in the development and implementation of local programs. He and his colleagues are concerned with facilitating problem-solving in their community. They avoid making decisions on behalf of the community. The social worker is MOST likely using which of the following approaches to public management? A.Principal-agent B.Expertise C.Inclusive D.Human relations

C.Inclusive **The inclusive management model is concerned with direct public (community) participation in policy management-it emphasizes the relationship between public managers and the public and encourages managers to focus on building the capacity of the public to participate in the policy process. Answer A: The principal-agent model emphasizes direct accountability to elected officials. Public managers are related to the public through a chain of command with elected officials at the top, and they focus on the technical implementation of public policies that have been defined by elected officials (e.g., managers use their managerial expertise to facilitate effective and efficient implementation of policies). Answer B: In the expertise model, the relationship between the public and public managers is mediated using professional expertise on behalf of the public. Managers assume that public interests are represented through elected officials, apply their expertise to enhance elected officials' knowledge about public interests and how to serve them, and focus on the application of managerial skill and policy expertise to improve public policy outcomes. Answer D: This is a distractor in this context. The human relations model is an organizational theory concerned with the needs, motives, and relationships of workers within an organization.

Question ID #13076: An Indian American family comes to therapy presenting with the problem that their two teenage sons, 13 and 17, refuse to follow family rules. The family immigrated from India 10 years ago, and both parents have good jobs in the computer industry. They report that they have tried everything, but still the boys want to do their own thing. When planning treatment for an Indian American family, it is important to remember that: A. Indian culture is inherently collectivist, with a matriarchal structure where earning males are expected to support the old and provide security for the disabled. B.Indian culture is strongly affected by the caste hierarchy in India, but not in the USA. C.Indian culture is inherently collectivist, with a hierarchical strata where women are expected to take a position subservient to males. D.family loyalty tends to minimize generational acculturation issues in Indian families.

C.Indian culture is inherently collectivist, with a hierarchical strata where women are expected to take a position subservient to males. **Indian culture is an inherently collectivist culture, as opposed to mainstream American culture, which is individualistic. Families tend to be organized in a hierarchical structure from youngest to oldest, often with three or more generations in the same household. Women are expected to take a position subservient to males, and earning males are expected to support the old and provide security to women, children, widows, and the disabled. Answer A: Indian culture is inherently patriarchal in structure. Answer B: Indian society in the USA is still affected by the caste hierarchy. The five castes are Brahmins (priestly people), Kshatriyas/Rajanjas (rulers, administrators and warriors), Vaishyas (artisans, merchants, tradesmen and farmers), Shudras (labor), and Dalit (broken/scattered, low caste/untouchable). Answer D: Generational acculturation issues in Indian families are frequently common, as second generation immigrants try to individuate from their collectivistic families.

Question ID #13092: The mother of a 4-year-old girl comes in for a consultation about changes in her daughter's behavior. She reports that, for the past two months, the child has been "forgetting" to go to the toilet and wetting and soiling herself during the day, both at nursery school and at home. The girl seems unworried and unembarrassed about her soiled panties, even at school. The mother says that she has "reached the end of her rope" concerning her daughter's behavior. She reports that the girl was toilet trained at age 2. What would be the BEST way to approach treatment in this case? A.Assess interaction patterns in the family and then use behavioral techniques B.Involve the mother and any other significant adults in a program of behavior modification C.Investigate recent stress at home and school and then develop a program of behavior modification D.Provide individual play therapy to assess for recent trauma and then provide family therapy

C.Investigate recent stress at home and school and then develop a program of behavior modification **The child should be referred to a pediatrician for a checkup, but this is not suggested in any of the answers. Among the choices given, C is best, in part because it is more inclusive than the other three answers. Answer A: Behavior modification is usually the treatment of choice for an elimination disorder. However, because the child's encopretic and enuretic behavior is new (and apparently started after a period of continence), the answer falls short because it says that the social worker would explore only the family's interactions. The precipitating stressor, if there is one, may have occurred outside the home. Answer B: Implementing a behavior modification program is appropriate, but this response fails to address the psychosocial factors that may underlie the problem. Answer D: Although assessing for a recent trauma is appropriate, this answer does not mention using behavioral interventions. Along with medical management in some cases, behavioral interventions are the treatment of choice for elimination disorders. While family therapy may be used to address misconceptions about the child's disorder that interfere with the behavioral treatment program or aspects of family functioning that have contributed to or are maintaining the problem, family therapy is not the treatment of choice for an elimination disorder.

Question ID #13100: A new client has been referred by his psychiatrist. The client complains of depression. He says he's been feeling sluggish and unhappy for months and can't sleep well at night. He adds that he's been spending a lot of time alone because he doesn't feel like being around other people. When the social worker questions him, he denies having any suicidal thoughts, though he does say that he's tired of feeling "so down." What is the BEST way to provide treatment in this case? A.Advise the client to just take medication for now. B.Arrange for inpatient treatment. C.Offer individual therapy. D.Refer the client to a support group.

C.Offer individual therapy. **Research has generally found individual psychotherapy alone (especially cognitive or cognitive-behavioral therapy or interpersonal psychotherapy) to be most effective for mild depressions; and psychotherapy plus antidepressant medication to be best for moderate to severe and psychotic depressions (e.g., American Psychiatric Association, 2000). Answer A: Research has shown that psychotherapy plus antidepressant medication is the best treatment for moderate to severe depressions. The social worker should avoid advising the client in regards to their medication, but should support the psychiatrist's treatment plan, and direct the client back to the psychiatrist for any questions or concerns regarding medication. Answer B: This would be a good choice if the client were suicidal or otherwise in need of medical or mental health intervention, requiring placement in a safe place, 24 hours a day. Though the potential for suicidality should continue to be monitored, the client does not seem to pose a danger to himself at this time. Answer D: This client doesn't appear to be a good candidate for a support group at this time. Group approaches are usually contraindicated for people who are very depressed and withdrawn.

Question ID #13053: When may a social worker conduct research that does not use consent procedures? A.Never B.Only when rigorous and responsible review of the research has found it to be justified because of its scientific value C.Only when consent is not feasible and a rigorous review has found it to be justified because of its scientific value D.Only when conducting naturalistic observation

C.Only when consent is not feasible and a rigorous review has found it to be justified because of its scientific value **The NASW Code of Ethics states that social workers should never design or conduct evaluation or research that does not use consent procedures, such as certain forms of naturalistic observation and archival research, unless rigorous and responsible review of the research has found it to be justified because of its prospective scientific, educational, or applied value and unless equally effective alternative procedures that do not involve waiver of consent are not feasible (5.02h). Answer A: There are some exceptions to when a social worker may conduct research without consent procedures, such as certain forms of naturalistic observation. Answer B: While this answer is partially correct, it also needs to include "when consent is not feasible" to better reflect the NASW Code of Ethics. Answer D: This is one form of research that does not use consent procedures; however, there are other forms as well.

Question ID #13703: The social worker is seeing an 82 year-old man who complains that he is noticing some problems with his memory. He wonders if there is anything that he can do to help him continue functioning and reduce his memory loss as he grows older. Based on her familiarity with research on geriatrics, the social worker would be MOST likely to tell the client which of the following? A.Research has shown that there is nothing that can be done about memory loss. B.The man should consult a nutritionist for supplements and dietary advice to help improve his memory. C.Physical exercise has been shown to the most important thing that one can do to preserve brain function. D.Memory loss is inevitable as one ages.

C.Physical exercise has been shown to the most important thing that one can do to preserve brain function. **Exercise has been shown to be the most important thing one can do to improve brain function at any age. It not only gets blood moving through the body, but also pumps blood to the brain regions responsible for thinking and memory. Researchers have found that the most active people have a larger total brain volume compared to those who reported lower amounts of physical activity. Answer A: While dementia cannot be prevented, normal memory loss associated with ageing can be positively affected by exercise, both physical and mental (using brain-based programs). Answer B: While there are supplements advertised to help boost brain function, they have not been shown to be significantly effective. However, a good diet (combined with exercise) is certainly important for physical and brain health at any age. Answer D: Age-related memory loss is not inevitable. Some people maintain a high level of mental competence into even highly advanced age. However, it is normal for most people to experience some memory loss as they age.

Question ID #13669: Kohlberg's (1963) Heinz dilemma poses a story where a man's wife is dying of cancer and he cannot get the money to buy the medication she needs. He breaks into the pharmacy to steal the drug to save his wife's life. Kohlberg was interested in what children would say about social conventions in this dilemma in terms of: A.Right and wrong B.Moral development C.Post-conventional moral development D.Abstract thinking

C.Post-conventional moral development **Post-conventional moral development goes beyond convention or what other people think, or the legalistic consequences of a behavior, to a higher, universal ethical principle of conduct. The focus is on doing the right thing, regardless of the personal consequences. Answer A: A right versus wrong approach to decision making reflects pre-conventional moral development, i.e., is based on what would physically happen to the man as a result of the act, which is a self-centered approach to moral decision-making. Answer B: Overall, Heinz's dilemma is about moral development, more specifically it is about post-conventional moral development. Answer D: While abstract thinking is required for post-conventional moral development, it doesn't use the correct terminology in answering the question.

Question ID #13368: A child does not like broccoli. His parents tell him that he must eat his broccoli before he watches television. The parents have used which of the following? A.Response cost B.Differential reinforcement for alternative behaviors C.Premack principle D.Negative punishment

C.Premack principle ***The Premack principle involves reinforcing a low-probability behavior with a high-probability behavior. In nontechnical terms, this can be stated as, "Eat your broccoli and then you can go out and play.***

Question ID #13070: The social worker is developing a treatment group in a school setting for children who have exhibited behavioral difficulties. Which approach is NOT indicated? A.Narrative therapy B.Cognitive behavioral therapy C.Rational-emotive behavior therapy D.Solution-focused therapy

C.Rational-emotive behavior therapy

Question ID #13238: A mother brings in her 3 year-old daughter because she doesn't respond to her mother's verbal commands. She says that her daughter changes moods from loving to screaming in a moment. The mother says that she is at a loss as to how to deal with it and is starting to get frustrated. She says she is a single mother, and she lives with her parents. What should the social worker LEAST suspect? A.Medical issues B.Hearing deficits C.Reactive attachment disorder D.Intellectual disability

C.Reactive attachment disorder **In the DSM-5, reactive attachment disorder (RAD) is characterized by a consistent pattern of inhibited and emotionally withdrawn behavior toward adult caregivers, as manifested by a lack of seeking or responding to comfort when distressed and a persistent social and emotional disturbance that includes at least two characteristic symptoms. The clue that rules out RAD is that the child is, at times, loving, according to the mother. Additionally, to make this diagnosis, there must be evidence of extreme insufficient (pathogenic) care of the child. Evidence of this is missing from this question. Answer A: The social worker should investigate the quality of the child's medical care and refer her to a pediatrician for a check-up, especially a hearing check, since the mother reports that the daughter doesn't respond to her verbal commands. Answer B: Because hearing deficits could account for the girl's symptoms, they must be ruled out before more serious conditions such as autism spectrum disorder or intellectual disability are considered. Answer D: A check-up with the pediatrician might be in order to see if there are any intellectual or developmental issues.

Question ID #13771: The social action model of community organizing emphasizes which of the following goals? A.Provision of needed services B.Economic progress within the community C.Reallocation of resources D.Development of indigenous leadership

C.Reallocation of resources ***Community organizing is an intervention used to help the residents of a geographic area address social problems and enhance their social well-being. The goal of the social action model is social change, with an emphasis on changing power relationships and reallocating resources in the community through institutional change. Social action interventions seek to shift the balance of power in a community by empowering residents, challenging injustice, expanding opportunities, strengthening participatory democracy, etc

Question ID #13037: A social worker practices mindfulness therapy, and is seeing several clients who seem to be benefiting from it. Mindfulness based therapy involves which two basic components? A.Teaching people to respond to stressors reflectively rather than reflexively; self-regulation B.Openness; acceptance C.Self-regulation of attention; an accepting orientation toward the present moment characterized by curiosity and acceptance D.Experiencing the present moment in a non-judgmental way; effectively counteracting the effects of external stressors

C.Self-regulation of attention; an accepting orientation toward the present moment characterized by curiosity and acceptance ***The two components of mindfulness therapy are 1) a non-judgmental awareness of one's physical, mental and environmental state and 2) an open, curious and accepting attitude towards where one is in the moment.

Question ID #13122: A middle-aged man seeks therapy a few weeks after his wife was raped by a stranger. His wife is receiving individual therapy from another therapist. The man tells the social worker that he feels distressed and confused about what happened: he desperately wants to support his wife, but he feels disconnected from her both sexually and emotionally. How should the social worker approach treatment in this case? A.Offer short-term counseling in which she encourages the client to support his wife more adequately by providing education about the effects of rape on the victim B.Offer short-term therapy in which she reassures the client that his feelings are normal and teaches him coping skillsIncorrect C.Refer the client to a support group for men whose partners have been raped D.Offer to see the man and his wife for couples therapy and collaborate with the wife's therapist

C.Refer the client to a support group for men whose partners have been raped **The partners of rape victims frequently have conflicted feelings. Participating in a group with other men facing a similar situation would help the client understand that his feelings are normal and reduce his sense of isolation. Answer A: This does not respond in a direct or adequate way to the client's expressed needs. Answer B: This intervention does not respond in a direct or adequate way to the client's expressed needs. Answer D: The rape occurred only a few weeks ago, so it is likely that the wife still has too many individual (including crisis-related) issues to be available for couples therapy.

Question ID #13453: A social worker has been working in individual therapy with a client for six weeks, and they have developed a good therapeutic relationship. In the seventh session, the social worker confronts the client about a behavior that she believes is contributing to his problem. The client reacts defensively and becomes angry. What should the social worker do FIRST? A.Explore what underlies the client's reaction B.Recognize her error, apologize, and shift the focus to another topic C.Reframe what she did as a sign of concern for the client D.Challenge the client's avoidance of change

C.Reframe what she did as a sign of concern for the client **This intervention could help deflect the client's defensiveness and open the door for a discussion about what happened. Confrontation in social work is a skill that allows the social worker to point out discrepancies to the client. Confrontation is an effective tool and should only be used once a therapeutic relationship has been established. Answer A: The social worker would want to explore the client's defensive reaction next, but doing this before reframing what she did as a sign of concern might cause the client to become even more defensive. Answer B: There's no reason to believe that the social worker did anything wrong. Instead, what is clear is that she should use this event as an opportunity for therapeutic intervention. Answer D: This is a form of confrontation used to point out a client's resistance. The client reacted badly when the social worker confronted him before, and this must be addressed before confronting him again.

Question ID #13060: A social worker has been providing psychotherapy to an adult male who is on probation. The client was ordered into therapy by the court and has been cooperating. His probation officer contacts the social worker and requests information about how the client is progressing in therapy. What is the BEST answer for how the social worker should handle this request? A.Release information to the probation officer with or without the clients permission because his therapy is court ordered. B.Remind the probation officer that the social worker holds the privilege in this situation and refuse to release the information to the officer if it is believed that doing so could harm the client. C.Release information to the probation officer only if the social worker has the client's permission to do so. D.Refuse to release information to the probation officer unless there is court order that mandates the social worker to release it

C.Release information to the probation officer only if the social worker has the client's permission to do so. **A client retains his right of confidentiality even when his therapy is court ordered. Therefore, the social worker needs to have a release of information signed by the client in order to discuss his case with other relevant parties, including his probation officer. Answer A: Even though therapy is court ordered, it is still required to obtain a release of information from the client before anything is discussed or released with the probation officer. Answer B: This is not a true statement. The client is the holder of the privilege. In this situation, the client is mandated by the court for treatment. A likely part of this requirement is the sharing of information on the progress or attendance of the client, among other possible conditions. The best way to handle this request from the probation officer is for the social worker to release the information after having received permission from the client to do so. Answer D: The client is mandated to receive services and so likely, as a result, the probation officer and court need some sort of verification or documents stating that the client has fulfilled, or is cooperating with this requirement. As long as the client has given written permission to share the required information, it is best to submit the information.

Question ID #13638: The client is a 24-year-old woman who gave birth to a premature boy four months ago. She reports getting little prenatal care while pregnant with her son and smoking cigarettes during her pregnancy. Her son weighed about 4 pounds when he was born and had fairly low Apgar scores. He remained in the hospital for two months but now lives at home with the client and her boyfriend. The client is feeling anxious about motherhood because her first child, who was fussy but seemed healthy, died at age 5 months. This information suggests that the new baby is MOST at risk for which of the following? A.Nonorganic failure to thrive B.Colic C.SIDS

C.SIDS **Sudden infant death syndrome (SIDS) refers to the unexpected death of an infant for which no physical cause can be found. The cause of SIDS is unknown, but certain risk factors have been identified, many of which are described in this question: SIDS occurs more often in male infants, low-birth-weight infants, premature infants, infants with low Apgar scores, infants who sleep on their stomachs, and infants with a sibling who previously died of SIDS. Maternal risk factors include young age, low socioeconomic status, smoking, drug abuse during pregnancy, closely spaced pregnancies, and inadequate prenatal care. Answer A: Failure to thrive occurs when a baby's weight falls below the 5th percentile for his age. Many failure-to-thrive babies are born at a normal weight but then markedly decrease their rate of weight gain. In nonorganic failure to thrive, no medical cause can be found. Although some of the risk factors described in this question (prematurity, low birth-weight) are also associated with nonorganic failure to thrive, the full "picture" in this case points more clearly to a risk for SIDS. Answer B: Colic involves daily episodes of intense, inconsolable crying that begin suddenly, may last from a few minutes to several hours, and then spontaneously resolve. Colic can develop between 2 and 6 weeks of age (this baby is already 4 months old) and has been attributed to food allergies, an immature digestive system, an immature nervous system, and an anxious caregiver. Many babies outgrow colic by about 3 months of age, and 90 percent of all cases of colic resolve by age 9 months.

Question ID #13041: Social policy emerges from governments, voluntary organizations and the will of the people. The policy that is instituted determines how resources are distributed. The differences between collectivism and individualism can be described in what ways? A.Collectivistic philosophy aligns with the idea that society collectively decides how best to address social problems, while individualism assumes individuals will rise in function to a level to meet their own needs. B.The idea that some individual choice must be limited to better serve the good of society has its roots in individualism, while collectivism is based on societal norms and customary values. C.Social policy influenced by individualism seeks to remove restrictions on personal freedom while the collectivist philosophy predicates that individual choice will necessarily be limited by the needs of the whole. D.Individualism is based in Social Darwinism that assumes that the wealthy are more fit for survival, while collectivism assumes that disparities in resources are purely determined by chance.

C.Social policy influenced by individualism seeks to remove restrictions on personal freedom while the collectivist philosophy predicates that individual choice will necessarily be limited by the needs of the whole.

Question ID #13402: Which of the following differences between a social worker and client is generally considered to be the MOST difficult to overcome in forming a therapeutic alliance? A.Gender B.Race C.Socioeconomic status D.Religious beliefs

C.Socioeconomic status **The primary determinants of socioeconomic status (social class) are income, education, and occupation. The differences between social classes are likely to involve value and lifestyle differences that are even more pronounced (and, perhaps, more uniform) than religious, racial, or gender differences. In fact, Sue and Sue (2003) and others have argued that class may be a more powerful determinant of values and behavior than race or ethnicity and that class differences between social workers and clients can therefore lead to barriers in communication and understanding: "For the therapist who generally comes from a middle- to upper-class background, it is often difficult to relate to the circumstances and hardships affecting the client who lives in poverty . . . Feelings of helplessness, dependence, and inferiority are easily fostered under [conditions associated with poverty]. Therapists may unwittingly attribute attitudes that result from physical and environmental adversity to the cultural or individual traits of the person" (Sue & Sue, 1999). Answer A: While gender can play a role in the development of therapeutic alliance, socioeconomic status is said to be the most difficult to overcome. Answer B: Race can also play an important role in the development of therapeutic alliance. However, according to the research referenced above, socioeconomic status is generally considered to be the most difficult to overcome. Answer D: As stated above, the differences between social classes are even more pronounced than other differences, including religious beliefs.

Question ID #13606: Early onset persistent bilateral otitis media with effusion has been linked to which of the following? A.StutteringIncorrect B.Intellectual disability C.Specific learning disorder D.Autism spectrum disorder

C.Specific learning disorder **Bilateral otitis media with effusion is a severe form of middle ear infection involving inflammation of the left and the right middle ear with fluid leakage. Middle-ear infections in early childhood, especially severe infections resulting in hearing loss, have been associated with attention deficits and the development of specific learning disorder later in childhood. Answer A: While the exact cause of stuttering has not been identified, researchers believed that it is a combination of genetics, environment, language development, and brain structure. Answer B: There are many different causes of intellectual disability, including genetics, chromosomal abnormalities, infections, metabolic disturbances, nutritional deficits, etc. Hearing loss is not one of them. Answer D: There is no known single cause for autism spectrum disorder, but it is generally accepted that it is caused by abnormalities in brain structure or function.

Question ID #13028: Carlos is an 18-year-old African American male who struggles with substance use and has been in and out of the foster care system for most his life. He is now transitioning out of foster care and his new social worker is attempting to integrate him into a substance abuse prevention program. However, his attendance is inconsistent and he says it feels like it is a waste of time. He wants to leave the transitional housing that he is currently in to live on the streets where he has more independence. What would be the BEST way to engage this client? A.Caution his desire to leave the transitional housing and remind him of potential consequences that could come from that B.Research other substance abuse prevention programs and allow him the autonomy to choose which one he feels will suit him best C.Start by building rapport with Carlos by emphasizing his voice and what he feels would be helpful

C.Start by building rapport with Carlos by emphasizing his voice and what he feels would be helpful ***This client has been moved around in the foster care system for his entire life, so it is not unlikely that he feels his voice has been ignored for most of that time. By first engaging him in a positive therapeutic alliance, it will be easier to work with him ongoing and then provide additional support for the substance use.***

Question ID #13415: A woman has been taking care of her 77-year-old father ever since he had a stroke several months ago. Recently, the father's cognitive functioning has declined significantly and his medical needs have become too great for his daughter to meet. The father's physician gives them the name of a complete care nursing facility in their community. The daughter is distraught about the prospect of leaving her father in the care of strangers and insists that she wants to continue caring for him at home. She has been referred to a social worker by her father's physician. Which of the following actions should the social worker take to address the problem described in this case? A.Set up a family session, including the father, to discuss what to do. B.Encourage the woman to be realistic and take the doctor's advice seriously, for the sake of her father. C.Suggest that the woman tour the facility.

C.Suggest that the woman tour the facility. **This is the most appropriate step given the daughter's misgivings concerning the care of her father. After the daughter is familiar with the environment where she would leave her father, she may begin to view the staff as something other than "strangers" and may feel more comfortable leaving her father in their care. She may also be able to see that the facility is better equipped to meet her father's needs than she is. Answer A: This is less constructive and not as immediately helpful. In addition, the question suggests that the father may not be capable of participating in a meaningful way in a therapy session. Answer B: This is too confrontive and ignores the daughter's normal concerns and feelings about placing her father in a nursing facility

Question ID #13004: The social worker has conducted an assessment on a Filipino client and is now discussing a treatment plan. The presenting problem is anxious depression. She carefully goes over the goals, objectives, and expectations of therapy and asks the client if she has any questions. The client shyly smiles and says that she does not. The next week, the client comes in and it is clear to the social worker that the client did not understand the treatment planning discussion. What MOST likely happened? A.The client wasn't paying attention because of her anxiety. B.The client didn't agree with the social worker's idea of what treatment should be. C.The client was likely concerned with 'saving face.' D.The social worker failed to include the client's family in the treatment planning, and since Filipino society is very collectivistic, this was a mistake.

C.The client was likely concerned with 'saving face.' **Embarrassment or respect may prevent the Filipino client from asking relevant questions. When explaining diagnosis and treatment, the social worker should not take at face value the client's statement that she understands. Many Filipinos may give a shy expression of acknowledgment because they may claim to understand so as to save face (avoid humiliation). Also, notice that this is the only answer that uses a hypothetical, such as "probably." Since the social worker doesn't know for sure what happened, the word "probably" makes this a better answer than the others, all of which are stated as certainties. Answer A: The client was likely paying attention (if for no other reason than to be respectful of the social worker) but didn't really understand what was being discussed. Answer B: This might be true, as the client may have felt it would be disrespectful to the social worker to disagree, but it's less likely to be the case. Answer D: While it is true that Filipino society is very collectivistic, the client hasn't seemed to indicate that she wanted her family involved in the therapy.

Question ID #13285: An Arab American male, age 22, has been referred by his physician who examined the client after he complained of feeling "dark and jumpy inside." The physician found no medical basis for the client's reported symptoms. The client immigrated to the United States with his parents and siblings six years ago. Based solely on the client's cultural background, the social worker would LEAST expect which of the following to be true in this case? A.The client will expect to be diagnosed and treated without having to reveal much information about his personal life. B.The client will not volunteer much information, and, when he does share information, he may complain about physical symptoms rather than emotional distress. C.The client will blame himself for his problems, attributing them an "internal" cause. D.The client will be reluctant to discuss his personal difficulties because he doesn't want to embarrass himself or shame his family.

C.The client will blame himself for his problems, attributing them an "internal" cause. **A first-generation Arab American would be more likely to attribute his mental or physical illness to an external cause (e.g., supernatural elements, such as spirits, or the participation of other people with the supernatural through the evil eye or sorcery). Note, as well, that the research has found no correlation between a client's educational level and his perception of his problem or illness as caused by supernatural forces (see Alean Al-Krenawi, Culturally Sensitive Social Work Practice with Arab Clients in Mental Health Settings, "Health and Social Work," February 1, 2000). Answer A: The client will most likely to be reluctant to reveal information about his personal life. Answer B: Both of these statements are true. Answer D: It would be expected for the client to be concerned with bringing shame upon himself or his family.

Question ID #13302: The label "primary," when applied to a sexual dysfunction, means which of the following? A.The person is extremely distressed by his or her sexual dysfunction B.The person's sexual dysfunction began following a psychosocial stressor. C.The person's sexual problem has been present since his or her first sexual experiences. D.The person's symptoms of sexual dysfunction are attributable to the effects of a substance, medication, or medical condition.

C.The person's sexual problem has been present since his or her first sexual experiences.

Question ID #13533: Problem drug use among adolescents is MOST linked with: A.peer pressure. B.lack of information/education. C.alienation. D.early experimentation with drugs.

C.alienation. **This question is about "problem drug use," not merely experimentation with drugs. Although "just say no" and educational programs are probably the most popular types of anti-drug programs aimed at children and adolescents, the research suggests that their success is destined to be limited because they are based on the wrong assumptions regarding the causes of problem drug use. Based on their longitudinal study, J. Shedler and J. Block (Adolescent Drug Use and Psychological Health, American Psychologist, May 1990, 612-630) conclude that problem drug users exhibit a coherent syndrome, often as early as age 7, that is characterized by alienation, impulsivity, and subjective distress and that these symptoms clearly precede the onset of drug use. Answer A: While peer pressure does underlie experimentation with drugs, it is not as closely linked to problem drug use among adolescents. Answer B: Lack of information has not been found to be a significant contributor to problem drug use. Answer D: Experimentation is only a predictor of problem drug use in the presence of the syndrome described above.

Question ID #13729: A social worker is working in the initial stage of therapy with an adolescent client and attempting to build a therapeutic relationship with him. Effective ways of doing this are likely to include all of the following EXCEPT: A.listening nonjudgmentally but telling the client when his thinking is dangerous. B.being clear and honest about the need to inform the client's parents about high-risk behaviors. C.being firm when urging the client to self-disclose if he is unwilling to do so. D.demonstrating empathy and personal warmth to help the client feel safe and accepted.

C.being firm when urging the client to self-disclose if he is unwilling to do so. **Many adolescent clients are involuntary in that they've been brought or sent to see a therapist by their parents, school officials, a probation officer, or a juvenile court judge. Therefore, it's common for adolescents to have negative feelings associated with therapy, including a fear that the therapist will control or punish them. In addition, from a developmental standpoint, adolescents are striving to form a coherent personal identity and achieve greater independence. Given all of this, an adolescent client is likely to view this intervention as an effort to control him and, if he does, he may become more resistant. In order to begin building a therapeutic relationship with a teenage client, the social worker should instead attempt to neutralize the negative feelings that probably underlie his unwillingness to self-disclose. To do so, the social worker can respond in ways that are antithetical to his expectations, relate as an accepting and understanding ally rather than as an "enemy," and start where he is by using empathic responding to elicit his negative feelings. Answer A: This is an example of an effective way to attempt to build a therapeutic relationship with the adolescent client. Answer B: Being clear and honest will help to build trust between the social worker and adolescent client. Answer D: This is an example of an effective way to attempt to build a therapeutic relationship with the adolescent client.

Question ID #13582: A client reports that she's having "a lot of problems" with food, including "episodes of overeating." She states that she's been on numerous diets over the years, and even when she achieves her desired weight, she always gains it back. She says that she's been evaluated for medical problems, such as hypothyroidism, but all of the tests have been negative. When determining if the client's symptoms meet the criteria for binge-eating disorder or, instead, bulimia nervosa, the social worker should keep in mind that: A.binges are more severe in binge eating disorder than in bulimia nervosa B.a disturbance in body image is not characteristic of bulimia nervosa. C.compensatory behavior to prevent weight gain is not a requirement for binge-eating disorder. D.a sense of lacking control over eating during binges is not characteristic of binge-eating disorder.

C.compensatory behavior to prevent weight gain is not a requirement for binge-eating disorder. **Compensatory behavior is a diagnostic criterion for bulimia nervosa but not for binge-eating disorder and, therefore, differentiates the two disorders. In the DSM-5, a diagnosis of binge-eating disorder requires recurrent episodes of binge eating that involve a sense of lack of control over eating, the presence of at least three characteristic symptoms (e.g., eating more rapidly than usual, eating until feeling uncomfortably full, eating alone due to feeling embarrassed about the amount of food consumed), and the presence of marked distress about binge eating; for the diagnosis, binges must occur, on average, at least once a week for three months. A diagnosis of bulimia nervosa, in contrast, requires recurrent episodes of binge eating that are accompanied by a sense of a lack of control, inappropriate compensatory behavior to prevent weight gain (e.g., self-induced vomiting, misuse of laxatives, fasting, excessive exercise), and self-evaluation that is unduly influenced by body shape and weight; for the diagnosis, binge eating and compensatory behaviors must occur, on average, at least once a week for three months. Answer A: Binges can be severe in both disorders and, therefore, is not a distinguishing characteristic. Answer B: The disturbance in body image associated with bulimia nervosa involves an excessive emphasis on body shape and weight in self-evaluation. Answer D: A sense of a lack of control is characteristic of both disorders.

Question ID #13342: A client says, "I'm not sure if I'm ready to start college yet." The social worker responds, "So, you've decided you don't really want to go to college." The type of reflection error the social worker has made is: A.timing. B.meaning C.depth. D.stereotyping.

C.depth. **The four main reflection errors (Brammer, 1985) include the following: depth, timing, stereotyping, and language. Depth error involves reading moreor lessinto a client's statement than is actually there, as has occurred in this case. Answer A: Timing error involves reflecting every client statement or waiting for a long monologue to finish and then trying to capture the whole message in one reflection. Answer B: Although the social worker seems to have missed the overall meaning behind this statement, it is more accurately called a depth error. Answer D: Stereotyping error is beginning every response in the same way (e.g., "I hear you saying. . .").

Question ID #13664: An African American woman, age 73, has been overusing her clinic visits. She suffers from depression and is recently retired. She often appears at the clinic agitated and visibly upset, reporting that she "worked too much before retirement." During her work history, which began when she was 22, she held just two positions but worked long hours. She has strained relationships with her grown children and does not see her grandchildren as a result. She expresses regret for her life choices, and often says it was "a life misspent." According to Erikson stages of psychosocial development, she is in the maturation stage that has resulted in ________________________. A.stagnation B.an identity crisis C.despair

C.despair **This woman is in Erikson's last stage called Ego Integrity vs. Despair. This is often when people look back on their life they lived and come away with either a sense of fulfillment or a sense of regret and despair. This woman is reflecting back on her life with regret and despair. Answer A: Stagnation refers to the stage: generativity vs. stagnation. Stagnation refers to a failure to contribute, a feeling of disconnection or un-involvement. Answer B: There is no indication to believe this woman is having an identity crisis.

Question ID #13631: The social worker is part of a team that assesses children that are victims of sexual abuse. The area where the clinic is situated covers a very mixed, multi-cultural urban setting. When interviewing a Chinese-American child, the social worker should keep in mind that in comparison to the European-American child the former is more likely to: A.show greater deference to authority. B.focus on details about their own experience and less on information regarding others. C.feel loyal to a familial abuser and unwilling to disclose information. D.feel less allegiance to the abuser and therefore more willing to disclose information.

C.feel loyal to a familial abuser and unwilling to disclose information **Chinese-American children tend to be more compliant to authority figures than European-American children and therefore would tend to be more obedient to the perpetrator if s/he is a family member. Answer A: While this is true, it is a broad statement, whereas answer choice C is a specific statement focusing on the particular dynamics of sexual abuse. Answer B: A Chinese-American child would actually tend to focus more on details regarding the experience of other people than a European-American child, who would tend to be more ego-centric in their responses. Answer D: The opposite is true.

Question ID #13565: As described in the DSM-5, the five core symptoms of the schizophrenia spectrum disorders are: A.delusions, hallucinations, negative symptoms, impaired cognition, and disorganized speech B.disorganized thinking, delusions, hallucinations, negative symptoms, and depersonalization or derealization. C.hallucinations, negative symptoms, grossly disorganized or abnormal motor behavior, delusions, and disorganized thinking. D.grossly disorganized or abnormal motor behavior, hallucinations, negative symptoms, affective instability, and delusions.

C.hallucinations, negative symptoms, grossly disorganized or abnormal motor behavior, delusions, and disorganized thinking. **Hallucinations, negative symptoms (e.g., diminished emotional expression, avolition), grossly disorganized or abnormal motor behavior, delusions, and disorganized thinking are the five core symptoms of schizophrenia and other schizophrenia spectrum disorders. Answer A: Impaired cognition is an associated feature of schizophrenia but is not one of the five core symptoms of the schizophrenia spectrum disorders. Answer B: Depersonalization and derealization are associated symptoms of schizophrenia but are not the core symptoms of the schizophrenia spectrum disorders. Answer D: Affective instability is characteristic of schizoaffective disorder, which has the same symptoms as schizophrenia with the addition of a disturbance in mood.

Question ID #13788: The research goal of formative evaluation is to obtain information to: A.determine whether a program should continue or close. B.measure the programs effects. C.identify what modifications are needed so that a program achieves its goal and objectives. D.identify the needs of a target population.

C.identify what modifications are needed so that a program achieves its goal and objectives. **Formative evaluation is conducted while a program is in the process of being developed or implemented. It is used to obtain information to identify what changes are needed so that the program achieves its goal and objectives. Formative evaluation is used to guide ongoing practice decisions. It involves monitoring a planned intervention and allows you to identify when you need to modify the intervention Answer A: This answer choice is associated with summative evaluation. Summative evaluation is used to assess the final outcome of intervention. It identifies the factors that contributed to the relative success or failure of an intervention. Answer C: This answer choice is also associated with summative evaluation. Answer D: Identifying the needs of a target population is a goal of needs assessment.

Question ID #13171: A social worker receives a phone call from a woman who is the ex-wife of a client he is currently treating in individual therapy. The woman and his client divorced over a year ago. The woman wants to start therapy and requests an appointment with the social worker. To behave in an ethical manner, the social worker should: A.schedule an appointment with the woman, but avoid telling his client that he has done so. B.find out why the woman is seeking therapy before deciding what to do. C.refer the woman to a different therapist. D.explain to the woman that he can't meet with her because he is treating her ex-husband and give her the name of another qualified therapist.

C.refer the woman to a different therapist. **This question raises two ethical issues: the responsibility to not enter into relationships that may conflict with a client's best interests and the responsibility to maintain a client's confidentiality. Because seeing both the client and his ex-wife in individual therapy could impair the therapeutic objectivity and effectiveness, the social worker should not take this woman on as a client. In addition, to maintain the client's confidentiality, the social worker should not reveal or mention that she is treating her ex-husband. Answer A: This is incorrect because providing treatment to both the client and his ex-wife would not be in the social worker's current client's best interests. Answer B: The reason this woman is seeking therapy is irrelevant in this case. For the reasons cited above, the social worker should not treat this woman. Answer D: This would violate the client's confidentiality. The social worker must keep not only the content of therapy confidential but also the fact that she is, or isn't, treating a particular individual.

Question ID #13525: The __________ nervous system activates the "flight or fight" reaction. A.parasympathetic B.somatic C.sympathetic D.central

C.sympathetic **In reaction to an external threat, the sympathetic branch of the autonomic nervous system (ANS) might cause dilation of the pupils, inhibition of peristalsis, dry mouth, sweating, and increased blood pressure and heart rate in order to prepare the body for "fight or flight." Answer A: The parasympathetic system conserves energy (rest) by decreasing heart rate and respiration and increasing intestinal activities. Answer B: The somatic nervous system consists of sensory and motor nerves and is associated with voluntary muscle control. Answer D: The central nervous system consists of the brain and spinal cord.

Question ID #13548: A 9-year-old boy has been referred for evaluation because he is careless, engages in risk-taking behavior, and is not achieving up to his potential at school. When meeting with the boy, the social worker observes that he has trouble staying focused but seems bright and is very engaging. Based on this information, what diagnosis is MOST indicated for this boy? A.Specific learning disorder B.Conduct disorder C.Oppositional defiant disorder D.Attention-deficit/hyperactivity disorder

D.Attention-deficit/hyperactivity disorder **First, this boy is "careless" and has trouble focusing - ADHD is characterized by a persistent pattern of hyperactivity/impulsivity and/or inattention. Second, the boy engages in risk-taking behavior - because of their high levels of impulsivity, some children with ADHD engage in potentially dangerous behaviors and have frequent accidents. Third, the boy is not achieving his potential at school - the academic achievement of children with ADHD is usually impaired. Fourth, the boy is bright - although children with ADHD tend to score lower on IQ tests than their peers, there is great variability in their IQ, and some are in the above-average or gifted range. And last, he is engaging - this is not a feature of ADHD but nor is it inconsistent with the disorder since a child with ADHD would be apt to enter easily into conversations with others and might be quite charming (when he is not interrupting others). Answer A: Specific learning disorder is a possibility since the boy is not meeting his potential at school. You can eliminate it as the correct answer for two reasons, however. First, the boy displays key features of ADHD, and, second, you don't know whether he meets the specific diagnostic criteria for specific learning disorder. A diagnosis of specific learning disorder is made when a person exhibits difficulties related to academic skills as indicated by the presence of at least one characteristic symptom that persists for at least six months despite the provision of interventions targeting those difficulties. The diagnosis also requires that the individual's academic skills are substantially below those expected for his age, interfere with academic or occupational performance or activities of daily living, began during the school-age years, and are not better accounted for by another condition or disorder or other factor such as uncorrected visual or auditory impairment or psychosocial adversity. Answer B: The boy is not violating major societal norms and the rights of others - he is just impulsive and inattentive. Answer C: The boy is not angry/irritable, argumentative/defiant, or vindictive; to the contrary, the question says he is "engaging."

Question ID #13779: Each year, an agency starts its budget process from scratch and must justify every financial request it makes. What type of budget is being used? A.Line-item B.Program C.Base-increment D.Zero-based

D. Zero-based **Budgeting entails allocating an agency's resources, and an agency's budget has two main functions: (a) to record, in monetary terms, the agency's goals or objectives for the coming year; and (b) to provide a way of monitoring the financial activities of the agency during the year. The goals and objectives must be specific, realistic, and approved by the agency's board or other governing body. In zero-based budgeting (ZBB), an agency starts from scratch at the beginning of each year (i.e., starts with no money) and must describe and justify every financial request it makes for the coming year. This type of budgeting encourages scrutiny of how money is spent and why. Answer A: A line-item budget is a simple type of budget that relies on explicit categories of expenditure to justify spending (e.g., personnel, rent, utilities). Each expenditure category is explicitly defined and authorized in terms of what can be spent on each line item. Answer B: Program budgeting considers expenditures in terms of the major program components that make up the agency's different services. "Program budgeting as an additional management tool is closely allied with the objective of effective monitoring of fiscal and human resources as these are targeted to achieve program objectives" (J. J. Stretch, Seven Key Managerial Functions of Sound Fiscal Budgeting: An Internal Management and External Accountability Perspective, "Administration in Social Work," 3, Winter 1979, p. 445). Answer C: This answer choice is not a budget type. Instead it refers to two terms used in agency budget theory. "Base" may be defined as past expenditures that are carried forward; in terms of budget decisions, they are financial resources that are not subject to negotiation during the budgeting process. For example, stakeholders may decide that the salaries of all agency employees are part of the "agency base" that must be funded no matter what. "Increment" is a unit of change (increase or decrease) in a budget (although sometimes the word "decrement" is used to describe a decrease). In terms of budget decisions, "increment" includes issues that are subject to negotiation and choice during the annual budgeting process.

Question ID #13763: A social worker has started working on case management services with a Mexican American family. After meeting with the family three times at her office, she visits their home to complete her assessment. The mother has prepared a meal and asks the social worker to eat with the family. What is the BEST way for the social worker to respond? A.Remind the clients of the purpose of her visit and decline the invitation B.Decline the invitation and explain the ethical problem C.Decline the invitation with a polite excuse, such as telling the family that she has just eaten D.Accept the invitation to share the meal

D.Accept the invitation to share the meal **Because personalismo (personal connection and warmth) is a basic value of Hispanic cultures, Hispanic clients may develop a personal bond with their social worker once trust has developed. The only behavior described in the question is the mother's invitation, and there's no mention of other behavior that could be perceived as a potential violation of therapeutic boundaries. Therefore, it's appropriate for the social worker to interpret the mother's invitation as a reflection of personalismo and share the meal. A social worker's responsibility is to set therapeutic boundaries with clients that are not only clear and appropriate, but also culturally sensitive. Answer A: The purpose of the social worker's visit is to complete the assessment and continue building a professional relationship with the family. There is no reason that this cannot be done in addition to sharing a meal with the family. Answer B: There is no ethical violation to sharing a meal with a family while providing services in the home. Answer C: Although it is acceptable to decline a meal, the best way for the social worker to respond, knowing personalismo is important and valued, is to accept the invitation and share the meal with the family.

Question ID #13338: A social worker is meeting for the first time with a new client, a Gulf War I veteran who uses a wheelchair. He has paraplegia. In making the appointment over the phone, the client said that he wanted to work on feelings of depression and improve his relationships, but he didn't mention his disability at all. What should the social worker do with regard to raising the topic of the client's disability? A.Refrain from mentioning the disability until the client does because the client seems more interested in dealing with his depression B.Ask the client why he didn't mention his disability and discuss the reasons for this omission C.Suggest that the client might be more comfortable at a veterans' counseling center where personnel share his experience D.Acknowledge the client's disability and ask him if he thinks it plays any role in his presenting problem

D.Acknowledge the client's disability and ask him if he thinks it plays any role in his presenting problem **The social worker should not ignore this client's disability. The best approach is to acknowledge it openly and ask the client if he thinks it contributes at all to his depression or interpersonal difficulties. Answer A: It would be disingenuous and probably counter therapeutic to ignore the client's disability. This approach would also place the burden of mentioning the disability on the client, which would be inappropriate. Answer B: This answer focuses on the fact that the client didn't mention his disability. During the initial stage of therapy, the better focus would be on how the disability might play a role in the client's presenting problems. In addition, the social worker would generally avoid challenging a client like this before rapport has developed. Answer C: This option suggests that, for some reason, the social worker is eager to refer. There is nothing in this scenario at this time that would suggest a reason for a referral.

Question ID #13605: A family comes in to therapy for help dealing with their 10-year-old daughter's obsessions and compulsions. They are frequently late getting her to school, because she has to keep checking to see if she's turned her TV, lights, etc. off in her room. Sometimes she checks as many as 15 times before she'll agree to leave the house. She is failing in her schoolwork because she cannot finish assignments. Instead, she erases her work over and over again, never getting to the end of something. She realizes that her behaviors are creating a problem, but she says she just can't help it. Which of the following is NOT a treatment recommended for treating OCD? A.Serotonin re-uptake inhibiters B.Acceptance and commitment therapy C.Exposure and response prevention (ERP) therapy D.Anxiolytics

D.Anxiolytics **Anxiolytics such as benzodiazepines are not recommended as a long-term OCD medication, as they can have serious negative side effects and are physically and psychologically addictive. They may be used short-term in combination with serotonin re-uptake inhibiters such as fluoxetine (Prozac) and sertraline (Zoloft), however. Answer A: SSRIs (serotonin re-uptake inhibiters) are the most commonly prescribed medications for OCD. Answer B: Acceptance and commitment therapy (ACT) is sometimes used to treat OCD. ACT teaches clients to accept their obsessions without trying to undo them with compulsive actions. Compulsive actions tend to reinforce the idea that the obsessive thought is important and dangerous enough that something must be done (compulsion) about it. Answer C: ERP is a type of behavioral therapy that exposes people to situations that provoke obsessions and the resulting distress while helping them prevent their compulsive responses. Response prevention is key, as being able to experience the obsession without getting rid of it with a compulsion allows the person to gradually learn to tolerate or get used to the obsession.

Question ID #13564: When meeting a new client for the first time, what is the BEST method to gather information about the client's issues? A.Have the client fill out an intake form, ask closed ended questions followed by open ended questions, take personal history, provide feedback to the client, validate feelings, ask about exceptions, explore chief complaint B.Have the client fill out an intake form, ask open ended questions followed by close ended questions, personal history, provide feedback to the client, validate feelings, provide interpretations, explore chief complaint C.Explore chief complaint, ask open ended questions followed by close ended questions, have the client fill out an intake form, avoid giving feedback to the client, validate feelings, ask about exceptions, take personal history D.Ask open ended questions followed by close ended questions, have the client fill out an intake form, provide feedback to the client, validate feelings, ask about exceptions, explore chief complaint, take personal history

D.Ask open ended questions followed by close ended questions, have the client fill out an intake form, provide feedback to the client, validate feelings, ask about exceptions, explore chief complaint, take personal histor

Question ID #13695: How might a social worker go about building a rapport with a Native American client who is coming in for a first session? A.Ask about the client's tribe, offer to use tribal healing methods in the therapy, and use self-disclosure. B.Inform the client of their experience/lack of experience in working with Native clients, offer the client coffee, tea, or water, and ask about their tribe. C.Avoid eye contact, wait for the client to express their concerns before asking about what brings them to therapy, and ask about the client's tribe. D.Avoid extensive paperwork, offer the client coffee, tea, or water, use self-disclosure, and ask about the client's tribe.

D.Avoid extensive paperwork, offer the client coffee, tea, or water, use self-disclosure, and ask about the client's tribe. **Generally, intake paperwork should be minimized before a face-to-face meeting, giving the client a chance to assess the social worker and their comfort level before having to answer a lot of personal questions. Offering the client coffee, tea, or water joins with the Native tradition of providing hospitality to a visitor. Using self-disclosure (within limits) role models the therapy process for the client and helps to build trust and rapport. Answer A: A non-Native social worker offering to use tribal healing methods in therapy is an example of cultural appropriation. Cultural appropriation refers to a power dynamic in which members of a dominant culture take elements from a culture of people who have been systematically oppressed by that dominant group. Answer B: If the social worker lacks experience, they will come across as unsure of themselves. If they have experience, they may come across as a know-it-all. There are many tribes and each person is an individual. Answer C: The social worker should ask any new client about their concerns, or what brings them to therapy, as a way to invite them into the process. Waiting for the client to bring up their concerns without greeting them or prompting them would be anxiety-provoking for many people.

Question ID #13526: Which of the following is NOT a true statement regarding alcohol use among older adults? A.Older adults may experience the effects of alcohol more readily than when they were younger. B.Health professionals are likely to confuse their symptoms with other medical problems. C.There is a better prognosis for recovery than for people who began abusing alcohol at a younger age. D.Because they are older, they have a higher tolerance to alcohol.

D.Because they are older, they have a higher tolerance to alcohol. **This statement is untrue about alcohol use among older adults. In fact, aging lowers the body's tolerance for alcohol. This means that older adults can experience the effects of alcohol more readily than when they were younger. It also means that an older person can develop problems with alcohol even though his or her drinking habits have not changed. Answer A: Since tolerance can decrease with age, this is a true statement. Answer B: Medical professionals often misdiagnose older adults' substance abuse issues. In part, medical professionals often lack training in geriatrics, and in part, older adults often present with more physical problems, masking the substance abuse. Answer C: Older adults have a better prognosis for recovery than for people who began abusing alcohol at a younger age.

Question ID #13014: Which of the following hardships is NOT likely attributed in part to globalization? A.A client's foreclosure after losing their job due to the Covid-19 pandemic B.Integrating into American society as a new immigrant C.Losing your home after a natural disaster D.Being fired from your job due to missed absences

D.Being fired from your job due to missed absences **This answer is incomplete. You would need to know more about the absences that resulted in the job loss. Answers A, B, and C: All of the other answer choices reflect trends in globalization, including environmental, financial, and demographic changes that have often resulted in economic and political instability across the world.

Question ID #13735: An 11 year old with autism spectrum disorder is irritable and has been behaving aggressively. A physician is LEAST likely to prescribe which of the following medications to manage these symptoms? A.Risperidone B.Fluoxetine C.Clomipramine D.Carbamazepine

D.Carbamazepine **Carbamazepine (Tegretol) is an anticonvulsant used to treat epilepsy that has also been found effective for some patients with bipolar I disorder. Individuals with bipolar I disorder who cycle rapidly (change from mania to depression and back again over the course of hours or days, rather than months) seem to respond particularly well to carbamazepine. The anticonvulsant divalproex sodium (Depakote) has also been approved by the FDA for bipolar I disorder. Clinical trials have shown it to be as effective at controlling manic symptoms as lithium; it is effective for both rapid-cycling and non-rapid-cycling bipolar I disorders. Answer A: Risperdal (resperidone) is approved by the FDA for the symptomatic treatment of irritability (e.g., sudden mood changes, tantrums, aggression, self-injury) in adolescents with autism spectrum disorder and children over age 5 with autism spectrum disorder. Answer B: Studies have found that, for people with autism spectrum disorder, certain antidepressants - fluoxetine (Prozac), clomipramine (Anafranil), and fluvoxamine (Luvox) - may reduce the frequency and intensity of repetitive behaviors and may decrease irritability, tantrums, and aggressive behavior. And, in some children with autism spectrum disorder, these medications may also improve eye contact and responsiveness to others. Answer C: Clomipramine (Anafranil) may be useful for some children with autism spectrum disorder.

Question ID #13103: The client is a 27-year-old man who has been referred by the court with a long history of criminal behavior. The social worker conducts an assessment of the client, including referring him for psychological testing, and determines that he has antisocial personality disorder. Based on the client's diagnosis, which of the following is NOT likely to be a focus of treatment? A.Reinforcing appropriate behaviors B.Emphasizing the discovery and labeling of appropriate emotional states C.Helping the client make a connection between his feelings and behaviors D.Closely monitoring the client's medication compliance

D.Closely monitoring the client's medication compliance **The question includes the qualifier "not." For clients with antisocial personality disorder (APD), medications should only be used to treat clear, acute, and serious co-occurring mental disorders. No research has suggested that any medication is effective in the treatment of APD itself. Answer A: For clients with APD, approaches that reinforce appropriate behaviors and attempt to make connections between the client's actions and feelings can be beneficial. One effective way to change the client's behaviors, as well as motivate the client to work on his problem, can be to help him see the self-destructive nature of his actions. Answer B: When working in therapy with a client with APD, the content of therapy will focus on the client's emotions (or lack thereof), including the discovery and labeling of appropriate emotional states (e.g., ones other than anger or frustration). Answer C: As the client learns to experience various emotional states, one of the first may be depression. The client will probably be unfamiliar with feelings of depression, and the therapist working with him should be supportive and empathetic when these feelings come up. Reinforcing the client's appropriate emotions is usually beneficial as well, and, usually, the client's experiencing intense affect is a sign of progress in therapy.

Question ID #13567: A 14-year-old boy is being seen by the school social worker for repeated angry outbursts at school. He is persistently irritable and negative, constantly argues with adults, has a history of behavioral referrals, and recently changed schools after being expelled for threatening a teacher. The boy is failing in school, and his parents are thinking of sending him to a wilderness camp where he can "get some sense knocked into him." The MOST likely DSM-5 diagnosis for this boy is which of the following? A.Intermittent explosive disorder B.Oppositional defiant disorder C.Bipolar II disorder D.Disruptive mood dysregulation disorder

D.Disruptive mood dysregulation disorder **Disruptive mood dysregulation disorder involves severe, recurrent temper outbursts with a persistent irritable and angry mood between outbursts on most days. Answer A: A persistent negative mood between temper outbursts is not a required characteristic of intermittent explosive disorder. Additionally, the DSM-5 classifies intermittent explosive disorder under disruptive, impulse-control and disorders; whereas, disruptive mood dysregulation disorder is a depressive disorder. Answer B: Oppositional defiant disorder differs from disruptive mood dysregulation disorder primarily in terms of the severity, frequency, and chronicity of the temper outbursts, with disruptive mood dysregulation disorder having more severe, frequent, and chronic symptoms. When the criteria for both disorders are met, a diagnosis of disruptive mood dysregulation disorder is assigned. Answer C: An essential feature of bipolar II disorder is hypomania (a distinct period of abnormally elevated, expansive, or irritable mood accompanied by increased activity or energy). Although people with disruptive mood dysregulation disorder are irritable, they do not exhibit the increased energy that is characteristic of bipolar II disorder. Also, the mood disturbance associated with bipolar disorder is episodic in nature, whereas the mood disturbance associated with disruptive mood dysregulation disorder is persistent.

Question ID #13191: A social worker suspects a colleague of violating ethical guidelines. To be consistent with the provisions of NASW's Code of Ethics, the social worker should do which of the following? A.Contact the state licensing board or a professional ethics committee about this as soon as feasibly possible B.Contact the state licensing board or a professional ethics committee about this only if the ethical violation is a serious one C.Handle the situation informally by discussing the violation with the colleague D.Either handle the situation informally or contact the state licensing board or a professional ethics committee, depending on which course of action the social worker believes is appropriate

D.Either handle the situation informally or contact the state licensing board or a professional ethics committee, depending on which course of action the social worker believes is appropriate **NASW's Code of Ethics allows social workers to use their discretion when deciding how to respond when they suspect that a colleague has acted unethically. Specifically, the Code says that when a social worker suspects that a colleague has acted unethically, he or she should seek resolution by discussing the concerns with the colleague when feasible and when the discussion is likely to be productive. If a discussion is not likely to be productive, however, the social worker should instead take action through appropriate formal channels (e.g., contacting a state licensing board or regulatory body, the NASW Ethics Committee, or other professional ethics committee). When deciding how to respond to a colleague's unethical conduct, it's also necessary to consider the confidentiality rights of any client affected by the colleague's ethical violation, but none of the answers to this question addresses that issue. Often, the best course of action when a client has been affected is to first let the client decide if they want to be the one to file a complaint. Answer A: This is not a complete answer as the social worker can also choose to discuss the concerns directly with the colleague. Answer B: The NASW Code of Ethics allows social workers to choose which approach to take, and this includes discussing the concern directly with colleague. This option does not mention that option, and it also states that only "serious" violations are reportable. This is not a true statement. Answer C: This is a possible option, but it fails to include the option of contacting the state licensing board or a professional ethics committee. The code of ethics allows social workers to choose which course of action is most appropriate.

Question ID #13584: Jane, 40, has been coming to therapy for over a year working on self-esteem issues. One day, she comes in weeping and tells the social worker that John, her husband of 10 years, has started acting strangely. He was banned from the grocery store for telling the clerk that she was a fat pig, and told the manager that he can throw himself in front of a bus and die. She noticed that, for the last month, John has acted depressed, but is unwilling to talk about it. She reports that they have always had a wonderful, open relationship where they could talk about anything. She also states that he has been bingeing on snacks and cookies, and she guesses he has gained at least 5 pounds and seems completely unconcerned about it, whereas before, he was a fitness geek. The social worker asks Jane if John seems to be exhibiting any memory symptoms, but Janes says she doesn't think so. What is the most likely diagnosis for John? A.Early onset Alzheimer's B.Bi-polar disorder C.Major depressive disorder D.Frontotemporal dementia

D.Frontotemporal dementia **John is showing some of the classic early signs of frontotemporal dementia (FTD). Early signs of frontotemporal dementia include apathy, change in personality or mood, lack of inhibition or social tact, obsessive behavior and weight gain due to dramatic overeating. FTD typically strikes between the ages of 45 and 65. FTD used to be thought of as rare, but now some estimates put it as the cause of up to 50% of dementia cases in people under 65. People tend to live about an average of eight years after diagnosis. Answer A: Alzheimer's patients experience severe memory loss, which we do not see in John. It is possible that he has early-onset Alzheimer's (if we assume that John is roughly the same age as Jane) but his symptoms strongly point to FTD. Answer B: Bipolar disorder could account for some of John's symptoms, so a careful neuropsychological exam would be in order to distinguish whether it is bipolar disorder or FTD. Answer C: Major depressive disorder could account for some of John's symptoms, so a thorough evaluation by a neuropsychologist would be very important.

Question ID #13749: A social worker is referred a client whose cultural background differs from her own. The client reports engaging in a particular behavior that, while disturbing to the social worker, is apparently approved of by members of the client's cultural group. What should the social worker do? A.Seek consultation immediately to address her loss of objectivity B.Be genuine and tell the client how she feels about the behavior C.Refer the client to another therapist, preferably one from his own culture D.Further educate herself about the client's culture, including the behavior in question

D.Further educate herself about the client's culture, including the behavior in question **This situation doesn't sound like one that would prevent the social worker from working with this client, so a referral doesn't seem necessary. Instead, the best way for the social worker to remedy this situation is to educate herself, such as by reading about the behavior in question and learning about its meaning within the client's culture. NASW's Code of Ethics (Cultural Awareness and Social Diversity) states that social workers are obligated to get education to improve their knowledge and skills. Answer A: Calling this a "loss of objectivity" is premature. If attempting to resolve this difficulty through self-education didn't resolve the problem, then the social worker would probably want to seek consultation to obtain further guidance and instruction. Answer B: There is no therapeutic benefit associated with this intervention, in part because the question implies that the behavior is not a problem for the client. Another difficulty with this intervention is that it suggests that the social worker would be imposing her own cultural values on the client. Answer C: This situation does not sound like one that would prevent the social worker from working with this client.

Question ID #13247: Transgender teenagers face many challenges that can lead to poor mental health outcomes, including a 1.5 to 3% increased risk of suicide (than that of cisgender teens). What is the most important factor in reducing the risk of trans teen suicide? A.Making mental health services available B.Making an early social transition C.Hormone therapy D.Having at least one supportive person in their life

D.Having at least one supportive person in their life **Research has shown that if a transgender teen has even one supportive person in their life, it greatly reduces their risk of suicide. Answer A: This certainly can be an important factor in reducing suicide risk, but mental health services may be temporary and fragmented, and having one supportive person is a consistent positive influence for the trans teen. Answer B: Making an early social transition (versus struggling to fit in in the wrong gender identity) would be associated with positive outcomes, but again, having one reliable supportive person is the most important factor for trans teens' mental health. Answer C: Hormone therapy can be helpful, but not in all cases.

Question ID #13156: A social worker meets with a depressed adult who needs medical care for what may be a stomach ulcer. What would be required for this client to be eligible for Medicare? A.He is unable to pay for medical care and has mental health or physical disabilities. B.He is unable to pay for medical care and is under the age of 65. C.He is unable to pay for medical care. D.He is age 65 or older.

D.He is age 65 or older. **Medicare (Health Insurance for the Aged and Disabled) is a federal entitlement program that guarantees health-care benefits (health insurance coverage) to people age 65 and older, to some people with disabilities under age 65, and to people of all ages with end-stage renal disease (permanent kidney failure treated with dialysis or a transplant). Eligibility for Medicare for a person without a disability is based on reaching age 65 rather than on the person's need.

Question ID #13585: An Hispanic man with major depressive disorder is MOST likely to say that his symptoms include which of the following? A.A problem of the heart B.Weakness, tiredness, and "an imbalance" C.Confusion, agitation, and a sense of disorientation D.Headaches, sleep problems, and nervousness

D.Headaches, sleep problems, and nervousness **Culture may influence the experience and manifestation of depression and other mental disorders. "Nervios" is a common idiom of distress for Hispanic individuals in the United States and Latin America and may be indicative of depression or other mental disorder. It is manifested primarily in terms of somatic complaints such as headache, sleep problems, and nervousness. Note that nervios is different from "ataque de nervios" (attack of nerves). The latter is a cultural syndrome characterized by symptoms of intense emotional upset, including acute anxiety, anger, or grief; screaming and shouting uncontrollably; attacks of crying; trembling; heat in the chest rising into the head; and becoming verbally and physically aggressive. It, too, is found among individuals of Hispanic descent. Descriptions of nervios, ataque de nervios, and other cultural concepts of distress are included the DSM-5's Glossary of Cultural Concepts of Distress.Answer A: Individuals from Middle Eastern cultures may describe depression as a "problem of the heart."Answer B: These terms may be used by members of Chinese and other Asian cultures to describe depression. In traditional Asian belief-systems, the mind, body, and soul are viewed as unitary and complementary. Individuals focus more on physical discomforts than emotional symptoms, and psychiatric problems often find expression through somatic complaints.Answer C: These symptoms are not typical manifestations of depression for Hispanic individuals.

Question ID #13118: The client is a 50-year-old woman whose presenting problem involves her relationship with her 26-year-old son. The woman rents out the guest house on her property to her son, who works part-time at a music supply store. The son spends his money on music downloads, vinyl records, concerts, and alcohol and relies on his mother to pay for his food and other needs; he rarely pays his rent. The social worker and client agree that a significant goal of therapy will be to help the client develop greater autonomy in her relationship with her son. Three weeks later, the client reveals in her session that her son smokes marijuana every day and is verbally abusive toward her. What should the social worker do? A.Recommend a session with the client and her son B.Have the client give her son an ultimatum to either seek treatment or move out. C.Help the client see how she plays a role in her son's addictive behavior and what she can do to change this pattern. D.Help the client set clear expectations with her son about behavior that is acceptable and unacceptable in her home.

D.Help the client set clear expectations with her son about behavior that is acceptable and unacceptable in her home. **This intervention is most consistent with the client's therapeutic goal of developing greater autonomy in her relationship with her son. This answer offers the client an opportunity to engage successfully in a growth-producing experience Answer A: This may be a worthy intervention in the future; however, the current goal is to empower the client with her son. Answer B: The son's behavior suggest that it is unlikely that the client would be able to convince him to get treatment. And, if the son refused to seek treatment, the client would have to make him move out and she may not be ready to take that step. Answer C: This may be a future treatment goal, but the current question is focused on the clients goal of developing greater autonomy, which is best expressed in answer D.

Question ID #13266: A client reports that he has been having difficulties with concentration and decision-making, feeling worthless, and having frequent crying spells. He also reports feeling depressed on some days. The social worker asks the client a few questions to find out whether he has been experiencing any vegetative symptoms associated with depression. Asking the client about vegetative symptoms allows the social worker to explore for the presence of which of the following indicators of depression? A.Social withdrawal, loss of interest in sex, psychomotor agitation B.Mental dullness or confusion, psychomotor retardation or agitation, hypersomnia or insomnia C.Anhedonia, hypersomnia or insomnia, appetite changes D.Hypersomnia or insomnia, appetite changes, psychomotor retardation

D.Hypersomnia or insomnia, appetite changes, psychomotor retardation

Question ID #13275: A married couple reports frequent arguments and difficulties in resolving problems. They say that they misunderstand each other when they fight, which leads to more intense arguments. What should the social worker do FIRST? A.Identify specific problems in the relationship by having each partner, in a separate interview, describe his or her view of the problem. B.Identify successful and unsuccessful anger-management strategies used by each partner and their consequences. C.Assess each partner's emotional health and stability D.Identify the couples specific communication deficits by having them attempt to resolve a major conflict while the social worker observes them

D.Identify the couples specific communication deficits by having them attempt to resolve a major conflict while the social worker observes them **Given the nature of the presenting problem (communication difficulties), this is the most useful assessment listed among the answer choices. Answer A: It would be much more useful to observe the couple interacting with each other. Separating the couple would be indicated only if their interactions were so dysfunctional (e.g., there was repeated blaming or intense anger) that they prevented the social worker from completing the assessment, or if there was spousal abuse. Answer B: This is more useful when the presenting problem involves uncontrolled expressions of anger. Answer C: The social worker may uncover unreported emotional problems in this case, but the presenting problem is communication deficits.

Question ID #13275: A married couple reports frequent arguments and difficulties in resolving problems. They say that they misunderstand each other when they fight, which leads to more intense arguments. What should the social worker do FIRST? A.Identify specific problems in the relationship by having each partner, in a separate interview, describe his or her view of the problem. B.Identify successful and unsuccessful anger-management strategies used by each partner and their consequences. C.Assess each partner's emotional health and stability D.Identify the couples specific communication deficits by having them attempt to resolve a major conflict while the social worker observes them.

D.Identify the couples specific communication deficits by having them attempt to resolve a major conflict while the social worker observes them.

Question ID #13455: A client says to a social worker during a session. "My life is so boring right now. Some good drugs and a few bucks would sure set me right." The social worker responds by saying, "It seems as if you believe you need money and drugs to feel good about yourself." What intervention is the social worker using? A.Paraphrasing B.Reframing C.Reflecting D.Interpretation

D.Interpretation **The social worker is using interpretation with the client by going a step further and providing the client with a new frame of reference for the client to consider. Interpretation may involve presenting a hypothesis about the cause-effect relationship, or other significant meanings in a client's actions, thoughts, or feelings. Answer A: Paraphrasing is a restatement of the main idea of a client's message that resembles the message, but is not identical to it. Answer B: Reframing is a technique used to help clients change the negative meaning they give to an event, behavior, or life experience by gently persuading them that it can be viewed in a different and more positive light. Answer C: Reflecting is an active listening skill that involves restating or repeating something a client has said with an emphasis on the part of the message that is most helpful.

Question ID #13656: A woman with a personality disorder is released from a psychiatric hospital. As part of her ongoing treatment, she will see a social worker for outpatient individual psychotherapy. To prepare for his first session with this woman, the social worker reviews the woman's clinical record and sees that a previous therapist noted that the woman tends to rely on primitive defense mechanisms. Therefore, the social worker can expect that this woman might rely on which of the following defense mechanisms? A.Projection and sublimation B.Intellectualization and denial C.Repression and rationalization D.Introjection and denial

D.Introjection and denial **The correct answer is the one that includes two defense mechanisms that are both considered to be "primitive." Primitive defense mechanisms are first learned in early childhood. The more primitive a defense mechanism, the less effectively it works over the long-term. Because more primitive defense mechanisms are usually effective in the short-term, however, they are preferred by many people, particularly children. Adults who don't learn more effective ways of coping with stress or trauma also tend to use primitive defense mechanisms. According to many authors, introjection is the most primitive defense mechanism. It ignores interpersonal boundaries and involves attributing the thoughts or feelings of someone else to oneself in order to have more control over those thoughts or feelings. Denial is also a primitive defense mechanism. It is characteristic of early childhood development and is related to a child's faith in the magical power of thoughts and words. Answer A: Projection is primitive, but sublimation is not. Projection involves attributing one's own unwanted impulses to others. (Projection is considered somewhat less primitive than introjection, however, which is logical since a person needs to "take in" a thought or feeling before she is able to "send it out.") Sublimation - which involves diverting an unacceptable impulse into a socially acceptable, even admirable, activity - is considered to be a "mature" defense mechanism. In fact, it is the most highly developed and adaptive defense mechanism and is common in "healthy" adults. Answer B: Denial is primitive, but intellectualization is not. Intellectualization (a.k.a. rationalization) occurs when an individual interprets her behaviors in a way that makes them seem more rational, logical, and/or socially acceptable. Because it requires relatively mature cognitive abilities, intellectualization rarely appears before adolescence. Answer C: Repression is fairly primitive, but rationalization is not. Repression first appears in the phallic stage of development (ages 3-6 years).

Question ID #13652: The clients are a family of four, including Dad, Mom, and two adolescent daughters. Dad and Mom immigrated to the U.S. shortly after marrying and have always worried about the effects of American culture on their daughters. They don't allow the girls to have friends over, and they closely screen and limit the girls' access to media on TV, radio, and the Internet. Dad says he's suspicious of "outsiders," including the social worker. He says family should depend on family for support and must hang on to their own traditions and values. From the perspective of systems theory, which of the following appears to be true about this family? A.It is a relatively open system that is vulnerable to negentropy. B.It is a relatively open system that is vulnerable to entropy. C.It is a relatively closed system that is vulnerable to negentropy. D.It is a relatively closed system that is vulnerable to entropy.

D.It is a relatively closed system that is vulnerable to entropy. **Familiarity with the systems theory concepts of open systems and closed systems may have allowed you to use a process of elimination to reduce your choices to C and D. Then, knowing the related concepts of negentropy and entropy would have enabled you to choose D. All families operate as open systems, but some families are more closed than others, in the sense that they are rigid or insular. The more open a family system, the more adaptable and accessible to change it is. Relatively closed family systems, by contrast, tend to seal themselves off from all but necessary exchanges with the outside world, as this family seems to have done. Families that engage in minimal exchanges with the environment-i.e., that have little or no contact with others outside the family-are less able to deal with stress and run the risk of entropy (disorganization and eventual disorder). Answer A: In contrast, a relatively open family system-one that welcomes and seeks new experiences and information-is more adaptable and accessible to change and is said to have negentropy (a tendency toward maximum order). Such a family can change its patterns in response to new information that requires a change in family rules and abandon established patterns that are no longer appropriate. Answer B: The family is not an open system. Answer C: The family is vulnerable to entropy (disorganization and eventual disorder) because it is a closed system.

Question ID #13847: According to Margaret Mahler (an object relations theorist), "individuation" involves which of the following? A.Establishing relationships with others. B.Incorporating the unconscious aspects of one's personality into the conscious aspects. C.Achieving unity of the four basic psychological functions (thinking, feeling, sensing, and intuiting). D.Recognizing the separate existence of self and others.

D.Recognizing the separate existence of self and others. **According to Mahler (1975), a child's process of moving from being a member of a mother-child unit to becoming a family member involves separation and individuation. "Separation" refers to the development of limits or the differentiation between the infant (self) and the mother; while "individuation" refers to the development of the infant's ego, sense of identity, and cognitive abilities. Individuation involves further movement away from symbiosis with the mother and toward the recognition and experience of the individual, or separate, existence. Answer A: This response is too narrow. You needed to be aware of the specific process described in answer choice D that belongs to the broader developmental task of individuation. Answer B: This is an element of Jung's concept of individuation. Jung defined individuation as the process of developing a fully formed self by integrating disparate aspects of one's personality. Answer C: This is also a Jungian concept.

Question ID #13063: Leroy, a 22-year-old white male, was diagnosed as having schizotypal personality disorder when he was 15. He has always been fascinated by aliens and believes that he was abducted when he was 10 and returned to the planet changed. Lately, Leroy has started hearing broadcasts from the aliens telling him to prepare for another trip. A month ago, he dropped out of community college and got fired from his job for not showing up on time, and being sloppy in his work. These indicates could show: A.Leroy is having a psychotic break. B.Leroy has developed delusional disorder. C.Leroy has developed a medical disorder that is affecting his ability to function. D.Leroy's schizotypal diagnosis was pre-morbid to schizophrenia.

D.Leroy's schizotypal diagnosis was pre-morbid to schizophrenia. **Although not all of the Cluster A personality disorders (Paranoid PD, Schizoid PD and Schizotypal PD) progress into more serious mental disorders such as schizophrenia, they are thought to be potentially pre-morbid (personality traits that are a precursor to mental illness). What has changed in Leroy's case that leads us to consider that he may now be developing schizophrenia (schizophreniform disorder if less that 6 months) is the presence of positive symptoms of schizophrenia (hallucinations) as well as negative symptoms (amotivation as evidenced by his not going to work) and possibly cognitive symptoms (sloppiness). Answer A: While Leroy may be indeed to suffering from a psychotic break, Answer Choice D is a more complete answer. Answer B: Delusional disorder does not explain the negative symptoms Leroy is displaying, and his hallucinations point toward emergent schizophrenia. Answer D: While this is possible, it is more likely that Leroy's schizotypal diagnosis was pre-morbid to schizophrenia.

Question ID #13637: Which of the following is LEAST likely to result in intellectual disability in a child? A.Fetal alcohol syndrome B.Phenylketonuria C.Rh incompatibility D.Maternal HIV disease during pregnancy

D.Maternal HIV disease during pregnancy

Question ID #13845: A family member of a client arrives at a social worker's office searching for information to get in touch with the client. He tells the social worker that he needs the client's most recent phone number and states that it is urgent that he contacts him. What should the social worker do? A.Provide the family member with the information because it is an urgent situation. B.Document the situation for his files before providing the information. C.Tell the family member that she needs to get a signed authorization from the client before she can release the information. D.Not give the family member any information about the client.

D.Not give the family member any information about the client. Feedback ***.The social worker cannot give out any information in this situation. She cannot confirm, nor deny, that this person is a client of hers or give out any information. The social worker must maintain the confidentiality of her client. Answer A: Regardless if the family member describes the situation as "urgent" or not does not give any rights for the social worker to violate confidentiality. Answer B: Documenting the situation does not give the social worker any rights to violate confidentiality. Answer C: By telling the family member that she needs a signed authorization from her client to speak to him acknowledges and confirms that the social worker is working with this client. This would be a violation of confidentiality.

Question ID #13322: What is the name of consent form that is required under HIPAA's privacy rule that helps clients understand how their PHI is used and disclosed? A.Covered Entity B.Protected Health Information C.Need-to-Know Requirement D.Notice of Privacy Practices

D.Notice of Privacy Practices **Notice of Privacy Practice (NPP) is the consent form required under HIPAA's privacy rule that helps clients understand how their PHI is used and disclosed. This form must be given to clients at the beginning of or before the first session. Answer A: A covered entity is a health care provider who transmits health information in electronic form in connection with a HIPAA transaction. Answer B: Protected Health Information (PHI) includes any information that identifies the individual or that could reasonably be used to identify the individual. Answer C: Need-to-know requirement requires that access to PHI by staff in an office or agency be assigned on a need-to-know basis, and have access to only the information needed to do their jobs.

Question ID #13205: The client is recently divorced and also recently unemployed. His wife has the house they shared and he is living in his car. According to Maslow, which of his primary needs is he most challenged in at this point? A.Safety B.Love C.Esteem D.Physiological

D.Physiological

Question ID #13396: An 11-year-boy was removed from his parents' custody because of chronic, severe neglect. The social worker has been working with the boy and his parents for some time in therapy. The parents have not made any progress at all; they have missed many sessions and resisted the social worker's efforts to draw them out. The local child protective agency determined last week that it will give the boy's foster parents the right to adopt him within the next two months. Under these circumstances, what should the social worker do? A.Explore the parents' resistance to change B.Initiate the termination phase of treatment C.Petition the agency to re-evaluate its decision D.Prepare the boy for not returning home to his parents

D.Prepare the boy for not returning home to his parents ***In some cases of child maltreatment, it is in the child's best interests for an action to terminate parental rights to be initiated. In this case, a qualified entity has determined that this child should be removed permanently from his parents' care; likely, the parents' lack of cooperation with the treatment plan has contributed to this decision. Under these circumstances, the best action is to shift the focus of treatment to preparing the boy for the upcoming changes in his life (e.g., addressing his feelings of loss, anger, guilt, etc., and helping him cope with the adjustment issues that are bound to arise).

Question ID #13586: The DSM-5 roughly categorizes mental disorders as _____________ and _______________. A.psychotic; non-psychotic B.developmental; induced C.serious; non-serious D.internalizing; externalizing

D.internalizing; externalizing **The DSM-5 introduction (pg. 13) notes that disorders are roughly clustered disorders by internalizing and externalizing types. Internalizing disorders include depressive, anxiety and somatic disorders, and externalizing disorders include disorders with prominent impulsive and/or disruptive conduct, and substance abuse. Answer A: Psychoticism (or lack thereof) is not a delineator in the DSM-5. Answer B: Although these categories are an interesting concept for organizing mental disorders, they are not delineators in the DSM-5. Answer C: The DSM-5 does not categorize by severity.

Question ID #13313: A social worker has been working in individual therapy with a 17-year-old client. During a session, the client reports that she was raped a few months ago. She refuses to tell the social worker who raped her. The client then abruptly says that, in fact, she was not raped. What should the social worker do? A.Maintain the client's confidentiality because she has retracted her statement B.Maintain the client's confidentiality for the time being because he doesn't know the age of the perpetrator C.Maintain the client's confidentiality for the time being because he doesn't know the name of the perpetrator D.Remind the client of the limitations to confidentiality and file a child abuse report

D.Remind the client of the limitations to confidentiality and file a child abuse report **The rape of a minor is form of child sexual abuse that must be reported. Answer A: The client's initial claim is sufficient to produce a reasonable suspicion of child abuse, which is the threshold necessary to invoke the mandate to report. Answer B: Rape, by definition, is nonconsensual, abusive, and coercive. Therefore, it is child sexual abuse in this case regardless of the age of the perpetrator. Answer C: This would not preclude the reporting duty. The social worker is still required to make a child abuse report based on her suspicion.

Question ID #13691: There are four broad categories of personality theory. In general, personality can be thought of as the pattern of unique thoughts, feelings, and behaviors of a person. Other words for personality are character, temperament, and nature. Which of the four personality perspectives would be most concerned with self-observation and self-efficacy? A.Psychoanalytic theory B.Trait theory C.Humanistic theory D.Social cognitive theory

D.Social cognitive theory **The social cognitive theory (Redmond, 2010) is composed of four interrelated processes of goal realization that have an effect on motivation: self-observation, self-evaluation, self-reaction and self-efficacy. Answer A: Psychoanalytic theory postulates that human behavior is the result of interactions between the id, ego, and superego. Answer B: Trait theory of personality (Allport, 1961) defines personality as having stable traits or habitual patterns of behavior, thought, and emotion. Answer C: Humanistic theory focuses on the wholeness and uniqueness of each individual, and that people exhibit free will or personal agency to choose the paths that they will take in life.

Question ID #13134: A social worker is providing case management services to a client who works part-time at a low-paying job, has diabetes, and lacks transportation because he cannot afford to own a car and doesn't understand the public transportation system in his city. He reports that he's been having difficulty getting good medical care for his diabetes-he says that doctors don't take him seriously because he can't read or speak very well. The social worker's overall focus should be on which of the following when providing case management services to this client? A.The client's unmet needsIncorrect B.The client's strengths and capacities C.The barriers that keep the client from using resources in his environment D.The client's relationship to his environment

D.The client's relationship to his environment **A case manager's overall focus is on the client's relationship to his environment. This is based on an ecological perspective, which assumes that a person has needs that are met by resources in his environment and that the environment makes demands that are responded to by capacities within the person. For healthy and adaptive functioning, there must be a balance of resources to needs and a balance of capacities to environmental demands. During assessment, a case manager examines which needs and demands must be balanced by which resources and capacities. The goal of case management is then to develop the client's competence to achieve and maintain this balance by himself. Answer A: This is a component of case management but is not as inclusive as the correct answer. Answer B: This is a component of case management but is not as inclusive as the correct answer. Answer C: This would be an incomplete answer.

Question ID #13838: The policy of deinstitutionalization has been a contributing factor to homelessness among people with mental illness. The policy of deinstitutionalization in the 1960s and 1970s was heavily influenced by which developments? A.The signing of the Mental Health Systems Act by Jimmy Carter to fund more community health centers B.Lobotomies and electroshock falling out of favor with the public C.The development of anti-psychotics and budget cuts D.The development of anti-psychotics and the creation of Medicaid and Medicare

D.The development of anti-psychotics and the creation of Medicaid and Medicare **The development of anti-psychotics such as chlorpromazine and later clozapine meant that many patients in state hospitals could function outside the hospital system. Secondly, federal funding such as Medicaid and Medicare would not pay for treatment at mental hospitals, but would pay for treatment at community mental health centers. Another factor that had a strong influence on public thinking about mental hospitals was the movie One Flew Over the Cuckoo's Nest that portrayed abuses of mental patients in hospital care. Answer A: The Mental Health Systems Act was not signed until 1980. The question is asking about the 1960s and 1970s. Answer B: Lobotomies and electroshock did fall out of favor with the public (especially after the release of One Flew Over the Cuckoo's Nest), but Answer Choice D directly addresses causes of deinstitutionalization. Answer C: Budget cuts were driven specifically by the fact that Medicaid and Medicare would not pay for treatment at mental hospitals, but would pay for treatment at community mental health centers.

Question ID #13679: A family life cycle theorist would be MOST likely to view symptoms in a family member as expressing which of the following? A.A family members struggle to negotiate a new developmental stage. B.A family members flight from an unresolved emotional conflict. C.A family members struggle to adapt to the demands of a new developmental stage. D.The family's struggle to adapt to the demands of a new developmental stage.

D.The family's struggle to adapt to the demands of a new developmental stage. **The family life cycle is a longitudinal view of family development suggesting that a family passes through expected phases in much the same way as an individual develops through specific psychosexual or psychosocial phases. Stages of the family life cycle are demarcated by entrances and exits of family members and the shifts in role function these changes in membership require. Answer "D." correctly states what a family life cycle theorist would say with regard to what the symptoms in a family member express. A number of factors may prevent a family from adapting to a new developmental stage, including a traumatic event in the family, a rigid family style, etc. Answer A: This focuses too much on the individual family member. Answer B: This focuses too much on the individual family member; in addition, it sounds more like emotional cutoff, which is a term associated with Bowen. Answer C: This focuses too much on the individual family member.

Question ID #13475: For a social worker who is a covered entity, which of the following is required under HIPAA's Privacy Rule? A.The social worker must give the Notice of Privacy Practices to clients either prior to disclosing confidential information without permission or before the termination of services, whichever comes first. B.The social worker is not legally required to give clients the Notice of Privacy Practices if he or she uses an office policies form. C.It is acceptable to forgo the Notice of Privacy Practices if the social worker verbally discusses HIPAA's Privacy Rule with his or her clients. D.The social worker must give the Notice of Privacy Practices to clients at the beginning of or before the first session

D.The social worker must give the Notice of Privacy Practices to clients at the beginning of or before the first session **The social worker must give the Notice of Privacy Practices (NPP) to clients at the beginning of or before the first session. HIPAA's Privacy Rule is designed to provide increased protection for protected health (PHI), and requires "covered entities" (health care providers who transmit health information in electronic form in connection with a HIPAA transaction) to implement procedures to assure clients' privacy. Answer A: This is not a true statement. The social worker should give NPP to clients at the beginning of or before the first session. Answer B: This is false. The social worker is required to give clients the Notice of Privacy Practices. Answer C: It is not acceptable to forgo the NPP and not allowed to only discuss verbally. It has to be a signed consent form.

Question ID #13595: The social worker is a case manager at an agency that provides services for a predominantly low-income clientele. She finds that many clients evidence a personality disorder, as well as mental illness. Which statement is most true? A.For a personality disorder to be diagnosed in an individual under 18, the symptoms must have been present for at least 2 years. B.Personality disorder symptoms are usually ego-dystonic. C.There is no difference in prevalence rates for personality disorders across gender. D.Traits of a personality disorder that appear in childhood may change through adult life.

D.Traits of a personality disorder that appear in childhood may change through adult life. **According to the DSM-5, traits of a personality disorder that appear in childhood may change through adult life. Answer A: For a personality disorder to be diagnosed in an individual under 18, the symptoms must have been present for at least 1 year. Answer B: Personality disorder symptoms are usually ego-syntonic (i.e., the person views what others regard as symptoms as acceptable and consistent with their fundamental personality and beliefs). Mental disorders tend to be ego dystonic, meaning that one's behavior or attitudes are viewed as inconsistent with one's fundamental beliefs and personality. Answer C: Certain personality disorders are more common in men, such as antisocial PD, and others are found more frequently in women (borderline, dependent and histrionic PD for example).

Question ID #13546: When using the DSM-5, a social worker or other clinician would code which of the following when a client has symptoms that do not meet the diagnostic criteria for a specific disorder and the clinician does not want to specify the reason why? A.Disorder not otherwise specified B.Disorder provisional C.Other specified disorder D.Unspecified disorder

D.Unspecified disorder **When using the DSM-5, diagnostic uncertainty about a client's diagnosis is indicated by coding one of the following: Other specified disorder is coded when the clinician wants to indicate the reason why the client's symptoms do not meet the criteria for a specific diagnosis (e.g., "other specified depressive disorder, recurrent brief depression"); and unspecified disorder is coded when the clinician does not want to indicate the reason why the client's symptoms do not meet the criteria for a specific diagnosis (e.g., unspecified depressive disorder). Answer A: Not otherwise specified (NOS) is used in the DSM-IV-TR to indicate diagnostic uncertainty but has been replaced in the DSM-5 with other specified disorder and unspecified disorder. Answer B: When using the DSM-5, the provisional specifier applies when "there is a strong presumption that the full criteria will ultimately be met for a disorder but not enough information is available to make a firm diagnosis" (p. 23). Answer C: See explanation for Answer Choice D.

Question ID #13479: Which of the following is NOT a strategy that is typically effective for establishing rapport? A.Conveying empathy nonverbally B.Admitting one's errors to clients C.A low level of self-disclosure if the client is defensive D.Using small talk during a warm-up period before asking the client why he came in

D.Using small talk during a warm-up period before asking the client why he came in **Be sure to take into account the word "not" when choosing the answer. A brief warm-up period with small talk can be used to help a client feel more comfortable before he begins sharing his reason for coming in, but, with most clients, the social worker should begin the first interview by asking them to share why they've come in. Providing a warm-up period beforehand is typically indicated only when the social worker detects that a client needs to "break the ice" in this way. Otherwise, it could be seen by the client as wasting their time. Answer A: Conveying empathy nonverbally demonstrates that the social worker is actively listening and attempting to understand the client. Answer B: Admitting one's errors to clients helps to humanize the social worker and provide an honest and transparent environment. Answer C: While the social worker would not self-disclose with most clients before rapport has developed, even at a low level, this option is considered effective for establishing rapport because it specifies that the client is defensive. The social worker may use a low to moderate level of self-disclosure early in the relationship if it is believed that doing so would be effective for reducing a client's defensiveness.

Question ID #13677: The client is a 19-year-old has been mandated to get therapy as a part of his probation. Over the course of the last year, he broke into several neighbor's houses, and also stole a car. He was accused of sexual assault by a girl at school, but the incident was never prosecuted. The social worker finds him to lack remorse for his actions, to show no empathy for his victims, and to generally project a fearless, callous attitude. She decides to give him a diagnosis of antisocial personality disorder. Recent studies indicate that people with antisocial personality disorder: A.always come from an abusive home. B.have a genetic predisposition. C.demonstrate increased activity in the prefrontal cortex that overstimulates their brain, interfering with the ability to feel empathy and remorse. D.often show brain abnormalities in the regions of the brain important for understanding other's emotions

D.often show brain abnormalities in the regions of the brain important for understanding other's emotions

Question ID #13625: A young child has learned that objects that fly in the sky are called "birds." The first time the child sees a plane in the sky, she points to it and says "bird." From a Piagetian perspective, this child's response illustrates: A.equilibration. B.adaptation. C.accommodation. D.assimilation.

D.assimilation. **According to Piaget, just as living organisms adapt to their environment biologically, people adapt to their environment cognitively. Such adaptation involves two complementary processes: assimilation refers to the incorporation of new knowledge into existing cognitive schemas (structures), and accommodation refers to the modification of existing schemas (structures) to incorporate new knowledge. For instance, when playing with a toy for the first time, the child will treat it as she would any other new object (e.g., hit it, throw it, taste it). At this point, the child is trying to understand the toy by assimilating it into her existing cognitive schemas. Answer A: Piaget believed that the motivation for cognitive development stems from a drive toward cognitive balance or equilibrium. Development takes place when a state of disequilibrium caused by a discrepancy between reality and a person's current understanding of the world (repertoire of schemas) is resolved through the processes of assimilation and accommodation. Answer B: This is the broader category to which assimilation belongs. Answer C: Over time, as the child begins to identify an object's unique properties, she will accommodate by modifying her schemas, thereby developing new ways of interacting with the object.

Question ID #13594: The DSM-5 diagnosis of social (pragmatic) communication disorder is characterized by: A.intense anxiety about social situations in which the individual may be exposed to scrutiny by others. B.a disturbance in the normal fluency and time patterning of speech. C.deficits in social communication and interaction and restricted, repetitive patterns of behavior, interests, and activities D.difficulties in the social use of verbal and nonverbal communication

D.difficulties in the social use of verbal and nonverbal communication **Social (pragmatic) communication disorder is a neurodevelopmental disorder in the DSM-5 that is characterized by persistent difficulties in the social use of verbal and nonverbal communication. The difficulties limit effective communication, social participation, social relationships, academic achievement, or work performance and are demonstrated by deficits in using communication for social purposes in a way that's appropriate for the social context; impairment of the ability to adjust communication to match the context or the listener's needs; difficulties following rules for conversation and storytelling; and difficulties in understanding what is not explicitly stated and nonliteral or ambiguous meanings of language. Answer A: Intense fear of, or anxiety about, one or more social situations in which the individual may be exposed to scrutiny by others is characteristic of social anxiety disorder (social phobia). The DSM-5 notes that in individuals with social anxiety disorder, social communication skills have developed appropriately, but the person may not use them because of anxiety or fear about social interactions. By contrast, in social (pragmatic) communication disorder, the person has never had effective social communication. Answer B: A disturbance in the normal fluency and time patterning of speech is characteristic of childhood-onset fluency disorder (stuttering). Answer C: The presence of persistent deficits in social communication and interaction across multiple contexts AND restricted, repetitive patterns of behavior, interests, and activities is characteristic of autism spectrum disorder. The DSM-5 notes that when a person has impairment in social communication and social interactions but doesn't show restricted and repetitive interests or behavior, criteria for social (pragmatic) communication disorder, instead of autism spectrum disorder, may be met.

Question ID #13673: The social worker asks the parent to briefly leave the playroom, and the child begins to cry and call for the parent. The child is demonstrating object permanence, which is generally acquired as a function of: A.continuous development. B.Piaget's cognitive theory. C.memory development. D.discontinuous development.

D.discontinuous development.

Question ID #13569: A 5-year-old boy is in foster care and enrolled in a therapeutic nursery school. He and his older sister were removed from their home after they were found wandering in the park asking people for food. Their parents were both found to have a drug problem. While observing the boy at school, the social worker notices that he impulsively approaches strangers, tends to be overly familiar with people he has just met, and quickly becomes attached to any adult who pays attention to him. Before assigning a DSM-5 diagnosis of ______________ to this boy, the social worker will want to confirm that his symptoms are attributable to ______________. A.reactive attachment disorder, disinhibited type and developmental delays B.disinhibited social engagement disorder and developmental delays C.reactive attachment disorder, disinhibited type and early neglect or deprivation D.disinhibited social engagement disorder and early neglect or deprivation

D.disinhibited social engagement disorder and early neglect or deprivation **Disinhibited social engagement disorder involves a pattern of culturally inappropriate and overly familiar behavior with unfamiliar people, providing evidence that the behavior is related to the experience of extremely insufficient care. Answer A: The DSM-5 diagnosis of disinhibited social engagement disorder replaces the DSM-IV-TR diagnosis of reactive attachment disorder, disinhibited type. Note that the DSM-5 does include the disorder reactive attachment disorder, but without the subtypes (disinhibited type, inhibited type) provided in the DSM-IV-TR. In the DSM-5, reactive attachment disorder is characterized by a consistent pattern of inhibited and emotionally withdrawn behavior toward adult caregivers. As with disinhibited social engagement disorder, the diagnosis requires evidence that the behavior is related to the experience of extremely insufficient care. Answer B: The presence of developmental delays is not necessary to make a diagnosis of either disinhibited social engagement disorder or reactive attachment disorder. Answer C: Reactive attachment disorder, disinhibited type would have been the correct diagnosis in the DSM-IV-TR.

Question ID #13537: According to observational learning theory, external reinforcement may influence the cognitive processes involved in learning and the behavior itself, but a behavior can occur in the absence of external reinforcement. Bandura believed that this is because performance of the behavior may be self-reinforcing in that it increases the learner's: A.sense of well-being. B.stimulus-response connection. C.stimulus generalization. D.feelings of self-efficacy.

D.feelings of self-efficacy. **Bandura concluded that observational learning entails a change in cognition involving attentional, retention, production, and motivational processes. Regarding the latter, the learner must be motivated to learn and perform the modeled behavior. Motivation is increased when the learner is reinforced, but the reinforcement can be either internal, vicarious, or external. Observational learning often includes progressive performance of the behavior by the learner with assistance from a model (guided participation). Bandura (and others) have suggested that the effectiveness of this approach is due to the sense of self-efficacy (personal mastery) the learner gains by successful performance of the target response. Answer A: Feelings of self-efficacy is part of a larger whole of having a sense of well-being. Answer B: Stimulus-response is defined as a stimulus that precedes a certain behavior and thus causes a response. Answer C: Stimulus generalization is the tendency of a new stimulus to evoke responses similar to those elicited by another stimulus. For example: Pavlov conditioning dogs to salivate at the sound of a bell by pairing the bell with food.

Question ID #13552: According to the DSM-5, a child with dyslexia who has not responded to interventions that target his reading problems would receive a diagnosis of: A.academic skills disorder with impaired reading. B.reading disorder. C.learning disorder NOS. D.specific learning disorder with impairment in reading.

D.specific learning disorder with impairment in reading. **The DSM-IV-TR diagnoses of reading disorder, mathematics disorder, disorder of written expression, and learning disorder NOS have been combined in the DSM-5 into the single diagnosis of specific learning disorder, with the type of disorder being indicated with a specifier. Answer A: A learning disorder was diagnosed as an academic skills disorder in DSM-III. Answer B: See explanation for D. Answer C: The DSM-IV-TR's NOS (not otherwise specified) designation has been replaced in the DSM-5 with two options "other specified disorder" and "unspecified disorder."

Question ID #13008: The social worker is working with a Chinese-American family who are dealing with difficulties the youngest boy, 8 years-old, is having in school. They have two other children, teenage girls. The social worker does most of the sessions with all of the family present, but occasionally meets with the parents and the children individually or in sub-systems. During a session with the three children, the teenage girls complain about how much work they have to do around the house. They state that they are always responsible for getting dinner on the table and the clean-up afterwards, as well as the laundry for everyone. They are both straight A students, but say they have no time to see friends because of the housework plus homework. This is: A.unusual, because most Chinese American families would focus their children on getting good grades above all else. B.normal, as it is more important for the Chinese American child to care for their family than to put an emphasis on grades or relationships. C.the norm for Chinese American families but inappropriate for teenagers who are trying to assimilate into the larger society in order to be successful and culturally competent.

D.the norm in Chinese American families - adolescents are responsible for many family functions as their duty to the family.

Question ID #13650: A social worker is working in family therapy with a family of five (mother, father, a 12-year-old boy, a 3-year-old boy, and an infant girl) in which the toddler son has been acting out since the birth of his sister three months ago. The mother is convinced that her toddler son is jealous of his sister. The social worker, however, is concerned with how the whole family has reorganized itself following the girl's birth and asks the clients about this. In general systems theory, this concept that any change in one part of a family system (or other system) will cause change in other parts of the system and eventually the whole system is known as: A.accommodation. B.multifinality. C.equifinality. D.wholeness.

D.wholeness. **The systems theory concept of "wholeness," maintains that combining units, components, or elements produces an entity that is greater than the sums of its parts. Therefore, a system cannot be adequately understood or fully explained if it is broken down into its component parts, and no element within a system can ever be understood in isolation because it never functions independently. Because of a system's wholeness, the movement of each part of the system influences the whole system and is explained, in part, by movement in related parts of the system. Answer A: Although one might think the whole system "accommodates" to change in one part of the system, the terminology does not fit general systems theory. Answer B: The systems theory principle of multifinality (many ends) refers to the fact that one cause (one action) may produce many different effects or outcomes. Answer C: The systems theory principle of equifinality (same end) refers to the fact that a single effect or outcome may result from several different causes.