ASWB

A new client comes for therapy complaining of anxiety and depression. After the social worker provides information about the benefits of medication and psychotherapy, the client emphatically states, "I refuse to take medication." What should the social worker do NEXT? A. Acknowledge the client's right to choose his treatment. B. Refer the client to a psychiatrist. C. Determine why the client is so against medication. D. Provide the client with research on the benefits of meds

A. The social worker always wants to encourage the client's sense of self-determination; therefore, it's important for the social worker to allow the client to decide what is best for him (A). B and D disregard the client's statement that he does not want to take medication. C may be important to explore after A is done.

A social worker sees a new client referred because of heavy alcohol use. During the initial assessment the client questions the social worker's credentials and competence. What should the social worker do FIRST? A. Provide the client with honest information regarding social worker's credentials. B. Confront the client about the evasive responses. C. Ask how the client feels about seeking help. D. Explain that the social worker has treated a lot of patients like him.

A. This question is asking what the social worker should do first. Providing the client with honest information regarding credentials (A) would help build rapport with client. After sharing information, the social worker could ask the client how he/she feels about seeking help (C) as well as explain history of working with similarly diagnosed clients (D). Confronting clients (B) is not an intervention used in the early stages of therapy and could be detrimental to the client-social worker relationship.

A foster care social worker is preparing an update for the court regarding the potential termination of parental rights for the mother of a 6-year-old girl. The social worker has been gathering information from collateral contacts. All of the following would be considered collateral contacts EXCEPT: A. The therapist running the parenting classes in which the mother is enrolled. B. The child's individual therapist. C. The child's older sister. D. The mother's individual therapist.

C. Collateral contacts are defined as individuals who have knowledge of a family's personal situation without having personal involvement themselves. C is correct because the child's older sister is a family member and has personal involvement in the family and would NOT be a collateral contact.

A hospital social worker is assessing a woman who was recently hospitalized due to self-neglect. In developing after care plans, the woman reports that she never married and has no family in the area. In helping the patient develop discharge plans, the social worker should FIRST: A. Assess the client's ability level to provide self-care at home. B. Refer the client to a local assisted living home. C. Encourage the client to find social support in the area. D. Refer the client to local home health care agencies.

A. Before anything else can be done the social worker must FIRST evaluate the client's ability to take care of herself at home (A). (B), (C), and (D) may be done at a later time, but the social worker can not develop any other plans before assessing the client's self-sufficiency.

A 32-year-old male with criminal history has been in therapy for several months to deal with anxiety and relationship issues. One session he shares that he robbed an electronics store three days prior. The social worker's BEST response is to: A. make a police report. B. call the store and inform them of what happened. C. talk to the client about turning himself in. D. maintain confidentiality and process the incident with the client.

D. Making a police report (A) or calling the store (B) would break the client's confidentiality that we are legally required to maintain. social workers are not legally required to break confidentiality and report past acts of violence, thus answer option D is correct. In addition, social workers are not legally required to encourage the clients to turn themselves in, thus C is wrong.

A social worker receives a referral for a 32-year-old woman who has a history of depression, low self-esteem, and suicidal ideation. During the initial session, the social worker notices that the client fails to make eye contact, speaks softly, and often appears to be lost in thought, going for long periods of time without speaking. The social worker should FIRST assess for: A. Substance abuse B. An autism spectrum disorder C. A personality disorder D. A history of trauma

D is the best answer. The combination of the information from the referral and the client's behavior in session is most suggestive of a trauma history. A and B are not indicated. The social worker should assess for C during the initial session, but not before D.

A hospital social worker is part of a multidisciplinary treatment team on an orthopedic unit. Part of the social worker's duties involves recording notes in the patients' medical records. The PRIMARY purpose of this documentation is to: A. Facilitate the appropriate discharge plans when necessary. B. Demonstrate to the hospital that appropriate services are being provided. C. Ensure continuity of care once the client has discharged. D. Allow for appropriate communication to occur between team members regarding the care of patients.

D is the correct answer because the primary purpose of documentation in this case is to facilitate communication among team members and ensure the clients are receiving proper care.

A researcher with a PhD in social work is interested in looking at help-seeking behaviors in her community. She plans to distribute a survey to all registered voters and analyze the results. This study is best described as using: A. Quasi-experimental design B. Single subject design C. Cross-sequential design D. Cross-sectional design

D is the correct answer because this study will collect data at a single point in time from participants of different ages. C would only be the correct answer if the same measure was used at different points in time (point A, 5 years beyond point A, 10 years beyond point A, etc.). A and B do not apply here.

A social worker in a small rural community has decided to consult with a colleague about a client who does not seem to be progressing in therapy. As part of the consultation the social worker's BEST course of action is to: A. Obtain a release from the client since the colleague might know him / her. B. Make the best effort at omitting any identifying information about the client. C. Disguise the client's identity by changing demographic information. D. Convey minimum amount of information needed to get help.

If a social worker does not disclose the identity of a client, a release from the client is unnecessary. If a social worker practices in a small rural area where the likelihood of anonymity is low, it would be appropriate for the social worker to obtain a release from their client (A). Making an effort to omit identifying information (B) and conveying the minimal amount of information (C) does not sufficiently protect a client's confidentiality. Altering a client's demographic information (C) could prevent social worker from understanding cultural component that could be contributing to lack of progress.

A school social worker is a member of the local school board and believes extracurricular activity policies are discriminatory toward students who come from lower-income families. What should the social worker do FIRST? A. Refer families to lawyers who specialize in discrimination B. Bring concerns to the next school board meeting C. Utilize local media to inform the community of these concerns D. Document instances of discrimination

D. While all of these answer options could take place at some point, the FIRST thing we should do is (D). The best place to start when concerned about discrimination taking place is to document the instances of discrimination that are taking place. This provides the social worker with reference materials they can refer to if and when taking further steps.

After working with a client for three months, a social worker notices that she is having trouble remaining impartial to the client and not letting her own values interfere with the treatment. The social worker's BEST response is to: A. Consult with colleagues. B. Discuss the case with a supervisor. C. Address the value conflict with the client. D. Provide the client with referrals to another social worker.

The BEST response for the social worker is to address the social worker's difficulties with a supervisor and how they may be affecting the work with the client (B). C would be inappropriate. D would interrupt the therapeutic relationship, which may not be necessary without first consulting with a supervisor. A would be incorrect because there is nothing in the stem stating that the colleague has the appropriate feedback or experience in this type of situation.

A new client meets with a social worker. The client has a history of multiple suicide attempts and self-harming behaviors. During the assessment, the social worker asks questions about the client's trauma history. The client discusses an extensive history of abuse by his father, though while he is talking, he often smiles or laughs. This behavior is best defined as: A. Congruence in communication B. Incongruence in communication C. A defense mechanism D. A sign that he isn't ready to deal with his trauma yet

This is a recall question. B is the best answer because the subject matter and the client's affect do not line up or make sense. A would be an appropriate answer if the subject matter and the client's affect/response were in line with one another. C may be true, but B is a better and more precise description of what is happening. D is not indicated.

A social worker in an outpatient clinic is assigned a Korean American client. The social worker has never worked with the Asian population before and discusses the situation with her supervisor. The supervisor encourages the social worker to be sensitive to which emotional process? A. Shame B. Rage C. Depression D. Anxiety

This is a recall question; A is the best answer because it is common to encounter the emotional process of shame when working with Asian clients; this can sometimes prevent or delay clients from seeking help, or may discourage clients from engaging in discussions around emotional content. B, C, and D are not commonly associated with working with Asian clients.

A community agency uses the Beck Depression Inventory to monitor client progress on a weekly basis. The social work team lead is concerned about the amount of time it is taking for staff to score and input this measure. After meeting with her team, the social work team lead determines the time it is taking to score the inventories makes it difficult to complete within their scheduled work week. What is the MOST appropriate solution for this problem? A. Find a measure that takes less time to score B. Hire additional social workers C. Encourage the social worker and client to collaboratively score and review the inventory in session D. Offer overtime to ensure social workers score and input data.

(C) is the MOST appropriate solution as it allows the inventory to continue to be used while actively engaging clients in the process and removing the time outside of sessions the social workers were using to score these measures. Concerns about the measure itself have not been reported, making (A) not our best option. (B) may not be possible. (D) may not be feasible and does not offer a long term solution to the issue.

During a therapy session, a client states that he recently found out his partner is having an extramarital affair. He says he is furious and so angry that he wants to do something to "get back" at his partner. What should the social worker do FIRST? A. Ask questions to clarify the client's statements. B. Remind the client about the limits of confidentiality. C. Notify authorities/partner according to the Tarasoff law. D. Assess the client for history of violent behavior.

A - it helps SW assess potential risk. B might be appropriate if the client's clarification indicated the necessity to warn the authorities and the partner. C is not the best answer because the client's statement does not reach the level of severity or specificity needed for Tarasoff. D might be appropriate but not until after the therapist has identified the level of risk.

A social worker was recently promoted to Director of Prevention Programs at a community mental health agency. The agency was awarded a grant to develop primary prevention strategies for the families they serve. The social worker should focus on all of the following EXCEPT: A. A social skills group for children with ADHD. B. Free informational sessions on immunizations for parents. C. Ongoing skills training for teens on how to build healthy relationships. D. Providing information on infant development to new parents.

A PRIMARY prevention effort involves a social worker creating services that target a problem and prevent the onset of that problem. A is not a primary prevention strategy because the children have already been diagnosed with ADHD and therefore the group is not preventing the disorder, but rather helping these kids who already have ADHD develop social skills.

A psychiatric hospital social worker is working with a man who was committed to the hospital after physically assaulting his wife. The man tells the social worker that he blames his wife for how he feels and says, "I would hurt her again if she was here right now." At the end of the conversation, the man says he didn't mean what he said and asks the social worker to not tell anyone. The social worker should FIRST: A. Inform the treatment team after documenting the threat. B. Call the police to notify them of the threat. C. Address the threat with the client and create a treatment plan. D. Speak with the client's wife to address the threat.

A is correct because the social worker must ethically FIRST document the threat and then notify the treatment team of what the client said during the session. B, C, and D may all be done if deemed necessary once A has been completed.

A social worker is part of a multidisciplinary team at a residential drug and alcohol treatment center. During the initial interview session, clients should be made aware that confidential disclosures are: A. Disclosed to other members of the treatment team. B. Kept solely between the social worker and the client. C. Disclosed only when the client expresses harm to self or others. D. At no point shared with others.

A is correct because when working on a multidisciplinary team, client's should always be made aware that confidential disclosures are disclosed within the team in order to provide continuity of care.

A social worker sees a 75-year old Asian American man whose wife died six months ago. In the intake interview, the client reports that he has lost weight, has very little energy, and has difficulty getting himself to do things. What should the social worker do FIRST: A. Complete a suicide risk assessment of the client B. Explore available family and community resources C. Suggest the client schedule an appointment with his doctor D. Refer the client to a local bereavement group

A is the best answer due to the symptoms of depression the client presents with assessing for suicidality is first. B, C, and D are all things the social worker would do in this scenario but not first.

During a supervision session at a community agency, a social work supervisor makes a sexual advance towards their clinical supervisee. What should the social work supervisee's INITIAL action be?: A. Report this incident to HR at their agency B. Begin working toward obtaining a new supervisor C. Explain to the supervisor that this is not appropriate D. Report the supervisor to their regulatory board

A, B, and D are all possible answer options. The INITIAL (first) action the social worker should take is (A), report this incident to HR. While generally the first step we take when we have an issue with a colleague is to address this directly with them (C), this is a different situation than addressing a behavior of concern with a colleague. First and foremost, a sexual advance was made and the supervisee may not feel comfortable addressing this directly with the person who harassed them. When sexual harassment occurs, the person who was harassed does not have a responsibility to confront their harasser, even if it is another social worker. Reporting this to HR is a good first step. Second, this isn't an issue of addressing a colleague, but is a supervisor-supervisee relationship where there is an inherent power differential.After doing (A), both (B) and (D) may occur.

While working in the hospital, a social worker is approached by the mother of a former patient. The mother states that she lost her son to cancer and is interested in knitting blankets for children in the hospital who have cancer. The mother asks if the social worker can tell her the names of the children who have cancer so she can personalize the blankets with their names. The BEST response for the social worker is to: A. Disclose the names of the children. B. Encourage the mother to speak with an oncology nurse. C. Inform the mother that this information cannot be given out. D. Encourage the mother to speak with the families directly.

A, B, and D are incorrect because sharing any client information would be a breach of confidentiality. C is correct because the social worker should not share any information with the mother.

A social worker receives a call from a 34-year-old woman who has been in treatment for two months. She has just been raped by her ex-boyfriend who broke into her apartment while she was sleeping. He left her alone in her apartment and threatened to come back. What should the social worker's initial focus with her be? A. Instruct her to file a police report and go to the emergency room. B. Help her create a safety plan and file a police report on her behalf. C. Encourage her to file a police report and help her assume responsibility for the rape. D. Suggest that she goes to the emergency room and file a police report on her behalf.

A. An example of a question where you have to choose the best of the worst. Start by eliminating bad answer. Both B and D break the client's confidentiality by filing a police report, thus they are out. Answer C implies that the victim is responsible for the rape, which is wrong. The only answer option left is A. The word "instruct" is rather strong, yet it is the only option that doesn't break confidentiality, and refers the client to emergency room where she should receive medical attention.

A 45-year-old lawyer comes to his session drunk. The social worker's INITIAL response would be to: A. Discuss his decision to drink before the session. B. Determine whether he was driving drunk. C. Reschedule the session and assist him in finding a safe way home. D. Call someone to come pick him up.

C is correct because the client it would be inappropriate for the client to be seen while he is in an intoxicated state. Therefore, the social worker should reschedule the session and help the client find a way home safely.

A social worker has been conducting home visits with a young mother who has a 10-month-old baby. During the most recent visit, the mother reports she is worried that her child is unable to walk yet, explaining that her sister's child started taking her first steps around this age. The social worker observes that the baby is able to pull himself up to a standing position while holding onto a table. The BEST response for the social worker is to: A. Educate the mother on normal child development. B. Encourage the mother to take her baby to see the pediatrician for an evaluation. C. Encourage the mother to join a group for mothers and babies. D. Increase the number of home visits to monitor the child's development.

A. Most children start to take their first steps between 9 and 12 months of age and can walk well by the time they are 13-14 months old. There is a wide range of what is normal when it comes to first steps. The child is able to be in a standing position while holding a table, which shows the child's first steps are probably not far off. Therefore, A is correct because the mother does not appear to be aware of normal child development and it would be important to first educate the mother.

A young woman comes into therapy upset because she was passed over for a job because she expressed interest in starting a family. What should the social worker do NEXT: A. Explore the client's feelings about the potential discrimination. B. Refer her to get some vocational training. C. Validate her anger and refer her to a lawyer. D. Suggest she speak to her employer.

A. Putting things in order, you would want to start with A. It says she is upset - but it isn't clear if it is anger she is feeling or disappointment or sadness. Once you did A, C and D could be done but that would depend on the client's response to A.

A social worker at a family mental health clinic sees a young boy whose parents have noticed recent behavioral changes in him. They report that he no longer hangs out with his friends at school, does not enjoy the same activities he used to, and appears withdrawn. Throughout the interview it becomes apparent that the changes occurred after the parents and child moved into a family friend's house. The social worker should NEXT: A. Explore the recent changes in the home environment. B. Inform the parents that these changes in behavior are developmentally normal. C. Address the possibility of child abuse with the parents. D. Encourage the parents to find a new living arrangement for the child.

A. Since the changes in behavior started to occur once the child moved into the family friend's house, it's most important for the social worker to NEXT have a better understanding of what these recent changes look like and how they may be affecting the child (A). B is incorrect because these behavior changes are not necessarily developmentally appropriate for a young child without further assessment. C is incorrect because the social worker does not have enough information to make the assumption that the child is being abused. D is incorrect because the social worker is not aware of what is causing the child's behavioral changes, and therefore moving him to live with another relative may not be fruitful before determining the cause.

A social worker at a psychiatric hospital has been working with an adult man to prepare him for discharge. In speaking with the client, the social worker learns that the client has a limited family and social network. To help the client successfully discharge and re-enter the community, which social work activity will BEST support the client in this transition? A. Connecting with agencies in the community B. Connecting the client to financial assistance resources C. Encouraging the client to join a support group D. Assisting the client in applying to local housing

A. Since the stem states that the client has limited family connections, it is necessary that the client connect with community agencies as he transitions out of the hospital (A). B, C, and D may be important to do at a later time but only after a connection has been made with other community agencies.

Which of the following treatments would be MOST appropriate for a teenager who experienced childhood sexual abuse?: A. TFCBT B. Psychodynamic Therap C. Motivational Interviewing D. DBT

A. The correct answer is A. This is a recall question. Out of the answer options available, Trauma Focused Cognitive Behavioral Therapy (TFCBT) would be the most appropriate treatment for a teenager who has a trauma history. TFCBT is an evidence-based treatment for children and adolescents used to treat the effects of trauma.

A social worker in a community agency is meeting with a 67-year-old woman who tells the social worker that she has lost interest in her spouse after 40 years of being happily married. The client also reports feeling disconnected from friends and agitated during the day. The woman states that she worked as a nurse for many years but stopped working after a double mastectomy and subsequent chemotherapy, which concluded 2 months ago. The social worker should FIRST: A. Determine when the client's problems first began. B. Refer the client for psychiatric evaluation. C. Obtain a signed release to consult with client's doctor. D. Refer the client to an exercise program.

A. This question is asking what the social worker should do first. The social worker should first take a history of the client's problems (A). The social worker should obtain a signed release to speak with the client's doctor (C) and in the future could refer for psychiatric evaluation (B), but only after taking a history. Referring a client to an exercise program (D) is not clearly indicated in the stem as an appropriate referral and the social worker should consult with the doctor to discuss this type of referral due to client's health issues.

A supervisee is unexpectedly dismissed from her job by her supervisor. The supervisee requests that she wants to contact her client about her dismissal but her supervisor denies her request. The supervisee's BEST action is to: A. Tell the supervisor that the code of ethics states proper termination B. Call state board and report supervisor C. Send letters to clients D. Appeal supervisor's decision to managed care

Answer (A) is the best place to start. If the supervisor refused, the social worker could do (B). (C) is a bad choice because it is going directly against the supervisors wishes. (D) is wrong because there is no indication that managed care is involved nor would they be the ones to address this issue.

Parents seek treatment for their 21-year-old daughter because they are concerned about her binge eating. What is the most accurate source of information when diagnosing eating disorders? A. Family history B. Self reports by client C. Eating inventory D. Behavior observation log

Answer (B) is correct. Self-reports, usually administered in a written questionnaire, have been shown to give the most accurate information regarding eating disorders.

A new middle-aged African American client reports to a social worker that it's been three months since her friend died, but she doesn't feel better and now and it feels like it is getting worse. What is the social worker's BEST action? A. Inform client that bereavement takes two years to get better. B. Explain that bereavement is an ongoing process. C. Tell client that depression can develop during the process of bereavement. D. Refer client for medication evaluation.

Answer (C) is the best answer because it addresses the client's concern. You could then do (D). Answer (A) is inaccurate as bereavement varies from person to person and (B) is too general and doesn't address the client's concern.

A new client comes to session displaying lethargy and describes her situation as "near hopeless." She failed her real estate examination two times. She tells the social worker that no matter what she does, there is no way she can pass that examination. She also says that she's been gaining weight since she's been studying. If the social worker was using Cognitive therapy, which of the following would constitute elements of the treatment plan? A. Forming a collaborative relationship; working on her misperceptions of physical symptoms; using Socratic questioning. B. Forming a collaborative relationship; working with her negative view of the cognitive triad; working on her underlying assumptions that are fueling her automatic thoughts. C. Forming a strong therapeutic relationship; working on her fear of being fat; employing collaborative empiricism. D. Assuming a directive stance; working on themes of loss and defeat; exploring her underlying negative schema.

B is correct because all of the elements listed are aspects of cognitive therapy. Cognitive therapy is a collaborative and goal-oriented therapy that explores patterns of thinking and beliefs that lead to self-destructive behaviors. Once a person understands the relationship between thoughts and behaviors they can begin to modify these patterns and cope with stressors in a more positive manner.

A 42-year-old woman has been in therapy for depression for two years. She has met the mutually agreed-upon goals. She requests ongoing therapy because she does not want her life to go back to the way it was. What course of treatment is most indicated at this point? A. Discuss termination issues and maintain regularly scheduled sessions. B. Discuss termination issues and gradually decrease the frequency of contact. C. Reformulate goals and address anxiety inhibiting client autonomy. D. Reformulate goals and normalize client's fears of independent living.

B is correct because the client has already met the agreed-upon goals. Therefore, issues around termination should be addressed while decreasing the frequency of sessions to slowly help the client adjust to her life without therapy. A is incorrect because the client has already met her treatment goals. C and D are unnecessary; there is no need to create new goals for the client.

Which of the following factors are key to the initial evaluation of an adult client who has no housing and who presents with fatigue and difficulties in sleeping and eating? A. Family relationships and support systems. B. Health status and ability to provide basic care. C. Social isolation and interpersonal functioning. D. Financial status and ability to access resources.

B is correct because the client reports fatigue and difficulties in sleep and eating. Therefore it is most important for the social worker to assess the client's health and ability to provide basic care during an initial evaluation. A, C, and D, are all important and should be evaluated but the client's presenting health problems need to FIRST be assessed.

A new student at a high school is told by a school administrator that she cannot wear her ethnic headdress to school. The student is very upset and is sent to the social worker's office. After processing the situation with the student, what should the social worker do NEXT? A. Contact her parents and inform them of situation. B. Advocate for the client by addressing the issue with the principal. C. Host a diversity training with the administration. D. Suggest that the student transfer to another school.

B is correct because the social worker should advocate for the rights of the client by meeting with the principal who has authority over the school administration. A is incorrect because there is no need to involve the parents yet. C may be necessary at a later date, but should not be done first. D is unnecessary to do.

A social worker has been treating a Native American woman for 3 months. The social worker has noticed that the woman often tells stories in response to questions asked by the social worker. The social worker should respond to this dynamic by: A. Refer to a therapist from the client's cultural group. B. Accept the client's form of communication. C. Confront the client about her avoidance. D. Remind the client about her reasons for seeking treatment.

B is the best answer as it respects the client's style of communicating and meets the client where she is. A is not the best answer because it may be disruptive and it is often difficult to find a therapist who shares an identical "culture" with the client. C is inappropriate since the client is not avoiding answering, but is answering in a different way. D would not be helpful as it disrespects the client's communication style and may hurt therapeutic rapport.

A 20-year-old student presents for therapy to address feelings of anxiety and confusion. He indicates that he is in an intimate relationship with another male student, and his parents are coming to visit this weekend. He states, "I don't know what to do. They will disown me if they find out." What interventions are indicated to treat this client? A. Present a nonjudgmental stance regarding the student's sexual orientation and encourage the student to be open with his parents. B. Assist the student in problem-solving around the immediate concern and work over the longer term to explore issues of sexual identity. C. Normalize the student's internal conflict regarding sexual dysphoria and develop a plan to safely meet with his parents. D. Schedule a family therapy session and allow disclosure of sexual orientation in a safe and supportive environment.

B is the best answer because the client needs immediate assistance in figuring out how to manage his parents' visit, but is also expressing feelings of confusion about his sexuality that should be addressed over future sessions. A is not the best answer because it may not be safe for him to disclose his current relationship to his parents; his fear may be legitimate. C is not the best answer because it doesn't address his internal conflict as strongly as B; normalizing his feelings might be immediately helpful, but does not address the longer-term issue. D is not the best answer, again because the client has stated that he does not feel safe disclosing his relationship, and the social worker should not pressure him into doing this.

A mother and her 8-year-old daughter are referred to a social worker after a school counselor receives several reports that the girl has been bullying classmates. The mother is confused and says that her daughter gets along well with her two siblings and other children in their apartment complex. After completing a social and developmental history from the mother, the social worker should NEXT: A. Schedule an individual session with the girl. B. Have the mother sign a release to talk with the school counselor. C. Schedule a session with the siblings to gather additional information. D. Request the girl's school record.

B is the best answer because this appears to be a school-based issue and the collateral information from the school is necessary for assessment. A and C might both be good steps after the collateral information from the school is obtained. D is not the best answer because reviewing the school records will not provide as much information as contact with the counselor.

A school social worker meets with a sixth grade teacher regarding a student who was recently diagnosed with Type I diabetes. The teacher reports that the student has isolated herself from the other students, has fallen behind, and isn't interested in participating in class like she used to be. The social worker FIRST: A. Meet with the student and explore her feelings about receiving the diagnosis. B. Contact the student's parents to obtain additional information. C. Help the teacher understand the effects of being diagnosed with a long-term illness during this critical stage of identity development. D. Refer the student to a support group.

B is the best answer in this case because the social worker needs to understand more about the student's overall functioning and adjustment to the diagnosis; A and D might be useful, but not until after the social worker contacts the parents for more information. C will likely not affect the student's behaviors.

A social worker uses a standard progress note to document treatment sessions. After a recent session with a client, the social worker realizes that she left out a key piece of information related to the client's plan before the next session. In order to document this additional information, the social worker should: A. Include it at the bottom of the note with the other pieces of planning information B. Make an addendum to the previous note and sign and date it C. Wait until the next session and note it as part of the weekly assessment D. Destroy the original note and create a new note with the updated information

B is the best answer. When a previously existing note needs to be updated/modified, the proper steps to take are to make an addendum to the note, signing and dating it.

A therapist is treating a court-mandated client with a substance abuse problem. The therapist has decided to utilize motivational interviewing for the treatment of the client's substance abuse. Which of the following techniques are NOT considered part of motivational interviewing? A. Open-ended questions B. Confrontation C. Reflective listening D. Summaries

B is the correct answer because motivational interviewing is non-judgmental and non-confrontational. Motivational interviewing tries increase a client's awareness of a problem in a warm and empathic therapeutic setting by using open ended questions (A), reflective listening (C), and summary statements (D).

The director of a social services agency is interested in developing a new social skills program to help children with ADHD. In working with staff, the director splits the appropriate clients into two groups: one group will undergo the experimental social skills group; the other will participate in an evidenced-based social skills protocol. This is best described as: A. Single-subject design B. Quasi-experimental design C. Randomized controlled trial D. Cross-sectional design

B is the correct answer because participants have been knowingly placed in the experimental vs. control group; while the participants themselves may not know which group is which, the researchers do, which makes this quasi-experimental.

A hospital social worker is preparing a discharge plan that includes a referral to a community mental health agency for counseling. The client will MOST likely follow through with the referral if the social worker: A. Clearly states the consequences of not using the referral. B. Outlines the benefits of the agency and how the agency can help the client. C. Ensures that the client understands that following through is optional. D. Informs the client that a staff member at the agency will be waiting to hear from him.

B. A client will generally most likely follow through with a referral if he is aware of how that agency or referral will best help (B). A and D are only trying to persuade the client to use the referral in a manner that doesn't allow the option of the client deciding what is best for him; self-determination is always key! C gives the client the option to not use the referral which is not what the social worker is trying to encourage the client to do.

A social worker was recently assigned as case manager for a family with three children who are in foster care due to neglect by their mother. While developing service plans for the siblings, the social worker should recognize that it is MOST important to: A. Meet with the foster parents' to address their concerns. B. Use a solution-focused intervention to address the individual needs of each child by creating separate treatment goals. C. Develop the same treatment goals for all three siblings. D. Develop treatment goals around the reason that the children were removed from their home.

B. A solutions-focused intervention would be MOST appropriate to use here because it allows each sibling to have separate goals based on their own needs (B). A may be important to do once the service plan has been created, but the foster parents' concerns are not the MOST important part of creating a service plan. C would disregard the individual needs of each child. D is unnecessary to do since some of the children's needs and goals may not be related to why they are in foster care.

A 32-year-old woman with a history of Bipolar II Disorder has been stable on medication for over a year. She arrives at her session with her social worker and is agitated, disheveled, and is speaking rapidly. She reports that she had a terrible cold over the weekend, couldn't sleep, and took an over-the-counter decongestant. The social worker understands her current presentation as: A. The probable result of her discontinuing her psychiatric medication B. A hypomanic episode induced by the over-the-counter medication C. A typical response to the over-the-counter medication D. A probable progression of her Bipolar II to Bipolar I disorder

B. B is the best answer because decongestants often contain pseudoephedrine, which can trigger hypomanic and manic episodes. A is not indicated in the question; C would not the be the case for the general population ; D does not make sense given the information provided.

A 45-year-old man seeks treatment from a social worker in private practice due to ongoing difficulties at work. During the assessment, the client reports that he has trouble getting along with his co-workers, does not have any "real" friends, and has never been in an intimate relationship. When the social worker attempts to explore his family history, the client becomes very quiet, appears distracted, and requests to talk about something else. From a trauma-informed perspective, the social worker should: A. Diagnose the client with Schizoid Personality Disorder B. ​​​​​​​Gently assess for further signs of early childhood abuse and/or neglect C. Avoid asking questions about the family until the client is ready to discuss them D. Refer the client to an adult social-skills group

B. B is the best answer because the client is exhibiting signs and symptoms of potential early childhood trauma. A is not indicated and is not related to trauma-informed care. C and D might be useful interventions, but given the client's presentation, B should come first.

A social worker is leading a support group for parents who lost children due to drug overdose. During the group, the social worker brings up her own experience of losing a child to drugs. This use of self-disclosure allows for the social worker to: A. Establish herself as an effective group leader. B. Illustrate a sense of understanding. C. Illustrate an understanding of the effects of addictions. D. Receive support from group members

B. By self-disclosing the social worker's own loss, she allows the group to learn that she shares an understanding of their experience (B). D would be inappropriate as the social worker is not in a role to receive support from the group. The social worker's personal experience does not necessarily establish her as an effective group leader (A) or show that she understands the effects of additions (C).

A client receives treatment for substance use by a social worker who is a recovering alcoholic. During the course of this client's treatment, the social worker begins to experience cravings to use alcohol and feels increasingly angry toward the client. Which of the following actions should the social worker take? A. Terminate services with the client and provide appropriate referrals. B. Seek immediate consultation with a supervisor for identifying and resolving countertransference issues. C. Return to alcohol treatment program for personal assistance with maintaining sobriety. D. Share feelings with client as way of creating a supportive common ground of experience.

B. Countertransference is defined as a set of unconscious or conscious emotional reactions to a client experienced by the therapist. In this case it is seen through the social worker's cravings and anger towards the client. Therefore, B is correct because the social worker needs to immediately address the countertransference issues by consulting with a supervisor. A is not necessary yet unless the social worker is unable to resolve the countertransference issues. The social worker is only experiencing cravings and has not actually started to use again. While it may be helpful to obtain personal assistance with maintaining sobriety, it is not necessary to return to alcohol treatment at this time (C). D would be inappropriate for the social worker to do.

A social worker is evaluating an 8-year-old child of a different ethnic background whose mother was recently reported to child protective services due to alleged child abuse. When assessing the risk factors, the social worker must FIRST: A. Understand culturally appropriate body language and communication. B. Understand how one's own cultural values and beliefs influence the social worker's ability to deal with issues regarding diversity. C. Understand that the clinical interview is more important than standardized assessments. D. Use a solution-focused model to develop effective treatment goals.

B. In order for a social worker to be culturally competent, he/she must understand how one's own cultural biases influence the manner in which the social worker is able to deal with issues regarding diversity (B).

A hospital social worker is developing an aftercare plan for a 75-year-old client who is confined to a wheelchair after a car accident. The client wishes to relocate to an area with limited support services, despite needing weekly medical attention. She currently lives with her daughter who is unhappy with her decision to relocate. The client has asked for help from the social worker during this transition. The hospital social worker should FIRST: A. Refer the client to agencies in the area where she wishes to relocate. B. Meet with the medical team to gain a better understanding of the client's medical needs. C. Conduct a meeting with the client and her daughter to understand both their concerns. D. Encourage the client's self-determination by creating a discharge plan that would help the client transition to the new location smoothly.

B. It is important for the social worker to facilitate the client's self-determination. In order to do this, the social worker must first determine what the client needs medically to see if relocating is in her best interest (B). A and D would ignore the client's medical needs. C may be important once the client's medical needs have been assessed.

The parents of a 2-year-old meet with a social worker stating that they are frustrated with their son who is constantly refusing to do what they say. The mother states, "All he does is say no, or does the opposite of what I want him to do." The father admits that his wife and him have minimal understanding of child development and what behaviors a 2-year-old should be exhibiting. What should the social worker do FIRST to help serve this family most effectively? A. Provide the parents with a referral to a parenting class. B. Empathize with the parents' frustrations and address ways they can better manage their child's behaviors. C. Encourage the parents to read child development books. D. Complete a comprehensive family history.

B. It's important to empathize with the parents and acknowledge their frustrations FIRST (B). This helps the parents feel like they are being heard and understood. A, C, and D, may be helpful steps to take only after the social worker has acknowledged how the parents are feeling.

A 31-year-old woman is admitted to the hospital following a suicide attempt. During the intake interview, the woman reveals that she was sexually abused by an older cousin when she was 10. The social worker should NEXT: A. Speak with a family member to determine the truth of the abuse. B. Explore the ways in which the abuse contributes to the client's presenting problem. C. Explore the specifics of the abuse with the client. D. Complete a comprehensive sexual history.

B. Since the client is in the hospital following a suicide attempt, the social worker is not providing long term therapy. The social worker needs to address the presenting problem, which in this case is the suicide attempt. B is correct because the social worker doesn't want to disregard the information that is given but rather needs to learn how the sexual abuse is contributing to the client's presenting problem. A would be inappropriate to do. C and D would both be unnecessary since it would be irrelevant to know the specifics of the abuse or the client's sexual history.

A social worker in private practice meets with a 32-year-old man for an intake. The man reports a long history of work issues involving productivity and task completion. He reports having done well in school and says that his relationships are stable. The social worker completes the social history to: A. Facilitate a referral for job training and support. B. Understand factors that affect the client's behavior. C. Identify client's social support system. D. Assess current coping mechanisms.

B. The social worker needs to understand what affects the client's behavior in order to identify issues to be addressed in therapy and gathering a social history would provide the social worker with this information (B). Answers (C) is only one component of a client's social history. Facilitating a referral (A) and understanding coping mechanisms (D) are not included in a client's social history, but rather are included in the assessment and referral phase.

A Hmong couple is referred to the school social worker. Their 6-year-old daughter has been sick recently and the teacher is concerned that the parents are not getting adequate health care. The parents share that they immigrated here five years ago. The social worker knows very little about the Hmong culture. The social worker should FIRST: A. Tell the couple that she knows very little about Hmong people. B. Research Hmong cultural beliefs. C. Explore their cultural beliefs and how it may be impacting the current situation. D. Consult with a social worker who is an expert on the Hmong culture.

C is correct because the social worker should FIRST explore the family's cultural beliefs and the ways in which their beliefs impact their health care decisions. A would be inappropriate. B and D would be important to do only AFTER the social worker has explored the cultural beliefs with the parents.

The parents of a 16-year-old boy make an appointment to meet with a social worker due to ongoing arguments at home. During the initial meeting, the boy reports feeling angry that his parents do not listen to him or value his feelings. His mother agrees, saying that she wishes they were all able to communicate better with one another. In creating a treatment plan, the social worker should write the objective as: A. Communication skills will improve for the majority of wk. B. No more than two arguments will be reported per week. C. Communication skills will improve 75 percent of the time. D. No arguments will be reported by the client during week.

B. When creating objectives, they need to be measurable and achievable. B is correct because it allows the client to work towards a goal that is not all black or white. Arguments are a normal part of adolescence and therefore no more than two arguments per week is obtainable for the client to work towards. The goal is also measurable so the client and social worker can see how well he is working towards that goal each week. A is too broad of a goal and not specific enough to be measured. C is incorrect because there is no way to measure what 75 percent of the time would be. D is incorrect because it is unreasonable goal and only sets the client up for failure.

A Native American man seeks therapy for alcohol abuse. In developing a treatment plan, how should the social worker take into consideration both his culture and his struggle with alcoholism? A. Refer him to an inpatient substance abuse facility. B. Ask how many friends in the Native American community he has. C. Recommend that he enroll in a group for Native Americans dealing with alcoholism. D. Consult his tribe in regard to how to treat this issue.

C is correct because it allows for the client to be in a group with others who understand his culture and his addiction. A is incorrect because nothing in the stems leads us to believe he needs a higher level of care. B is incorrect because it does not necessarily take into account his addiction. D is incorrect because it would be a breach of confidentiality for the social worker to address his tribe.

A 53-year-old military veteran is experiencing a great deal of frustration and anger in his relationship with his 12-year-old son. He complains, "My son doesn't listen to me. I know my wife is turning him against me." How would a solution-focused social worker intervene to assist this client? A. Directly realign the executive subsystems with expectations for change. B. Devise strategies to eliminate symptoms, thereby leading to change. C. Collaboratively design a solution with expectations for change. D. Rewrite the problem for the client, thereby leading to change.

C is correct because solution-focused treatment is a brief, goal-directed therapy where solutions are focused on rather than problems. With that in mind, it would be most appropriate for the social worker and client to collaboratively work together towards a solution.

A social worker has many clients who live in residential group homes in a city. During recent meetings with clients, the social worker notices that the group homes are providing inadequate treatment. What should the social worker do FIRST to try to correct the problem? A. Set up a meeting with families of residents to encourage change. B. Create more appropriate outpatient programs to discourage clients from needing higher levels of care. C. Facilitate the creation of interest groups in which different options can be explored. D. Meet with city officials to discuss the need for evidence-based treatments.

C is the best answer because by creating interest groups, the social worker can pull together like-minded individuals who also want change to occur. A, B, and D are all options that may be done at a later point but only after the creation of interest groups has occurred.

A couple in their early 40's seek help from a social service agency after adopting two children, ages 8 and 12. During the assessment, the parents report the kids are "out of control" and they can't "get them to do anything." When the social worker clarifies what the parents mean, they report that the kids don't get themselves ready for school and haven't been completing homework on time. They go on to report that they themselves go to bed at 10pm, but the children are often still up, which makes it harder for them to get up in the morning. The social worker should: A. Make a report to CPS regarding neglect B. Provide a referral for a parenting skills class C. Assist the parents in identifying ways to establish basic routines with the children. D. ​​​​​​​Meet with the children to obtain information from their perspectives

C is the best answer because it meets the parents where they are and assists them in developing some basic parenting skills that might help the family. A is not indicated in this situation. B and D are both decent interventions and could be done at some point, but would not be done before C.

A therapist is facilitating an anger management group for men who have been court-ordered for treatment due to domestic violence charges. During the initial session, the group members ask the therapist questions about confidentiality and how much information from group will be shared with the court. The therapist should: A. Explain that the court will only be provided with general treatment summaries B. Explain that all information from groups will be shared with the court C. Review the requirements from the court to identify what information will be shared D. Encourage clients to only share information they feel comfortable being passed on to the court

C is the best answer because it will make clear to the clients what information will be shared with the court and what is protected. A and B both may be true, but could differ depending on the specific arrangement between the court and therapist. D does not address the client's questions and may significantly decrease how effective the group could be.

A family meets with a social worker for family therapy due to concerns regarding their 16-year-old daughter. The mother reports that their daughter was recently diagnosed with a medical condition that requires medication monitoring and a strict diet. She says that her daughter has many friends, and does well in school, however has recently been questioning her parent's authority and demanding to make her own choices. The father also reports that their daughter refuses to follow her required diet. This behavior is MOST likely due to? A. Her parents misunderstanding of typical adolescent behavior. B. The client is experimenting with drugs and alcohol. C. The client's need to exert control over a part of her life. D. Noncompliance with medication in combination with irregular diet.

C is the best answer because the stem describes normal adolescent development. A may be true, but is not the reason for the daughter's behavior. B is not the best answer because there is nothing in the stem to indicate substance abuse. D is not the best answer because the stem does not mention noncompliance with meds, and while dietary changes may impact mood, they are not the MOST likely reason for the behavior.

A 72-year-old Mexican-American man has been referred to the social worker by his adult day care facility. The man reports that his wife recently died after a long battle with cancer and that he has been working on an altar in his house to honor her. He reported to his friends that he can't wait to see his wife's ghost and regularly leaves flowers and gifts on the altar for her. The social worker should FIRST: A. Refer the man to his primary care physician for a medical evaluation B. Assess the client for other signs of psychosis C. Explore the client's cultural beliefs around death and dying D. Refer the client to a grief support group

C. C is the best answer because the client's behavior and statements are within cultural norms and the social worker should find out more about his cultural beliefs. A and D may be good interventions at some point, but not before the social worker meets the client where he is and understands more about his beliefs. B is too extreme in this situation. ​​​​​​​

A social worker is assessing a 2-year-old foster child. The social worker notes that the child cries when the caregiver leaves the room and the child is unable to be soothed upon the caregiver's return. What theory is guiding the social worker's assessment? A. Psychodynamic B. Systems C. Behavioral D. Attachment

D is the best answer in this case because evaluating a child's response when the caregiver both leaves and returns is drawn from attachment theory. A, B, and C would be indicated by different evaluation techniques.

A social worker in private practice has worked with children for several years when suddenly she loses a child of her own in a car accident. Ever since the social worker has returned from a leave she finds herself drifting off into her own thoughts and memories when working with kids. The social worker notices that she is constantly staring past the children and daydreaming about her child. Which of the following actions should the social worker take? A. Refer children out of her practice to other clinicians. B. Consult with colleagues regarding countertransference. C. Address grief and loss issues in personal psychotherapy. D. Journal personal process after every session.

C. Ethically, social workers seek appropriate professional assistance for their personal problems or conflicts that impair work performance (C). Consulting with colleagues (B) or journaling (D) do not address the severity of the situation. If the social worker is still unable to work after seeking professional assistance then she would have to refer her clients out (A).

A 54 year old Ukrainian male comes in for treatment complaining of irritability and low levels of energy. He lost his job 2 months ago and has found himself drinking more and more often. He states that he cannot afford paying for therapy out of pocket, however, he can use his wife's insurance that covers him up to 12 sessions. When the social worker looks into the details of coverage, he finds out that the insurance company does not cover treatment for some diagnoses, such as Adjustment Disorder or Substance Abuse, which is precisely the diagnosis given to the client. The social worker should: A. Keep the diagnosis as is and discuss bartering with the client. B. Change the diagnosis to Depression NOS, which is covered by the insurance company and submit billing for reimbursement. C. Keep the diagnosis as is and discuss other payment options with the client. D. Discuss the situation with the client and allow him to make an informed decision as to what diagnosis to submit to the insurance company.

C. It is unethical to change the client's diagnosis based on the demands of the third party payer, thus options B and D are out. Referring the client to a low fee clinic (A) might be what the social worker ends up doing, but only after discussing payment options with the client (C). Referring him out right away could be seen as abandonment.

A 42-year-old woman is in short-term treatment with a social worker for issues in her long-term relationship. In session, the client frequently deflects questions, makes small talk, and focuses on issues in her best friend's marriage. As the social worker becomes aware of this dynamic, the MOST APPROPRIATE intervention would be to: A. explore how the client deals with problems outside of session. B. respect the client's style of relating. C. confront the client with regards to this pattern. D. remain silent and allow the client to bring up the material.

C. Short-term therapy indicates a limited number of sessions to work on issues with the client. Because the client is being avoidant, the best intervention would be to confront the client regarding this pattern (C). Attempting to explore how client deals with problems outside of session (A) would be ineffective based on client's avoidance. Answers (B) and (D) could be appropriate for long-term, but not short-term therapy.

A social worker at a residential treatment center is having trouble focusing at work due to a recent divorce. A co-worker tells the social worker that a few patients have come up to her saying they are frustrated by the social worker's negative demeanor. The social worker should FIRST: A. Meet individually with the patients who are frustrated. B. Decrease her caseload. C. Consult with a supervisor. D. Be more conscious of her demeanor around patients.

C. The Code of Ethics states that social workers should seek consultation with a supervisor when faced with personal problems that are affecting their work in order to protect their clients (C). A, B, and D may be done after the social worker has consulted with a supervisor if it is deemed appropriate.

A social worker is treating a client who recently informed her employer that she was five months pregnant and planning to take maternity leave following the birth of the child. The client soon after received written notice of termination from employment due to "personnel conflicts." The client asks the social worker what she should do. What is the BEST response the social worker should give? A. Request disability insurance. B. Explore alternative employment options. C. Seek legal advice regarding the termination. D. Confront her manager about the termination.

C. The client has presented a legal issue to the social worker, which is outside the social worker's scope of practice. Therefore, the social worker would best serve the client by encouraging her to seek legal advice by someone qualified to provide those services (C). Encouraging the client to request disability insurance (A) or exploring alternative employment options (B) do not address the potential legal issues that arise in this case. Confronting the manager could be detrimental to the client if she is to pursue legal action (D).

An 85-year-old woman has been in the hospital due to ongoing medical problems. The woman lost her husband 5 years ago and has since then been living on her own with the help of family who live nearby. The hospital social worker meets with the physician who states that the client will need to move into an assisted living home. The physician reports that the client will be angry with this plan and therefore asks that the social worker arrange for the move to occur without the client's knowledge. The social worker should tell the physician that: A. Family members should be given the option to have the client live with them. B. The family should be in charge of finding the appropriate placement. C. The client should be a part of the process in deciding what happens next. D. The client should be given the option to select various discharge plans.

C. The physician is completely disregarding the client's right to self-determination which is why C is correct. The social worker needs to state that the client has a right to be a part of her discharge plans.

6-year-old and 4-year-old siblings were placed in foster care after reports of neglect were made by a neighbor. Despite ongoing casework and an extension of services, the single mother of the young kids has made no progress in changing her behaviors. It has been determined by the child services agency that the process to terminate parental rights should begin to take place. The NEXT step the foster care worker should take is to: A. Increase meetings with the mother to encourage a change in behavior. B. Appoint a legal guardian for the children. C. Meet with the children in order to prepare them for changes that will occur as parental rights are terminated. D. Advocate for the mother by encouraging Child Protective Services (CPS) to give her another extension for casework services.

C. The stem makes it clear that the mother has made no progress in improving her behavior despite extensive casework services. With this in mind, it is important for the fostercare worker to prepare the children for the next step, which would be having parental rights terminated due to the lack of parental progress (C). A and D are incorrect because the stem states that extensive efforts have already been made to change the mother's behaviors. B may be done at a later date if deemed necessary but would not be the NEXT step.

A client seeks therapy after the death of her mother. The client shares that her 82 year-old mother was living with her when she died. The client shares that her mother had dementia and would frequently become verbally and physically aggressive to her and her children. She tears up when she reports that she would be so desperate for a break that she'd sometimes lock her mom in her bedroom for an entire day. The social worker should NEXT: A. File an abuse report with Adult Protective Services B. Assess for child abuse C. Acknowledge her feelings of shame D. Refer her to a grief support group

C. This would be reportable if the mother was still alive, but since she isn't the best answer is C. You could also do B and D at some point but you'd want to start where the client is.

A client reports that she recently awoke in the middle of the night to sounds of crying children in the apartment next door. She went to see if everyone was okay and discovered that the parents had left the 8-year-old, 5-year-old, and 2-year-old home alone. The client suspects that the parents are using drugs and expresses a desire to help the kids. The social worker should FIRST: A. Process client's feeling about the situation B. Discuss ways the client could help the kids C. Inform the client that the social worker must file a child abuse report D. Determine if the children are in danger

C. This would trigger a mandated report for neglect so C is the best answer. There is enough for reasonable suspicion so D is not indicated. A and B could be done at some point but a report has been triggered so that needs to be done first.

A social worker in a community clinic meets with a recently retired 63-year-old man and his wife. During the first meeting, the wife reports that she wants her husband to get help because she is concerned about him, due to recent behavior changes, increased irritability, and difficulty focusing. The FIRST step the social worker should take is to: A. Assist the client in structuring his time better. B. Explore the client's feelings regarding retirement. C. Provide the client with a referral for a comprehensive physical exam. D. Assure the client it is normal to experience these symptoms during life transitions such as retirement.

C. When a client presents with recent physical or emotional changes, it is always important for the client to FIRST see a doctor for a physical exam (C). A, B, and D may be appropriate interventions after a medical exam has ruled out any biological causes for the change.

A social worker has recently discovered that a colleague at the same agency has developed a platonic outside relationship with a client's spouse while providing couples therapy for them. The social worker's FIRST action should be to: A. Address the ethical violation with the client's spouse. B. Meet with a supervisor to address the ethical violation. C. Meet with the colleague to address the potential ethical violation. D. File a complaint with the licensing board.

C. When an ethical violation occurs, it is important for the social worker to FIRST speak with the colleague in order to discuss the boundary violation before taking further action. (A), (B), and (D) may be done at a later date once the social worker has spoken with the colleague.

Parents of a 4-year-old boy seek help from a social worker in private practice after finding their son dressing up in his mother's skirts and high heels. The parents report that when they asked their son what he was doing, he said, "going to work, like Mommy!" The social worker should: A. Normalize the parents' concerns B. Explain that these are early signs that their son may be transgender C. Complete a biopsychosocial assessment D. Provide the parents with psychoeducation around typical child development to normalize the child's behavior

D - the child's behavior is well within typical developmental expectations. A is not the best answer because the boy's behavior is not concerning. B is not the best answer because this behavior, in and of itself, does not indicate the child may be transgender. C may be a good intervention and is necessary, but is not as good as D because it doesn't meet parents where they're at.

A 53-year-old female, married for 25 years, self-refers to therapy as she has been losing weight and not sleeping. She states that her husband screams and yells when he gets very angry and has hit her in the past. How should the social worker initially respond to the client's disclosure? A. Assist the client in locating appropriate shelters and contact the police. B. Refer the client to a doctor for a medical evaluation and couple's therapy. C. Assist the client in developing a safety plan and refer to psychiatrist. D. Refer the client to a doctor for a medical evaluation and assist the client in developing a safety plan.

D is correct because any time a client discusses medical symptoms, in this case losing weight and not sleeping, a medical doctor should be referred to for an evaluation. The client also discusses issues regarding domestic violence, thus the social worker should help the client develop a safety plan. A is incorrect because it does not address the medical issues, although it may be appropriate to explore at a later time. B is incorrect because couple's therapy should never occur with a couple where domestic abuse is happening. C is incorrect because a psychiatrist will not be able to address the medical symptoms.

A social worker has been assisting a 75-year-old woman who recently had surgery and is now on bed rest. A neighbor has been helping the client with everyday tasks so that she can remain at home. During the most recent visit, the social worker has become concerned that the neighbor is stealing valuable items from the client and is not providing appropriate care. The client reports that she wants to continue to live at home, but the home health staff is concerned that intervening will damage the relationship with the client. The social worker's FIRST responsibility is to: A. Work with the client to develop an alternative treatment plan. B. Address concerns with the neighbor. C. Encourage the client to confront her neighbor. D. Report the neighbor to Adult Protective Services (APS).

D is correct because it is the social workers ethical duty to report the potential financial abuse to Adult Protective Services before any other actions are taken. A does not directly address the issue of financial abuse which is the most important problem at this time. B and C would be inappropriate for the social worker to do at this time.

A pregnant client is referred to therapy after she tested positive for cocaine. The client states that it was a one-time event and she doesn't have a problem. The social worker is utilizing a stage of change model. During the precontemplation phase of treatment, the social worker would do all of the following EXCEPT: A. Establish rapport and trust. B. Explore events that precipitated treatment. C. Commend the client for entering therapy. D. Explain that the client needs to be open to change for therapy to work.

D is correct because one of the key features of the precontemplation phase of treatment is that the client is not yet ready to admit that they have a problem or need to change their behaviors. A, B, and C are all aspects of the precontemplation phase.

A school social worker is referred a 16-year-old girl for missing class. She has been skipping classes, is often moody and is failing to turn in assignments. During the session, she tells the social worker that she is absent from school because her mom drinks a lot and will forget to pick up her sister from kindergarten. The social worker should FIRST: A. Call the mother and schedule a session. B. Identify if there are other people to help with childcare. C. Refer mother to substance abuse treatment. D. Call Children's Protective Services.

D is correct because the girl is describing behaviors that may be putting the two girls in danger. Therefore, before any other interventions can be done, the social worker must FIRST call child protective services.

A social worker has started to work with a 15-year-old boy who came in feeling confused because he has started to have feelings for other boys at school. The client states that his parents are very religious and would be upset if they found out he was gay. The social worker realizes after meeting with the client for a month that her own values may be interfering with her relationship with the client. The MOST appropriate action for the social worker to take is to: A. Provide the client with referrals to another social worker. B. Meet with the client and his parents in order to address the client's concerns. C. Continue to meet with the client. D. Meet with a supervisor to address the value conflict.

D is correct because the social worker should FIRST address the values conflict with a supervisor before doing any of the other options. A is inappropriate because it creates an interruption in services by referring the client elsewhere and should only be done if the social worker is unable to manage her own values. B is incorrect because while it may be necessary to involve the client's family at some point in the treatment, providing a family therapy session will not resolve the social worker's value conflict. C is incorrect because it ignores the problem by continuing to meet with the client without addressing the value conflict.

A 35 year-old African American woman presents for an initial appointment with a white female social worker. The client has worked at a predominantly male technology company since obtaining her doctoral degree, but is experiencing increasing frustration and anger about how she is treated in the workplace. The social worker says, "I can absolutely imagine how frustrated you are. I'm sure your coworkers aren't intentionally leaving you out, but that's what's happening." The client says angrily, "You absolutely CANNOT imagine my frustration! You have no idea what you're talking about." The social worker should next: A. ​​​​​​​Explain that she was trying to empathize with the client B. ​​​​​​​Offer to make a referral to a Black social worker C. Explore how this behavior relates to her difficulties at work D. Acknowledge the social worker's misstep and the client's real experiences of discrimination

D is the best answer because the social worker has made a mistake in this situation and this may help repair it. A devalues the client's experience and potentially puts the client in the position of having to reassure the social worker. B is not indicated at this time, nor has it been requested. C is not indicated in this exchange.

A hospital social worker is preparing a discharge plan for an 82-year-old woman who fell in her home and broke her hip. The client previously lived at home alone and would like to return home if at all possible. In developing a discharge plan, the social worker should FIRST assess: A. The client's social and familial supports B. The client's commitment to participate in physical therapy C. The client's cognitive functioning D. The client's ability to independently engage in activities of daily living

D. All of the answers here are reasonable things to assess, but the most important thing for the social worker to determine is the client's ability to engage independently in daily self-care. Whether or not the client can reasonably care for herself is the first thing to determine; everything else would go from there.

A social worker meets a client who is in her 8th month of her first pregnancy. The client and social worker have been working for several years around the client's Generalized Anxiety Disorder. During the session, the client discloses that she has continued to take her PRN Xanax even though it may have a harmful impact on her baby. She confirms that her OB-GYN is aware of this and has provided her with the relevant research. The social worker realizes she is feeling judgmental about the client's ongoing medication use. The BEST approach to this situation is: A. express a genuine sense of being perplexed by the client's decision. B. contact the psychiatrist and share concerns. C. have another conversation with the client making sure she is adequately processing the reality of negative side effects. D. manage countertransference by consulting with a colleague.

D. It would be appropriate for the social worker to consult with a colleague to manage countertransference which is noted in the stem and could interfere with treatment (D). The social worker would be imposing his/her own values on the client by expressing a sense of being perplexed (A). It is clear in the stem that the psychiatrist has already discussed the effects of taking xanax during pregnancy (C) and it is not within the social worker's scope of practice to influence medication decisions made by the psychiatrist (B).

A hospice social worker is meeting with two women whose father is dying. The social worker should FIRST: A. Address end-of-life wishes. B. Provide referrals to local agencies that can assist with funeral arrangements and costs. C. Encourage the daughters to express unresolved issues to their father. D. Help the daughters understand what to expect during the grief process.

D. It's important that the social worker provide the two women with psychoeducation regarding the grief process before anything else is done (D). This allows the family to understand what they may be able to expect as they move through the grief process with their father. A, B, and C, may be appropriate at a later time.

A social worker at a community agency has been meeting with a 15-year-old boy for one month. During the most recent session, the boy discloses that he still meets up occasionally with his previous social worker. The social worker should should: A. At the next session, inform the boy that the previous relationship must be terminated. B. Have the client sign a release allowing the social worker to contact the previous social worker. C. Terminate therapeutic relationship. D. Speak directly to the boy about the conflict.

D. Professional ethics dictates that social workers do not generally see a client who is receiving services from another social worker. Answer (D) allows the social worker to address this conflict directly with client. Telling the boy to no longer see the other social worker (A) interferes with client's self-determination; (B) is not the best answer since we don't know whether or not the client can sign his own release forms; (C) could be correct, but only after speaking with client about conflict.

A 20-year-old woman recently started therapy with a social worker due to posttraumatic stress symptoms after being sexually assaulted on her college campus. The mother of the client has contacted the social worker asking for information regarding the client's sessions saying that she " wants to stay in the loop." The social worker's FIRST response to this request would be to: A. Provide the mother with minimal details of the client's treatment. B. Encourage the mother to speak with her daughter directly. C. Set up a family session where the mother is able to directly address her concerns with her daughter. D. Decline to provide information by addressing the confidential nature of the therapeutic relationship with the mother.

D. Since the client is over the age of 18 it would be unethical for the social worker to disclose any information regarding the client. Therefore, the best response would be to decline providing the information and address the confidential nature of the relationship with the mother (D). While incorporating the mother into treatment may be helpful at a later time, it can only be done if the client with the client's permission.

A 25-year-old client has been working with a social worker in a community mental health clinic. The client is often late for appointments and states that she forgets to call in advance to cancel despite being told the attendance policy. When the social worker confronts the client she states, "What's the big deal? It's too hard to be here all the time and you are being unrealistic." The MOST appropriate action for the social worker to make is to: A. Provide the client with a referral to another therapist. B. Reiterate the attendance policy to the client. C. Provide the client with an alternative appointment time. D. Facilitate a conversation about the client's feelings and view of the problem.

D. The MOST appropriate response here is D because it encourages the client to explain how she views the problem. The social worker may think the client understands, however, the client may be viewing from a different angle and therefore A would be unnecessary because it does not address the client's behaviors. B and C don't address the client's reaction to the social worker although they may be important to do after the client's view of the problem has been explored.

A school SW is hired mid-year after several student suicides at the high school. The social worker discovers that the school's Vice Principal has been the point person for evaluating students who express suicidal ideation, despite not having a mental health background or training. The social worker implements a protocol in which only trained mental health professionals formally evaluate students who express suicidal ideation. All of the following are reasons for this change of protocol EXCEPT? A. To create a systematized process for responding to students reporting thoughts of suicide B. To prevent future suicides from occurring C. To ensure staff are operating within their scope of competency D. To empower all staff to evaluate students for suicide risk

D. The social worker has implemented a protocol that ensures only trained mental health professionals will do formal risk evaluations for suicidal students, therefore making D incorrect. What is being described in the question stem is not empowering all staff to evaluate students for suicide risk.

An 8-year-old boy is constantly falling asleep at his desk during school and often arrives to school in dirty clothes. Due to these concerns, the boy's teacher refers him to the school social worker. The social worker should FIRST: A. Have the school nurse evaluate the boy. B. Make a report to Child Protective Services (CPS). C. Refer the child to a community mental health center that specializes in children. D. Set up a meeting with the parents and the child.

D. The social worker should FIRST meet with the parents and child for an assessment and to discuss the problem from their perspective (D). There is no discussion in the stem of a need for the child to see the school nurse (A). B may be done at a later date if it is determined that child abuse may be occurring. C may also be done at a later date but only once the social worker has met with the parents and child.

A social worker at an agency received a written request about a former client to send a summary of client's mental health treatment. What is the BEST response to the request? A. Send all treatment records. B. Send only medication. C. Send only progress. D. Send only selected portion of records.

D. The social worker should send (D), portions of the record, when asked for a summary. You would not send the whole record (A). And only medications or progress notes would be inadequate.

A social worker meets with a 14-year-old client who enters the session in tears. The client says she is afraid for her 15-year-old best friend, who lives in a group home. The client says that her friend recently had a black eye and marks on her wrists that appear to be from straps. When the client asked her friend about these marks, her friend changed the subject, but the client says that her friend has become more withdrawn lately. The social worker working from a psychodynamic perspective should NEXT: A. Contact the group home supervisor to address ethical consideration. B. Role play with the client another conversation she should have with her friend about the possibility of abuse. C. Help the client experience a cathartic moment regarding the situation. D. Validate the client's concerns and make a child abuse report.

D. There are enough signs to reasonably suspect child abuse. Thus, the social worker working from any theoretical perspective should first and foremost make a child abuse report (D).

A 24-year-old seeks therapy on the advice of his new girlfriend. He reports that he is taking neuroleptics prescribed by his psychiatrist. Neuroleptics are most commonly prescribed for which of the following? A. Bipolar B. Psychosis C. Depression D. Memory loss

Neuroleptics are used to treat (B) psychosis.

A 22-year-old man who is diagnosed with Borderline Personality Disorder meets with a social worker. During the initial interview with the social worker, the client states the he feels like he is always in crisis. The social worker feels uncomfortable working with the client since she has no experience in this area. Social work ethics require that the social worker: A. Research effective treatments for borderline personality disorder. B. Consult with a colleague who is skilled in treatment of borderline personality disorder. C. Provide the client with a referral to a therapist who is knowledgeable in this area. D. Assist the client in identifying effective coping mechanisms.

The Code of Ethics states that a social worker should refer clients to other professionals when the other professionals knowledge or expertise is needed to fully serve the client. The social worker in this case does not have the appropriate knowledge to best serve this client and should therefore refer the client to a therapist who is knowledgeable in that area (C).

A 13-year old boy discloses a history of sexual abuse. He informs the social worker that his former social worker touched him during several sessions to demonstrate what is appropriate versus sexually inappropriate touch. What is the social worker's BEST response? A. Maintain confidentiality B. Confront the social worker C. Report child abuse to appropriate authorities D. Report misconduct of social worker to state licensing board

The best answer is C. The information shared by the boy points to sexual abuse, which requires the social worker to make a child abuse report, answer C. Answer A and D are incorrect because they do not address the legal mandate to report abuse. B would be breaking confidentiality of the client.

A 10-year-old boy is placed with a foster family that has different religious beliefs than the child. The foster parents want the foster child to follow their religious practices. What is the social worker's BEST course of action in this situation? A. Tell the family to follow the child's religion. B. Instruct the child to follow the family's religion. C. Tell the child not to practice any religion to avoid conflict. D. Identify alternate placement for the child.

The best option here is D. All the other options go against honoring the diversity of the people. Some people may not pick this because they think that another option would not be available, but if it is an option on the exam then it is available.

A social worker is contacted by the local police department requesting the records of a client who recently committed suicide. What is the BEST response for the social worker? A. Consult with their supervisor B. Turn over a copy of the client's record to the police department C. Not share the record under any circumstances D. Contact the client's legal representative to determine how to proceed with the request.

The correct answer is D. Even if contacted by the police, the social worker is not required to disclose information about a deceased client (B). The NASW Code of Ethics requires that we use the same standards of confidentiality for deceased clients as we do for living clients. It allows us to release information only with the consent of a person legally authorized to consent on behalf of the client. There is no reason to consult with a supervisor since the law is clear and there is no indication the social worker is uncertain how to proceed (A). (C) is incorrect because it is too absolute. There are circumstances in which we can share this information, including when asked to do so by the client's legal representative.

During a session with a client who is diagnosed with anxiety, the social worker notices the client has stereotyped beliefs against various racial groups. These beliefs go against the social worker's personal values. The social worker should: A. Provide the client with referrals to another therapist. B. Address the client's stereotyped beliefs in a nonjudgmental manner. C. Address the presenting problem while respecting the client's beliefs. D. Discuss the conflict in value system with the client.

The social worker needs to focus on the presenting problem (anxiety) and respect the client's beliefs even if she does not agree with them (C). A is incorrect because it is the social worker's job to maintain her own value system and therefore providing the client with outside referrals would create an unnecessary interruption of services. B and D would be inappropriate to do.

Which of the following type of progress notes looks at the subjective report of the client, the objective observations of the therapist, an assessment of the client's diagnosis/presenting condition, and a plan to address the presenting issues? A. Progress notes B. SOAP notes C. Process notes D. DAP note

This is a factual recall question. What is being described in the question stem is a SOAP (Subjective, Objective, Assessment, Plan) note (B). A SOAP note is a type of progress note (A). A progress note is a more general term for notes that are part of the client's written record and offer details about the client's presenting issue/symptoms, diagnosis, assessment, treatment plan, progress toward goals. (B) and (D) are two types of progress notes. Process notes (C) is not a type of progress note. These are personal notes taken by a social worker that are not part of the client's formal record, but are taken to help the social worker best help their client. They include things like hypotheses and notes/questions for reflection and consultation. A DAP note (D) is a type of progress note that stands for data, assessment, and planning

A gay couple seeks therapy for communication and commitment issues. During the initial session, one of the clients asks if the social worker believes in gay marriage. How should the social worker respond? A. Refer them to a gay therapist. B. Explore why the information is important to the client. C. Share views of gay marriage. D. Ask how the couple feels about gay marriage.

When a client asks a personal question like this, it's important to always explore FIRST why the information is important to the client (B).