Pearson ASWB

A social worker meets with a client at an outpatient clinic. While obtaining a psychosocial history, the social worker nots that the client frequently shifts the conversation to completely unrelated topics. The social worker should FIRST: A. perform a mental status exam B. confer with the psychiatrist about medication C. schedule a family therapy session D. refer the client for cognitive testing

"Shifts of conversation to completely unrelated topics"shows loose associations that can be indicative of schizophrenia, manic episodes, or other psychotic disorders. The social worker needs more information that can be obtained through performing a mental status examination (key A). This must be done FIRST. The social worker may do (B), (C), and (D), but first needs more information to determine a diagnosis.

A social worker evaluates a youth arrested for armed robbery who has had repeated drug related offenses. After the court ordered assessment of the youth, the social worker should recommend that the youth be placed in a secure residential facility only if: A. it is not likely that he can be rehabilitated because he is a repeat offender B. family members are unwilling to have the youth live at home C. the safety and welfare of the community are at risk D. this youth needs to have his experience to stop his criminal behavior

A principle of social work is that the client be treated in the least restrictive environment possible, commensurate with ensuring the safety of both the client and the community.

A couple is seeing a social worker for marital problems. During one session, the wife compliments her husband. The husband says, "Its nothing." What should the social worker do FIRST? A. Explore the wife's reason for the compliment B. Assist the husband in accepting the compliment C. Focus on the husband's inability to accept praise D. Suggest a couples communication workshop

All of these options might be possible, but the FIRST step should be to assist the husband in accepting the compliment (key B) because this could be a central issue causing them to seek marital counseling.

A social worker sees a teenager with a diagnosis of anorexia nervosa. The family physician believes hospitalization is necessary. A psychiatrist has diagnosed a comorbid condition of major depressive disorder and recommends intensive outpatient treatment. The client and her parents are confused and frightened. The social worker should FIRST: A. try outpatient therapy with the support of a dietician B. discuss the importance of weight gain with the family C. schedule a case conference with the professionals involved D. help the family choose a treatment option

Anorexia nervosa can be a life threatening condition, which is difficult to treat and often requires hospitalization. The psychiatrist may not be aware of the physician's recommendation, which may be based on the client's medical condition. It is necessary for everyone involved in the client's treatment to be in agreement as to setting and type of treatment (key C).

A social worker meets with a young man who is in his first year of college. He expresses feelings of acute anxiety and distress. He was an outstanding student in high school, maintaining an A average, but his college grades are low. He says that if things do not improve, he does not know what he will do. What should the social worker do FIRST? A. Assess for the risk of suicide B. Offer to see the client with his family C. Suggest relaxation techniques D. Address the client's rigid expectations

Any time a client implies that he may be at risk of harming himself, a suicide risk assessment must be completed first. Therefore, the correct answer is to conduct such an assessment (key A). The use of relaxation techniques (B) and exploration of the client's expectations (D) may be approaches the social worker would use, but not FIRST. There is no reference in the stem to the family bing involved in this situation (B).

A social worker sees a couple after the birth of their first child. They are very stressed by the demands of parenthood. What should the social worker do FIRST? A. Ask the couple what family resources are available B. Refer the couple to a pediatrician C. Determine what is causing the stress D. Refer them to a support group for new parents

At this point, the social worker needs to identify the source of the stress (key C) before exploring options that might help address the stress. Options (A), (B), and (D) may be done, but only after the cause of the stress has been determined.

The court orders a woman to have individual therapy as a condition for her children to be returned. She attends two sessions with the social worker. She misses the next two sessions. What should the social worker do FIRST? A. Report the woman's missed appointments to the court B. Call the woman to reschedule appointments C. Close the woman's case due to noncooperation D. Contact the woman to discuss the consequences of missed appointments

By calling to discuss the consequences of the missed appointments, the social worker can ensure that the client is informed and understands the conditions set by the court (key D)

During the initial interview of a recent victim of domestic violence, the social worker observes a rapid emotional decompensation as the client recalls earlier childhood abuses. She becomes intensely distressed and then withdraws into a trancelike state while seeming to respond to visual and auditory hallucinations. It is MOST likely that the client: A. is relieving past trauma B. is experiencing a psychotic episode C. has repressed memories D. Has multiple-personality disorder

From the information given, it appears likely that the client is reliving a past traumatic event (key A). While (B) appears to be a strong possibility, there is no indication that the social worker has verified that the client is actually experiencing hallucinations. (C) is incorrect because there is no indication of a process that led to discovery of repressed memories. (D) is incorrect because there are no indications of more than one personality.

An emergency room social worker is asked to complete a psychosocial assessment. The patient is confused and unable to provide reliable information about the events leading up to the hospital admission. What should the social worker do NEXT? A. Seek permission from the patient to contact relatives B. Recommend psychological testing for client C. Discuss the case with the social worker's supervisor D. Wait until the client is stable before completing the report

If the client is unable to provide reliable information, the NEXT best source of information could be family or significant friends (key A). Seeking permission to make these contacts would be the appropriate and ethical thing to do.

In sessions with a social worker, a client has established the goals of empowerment and structure in family life. Each week the client mentions concurrent involvement with homeopathic treatment, from which the client derives benefit. The social worker' PRIMARY responsibility in this situation is to: A. discourage the client's use of nontraditional methods B. explain that social work intervention is less effective when combined with other therapies C. ask the client for permission to contact the other therapist for information D. continue working with the client toward the treatment goals

In most cases there is not indication that homeopathic treatment is contraindicated; additionally, the use of nontraditional methods can reflect some progress toward the goal of empowerment. The social worker should continue to work toward the treatment goals (key D) without interfering in the client's pursuit of homeopathic treatment.

A client scores high on the Beck Depression Inventory. After the Social worker has reviewed the results, the social worker should NEXT. A. Discuss the results with the client at the next session B. validate the results by having the client take another instrument measuring depression C. share the results with the client after progress has occured D. share the results with the client after the client has taken the inventory several times.

It is imporktant to share the results with the client as soon as possible (key A). The results of this inventory do not have to be validated (B). It is not therapeutic to wait for progress to be made before sharing these finding (C). There is need to engage in repeated administrations of inventory (D).

When sharing diagnostic information with a client, the social worker should give greatest consideration to: A. identifying behaviors that clarify the diagnostic information B. describing behaviors that clarify the diagnostic information C. protecting the client from any painful information D. assessing the potential legal liability of the social worker

It is important for the client to understand the reasons for the diagnosis, and the behavior that led to it, in order to fully participate in treatment (key B).

A teacher meets with the school social worker regarding an eight-year-old student who has repeatedly come to school with the same injuries, which are blamed on a sibling or on outdoor sports. The student is increasingly withdrawn, depressed, and angry, and is reluctant to get on the school bus after school. What should the social worker do NEXT? A. Refer the child for a medical evaluation B. Explain to the teacher the need to report the suspected abuse C. Contact the parents in inquire about the child's unusual behaviors D. Interview other school personnel involved with the child

It is the responsibility of mandated reporters to notify the appropriate authorities when abuse is suspected (key B). It is the responsibility of the appropriate authorities to investigate whether abuse exists. A medical evaluation may be appropriate, but not as the NEXT step in this scenario.

A couple bring their 15-year-old son who is diagnosed with type 1 diabetes mellitus to see a social worker. Although he is doing well in school, the adolescent has an increasing need to be in control at home and is rebelling against family rules and is required diet. What is the MOST likely reason for this behavior? A. He is using illicit substances in addition to his prescribed medication. B. His parents do not understand normal adolescent behavior. C.His irregular diet is contributing to fluctuating moods and behavior. D. He needs to control whatever parts of his life he can.

Normal adolescent behavior includes efforts to exert greater control over decisions, and in this item these normal behaviors are drawn into sharp focus by the health issues, prompting the son to desire more control over other elements of his life (key D). There is nothing in the stem to suggest substance misuse (A), and while dietary issues may play a part (C), there are not the MOST likely reasons for the general behaviors. The parents' level of understanding of normal adolescent (B) is not in itself a reason for the behavior.

At the recommendation of the school counselor a mother request that a social worker treat he ten-year-old son for persistent fighting in school. The mother states that her son is well disciplined in the home and neighborhood. After obtaining a social history from the mother, the social worker should NEXT: A. obtain a release to talk with the school counselor B. arrange to meet with the boy C. obtain school records on the child's social adjustment D. obtain further information about the son's behavior from the father

Obtaining collateral information from the school setting is necessary in this situation, particularly given the age of the student ( Key A). A meeting with the child (B) may be appropriate, but only after the social worker has obtained collateral information. Simply reviewing records (C) would not provide sufficient insight. Getting more information from the father (D) may be appropriate later, but it is not the NEXT thing the social worker should do.

A social worker meets with a client at an outpatient clinic. While obtaining a psycho-social history, the social worker notes that the client frequently shifts the conversation to completely unrelated topics. The social worker should first: A. perform a mental status exam B. confer with the psychiatrist about medication C. schedule a family therapy session D. refer ther client for cognitive testing

Rational: "Shifts of conversation to completely unrelated topics" shows loose associations that can be indicative of schizophrenia, manic episodes, or other psychotic disorders. The social worker needs more information that can be obtained through performing a mental status examination (Key A). This must be done FIRST. The social worker may do (B), (C), and (D), but first needs more information to determine a diagnosis.

A social worker evaluates a youth arrested for armed robbery who has had repeated drug related offenses. After the court ordered assessment of the youth, the social worker should recommend that the youth be placed in a secure residential facility only if: A. it is not likely that he can be rehabilitated because he is a repeat offender B. Family members are unwilling to have the youth live at home C. the safety and welfare of the community are at risk D. this youth needs to have this experience to stop his criminal behavior.

Rational: A principle of social work is that the client be treated in the least restrictive environment possible, commensurate with ensuring the safety of both the client and the community.

A 19-year old is brought to a family service agency by the parents, who report a history of school truancy, deliberate destruction of their property, lying, and stealing since age 14. According the the DSM-5, which of the following diagnoses BEST describes the client? A. Antisocial personality disorder B. Oppositional defiant disorder C. Conduct disorder D. Intermittent explosive disorder

Rational: According to the DSM, deliberate destruction of another's property, lying, stealing, and symptoms of conduct disorder before the age of 16 years meet the criteria for conduct disorder, adolescent onset type, as an adult (key C). The irresponsibility and aggressiveness toward others necessary for diagnosis of oppositional defiant disorder (B)-normally a childhood diagnosis-are not mentioned in the stem, nor are the impulsive aggressive behaviors necessary for a diagnosis of intermittent explosive disorder (D).

A social worker sends a client to a colleague for a second opinion. The client has been in treatment for past three months and has a diagnosis of major depressive disorder, recurrent episode. The client believes the therapy is not working because of continuing episodes of depression. The client says that the treating social worker has suggested psychotropic medication. The client refuses to consider the medication. The colleague should NEXT. A. conduct a literature search on the value of psychotherpay for depression. B. discuss information given by the client with the treating social worker C. suggest the client see a psychiatrist for a medication evaluation D. explore with the client her resistance to taking medication.

Rational: After three months in treatment without improvement, refusal by the client to consider medication represents resistance (key D). This issue needs to be explored with the client before any other options are considered.

A social worker in private practice is temporarily moving to another city. Following consideration of he risks and benefits that may be experienced by each client, the social worker offers to continue the therapeutic relationship with several clients through email. This suggestion is MOST appropriate for clients who A. have completed their treatment B. would be harmed by early termination C. are able to cope with day-to-day issues D. are dealing with ongoing crises

Rational: The less immediate contact associated with email is more appropriate for higher functioning clients--in this item, those who are able to cope with "day-to-day issues" (key C). Crisis clients (D) require more direct contact, and clients who would be harmed by early termination are not necessarily the MOST appropriate group for this approach. There would be no reason to offer a therapeutic email relationship with clients who have completed treatment (A).

A young man with a developmental disability moves into a group home upon becoming a legal adult. His parents inform the group home staff that they want nothing to do with him. What should the group home social worker do FIRST? A. Develop a treatment plan with the young man B. Meet with the parents to discuss their decision C. Develop a reconciliation plan for the parents and the young man D. Locate other community supports for the young man

Rational: Until the social worker understands why the parents have made the decision they have (key B), the social worker cannot effectively do options (A) (C), or (D).

In the evaluation process for a client's sexual dysfunction, the FIRST consideration is to: A. gain an understanding of the client's past sexual functioning B. rule out any medical basis for the dysfunction C. meet conjointly with the sexual partner to evaluate sexual communication D. evaluate the client's history for sexual trauma

Rationale. All of these options should be done at some point during the evaluation process; however, anytime there is a physical symptom, a medical cause must be ruled out first. (b)

During an initial interview a social worker asks a question. The client blushes and becomes silent. What should the social worker do NEXT? A. Ask the question again in a slightly different form B. Remain silent for a few seconds C. Delay discussion of the topic at hand D. Identify the emotions the client may be experiencing

Rationale. Silence allows clients to formulate their thoughts and deal with emotions (key B).

A client in short-term therapy with a social worker expresses general dissatisfaction with life. During the first few sessions, the client skirts answers to questions, avoids issues, and changes the subject often. Upon observing these behaviors, the social worker should: A. employ ego-supportive techniques B. respect the client's pace C. confront the client with the resistance D. review the social history

Rationale: "Short-term therapy" means there is limited time to work on issues. While the social worker would not confront the client's resistance during the first or second session because of the importance of developing a therapeutic relationship, it would be appropriate to attempt to address important issues after the first few sessions (key C).

A client in short-term therapy with a social worker expresses general dissatisfaction with life. During the first few sessions, the client skirts answers to questions avoids issues and change the subject often. Upon observing these behaviors, the social worker should: A. employ ego-supportive techniques B. respect the client's pace C confront the client with the resistance D. review the social history

Rationale: "Short-term-therapy" means there is limited time to work on issues. While the social worker would not confront the client's resistance during the first or second session because of the importance of developing a therapeutic relationship it would be appropriate to attempt to address important issues after the first few sessions (key C).

A social worker sees a 75-year old 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

Rationale: After six months the client should be further along in grief process, and his reports describe depression and risk that warrant a risk assessment (Key A). Options (B), (C), and (D) are all plausible but not the FIRST action the social worker should take.

A client contacts a soicla worker for help with his anger over his partner's extramarital affair. During the initial session, the client states he "will do whatever it takes" to get even with his partner. What should the social worker do FIRST? A. Notify the partner of the verbal threat B. Explain the limits of confidentiality C. Obtain a history of previous violent behaviors D. Seek further clarification of the statements

Rationale: It is important to clarify what the client means by "get even" before deciding on next steps (key D). If the client means divorcing and getting as much

A social worker sees a 75-year-old 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

Rationale: After six months the client should be further along in grief process. and his reports describe depression and risk that warrant a risk assessment (key A). Option (B), (C), and (D) are all plausible but not the FIRST action the social worker should take.

A social worker leads a group of pregnant adolescents with the purpose of developing the members' coping skills and decision-making capabilities. The group has met weekly for three months with minimal gains. To facilitate growth in independence, the social worker should FIRST. A. give the group members control over as many decisions as possible B. encourage the members to make decisions within agency guidelines C. educate the members regarding assertiveness techniques D. assign clear roles to each of the group members

Rationale: An effective approach to support growth is to allow the group to assume control of their group and make as many decisions regarding the direction and goals for the group as possible (key A). Experience making decisions can support skill development. Accomplishing goals can lead to an increased sense of competency that can in turn lead to confidence and independence.

A social worker meets with a young man who is in his first year of college. He expresses feelings of acute anxiety and distress. He was an outstanding student in high school, maintaining an A average, but his college grades are low. He says that if things do not improve, he does not know what he will do. What should the social worker do FIRST? A. Assess for the risk of suicide B. Offer to see the client with his family C. Suggest relaxation techniques D. Address the client's rigid expectations

Rationale: Any time a client implies that he may be at risk of harming himself, a suicidal risk assessment must be completed first. Therefore, the correct answer is to conduct such an assessment (Key A). The use of relaxation techniques (B) and exploration of the client's expectations (D) may be approaches the social worker would use, but not FIRST. There is no reference in the stem to the family being involved in this situation (B).

A 45-year old gay man sees a social worker because of a long history of depression. He states that "in most areas of my life things are fine, but I have never had an emotional relationship that felt intimate." He also reports being distanced from the gay community because he's not political and "after all, it is no different from being straight, except that I have sex with guys". The social worker should FIRST: A. conduct a comprehensive assessment B. explore the client's disconnection form the gay community C. refer the client for a medication evaluation D suggest the client consider joining a gay men's group

Rationale: Assessment (key A) is the FIRST step in this situation, before any kinds of explorations, referrals, or suggestions would be made.

A social worker sees a couple after the birth of their first child. They are very stressed by the demands of parenthood. What should the social worker do FIRST? A. Ask the couple what family resources are available B. Refer the couple to a pediatrician C. Determine what is causing the stress D. Refer them to a support group for new parents

Rationale: At this point, the social worker needs to identify the source of the stress (key C) before exploring options that might help address the stress. Options (A), (B), and (D) may be done, but only after the cause of the stress has been determined.

A social worker is working with a woman who was recently diagnosed with HIV. The client abruptly stopped her medication. Her doctor asked that the social worker address the issue of medication noncompliance with the client. The client tells the social worker that she stopped the medication at the time her partner died of AIDS. The MOST likely explanation for the client's behavior is that she is: A. dealing with bereavement B. implementing a suicidal plan C. exhibiting symptoms of depression D. accepting her mortality

Rationale: Bereavement (key A) is correct because the client initiated an action immediately after the loss of a loved one. There is not enough information to suggest that this is a suicidal plan (B), or a symptom of depression (C), or the acceptance of her mortality (D). Since this happened immediately after a death, the MOST likely explanation is bereavement.

A social worker sees a family for therapy. During one session, the youngest family member tells the social worker. "I need to share something with you." Another family member responds by saying "Don't talk about it.." The social worker makes several unsuccessfull attempts to assist family members in more open discussion. To increase open communication, what should the social worker do NEXT? A. Clarify the initial symptoms presented by the family B. Talk with the youngest family member individually C. Use circular questioning with all family members D. Take a one-down position with the family

Rationale: Circular questioning (key C) is a technique that can be used to explore differences between the family members, which is the social worker's NEXT task in this situation. There is no need to revisit the family's initial symptoms (A), while taking a one-down position witthe family (D) does not address the issue and could in fact make things worse. Talking individually with the youngest member (B) could put that member at risk.

A social worker is abusing alcohol. The primary rationale for taking action to remove this colleague from direct service is to: A. ensure quality service for clients B. decrease the liability of the agency C. motivate the colleague to get help D. comply with professional standards

Rationale: Client protection must be the first priority in the provision of social work service (key A).

A social worker sees a new client for severe anxiety and panic attacks. The client is a recent immigrant from Asia and has difficulty understanding and speaking English. What should the social worker do FIRST? A. Arrange for a qualified interpreter for the session B. Determine the client's specific language C.Demonstrate nonverbal relaxation techniques D. Conduct a full psychosocial assessment

Rationale: Determining the client's specific language (B) is crucial in determining next steps, whether those involve arranging for an interpreter or a referral.

What is MOST important to remember about defense mechanisms? A. Defense mechanisms reduce anxiety B. Defense mechanisms relieve conflict C. Defense mechanisms are an unconscious process. D. Defense mechanisms are interpersonal response

Rationale: This is an unscored question. By definition, a defense mechanism is not a conscious behavior or thought. However, its use allows the client to avoid addressing an issue that the client finds too painful to deal with directly.

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 NEXT? A. Confront the client about evasive responses B. Discuss the physical consequences of alcohol abuse C. Ask how the client feels about seeking help D. Obtain more detailed information by indirect questions

Rationale: During the initial assessment it is too soon to confront (A) the client. The social worker is avoiding the question (B) and (D) by addressing another issue. By asking a direct question about the client's feelings, the social worker refocuses the discussion and redirect the client back to why help is being sought (key C).

A social worker is the new manager of a human service organization that is simultaneously struggling with maintaining positive employee morale, increasing client services, and improving outcomes. The manager should FIRST. A. ensure that employees know the importance of client outcomes. B. institute a flextime policy for employees C. introduce more efficient data collection techniques D. initiate a staff recognition program

Rationale: Employees, including social workers, need recognition for their work (key D). If employees do not feel appreciated by their supervisors, their work tends to be less than optimal. By recognizing those staff members whose performance is above expectations, other employees will be encouraged to improve their performance.

A social worker assesses an adolescent who feels worthless and who recently began failing in school. For the past two months, she has had difficulty sleeping and maintaining concentration in school. Her teachers describe her as inattentive, irritable, and agitated. What should the social worker do FIRST? A. Evaluate the client for depression B. Ask the teachers to complete a behavior checklist C. Refer the client for a substance abuse evaluation D. Schedule an assessment for special education services

Rationale: Feelings of worthlessness, difficulty sleeping, and irritability can all be symptoms of depression and warrant an evaluation (key A).

A 25-year old woman seeks help at a local mental health clinic. She complains of nightmafes, agitation, an inability to concentrate, and weight loss. During the assessment phase, the social worker learns that the client had been recently raped and mugged. The social worker should FIRST focus on: A. the details of the rape B. the nature of nightmares C. potential for self harm D. medication for depression

Rationale: Given the level of trauma experienced and the severity of symptoms being expressed, an evaluation of risk of self harm must be the social worker's priority (key C). All other areas may be acceptable to focus on later, but not FIRST.

An emergency room social worker is asked to complete a psychosocial assessment. The patient is confused and unable to provide reliable information about the events leading up to the hospital admission. What should the social worker do NEXT? A. Seek permission from the patient to contact relatives B. Recommend psychological testing for the client C. Discuss the case with the social worker's supervisor D. Wait until the client is stable before completing the report

Rationale: If the client is unable to provide reliable information, the NEXT best source of information could be family or significant friends (key A). Seeking permission to make these contacts would be the appropriate and ethical thing to do.

A social worker is seeing a client who sometimes cancels appointments at the last minute, does not show at all for some appointments, and always pays fees late. The client describes frequent fights with friends but doesn't understand why this keeps happening. What should the social worker do FIRST? A. Point out the client's disrespectful behavior with the social worker B Talk about the secondary gain from the client's behavior C. Explain that continuing the behavior will result in termination D. Relate the client's behavior with the social worker to that with friends

Rationale: Information provided in the stem indicates that the client is unaware of the impact of this behavior on relationships. Relating the client's behavior with the social worker to behaviors with fiends (key D) is the only option that addresses this lack of awareness.

An elderly widower is brought for an evaluation to a geriatric clinic by his adult daughters, but of whom live a half hour away from where he still resides in the family home. The daughters are concerned that there is "no one to look after Dad." They believe he is having some difficulty with walking and memory. The neurological and mental status exams reveal no dementia. The man is ambulatory although a cane is recommended. The daughters want to place him in an assisted living facility but the father is adamantly A. offer an in-home evaluation, with the assurance to keep in touch with the daughters if he consents B. offer to arrange a tour of several facilities for them to consider C. request a follow-up appointment at the clinic with the father D. discuss with the daughters the possibility of applying for legal guardianship of their father

Rationale: It has already been determined that there is no dementia, therefore the provision of an in-home evaluation (key A) is the approach that recognizes the client's right to self-determination.

A social worker meets with a 35-year-old Japanese American man who is anxious because his wife is pressuring him to move his mother into a nursing home. He prefers that she live with them. The social worker asks the man if he has any siblings and what his birth order is. This information is important to understand of the man's. A. cultural perspective B. support system C. financial options D. family dynamics

Rationale: It is always important for a social worker to understand the cultural context of client situations, and views on siblings and birth order can reveal much about the impact of culture on a client from the broadest perspective (key A). Information on birth order and siblings is less likely to provide an understanding of support system (B), financial options (C), or family dynamics (D).

When sharing diagnostic information with a client the social worker should give greatest consideration to: A. identifying the diagnostic category into which the client falls B. describing behaviors that clarify the diagnostic information C. Protect the client from any diagnostic information D. assessing the potential legal liability of the social worker

Rationale: It is important for the client to understand the reasons for the diagnosis, and the behaviors that led to it, in order to fully participate in treatment (key B).

A social worker meets with the parent of a child with severe physical disabilities. The child's disabilities impact the family in all areas of daily life. Although the family receives support from several professionals, there are gaps in service. What should the social worker do FIRST? A. Explore available community resources B. Arrange an interdisciplinary meeting C. Help the parent prioritize needs D. Schedule an extended family meeting

Rationale: It is important to determine what issues are most important or pressing for the client and to help the client determine an order of importance (key C) before proceeding. Options (A), (B), and (D) are plausible actions to take but only after needs have been prioritized.

A social worker is conducting an insight oriented psychotherapy group. Although all parties have been briefed on confidentiality, during the group session, one individual admits discussing the group with friends and family. The BEST way for the social worker to handle this situation is to: A. encourage group members to confront the individual regarding this breach B. see the client outside of the group setting to explain the inappropriateness of this behavior C. have other group members vote on whether this client can stay in the group D. have group members discuss this situation and reach a mutually satisfactory resolution

Rationale: Normalizing (key B) is correct because it serves to relieve some of the stress between parent and child. (A), (C), and (D) should all be done, but not until the teenager's feelings have been normalized.

A social worker is asked to treat a child who was sexually abused by an older sibling. The social worker learns that the victim and the perpetrator are living in the same house with the permission of social services. What should the social worker do FIRST? A. Develop a safety plan for the victim B. Schedule a joint session with the victim and the perpetrator C. Contract with the victim to report any further abuse D. Insist that the offender attend outpatient sex offender treatment.

Rationale: Obtaining collateral information from the school setting is necessary in this situation, particularly given the age of the student (key A). A meeting with the child (B) may be appropriate, but only after the social worker has obtained collateral information. Simply reviewing records (C) would not provide sufficient insight. Getting more information from the father (D) may be appropriate later, but it is not the NEXT thing the social worker should do.

A social worker is seeing a client with a diagnosis of generalized anxiety disorder. In discussing the treatment plan, the social worker suggests certain goals and interventions. The client quickly agrees, stating, "I'll try anything." The client has a history of multiple treatment failures. In developing a realistic treatment plan, the social worker should FIRST. A encourage the client to develop treatment goals B. explore effective treatment protocols for generalized anxiety disorder C. identify obstacles that hindered earlier treatment efforts D. disuss the client's understanding of the treatment process

Rationale: Past barriers to reaching treatment goals must be identified FIRST so that the social worker and client can be successful moving ahead (key C). All other options listed may be appropriate actions to take, but not as a FIRST step.

The parents of a 13-year old boy consult with an employee assistance program social worker regarding the adolescent's mark change in behavior since entering junior high school. During the past year his grades have dropped dramatically and he has been arrested for shoplifting has started several small fires while smoking, and insists on having long hair and baggy clothes The parents adopted him when he was nine months old, after he had been in two foster homes. Before this last year his behavior and development had progressed normally. The social worker should: A. refer the family for assessment and treatment B. see the adolescent and his family for brief therapy C. assure the parents this is a normal adolescent phase D. suggest he parents place the adolescent in a more structured school

Rationale: Several of the adolescent's behaviors described in the stem are extreme, so further assessment (and appropriate treatment) are indicated (key A). The behaviors described in the stem do not reflect normal adolescent behaviors (C). Moving the adolescent to a more structured school (D) may be too disruptive and should not be considered until after further assessment. Similarly, the appropriateness of brief therapy (B) could only be considered after an assessment is conducted.

A parent in great distress consults a social worker, because of having heard so much in the media about sexual abuse, the parent is unsure how to respond to recently finding her five-year-old exploring the body of another child. The parent does not know whether this is deviant behavior. This social worker should: A. reassure the parent that this is normal for children this age B. advise the parent to call the appropriate authorities C. discuss the parent's feelings about sexuality D. suggest that the parent call the other child's parent

Rationale: Sexual curiosity is a normal developmental process for children (key A), but many parents become anxious about this behavior. The social worker should reassure the parents that this is normal. Getting other authorities involved (B) and contacting the other child's parent (D) would be overreactions. It is important to discuss the parents' feelings about sexuality (C) in order for them to accept their child's behavior, but this should be done only after they have been reassured about the behavior.

During an initial interview, a social worker asks a client a question. The client blushes and becomes silent. What should the social worker do NEXT? A. Ask the question again in a slightly differently form B. Remain silent for a few seconds C. Delay discussion of the topic at hand D. Identify the emotions the client may be experiencing

Rationale: Silence allows clients to formulate their thoughts and deal with emotions (key B).

In an initial marital therapy session, a husband claims his wife has poor housekeeping skills, nags him constantly and is not interested in having sex with him. The wife claims her husband always comes home late from work, controls the household money and is not interested in sex because he spends most evenings drinking. Which of the following issues should the social worker address FIRST? A. Anger and depression B. Sexual conflict C. Substance abuse D. Control and manipulation

Rationale: Substance abuse must be addressed as an underlying issue before dealing with other dynamics of the marriage (key C).

A social worker sees a client who was referred after a conviction for embezzlement. The client has an extensive history of gambling but denies that it is a problem for him or his family. What type of therapy would be MOST effective in treating this client's gambling addiction? A. Individual B. Family C. Group D. Couples

Rationale: This is an unscored question. Group therapy is the preferred method of treatment for all addictive behaviors, since the group process breaks down the individual client's denial and rationalizations.

A social worker meets with a couple struggling to provide adequate housing, food, and health care for their family. The social worker should FIRST: A. refer for employment counseling B. offer family preservation services C. provide information about financial services D. link their specific needs to service options

Rationale: The FIRSt task of the social worker is to identify and prioritize the client's needs and then to link them with services to meet those needs (key D). When the immediate needs have been met, the social worker can begin to help the client develop those skills necessary to provide for their own needs.

After six months of treatment for post-divorce adjustment issues, a client abruptly stops coming to see the social worker. The social worker should NEXT. A. call the client to ask the reasons for the abrupt stop B. respect the client's right to self-determination C. send the client a flyer advertising a group for divorced people. D. send a letter suggesting a termination session

Rationale: The abrupt way in which the client stops treatment warrants further inquiry by the social worker (key A). Respecting self-determination (B) may be an appropriate action, but only after more information is gathered. Sending out information (C) or a letter (D) are indirect approaches.

A social worker admits to an intimate relationship with one of his clients whom he has treated for over two years. The social worker is the subject of a regulatory board investigation. He tells the investigator that he truly loves the client and would like to marry her. When interviewed, the client reports that she initiated the sexual contact with the social worker. The social worker terminated therapy with the client when she moved in with him. The social worker's actions are: A. a violation of boundaries B. not an ethical breach because no harm was caused to the client C. acceptable because the therapeutic relationship was terminated D. illegal in all jurisdictions

Rationale: The actions described in this item amount to a violation of boundaries based on professional ethical codes (key A). Defining actions as boundary violations does not depend on whether harm occurred (B) or whether therapy was terminated (C). The behavior may not rise to the level of criminal behavior in all jurisdictions (D).

During a family therapy session with a social worker, the parents of a 16-year-old girl reveal that they have been reading her email and have become aware of her sexual activity The social worker should FIRST. A discuss the parent's reasons for reading B. advise the parents that they were wrong to invade their child's privacy C. encourage the adolescent to respond to this disclosure D. schedule and individual session with the adolescent

Rationale: The adolecent's privacy has been violated. She should be provided with an opportunity to talk about how this has impacted her (key C).

A social worker is interviewing a client who feels depressed, overwhelmed, and hopeless about the future. The BEST way for the social worker to empower the client and create a sense of hope is to: A. collaborate with the client t negotiate goals for behavior change B. assist the client with identifying maladaptive thinking patterns C. respect the client's circumstances and view of self D. ask questions to identify client strengths and successes

Rationale: The best thing to do FIRST is to identify the client's strengths (key D). Collaborating on goals (A) and identifying maladaptive thinking patterns (B) might help the client move toward strengths, but these are not appropriate actions to take FIRST. Respecting the client's view

A social worker on a multidisciplinary team works with a young adult who is hospitalized following a suicide attempt. The client complains bitterly about the number of staff who know the details of her hospitalization She says that she is tired of answering the same questions from different people. She reports having had a temper outburst because of all the questions. After acknowledging the client's feelings what should the social worker do NEXT. A. Explore how the client thinks the social worker can help with the situation B. Discuss with the client the specific roles of the people working with her C. Reassure the client that the staff can deal with her anger D. Tell the client that her feelings will be discussed at the next staff meeting

Rationale: The client is expressing frustration over the loss of control over the circumstances around her hospitalization. Exploring the client's thoughts about how the social worker can help (key A) provides the client with a sense of control.

A retired person requests counseling because of "boredom and feeling worthless." As a successful middle manager, the client looked forward to retirement and to spending time with family and friends. However, the client now spends time sleeping and watching television rather than enjoying long anticipated pastimes. The social worker should FIRST inquire about. A. civic clubs or organizations that might indicate depression B. other symptoms that might indicate depression C. effects of losing social validation and opportunities to be productive. D. dysfunctional changes in family role expectations or communication patterns.

Rationale: The client is indicating some symptoms of depression, and the social worker should delve into this issue (key B). Additional investigation of depressive symptoms should be done FIRST. Options (A), (C), and (D) should be considered, but only after a possible diagnosis of depression has been ruled out..

A 49-year old woman seeks therapy, citing problems with her 74-year-old mother. She reports that her mother moved to a retirement community seven years ago after the death of the client's father. The mother has adjusted well and made many new friends. Six months ago, the client's mother began dating a man and they have decided to live together . Since this decision, the client and her mother argue each time they see each other. The client states that her mother " is not thinking clearly and is betraying my father." The client is very upset to think of her mother being sexually active. The Social worker should FIRST. A. focus on the client's feelings about her mother's changes in behavior B. recommend the client's mother have a psychological evaluation C. discuss other possible living arrangements for the client's mother D. explore the client's feelings about her deceased father

Rationale: The daughter is having trouble adjusting to what appear to be normal life events for the mother, and she needs to explore her feelings around her mother's behaviors (key A). A discussion of the deceased father (D) ignores the current issue and presenting problems. Discussing other living arrangements for the mother (C) puts the social worker in a role of colluding with the daughter. There is nothing in the stem to indicate the need for a psychological evaluation of the mother (B).

An elderly woman has been hospitalized for treatment of a stroke. The physician recommends placement in a rehabilitation facility and refers the woman and her caregiver daughter to the social worker. The daughter wants her mother to come home since she would like to continue caring for her, but she is concerned about being able to provide necessary care. The social worker should FIRST. A. reassure the daughter that the facility can provide better care B. confer with the mother and family members regarding placement C. refer the daughter to her mother's physician to discuss the placement D. suggest the daughter take a tour of the rehabilitation facility

Rationale: The daughter's preference for the mother's care affects the entire family, and the social worker should FIRST discuss all options with the daughter, mother, and other family members (key B). Pressing the daughter to agree to facility placement (A) amounts to the social worker imposing his/her own agenda on the daughter. Sending the family back to the physician (C) is not helpful and avoids addressing the issue. A tour of the facility (D) may be appropriate, but only after a discussion about the preferences and options has taken place.

A social worker in private temporarily moving to another city. Following consideration of the risks and benefits that may be experienced by each client, the social worker offers to continue the therapeutic relationship with several clients through e-mail. This suggestion is MOST appropriate to clients who: A. Have completed their treatment B. would be harmed by early termination C. are able to cope with day-to-day issues D. are dealing with ongoing crises

Rationale: The less immediate contact associated with email is more appropriate for higher functioning clients--in this item, those who are able to cope with "day-to-day" (key C). Crisis clients (D) require more direct contact, and clients who would be harmed by early termination are not necessarily the MOST appropriate group for this approach. There would be no reason to offer a therapeutic email relationship with clients who have completed treatment (A).

The social work supervisor is assigned a new supervisee. During the initial supervisory sessions the Supervisor discusses the purpose of supervision, the role of the supervisor, and the expectations for the supervisee The Supervisee is asked to describe past practice experience, perceived strengths and weaknesses, and goals for superviison The supervisor and supervisee jointly formulate goals for the supervision. The purpose of this process is to:. A. establish learning objectives B. determine boundaries C. establish outcomes measure D. establish trust

Rationale: The main purpose of early supervision is to establish learning objectives (key A).

An adult client with an intellectual disability confides to her social worker that the receptionist at the community center often treats her like a child. To help the client deal with this, the social worker should: A. document the instances of inappropriate behavior B. discuss the situation with the client C. role play appropriate responses with the client D. file a discrimination complaint against the receptionist

Rationale: The situation described in the stem provides the social worker with an opportunity to help the client develop important social skills. Helping the client develop skills to deal with difficult situations through role play (key C) will help improve overall functioning.

A client comes to a social worker complaining of persistent and intrusive thoughts. The client asks for help to better manage his thinking. What should the social worker do FIRST? A. Refer the client to a psychiatrist for possible medication B. Ask the client to describe the content of his thoughts C. Teach the client thought-stopping and thought replacement D. Ask whether there are time when he does not experience the problem

Rationale: The social worker can proceed only after FIRST obtaining an understanding of the content of the intrusive thoughts (key B).

A client comes to a social worker complaining of persistent and intrusive thoughts. The client asks for help to better manage his thinking. What should the social worker do FIRST? A. ask the client to describe the content of his thoughts B. Teach the client thought-stopping and thought replacement C. Teach the client thought-stopping and replacement D. Ask whether there are times when he does not experience the problem

Rationale: The social worker can proceed only after FIRST obtaining an understanding of the content of the intrusive thoughts (key B).

A second grade teacher consults the school social worker about a student who has had chemotherapy and lost all hair. The student seems sad, is doing poorly in schoolwork, and is not participating in activities. The social worker should FIRST. A contact the parents to gain more information B. help the teacher understand the effects of chemotherapy on mood and energy C. refer the child to a children's cancer support group D. explore the student's feelings about what it means to have cancer

Rationale: The social worker in his item needs to gather more information to inform treatment and should gather this information from the child's parent (key A). A support group referral (C) may be appropriate later, but not FIRST. Helping the teacher to understand the effects of chemotherapy (B) does not address the student's behaviors, which may lead to further deterioration of the situation. An exploration of the student's feelings (D) may be appropriate, but not as the social worker's FIRST action.

A 14-year old Asian American student is referred to a family agency because of the student's recent poor academic performance and behavioral changes, including lack of paying attention and social withdrawal. During the second family therapy session, the student angrily states that she is tired of the painful physical punishment from her father for "trying to fit in with her friends at school." The father notes that the punishment is necessary to prevent his daughter from imitating the behaviors of he American friends and thus bringing shame to the family. The social worker should FIRST A. assist the parents to explore alternative modes of discipline B. inform the parents that their behavior requires a report of suspected abuse C. attempt to determine the severity of the physical punishment D. help the daughter understand her parents' behavior as culturally appropriate

Rationale: The social worker must FIRST assess for abuse (key C) before taking any other actions.

A male client comes to a first session with a social worker. When the client sits down he makes little eye contact and seems guarded, awkward, and uncomfortable. What should the social worker do NEXT? A. Inquire about how the client is feeling B. Interpret the client's discomfort as a cultural behavior C. Allow the silence to continue for a brief period of time D. Initiate an informal, personal conversation

Rationale: This is an unscored question. Acknowledgment of client's feelings is a first step in making the client feel more comfortable in a strange and stressful situation, and in the establishment of a therapeutic relationship.

An immigrant family is referred to a social worker because of the ten-year-old child's frequent absences from school. In the intake interview, the social worker asks for information from various members of the family, but all responses come from the father, who speaks sharply and whose facial expression appears angry. The social worker's BEST course of action is to. A. ask the child's teacher if there are other behavior problems B. meet with each family member individually C. refer the mother to a spousal abuse counselor D. Learn about the communication styles typical of the family's culture

Rationale: The social worker must understand cultural norms and issues that may be coming into play with clients (key D) in order to provide effective treatment. Finding out about other behavior problems (A) and meeting with the family member individually (B) are possible actions to take but are not the BEST approaches to take, given the immediate needs to place the family's communication style in a cultural context. Nothing in stem indicates spousal abuse (C).

A social worker begins treatment with a couple by asking many questions about their marital history. The social worker is MOST likely. A. looking for the unspoken, unidentified problem B. understand how the present problem evolved C. identify the person with the most problems D. searching for the strengths in each spouse.

Rationale: The social worker needs to understand the couple's relationship as well as factors that led to and brought them into couples therapy (key B).

A social worker sees a client who is concerned about excessive internet use. The client worries about not being able to control online activity and feels it is harming interpersonal relationships outside of the internet. What should the social worker determine FIRST? A. The degree to which the client's life is affected B. The number of hours each day spent online C. How many online relationships the client has D. What kind of website the client is visiting

Rationale: The social worker would need a complete picture of the client's presenting problem and its impact on the client's life, which must include an evaluation of how internet use affect the client's life (key A). Options (B), (C) and (D) would be done only after the social worker had an understanding of the extent of the problem

In a treatment session, a client diagnosed with social anxiety disorder discusses having joined a new community group whose members are picketing to protest the local library's current policy for book purchases. The social worker personally agrees with the library's current policy. The social worker should: A. explain why the policy should stay as it is B. explore other ways to advocate for policy changes C. advise the library staff about the new group D. discuss the pros and cons of joining the group

Rationale: The social worker's focus should be on exploring the client's decision in terms of treatment goals (key D). Explaining the value of the library's policy (A) or discussing other ways to advocate for change (B) forward the social worker's own agenda. Alerting the library staff to the group (C) is irrelevant to social work practice and violates client confidentiality.

A woman is referred to a social worker because of noticeable decline in job performance. The client describes an unhappy childhood, sexual assault at age 12 by her older sister's boyfriend , and two brief marriages which ended in divorce. She is afraid of losing her current boyfriend and attribute her job problems to her chaotic love life. She acknowledges using cocaine for several years but minimizes it as a problem. The social worker should FIRST focus on: A. self-image problems from her childhood B. her childhood sexual abuse C. her problems with men D. stopping her drug use

Rationale: The substance use must be addressed (Key D) before other issues can be explored

A social worker sees an adolescent because of poor academic performance. The adolescent also frequently lies to family members, is manipulative, and has shown a change in friendship patterns. What diagnosis should the social worker consider FIRST? A. Substance use disorder B. Reactive attachment disorder C. Specific learning disorder D. Major depressive disorder

Rationale: The symptoms exhibited are consistent with substance use (key A). There is no indication that there are problems with attachment (B), and a learning disorder (C) would not account for any of the symptoms except for academic performance. Also missing is an indication of depressive symptoms (D).

A social worker at a mental health crisis hotline receives a telephone call about an adult woman who has been observed hanging laundry out while naked. She was also seen defecating in a local parking lot. What should the social worker do? A. visit the woman to conduct a biosychosocial assessment B. Suggest the caller refer the woman adult protection C. Make arrangements for supportive living for the woman D. Arrange for an immediate mental status assessment

Rationale: The woman appears to be exhibiting self-care failure, is at risk for hurting herself, and may lack the capacity to understand the consequences of her behavior. She may need involuntary treatment and needs an assessment. An immediate mental status exam (key D) is indicated.

A new client wants to be assured that her sessions are absolutely confidential. When should the possibility of a subpoena for confidential records of a client's social work sessions be discussed? A. If it appears that the problem might involve court actions B. In the first session before the client contracts for services C. After rapport and trust are firmly established D. Whenever the social worker deems it is most appropriate

Rationale: This is a recall item requiring knowledge of when to discuss limits of confidentiality with clients.

Heavy prolonged used of which of the following substances is MOST likely to result in seizures during withdrawal? A. Heroin B. Marijuana C. Alcohol D. Cocaine

Rationale: This is a recall question. (Key C) is correct because alcohol is the only substance that includes seizures as a part of withdrawal.

In an agency in which there is a suspected disparity in the pay rates of male and female social workers, the female social workers, the female social workers decide that th difference must be addressed. They should FIRST: A. educate colleagues about how to file discrimination claims B. encourage colleagues to become more politically active C. advocate with the director to increase salaries of female workers D. initiate a salary survey to determine whether discrpancies exist

Rationale: This is a suspicion that must be objectively investigated before any other actions can be taken (key D). Until the social worker validates the suspicion, remediation or other actions cannot be taken

A social worker sees a client who was referred after a conviction of embezzlement. The client has an extensive history of gambling but denies that it is a problem for him or his family, what type of therapy would be MOST effective in treating his client's gambling addiction? A. Individual B. Family C. Group D. Couples

Rationale: This is an unscored question. Group therapy is the preferred method of treatment for all addictive behaviors, since the group process breaks down the individual client's denial and rationalizations.

In an initial interview, a five year-old girl is anxious and emotionally constricted. In order to lower anxiety and begin a working relationship, what should the social worker do FIRST? A Assure the child she is safe and can express feelings B. Involve the parents in the treatment C. Ask the child gently what is bothering her D. Relate to the child through the use of play materials

Rationale: This is an unscored question. Young children do not often express their feelings verbally but rather act them out through play.

A social worker works at an emergency shelter for women and children who are victims of domestic violence. The children are in desperate need of basic items such as socks, underwear, diapers, and school supplies. The shelter's budget has already been cut significantly and the shelter director informs the social worker that they cannot use any agency funds to purchase these items. The social worker should FIRST: A. apply for a grant to obtain extra supplies from local funding source B. call community stores for donations of needed items C. plan a fund-raising event for the needed supplies D. contact the board of directors for funding approval

Rationale: This item describes a situation in which needs are immediate, and these items can most quickly be supplied from existing community stores (key B). All of the other options would require a great deal more time before supplies could be obtained.

A parent brings a four-year old child to a family services agency because the child is having fantasies of being chased by a giant and a tiger, and has nightmares of running in terror. What should the social worker do FIRST? A. Ask the child to describe the fantasies B. Do a comprehensive biopsychosocial assessment C. Refer the child for play therapy D. Tell the parent that the child is developing normally

Rationale: This item highlights the importance of qualifying words, such as FIRST. While asking for descriptions from the child (A) and making referrals for play therapy (C) may be appropriate at a later point, these are actions that should be implemented only after assessment (Key B). Similarly, without conducting such an assessment, the social worker does not have enough information to tell the parents that the child's fantasies are normal (D).

A 13-year old who is being treated for depression is concerned about disclosing his homosexuality to his parents, who are homophobic. The parents also want to know the details of the treatment. The social worker should plan to: A. meet with parents and adolescent to share the information B. work with the adolescent around the timing of a safe disclosure C. advise the adolescent never to tell his parents that he is gay D. help the adolescent understand that being gay is just a phase

Rationale: Working with the client around disclosure (key B) honors self-determination and meets the client where he is. Describing homosexuality as a "phase" (D) is inappropriate. Advising the client to never tell his parents (C) is prescriptive. The client is likely not yet ready for a meeting with parents to share this information (A).

A social worker discovers that a newly referred client is currently in individual therapy with another therapist. Before accepting this client for individual therapy, the social worker should FIRST: A. ask what the other therapist has recommended and continue with that approach B. get a release of information and consult with the other therapist C. define another area to work on and set other goals D. advise the client to discuss the change with the other therapist

The client should not be accepted for individual therapy until the client's ongoing therapeutic relationship has been clarified (key D). There is nothing in the stem to indicate that the relationship with the other social worker has been terminated.

A teacher asks the school social worker for professional advice about a six-year-old student who has been diagnosed with an autism spectrum disorder. After offering information to the teacher and discussing options with the parents, the social worker should NEXT: A. enroll the child in an after school social club B. encourage the parents to invite a classmate over to play with the child C. refer the child to a social skilss group D. ask for a teacher's aide to assist wit the child in class

The development and reinforcement of social skills should be addressed NEXT (key C) in order to help the child be better prepared for any of the other steps listed.

A social worker is evaluating a 46-year-old married woman who is distressed by her husband's recent inability to sustain a erection. She reports that her husband has insulin-dependent diabetes. She says the physician has explained how diabetes causes this problem but she believes that "He doesn't love me anymore." The social worker's MOST appropriate action is to: A. offer individual therapy to the client B. give the client literature on the effects of diabetes C. suggest that he husband seek a second medical opinion D. offer conjoint sessions to the client and her husband

The feelings of both the husband and the wife need to be explored in light of the changes to the marital relationship, so conjoint therapy is the MOST appropriate option (key D). Individual therapy (A) addresses only one partner in a shared issue. The woman is already aware of the medical factors involved, so providing educational literature (B) is not a particularly effective action to take. Suggesting that the husband receive a second opinion on his condition (C) is unnecessary and does not address the presenting problem.

A social worker is seeing an adolescent for individual treatment. The adolescent's mother asks the social worker to see her in individual therapy also. What would the social worker do? A. Provide the mother with the names of several social workers B. Refer the adolescent to another therapist C. See the adolescent and the mother together in therapy D.See both members of the family in individual treatment

The potential confidentiality breaches and dual relationships precludes the social worker form providing individual treatment to both the mother and adolescent (D), so the social worker should suggest other therapists (key A). Providing therapy for the mother and adolescent together (C) is not indicated, and it would be inappropriate to refer the adolescent at this point (B).

A social worker sees a university student who reports compulsive exercise, and bingeing and purging several times per week. This has been going on for four months and, in addition, the client reports having nightmares and continually feeling " on edge.," The client has missed classes because she loses track of time and is sometimes afraid to walk across campus. The client says she broke up with her boyfriend over a month ago after a violent fight during which he he tried to kill her. The MOST likely comorbid diagnoses are bulimia nervosa and : A. dissociative amnesia B. nightmare disorder C. adjustment disorder D. postraumatic stress disorder

The seriousness of the precipitation event (boyfriend tried to "kill her") In addition to the nightmares, avoidance of classes and fear, all meet the criteria for the diagnosis of posttraumatic stress disorder (key D). In order for adjustment disorder (C) to be correct, the stressors would be less severe and within the range of common experiences. There is not enough information to meet the criteria for nightmare disorder (B), and no indication of amnesia (A).

A social worker meets with a couple who have difficulty expressing feelings. During one session, the couple begin to argue about fiances. The husband yells and the wife cries. The husband responds by saying, "Crying won't work. You need to spend less money." This interaction BEST demonstrates the: A. use of anger to control B. wife's crying as manipulation C. husband's beliefs about gender roles D. couple's poor communication skills

The social worker is seeing an ineffective communication style on the part of both the husband and the wife (key D). Option (A) and (C) address only the husband's role, while option (B) addresses only the wife's role in communication.

A married mother of two children is referred to a social worker by her employer for depression and inability to maintain expected standards at work. The initial assessment reveals that the client has recently experienced the sudden death of her younger sister who was a single mother of two young children. The children are now in the client's care. The client's mother and one brother are in prison. The client's husband is employed, but they need her paycheck to make ends meet. The social worker's MOST appropriate practice approach is. A. Solution-focused B. ego psychology C. problem-solving D. behavioral therapy

The social worker must address the issues being presented, which demand resolution within a fairly limited time span. A problem-solving practice approach would be the most appropriate one given these factors (key C). Solution-focused (A) examines how progress is made and would not provide assistance with immediate problems. Both ego psychology (B) and behavioral therapy (D) are therapeutic approaches that do not match client's problems and needs.

The term "tardive dyskinesia" refers to: A. truant behavior B. impaired memory C. a speech disorder D. a movement disorder

This is a basic recall item that requires knowledge of tardive dykskinesia.

According to the DSM, all of the following behaviors are considered to be paraphilias EXCEPT: A. autoeroticism B. exhibitionism C. fetishism D. sexual masochism

This is a recall item that requires the test taker to understand elements of the current DSM.

A child who no longer characterizes objects as "all good" or "all bad" and appears to demand an increased amount of attention from the primary caretaker is, according to developmental object relations theory, in the stage of : A. object constancy B. rapprochement C. individuation D. Symbiosis

This is a straightforward recall question that requires the test-taker to be able to identify developmental stages in object relations theory.

A social worker works with clients recently discharged to the community after long-term stays in a mental hospital. Despite the monthly medication monitoring and treatment services offered by the mental health center, the social worker notices a pattern in which many of these clients have frequent crises that require rehospitalization. What is the MOST likely explanation for this pattern? A. The program staff are inexperienced in working with severely mentally ill clients. B. The community lacks follow- up services. C. Clients' families are not supportive of the treatment plan. D. The hospital did not provide clients with the opportunity to learn self-care rehospitalization.

This is an unscored question. The lack of adequate follow-up services to ensure medication compliance and supportive psychotherapy by seriously mentally disabled clients is the most frequent reason for their needing rehospitalization.

A social worker is assigned a client who is believed to be a victim of domestic violence. The client does not speak English and is accompanied to the interview by several members of the extended family. The social worker has a very limited ability to speak the client's language, but several nonclinical employees of the agency are fluent in it. The Social worker's MOST approrpriate action is to: A. ask a family member to translate B. ask one of the agency employees to translate C. request the services of a professional translator D. attempt to conduct the interview without assistance

To assure that translation is accurate, it is important to use a professional translator (key C).

An adolescent arrives for a therapy session intoxication, yet coherent and cooperative. What should the social worker do FIRST? A. Involve the family in the treatment process B. Provide crisis intervention C. Set up a behavioral plan to change negative behaviors D. Confront the acting out behavior

Until the behavior is confronted (key D) FIRST, none of the interventions will be effective.