Clinical Level Final Mock Exam I
(Correct) The answer to question 3 is B: Rationale:
A client expressing disinterest in discussing emotional material is likely a sign of resistance.
(Correct) The answer to question 25 is C: Rationale:
C is the best answer, because it represents subjective data (information from the client's point of view gathered through an interview). A, B, and D are all examples of objective data: observable and measurable data.
(Correct) The answer to question 42 is C: Rationale:
C is the best answer, because this is a matter that should be handled privately and confidentially. A and B are inappropriate and would clearly shame the client in front of other group members. D could be done as part of the individual appointment, but would not be done FIRST.
(Correct) The answer to question 49 is C: Rationale:
C is the best place to start. You want to connect with your client (the child) and find out what is going on from him directly before you proceed with any other action. A dismisses the mother and the child's feelings; B disempowers the client. D might be helpful at some point but not before C.
A social worker is attending a neighborhood block party. While speaking with her neighbor, the neighbor discloses that she was so frustrated with her child the other day that she hit her with a belt. While the neighbor is not a client of the social worker, the social worker should first:
A. Make a suspected child abuse report B. Report the incident according to state law. C. Refer the neighbor to a different social worker so there is no dual relationship. D. Contact the school to discuss the child.
A client is being treated by a social worker. She has a history of relationship problems and suicidal gestures. In the first session, the client tells the social worker how great she thinks the social worker is. What is the MOST important element of a treatment plan for this client?
A. Establishment of clear therapeutic boundaries with the client. B. Short-term cognitive therapy to work with distorted self-image. C. Long-term psychoanalytic therapy to process painful memories of the past. D. Adjunctive group treatment to address relationship problems.
A 53-year-old man comes to a social work agency for help regarding a loss of interest in sexual relations with his wife of 20 years. In the intake interview, the client further describes decreased energy, achiness all over his body and depressed mood. The social worker should FIRST:
A. Evaluate the client for sexual dysfunction. B. Assess the client for depression. C. Refer for a psychiatric evaluation. D. Refer for a physical evaluation.
A 50-year-old woman in the commercial real-estate business is referred to her EAP due to interpersonal conflicts with female co-workers. During the assessment, the social worker learns that the woman frequently minimizes her colleagues concerns regarding sexism and sexual harassment in the workplace and during work functions. The woman says, "They need to get over it. This is just part of the business. They're being too sensitive." The social worker should view this response as:
A. Expected, given the employment setting and cultural standards. B. An internalization of the sexism the client has experienced during her career. C. Evidence of a personality disorder. D. An indication that long-term therapy is needed.
A social worker is conducting a study on the effectiveness of group therapy in decreasing depression in teenagers recently diagnosed with diabetes. Which of the follow refers to the extent to which the results of a study can be generalized to other situations and people?
A. External Validity B. Internal Validity C. Reliability D. Statistical Significance
A social worker receives a referral for family therapy. The family consists of mother, father, a 14-year-old girl, and an 8-year-old boy. The parents report they want the family to spend "quality time" together, but whenever they try, everyone ends of up fighting. The daughter rolls her eyes and reports that her parents try to talk to her "like they are my friends." The 8-year-old says he wants to play with kids in the neighborhood and go to sleepovers, but the parents refuse, saying he can have "all of that fun right here at home." The social worker should focus treatment on:
A. Helping the family establish appropriate roles and boundaries B. Assisting the family in healthy communication strategies C. Facilitating activity-based family interactions to build on relational strengths D. Creating connection through conflict resolution
A 38-year-old woman with Borderline Personality Disorder continually engages in scapegoating during a weekly treatment group. After consultation, the social worker facilitating the group decides to dismiss the client from the group due to the destructive nature of her in-group behaviors. What should the social worker to FIRST in order to facilitate termination?
A. Inform the client during a group session that she will be leaving the group in 2 weeks. B. Ask the group whether the client should be dismissed from the group. C. Schedule an individual appointment with the client to discuss the decision. D. Refer the client for individual treatment before termination is discussed.
A 41-year-old woman has been in therapy for two years for anxiety attacks and depression. She is no longer taking medication and is currently symptom free. During recent therapy sessions she frequently laughs and enjoys herself. Which of the following actions should the social worker take?
A. Interpret the client's behavior as a flight into good health. B. Confront the client regarding avoidance of underlying issues. C. Develop a termination plan with the client to maintain progress made. D. Identify precipitating events leading to the new symptom development.
A social worker in a community agency receives a referral for her friend's preschool-age son. The social worker should:
A. Involve the friend in a comprehensive assessment and treatment plan B. Conduct an initial assessment and make treatment recommendations C. Refer the son to a different therapist D. Treat the son after getting consultation regarding confidentiality and boundaries
An agency has chosen to use a single subject research protocol to assess their postpartum depression support groups. Which of the following BEST describes why an agency would choose this research model?
A. It has strong external validity B. More than one variable can be measured C. Avoid ethical issues related to creating a control group D. Baseline measures are not required
A social worker is part of an evaluation team assessing the effectiveness of a neighborhood outreach program targeting families with children ages 0-5. The social worker is in charge of collecting qualitative data. Which of the following is the BEST example of a qualitative measure?
A. Looking at the way variables such as age and income level impact the utilization of client services. B. Tracking the number of clients served in a year through a specific program C. Comparing the number of clients using a new service compared to an old service D. Interviewing clients about their level of satisfaction with the changes in program delivery
(Correct) The answer for question 44 is A: Rationale:
The best answer option is A, because it deals directly with the client-therapist relationship and brings the topic up for exploration. B might be done later in treatment but not FIRST. C would be addressed in consultation or supervision if the therapist felt it was interfering with treatment but would not be done FIRST. D would not do anything to help establish a therapeutic alliance between the client and social worker.
(Correct) The answer to question 2 is A: Rationale:
The clues in the stem are that the child excels and hasn't had an infraction but seem unhappy and has a hard time socially. This is the description of a child raised in an Authoritarian home. Children raised with Authoritative parenting styles are the best adjusted. Both Permissive and Uninvolved children display behavioral problems and generally have lower school performance.
A client who has recently immigrated to the United States seeks therapy to adjust to the client's culturally different spouse. To assess the client's level of acculturation, which of the following factors should the social worker take into consideration FIRST?
A. Newly immigrated individuals are often hesitant to challenge cultural traditions in their marital relationships. B. Newly immigrated individuals are resistant to learning the rules of a new country. C. Gender differences cause more discomfort than acculturation issues. D. The pace of acculturation may vary from group to group.
A couple starts seeing a social worker after the death of their two children in a car accident. The social worker's supervisor notices that the social worker is spending many hours on the phone with the couple and is seeing them more often than her other clients. The supervisor should:
A. Work with the social worker to assess if the level of intervention is necessary. B. Advise the social worker that her behavior is unethical. C. Transfer the clients immediately to a different social worker. D. Have the social worker tell the clients that they can't contact her after hours.
(Correct) The answer to question 46 is C: Rationale:
C is the best answer because it directly relates to Feminist Theory and how mental health is affected by a patriarchal culture. A would be more of a psychodynamic view. B would be a Cognitive Behavioral view. D is not as specific but is more psychodynamic in nature.
(Correct) The answer to question 26 is C: Rationale:
C is the best answer because the client's presenting problems have been resolved and the client is doing well without the aid of medication, both of which indicate a readiness for termination. A does not make sense because the client has been in treatment for 2 years; a flight into good health is typically seen at the initiation of treatment. B and D are not supported by the information in the stem.
(Correct) The answer to question 38 is C: Rationale:
C is the best answer, because it meets the client where she is and also monitors when she might be ready to address her substance use. A is not the best answer, because the social worker has already attempted to confront the client and it was not effective. Continuing to confront the client may damage the therapeutic relationship. B might be appropriate but is not as good as C in terms of meeting the client where she is. D is not indicated: the client keeps coming to treatment and may be benefitting from it in many ways.
(Correct) The answer to question 12 is B: Rationale:
B is the best answer, because a decrease in intimacy and an increase in arguments may be signs that one partner has relapsed, putting stress on the relationship. This needs to be assessed first. A, C, and D can be done later.
(Wrong) The answer to question 41 is B: Rationale:
The activities described fall into the educational component of supervision described by the NASW and ASWB's document on the Best Practice Standards in Social Work Supervision
(Correct) The answer to question 32 is A: Rationale:
A is the best answer because it is not a question associated with process evaluation; it is associated with program evaluation.
(Correct) The answer to question 21 is A: Rationale:
A is the best answer, because it focuses on the client's strengths. B is not indicated by the client's symptoms or presenting problem. C and D may be helpful, but the social worker should identify the client's strengths and resources so that interventions and treatment decisions can be made appropriately.
(Wrong) The answer to question 35 is A: Rationale:
A is the best answer, because it meets the student where she is and will help empower her and help her be hopeful about her future. B is in opposition with social work values. C may be needed at some point, but is not indicated at this time. D would be a longer term goal but would not be what the social worker does FIRST, particularly in a school setting.
(Correct) The answer to question 45 is A: Rationale:
A is the best answer, because it takes into account the cultural issues presented in the case. B and C both pathologize the client's behavior; D makes a negative judgment about the client's behavior, when it may in fact be protective.
(Wrong) The answer to question 40 is A: Rationale:
A is the best answer, because the client is experiencing a flashback and the social worker should try to help him distinguish between what is happening now versus what happened in the past to decrease his distress. B is not a good answer, because therapeutically it is not helpful to allow flashbacks to continue. C is not indicated in this moment. D does not make sense since the client in the question is not expressing these feelings.
(Correct) The answer to question 30 is A: Rationale:
A is the best answer, because the client is presenting with several symptoms indicative of Borderline Personality Disorder (relationship problems, suicidal gestures, idealization of the social worker) and boundaries are a key component to engaging in effective treatment with a client with this profile. B, C, and D are not specifically related to treatment with clients with Borderline Personality Disorder.
(Correct) The answer to question 47 is A: Rationale:
A is the best answer, because the question stem indicates that the parents are trying to interact with their children like peers instead of parents. Helping the parents establish more appropriate roles with the children may decrease the tension and allow for more positive family interactions. B and D may be helpful but would not be the focus of treatment in this case. C will not be as helpful until the parents develop more appropriate boundaries and roles for themselves.
(Correct) The answer to question 28 is A: Rationale:
A is the best answer, because the social worker should be discussing the client's feelings about the relationship. This would be the place to begin, so A is the best answer. B, C, and D could be done once the issue had been explored more.
(Correct) The answer to question 18 is A: Rationale:
A is the best answer. The social worker should recognize that a community that has recently experienced a stressful or traumatic event may not be open to new people or offerings. Joining with the community and understanding their needs will assist the social worker in meeting those needs effectively. B might help but does not do as much to create a relationship between the social worker and the community. The social worker will not know unless s/he gets to know the community better. C is premature, and D continues with an intervention that is not working at this time.
A 12-year-old African-American boy has been meeting with a social worker for 2 months for feelings of depression. He recently discovered that one of his ancestors was a slave who led a rebellion during the Civil War. He previously felt ashamed of his background, but in sessions, starts speaking about his ancestor as being a "brave leader." In terms of racial identity development, the client's experience could be best described as:
A. Conformity B. Dissonance C. Resistance D. Introversion
Social work supervisors engaging in activities that help the supervisee to: increase self-awareness, refine knowledge and skills, develop professionally as it pertains to their specific role, deal with ethical issues that arise,as well as learn appropriate techniques around assessment, intervention, and treatment planning is engaging in what type of supervision activities?
A. Administrative B. Educational C. Supportive D. Clinical
An 8-year old child with developmental delays is currently in a regular classroom setting. He is struggling to keep up with the work and he is noticing he is not being assigned the same work material as his classmates. The social worker should first:
A. Advocate for him to receive an aid in the classroom. B. Transfer him to a special education classroom. C. Assess him using the mental status exam. D. Speak to his classmates about his situation.
A client who is gay tells his social worker that he wants to have a baby. He reports that his plan is to contact an adoption agency to begin the process. What should the social worker do FIRST:
A. Assess the client's ability to manage the potential negative response from family members. B. Refer the client to a parenting class for single fathers. C. Assess the client's understanding of the steps needed to adopt a child. D. Explore the client's desire to become a parent.
A school social worker is meeting with a 17-year-old Latino student as part of her post-graduation assessment/planning. During the conversation, the student expresses a desire to go to college and then begins weeping and explains that as an undocumented student, most colleges will be out of reach. The social worker should FIRST:
A. Assist the student in identifying colleges that will accept undocumented students B. Explain that the social worker cannot help since the student is technically breaking the law C. Refer the student to an immigration attorney D. Help the student process her feelings about being undocumented
A newly licensed social worker is providing outreach to a community that recently experienced a major hurricane. The social worker goes door-to-door, asking families if they need mental health services and outlining opportunities to receive these services. At the end of her first week, the social worker realizes that no families have expressed interest in receiving mental health services. The social worker should next:
A. Attend upcoming community events to join with the community and understand their needs. B. Provide informational flyers in community centers to reach people in a less threatening way. C. Terminate the intervention since no one is interested. D. Continue the intervention as planned.
A family comes in with high expectations of their 10-year-old child. The child excels in school and the teacher states that he has never had an infraction although he appears to be unhappy and has a hard time socially. The parents are likely using what kind of parenting style?
A. Authoritarian B. Authoritative C. Permissive D. Uninvolved
A 55 year-old Native American woman seeks treatment following the death of her son. When working with Native American clients, in order to be culturally sensitive and develop a good therapeutic relationship it is important to observe all of the following EXCEPT:
A. Be directive B. Use active listening and reflective responses. C. Avoid interrupting D. Allow for periods of silence
A patient admitted into ER has his partner listed as the emergency contact. The social worker learns that the nursing staff contacted his family instead of the partner. The social worker should NEXT:
A. Call the partner. B. Tell the patient that his family was notified. C. Wait until the family arrives and find out what they think is best. D. Discuss the situation with the doctor.
A social worker and client have been working together for 2 months. The client, a 27-year-old woman, initially presented due to concerns about her alcohol use and its effect on her relationships and ability to perform her job duties. After the initial session, the client began minimizing her alcohol use and typically comes to session with another topic she wants to discuss. The social worker has attempted to confront the client about her avoidance of the topic, but the client is adamant that her drinking is not a problem at this time. The social worker should:
A. Continue to confront the client about her alcohol use B. Consult with a colleague about the client's resistance to change C. Convey acceptance and monitor the client's readiness for change D. Discuss termination due to lack of client engagement
A white social worker at a hospital is asked to evaluate a black woman who was recently brought in by the paramedics. When the social worker approaches the client, she refuses to tell the social worker what happened and states repeatedly that she fears anything she says to the social worker will be used against her. The woman requests to instead speak with the Latina nurse who has been caring for her since arrival. What is the MOST likely explanation for the woman's behavior?
A. Cultural paranoia, which represents a healthy reaction to racism. B. An episode of acting out of Borderline Personality dynamics. C. Pathological paranoia regarding all social workers. D. Resistance to assessment and treatment.
A social worker in a community clinic meets with a woman who presents with issues related to her job. She discusses a recent incident in which she was gone from work for several days without notifying her boss or coworkers, although she has no memory of this. The client has found a pamphlet and tickets from a Broadway show in her home, although she states that she's never been to New York. The client is describing which of the following conditions?
A. Depersonalization B. Derealization C. Delirium D. Dissociation
A social worker receives a referral from parents regarding their 9 year-old daughter. A social history reveals symptoms consistent with a diagnosis of Major Depressive Disorder. What should the social worker do FIRST?
A. Determine if the child has had a recent physical examination to rule out possible physical causes for her symptoms B. Under the diagnosis of Major Depressive Disorder, refer the child to a psychiatrist for medication. C. Have the parents fill out a questionnaire to confirm the diagnosis of Major Depressive Disorder. D. Begin cognitive behavioral therapy with the child to decrease symptoms.
A clinical social worker is evaluating a friendly, 5-year-old child who has difficulty making friends in school. He is very verbal, but has a hard time answering questions about his feelings. He is eager to talk about all the different types of reptiles and knows all about them. What should be the social worker's next step:
A. Diagnose him with Autism Spectrum Disorder. B. Use play therapy to try to connect with him on different topics. C. Refer him to a social skills group. D. Suggest that he is transferred to a different school.
A social worker is approached by a mother regarding her 2 ½ year-old daughter. The mother is distressed by the fact that her daughter frequently says "NO" when asked to clean up after herself, has occasional temper tantrums and wants to do "everything" independently. The social worker's BEST response would be to:
A. Educate the mother about child development. B. Schedule a biopsychosocial evaluation of the child. C. Review possible behavior modification techniques. D. Engage the mother and daughter in family therapy.
A social worker meets with a veteran who has been diagnosed with PTSD. During a session, the client's eyes glaze over while he is talking about an experience in which several members of his platoon were killed. He sits forward in the chair, staring over the social worker's shoulder, and talks in a calm, monotonous voice. The social worker should:
A. Employ a grounding technique to reconnect the client with the present moment B. Allow the flashback to continue so the client can express his feelings C. Assess the client for suicidal ideation D. Empathize with the client's feelings of fear and loss of control
A 55-year-old female client is in therapy with a male social worker for help with her relationships with her grown sons. The social worker perceives that a good working relationship has been established, but in the eighth session, the client announces that she wants a new social worker. She states that the social worker is too young and inexperienced to help with her particular problem. The social worker should FIRST:
A. Encourage the client to discuss her feelings about their relationship. B. Review his professional experience to reassure the client. C. Help the client to differentiate the social worker from her grown sons. D. Offer a list of older social workers and facilitate a referral.
The mother of an eight-year-old boy calls the school social worker and says that her son has been refusing to come to school because he is teased about being overweight. The mother demands that the school punish the students who have been teasing her son. What should the social worker do FIRST?
A. Encourage the mother not to overreact to the child's report. B. Get a list of the names of the bullies from the mom. C. Meet with the child to assess and develop problem-solving strategies. D. Refer the mom to a parenting support group.
The 66-year-old wife of a man with a Mild Neurocognitive Disorder seeks counseling from a social worker due to increasingly stressful caregiving responsibilities. The wife is well-integrated into the mental health and medical care delivery systems since her husband has been receiving a range of treatments since age 55. In order to reduce the wife's sense of burden, the social worker should FIRST help her:
A. Provide her with psychoeducation regarding the illness and available treatments. B. Utilize a life review to help her identify her husband's positive contributions. C. Improve her response accuracy to decrease crises. D. Re-evaluate her system of caregiving resources outside the family.
A 45-year-old man meets with a social worker for an initial appointment. He reports that his wife is an alcoholic and becomes verbally abusive when she is intoxicated. He indicates that his wife refuses to go to treatment, insisting that they can resolve this problem on their own. The therapist should FIRST:
A. Provide the man with psychoeducation around substance abuse and the stages of change. B. Explore the man's issues and work collaboratively to develop treatment goals. C. Explore the man's commitment to the relationship. D. Help the man identify the reasons behind his wife's behavior.
An adult with Down Syndrome and diabetes is in an emergency room for treatment due to noncompliance with insulin shots. Before releasing her, the physician asks the social worker to interview the client and her parents, with whom she lives, about the situation. The social worker learns that the noncompliance with insulin has been an issue at home and at the client's place of employment. What should the social worker do FIRST?
A. Provide the parents with information about how to apply for conservatorship. B. Explore the client's understanding of her illness and the significance of medical treatment. C. Discuss the effects and benefits of medication with the whole family. D. Reframe the client's noncompliance as an example of her seeking independence.
A client with a history of severe depression reports hypersomnolence and decreased appetite. The client reports having discontinued his prescribed medication because he didn't think he needed it anymore. The social worker should FIRST:
A. Question the client as to the other reasons for discontinuing the medication B. Instruct the client to resume the medication C. Encourage to the client to speak to his psychiatrist D. Discuss alternative treatment options
A married couple meet with a social worker in private practice for an initial session. Afterwards, the wife calls the social worker and states, "I have something I want to talk to you about, but my husband can't find out." The social worker's MOST appropriate response would be to:
A. Reassure the wife that what she says will be kept confidential. B. Recommend that both husband and wife meet individually before the next couple's session. C. Advise the wife of the therapist's "no secrets" policy and suggest disclosure at a future couple's session. D. Refer the husband and wife to separate individual therapists.
A 30-year-old man meets with a social worker for the first time and describes himself as a failure. He recently lost his job and his girlfriend of two years broke up with him. He feels hopeless about his life and is beginning to believe his family's criticism and rejection of him are justified. As the interview progresses, his discouragement and feelings of worthlessness become more apparent. The social worker should FIRST:
A. Refer the client to a psychiatrist for a medication evaluation. B. Help the client identify why his relationship with his girlfriend ended. C. Schedule a family session. D. Ask the client if he's had any thoughts about hurting himself.
A social worker at a day treatment facility for teens with mood disorders is asked to provide crisis intervention following the suicide of a program participant. The social worker should FIRST:
A. Refrain from sharing information due to confidentiality. B. Contact the residents' parents to inform them of the situation. C. Facilitate a group session to discuss the incident with the other participants. D. Have individual meetings with each participant to discuss the incident.
A client with a history of interpersonal problems with co-workers has recently been fired for getting into repeated arguments with colleagues and supervisors. The client arrives at the next session late and becomes very angry when the social worker inquires about the client being late. The client yells, "Why are you monitoring my every move? Can't you just trust me and leave me alone?" The social worker should interpret the client's behavior as:
A. Resulting from a feeling of judgment by the social worker. B. Displaying problems that occur in workplace relationships C. Indicating a need for medication to stabilize the behavior. D. Signaling a desire to terminate treatment.
A social worker in a community mental health agency begins working with parents and their 12-year-old son. The family has been referred because the son's grades are deteriorating and he's been getting into fights at school. During the first few sessions, the social worker notices that the parents repeatedly express anger toward their son for lying, but when the son tells the truth, they yell at him for his "poor choices." The social worker should NEXT:
A. Separate the child and the parents to help them each express frustration in a safe space B. Point out this double bind to the parents C. Ask the son to respond to the parents' anger D. Point out how unproductive being dishonest it
An unlicensed social worker is meeting with an older woman for their first therapy session. The older woman reminds the social worker a lot of her mother who she does not have a good relationship with. The social worker finds herself becoming easily frustrated with the older woman and is having a hard time remaining calm. What should the social worker do first:
A. She should bring up the situation with the client and explain why she is becoming agitated. B. Since it is only the first session, she should transfer her to another therapist. C. She should talk to a supervisor about her countertransference issues. D. She should journal about her feelings after the sessions.
A social worker at a local community mental health agency started a group for adults who grew up in the Foster care system. Each week fewer group members show up. In order to keep the group strong and ensure reasonable attendance, the social worker should:
A. Talk to the group members to assess why attendance is dwindling and have them assist with the group structure and future topics. B. Cancel the group since it is not needed. C. Change the day and time of the group to hopefully make it more convenient. D. Have a different social worker take over the group.
A gay couple who say they are both in long-term recovery for cocaine addictions request couples' therapy. The couple reports frequent arguments and an increased sense of distance in their relationship. The social worker should FIRST:
A. Teach the couple communication skills. B. Assess for a drug relapse in either partner. C. Assign the couple intimacy exercises as homework. D. Teach the couple anger management skills.
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.
A woman has been going to therapy for the past two months. Whenever the therapist brings up emotional material the woman dismisses it and says she isn't interested in talking about those subjects. She talks a lot about her day to day life and says she thinks she is ready to terminate. What should the therapist do next:
A. The client seems like she is doing fine and feels she is ready to terminate so the therapist should start the termination process. B. The therapist should address the client's resistance in discussing the emotional material. C. The therapist should give the client two more sessions to see if she still feels ready for termination. D. The therapist should inform the client that she needs to talk about this material or else the therapy sessions will be over.
A new client comes to treatment after losing his job of 15 years. He reports that "nothing in his life is going right," and goes on to note that his marriage is failing, recent investments are not paying off, and that he has "no real friends." In addition to a risk assessment, the social worker should focus on:
A. The client's strengths and resources B. A possible medical issue C. Referring the client for employment assistance D. A referral for couples therapy
A social worker in a community mental health agency meets with a 14-year-old boy and his parents after 3 months of treatment. The family first presented for treatment because the boy was experiencing feelings of anxiety and had several panic attacks. The goal of the session is to review the client's progress and reevaluate the treatment plan. All of the following are examples of objective data EXCEPT:
A. The number of panic attacks the client reports in the past 2 weeks B. The client's score on the Beck Anxiety Inventory C. The client's ability to express feelings to the social worker D. The parents' report on how often the child avoids anxiety-provoking situations
In establishing a therapeutic alliance with a client from a different racial or ethnic background, the FIRST issue for the social worker to address is:
A. The racial or ethnic difference and how it may impact treatment. B. Transference issues with the therapist. C. The therapist's countertransference. D. The client's history of encounters with people of different racial or ethnic backgrounds.
A 16-year-old is brought to treatment for an eating disorder. How would a social worker using Feminist Theory Therapy view this issue?
A. Unresolved issues of early childhood can manifest as eating disorders. B. Her automatic thoughts cause unhealthy body-image. C. Cultural expectations of women negatively affect their sense of self. D. Denial of food is a defense mechanism to manage anxiety.
A social worker is hired by a non-profit foundation to complete a process evaluation on three agencies that received grants from the foundation. Each of the following is an example of a process evaluation question EXCEPT:
A. Was the program more successful with certain groups of people than with others? B. Was the program well managed? C. Was there adequate agency support for the program? D. What specific interventions were put into place by the program?
(Correct) The answer to question 10 is A: Rationale:
Answers B, C, and D are all advised approaches with Native Americans. This leaves A as the only one that should be avoided.
(Wrong) The answer to question 17 is B: Rationale:
B is the best answer, because according to a minority identity development model, the stage of dissonance includes a period in which the individual moves from feeling shame about their identity to feelings of pride. In the stage associated with A, the individual prefers the dominant culture and devalues their own background; in the stage associated with C, the individual rejects the dominant culture and has a sense of appreciation for their own culture; in the stage associated with D, the individual moves toward feeling that the dominant culture is not all bad and that there are individual differences.
(Correct) The answer to question 33 is B: Rationale:
B is the best answer, because it is MOST likely that the client is exhibiting behavior that is typical in another area of the client's life; since the question references problems in the workplace, this is probable. A, C, and D are not supported by information in the stem.
(Wrong) The answer for question 43 is B: Rationale:
B is the best answer, because it names the dynamic that is occurring in the room and may help the parents understand why the boy is not likely to be honest with them. A is not indicated in this situation and will not help address the dynamic that is occurring. C may be helpful, but not before the social worker helps raise the parents awareness of the dynamic. D is not supportive and will also not help address the dynamic at hand.
(Correct) The answer to question 34 is B: Rationale:
B is the best answer, because the client should know and be able to emotionally prepare for his family's response or arrival at the hospital. A might be a good step, but not until after the client is informed of the mistake. C would violate the client's confidentiality and take away his self-determination. D does not make sense, since the doctor is not mentioned in the stem and has not been a part of this particular situation.
(Correct) The answer to question 19 is B: Rationale:
B is the best answer, because the client's behavior indicates she has internalized the sexism she has experienced over time. A is not a good answer, because, while it may be true, it does not identify the process through which this has occurred as well as B does. C is not indicated by the client's statements or behavior. D may be true, but is not clear from the information provided in the question stem.
(Wrong) The answer to question 36 is B: Rationale:
B is the best answer, because the social worker first needs to understand what is behind the client's noncompliance before moving forward. A is too extreme and likely unnecessary. C is a good intervention but not before B; D is not supported by the information in the stem.
(Correct) The answer to question 11 is C: Rationale:
Because the increase in symptoms is likely to be directly related to the discontinuation of medication, the client should be encouraged to go back to his psychiatrist. It would be outside of the social worker's scope of practice to instruct the client to resume medication. While questioning the client about the reasons for discontinuing medication and discussing alternative treatment options may be appropriate interventions at some point, the social worker should FIRST encourage the client to speak to his doctor regarding his increase in neurovegetative symptoms.
(Correct) The answer to question 8 is D: Rationale:
D is the best answer because it involves gathering information directly from program participants. A, B, and C are all examples of quantitative data.
(Wrong) The answer to question 16 is D: Rationale:
D is the best answer, because engaging in activities with no consciousness or memory of the activities is a form of dissociation; A, B and C describe different phenomena.
(Correct) The answer to question 39 is D: Rationale:
D is the best answer, because it does not make assumptions and encourages the social worker to understand more about this individual's experience. A and B both make negative assumptions. C is not true.
(Correct) The answer to question 37 is D: Rationale:
D is the best answer, because it most directly addresses the client's feelings of stress related to caregiving duties. A is probably not necessary since the client has been integrated into delivery systems for over 10 years. B will not address her stress level; C may not be possible given the nature of her husband's illness.
(Wrong) The answer for question 31 is D: Rationale:
D is the best answer, because it starts where the client is and takes a nonjudgmental stance. A does not make sense, since the stem does not indicate that his family is involved or that they would be unsupportive. B might be helpful later, but not before D. C is somewhat judgmental and assumes that the client has not thought through or researched the decision.
(Correct) The answer to question 29 is D: Rationale:
D is the best answer, because the client is describing physical symptoms and depressed mood; the social worker needs to rule out a medical cause for the client's problems before moving forward. A, B, and C could be done after a medical issue was ruled out.
(Wrong) The answer to question 7 is C: Rationale:
Having a control group means that some individuals are not receiving the treatment. Withholding treatment from some individuals has ethical implications, making (C) the best answer.
(Correct) The answer to question 27 is D: Rationale:
Hopelessness and feeling like a failure are both risk signs for suicide. D would be the place to start. Once that was ruled out, A, B, and C could be considered.
(Wrong) The answer to question 23 is B: Rationale:
In some states, social workers are mandated reporters 24/7, while in others, they are only mandated reporters while in their professional capacity. A would not be correct, since the law may not require this. B is the best answer, because it allows the social worker to do whatever is legally required. The social worker could do C if the neighbor asked for assistance. D would violate the neighbors trust.
(Correct) The answer to question 13 is C: Rationale:
Redirecting the wife to reserve the disclosure for the marital session is the best answer, because it will preserve the therapist's ability to treat the couple effectively. A would potentially jeopardize the couple's treatment by creating a situation in which the social worker and wife are keeping secrets from the husband. B does not make sense since couple's treatment has already been initiated. Recommending that the couple see individual therapists may be missing the point, as the couple has presented for marital therapy, not individual therapy, and keeping secrets may be part of the couple's problem.
(Correct) The answer to question 9 is C: Rationale:
Social workers should avoid dual relationships with clients. In this case, the son would be at risk of not receiving the best treatment, as the social worker may have preconceived notions about the son or may treat him differently due to the social worker's relationship with the mother. Avoiding dual relationships ensures the client's safety and ability to receive appropriate treatment.
(Wrong) The answer to question 48 is A: Rationale:
The best answer is A as you would do this before having him transferred to a special education class. There is no reason to do a mental status exam at this point. D would be breaking the child's confidentiality.
(Wrong) The answer to question 20 is B: Rationale:
The best answer is B. A, C, and D could be options later in treatment after a treatment plan focusing on the man has been established.
(Correct) The answer to question 1 is D: Rationale:
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.
(Wrong) The answer to question 5 is C: Rationale:
The best option is C. While there are signs of Austism Spectrum Disorder, there is not enough to make a formal diagnosis. B suggests the social worker direct the play, which you wouldn't do in the initial phase of treatment. The main issue is his inability to make friends and talk about his feelings, so a social skills group is clearly indicated. There is no reason to have him transfer to another school.
(Correct) The answer to question 15 is A: Rationale:
The best place to start would be A. This is an example of the supervisor recognizing that the social worker's boundaries may be compromised, so the best response would be to discuss it with the social worker.
(Correct) The answer to question 50 is A: Rationale:
The child is exhibiting normal, healthy behavior for a 2-year-old. A would be the best place to start.
(Correct) The answer to question 24 is C: Rationale:
You would want to host a group meeting to ensure that all members hear the same information at the same time so C is the best thing to do first. You could then do B and D. While you would want to be sensitive to issues of confidentiality, you would not have to refrain from sharing any information as it affects the whole community.
(Correct) The answer to question 4 is C: Rationale:
The experience the social worker is having is a countertransference reaction. When you put the answers in order, the first thing to do would be to talk to a supervisor; this could lead to her doing D or B. A would not be appropriate in the initial phase of treatment, as it makes the social workers issues the focus.
(Correct) The answer to question 6 is A: Rationale:
This is a factual recall question; B, C, and D would all be described differently.
(Wrong) The answer to question 14 is A: Rationale:
While B, C and D may all be appropriate at some time in the near future, option A is the best choice as medical conditions should always be ruled out before giving a diagnosis.
(Correct) The answer to question 22 is A: Rationale:
You would start by asking group members why they haven't been attending the group. B, C, and D are possible responses once you ask the members about their experiences.
