exam 5

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Question ID #4995: A woman has been taking care of her 77-year-old father ever since he had a stroke several months ago. Recently, the father's cognitive functioning has declined significantly and his medical needs have become too great for his daughter to meet. The man's physician gives them the name of a complete care nursing facility in their community. The daughter is distraught about the prospect of leaving her father in the care of strangers and insists that she wants to continue caring for him at home. She has been referred to the social worker by her father's physician. Which of the following actions should the social worker take to address the problem described in this case? Select one: A. Tell the woman to discuss the issue further with her father's physician B. Encourage the woman to be realistic and take the doctor's advice seriously, for the sake of her father C. Suggest that the woman tour the facility D. Set up a family session, including the father, to discuss what to do

The correct answer is C.The daughter has several concerns and misgivings; therefore, this is the most appropriate step. After the daughter is familiar with the environment where she would leave her father, she may begin to view the staff as something other than strangers and may feel more comfortable leaving her dad in their care. She may also be able to see that the facility is better equipped to meet her father's needs than she is.

Question ID #5007: A social worker begins working in therapy with a young married couple. In the third session, the wife suddenly asks the social worker if she has any children. What is the social worker's BEST response? Select one: A. No, do you? B. What would it mean to you if I did? C. I'm wondering why you ask. D. I'm sorry, but my personal life really should not concern you.

Question ID #4965: A DSM-5 diagnosis of schizophrenia requires the presence of two or more active-phase symptoms during a one-month period with at least one symptom being ____________ plus continuous signs of disturbance for least six months. Select one: A. negative symptoms B. disorganized speech or disorganized behavior C. delusions or hallucinations D. delusions, hallucinations, or disorganized speech

The correct answer is D.A change in the DSM-5 is that, unlike the DSM-IV-TR, it specifies that at least one of the active-phase symptoms must be delusions, hallucinations, or disorganized speech.

Question ID #4945: A social worker has been working in individual therapy with a client who has a substance use disorder and has agreed to abstain from using substances. The client has also been attending 12-Step meetings. In the current session, the client presents, for the first time, with depression-like symptoms. The social worker learns that the client has been using again. The client's depression-like symptoms suggest that she may be experiencing which of the following? Select one: A. Barbiturate intoxication B. Cannabis intoxication C. Opioid withdrawal D. Alcohol withdrawal

Among the signs associated with opioid withdrawal are a dysphoric mood, nausea or vomiting, muscle aches, lacrimation (teariness) or rhinorrhea (runny nose), pupillary dilation, piloerection, sweating, diarrhea, yawning, fever, and insomnia. Answer A: Barbiturates are among the sedative, hypnotic, and anxiolytic substances discussed in the DSM. Among the behavioral and psychological changes associated with barbiturate intoxication are mood lability, impaired judgment, and inappropriate sexual or aggressive behavior; signs that may develop during or shortly after use include slurred speech, incoordination, unsteady gait, nystagmus, impaired attention or memory, and stupor or coma. Answer B: Behavioral and psychological changes associated with cannabis intoxication include euphoria, anxiety, impaired motor coordination, impaired judgment, social withdrawal, and the sense that time is passing slowly. Signs associated with cannabis intoxication include tachycardia, conjunctival injection (the forcing of fluid into the conjunctiva, the mucous membrane that lines the eyelids, making the eye appear swollen and red), increased appetite, and dry mouth. Answer D: Alcohol withdrawal is associated with autonomic hyperactivity, increased hand tremor, insomnia, nausea or vomiting, transient hallucinations or illusions, psychomotor agitation, anxiety, and grand mal (generalized tonic-clonic) seizures. The correct answer is: Opioid withdrawal

Question ID #4976: A client reports being very upset and embarrassed about losing her hair. She checks herself in the mirror several times a day to see if more hair has fallen out and always wears a hat when she leaves the house. In fact, the client's hair loss is minor and not noticeable to other people. What DSM-5 diagnosis is MOST indicated for this client? Select one: A. Body dysmorphic disorder B. Illness anxiety disorder C. Somatic symptom disorder D. Factitious disorder

The correct answer is A.Body dysmorphic disorder is characterized by a preoccupation with a defect or flaw in appearance that appears minor or is unobservable to others. In addition, the performance of repetitive behaviors or mental acts related to the individual's concerns was added to the DSM-5 as a diagnostic criterion for body dysmorphic disorder. The DSM-5 categorizes body dysmorphic disorder with the obsessive-compulsive and related disorders. The disorders provided as distractors for this question are classified as somatic symptom and related disorders. Answer B: Illness anxiety disorder is characterized by excessive worry about being or becoming ill, an absence of somatic symptoms or the presence of mild somatic symptoms, a high level of anxiety about one's health, and performance of excessive health-related behaviors or maladaptive avoidance of doctors, hospitals, etc. Answer C: The essential feature of somatic symptom disorder is the presence of multiple somatic symptoms that cause distress or disruption in one's daily life. Answer D: Factitious disorder is characterized by falsification of physical or psychological symptoms or induction of an illness or injury that is associated with an identified deception. The correct answer is: Body dysmorphic disorder

Question ID #4915: An adult therapy client reveals that she is being stalked and harassed by her ex-boyfriend who is a police officer. She hasn't told anyone else about this and doesn't know what she should do. During the past week, the ex-boyfriend has left her several threatening voicemail messages. What should the social worker do FIRST? Select one: A. Urge the client to file a police report B. Break confidentiality and file a police report C. Encourage the client to express her feelings about this D. Assess the degree of risk

The correct answer is A.From both a clinical and ethical standpoint, the social worker must do what she can to encourage and assist the client to better protect herself from this danger. It doesn't matter that the ex-boyfriend is a police officer. The social worker should still encourage the client to report this dangerous situation to the police.

Question ID #5024: A social worker is meeting with a 21-year-old Korean-American woman who immigrated to the U.S. four years ago with her family. In the interview, the client reports that she suffers from aches and pains and occasional insomnia. She does not describe any other symptoms or disclose information about her personal life or family. She says she has come in only because her doctor told her to. What should the social worker do? Select one: A. Offer the client referral to a pastor at the local Korean church B. Refer the client to a neuropsychologist for testing C. Focus on the problem brought in by the client and help her develop her own goals for therapy D. Ask the client if she has been feeling depressed

The correct answer is A.It's difficult to choose an answer without knowing more about this client, in particular her level of acculturation and religious background. However, the question implies several things that could help you identify the best answer. First, the client immigrated quite recently, suggesting that she may still adhere to the values of native culture. Second, the client was sent to you by her doctor, suggesting that a medical condition that could account for her symptoms has been ruled out. Third, the client may be somaticizing emotional stress, since, among traditional Asian individuals, physical illnesses are more acceptable than psychic ones. There is a good chance the client is experiencing a psychosocial problem that she is unwilling to disclose during treatment. Fourth, the client's behavior in the initial interview suggests that, consistent with traditional Asian values, the client believes that she should solve her problems within her family or community, rather than disclose personal information to an outsider such as a social worker. All of this suggests that the best answer offered is a referral to a local Korean pastor. Korean individuals in the U.S. have high church attendance and their churches are often the focal institutions of their community. The client may feel more comfortable addressing her problem with a pastor and, perhaps, framing it as a spiritual issue.

Question ID #4988: The client is a 36-year-old single woman who reports feeling bored at her job and at a "dead-end" socially. She completed two years of college and sometimes thinks about re-enrolling to complete her degree but does not enroll. The client feels she is in a rut and cannot get out of it. The social worker decides to use a brief therapy model with this client. The assumptions of this model include all the following EXCEPT: Select one: A. a client lacks resources for change and a social worker's key role is to provide skills and knowledge to facilitate change B. problems are a normal part of life rather than signs of dysfunction or pathology C. the purpose of therapy is to find solutions rather than meaning or insight D. a social worker should believe that change is possible and convey this expectation to the client

The correct answer is A.Social workers using a brief therapy model adopt a strengths perspective, which means that they recognize that both the social worker and the client have resources that can be used during treatment to facilitate change. The client is presumed to have resiliency, knowledge, abilities, and problem-solving and coping skills - she is temporarily stuck or overwhelmed and unable to fully use her own strengths, and your role is to help her access and use these resources so that she can move forward and find solutions. This assumption has been described by the term utilization which refers to conducting the work with what the client brings.

Question ID #4964: Which of the following is NOT included as an alcohol-related disorder in the DSM-5? Select one: A. Alcohol dependence B. Alcohol intoxication C. Alcohol withdrawal D. Alcohol-induced major neurocognitive disorder Feedback

The correct answer is A.The DSM-IV-TR diagnoses of alcohol abuse and alcohol dependence have been replaced in the DSM-5 by alcohol use disorder. Answer B: Alcohol intoxication is included as a diagnosis in the DSM-5 and involves maladaptive behavioral and psychological changes with at least one characteristic symptom (e.g., slurred speech; unsteady gait; nystagmus; impaired attention or memory). Answer C: The DSM-5 describes alcohol withdrawal as involving the development of at least two characteristic symptoms within several hours to a few days following cessation or reduction of alcohol consumption (e.g., autonomic hyperactivity, hand tremor, insomnia, transient illusions or hallucinations, seizures).

Question ID #4966: Based on the initial evaluation of a 15-year-old boy, a social worker believes that the nature and number of his symptoms suggest a DSM-5 diagnosis of attention-deficit/hyperactivity disorder (ADHD), predominantly inattentive presentation. Before assigning the diagnosis, the social worker will want to confirm that some symptoms were present before the boy was _____ years of age and that he exhibits them in at least _____ settings. Select one: A. 7; two B. 12; two C. 6; two D. 10; three

The correct answer is B.For a diagnosis of ADHD, the DSM-5 requires that several inattentive or hyperactive-impulsive symptoms were present prior to age 12. (p. 60) and that symptoms are present in at least two settings.

Question ID #4940: A client is taking medication to control the symptoms of a mental disorder. Because of the potential side effect of a serious blood disorder, she is required to have a blood test every week. The client is MOST likely taking which of the following medications? Select one: A. Clozaril B. Chlorpromazine C. Clonazepam D. Celexa

The correct answer is A.The atypical (second-generation) antipsychotic clozapine (Clozaril) was introduced in the United States in 1990. In clinical trials, this medication was found to be more effective than conventional (first-generation) antipsychotic medications in individuals with treatment-resistant schizophrenia (schizophrenia that had not responded to other drugs), and the risk of tardive dyskinesia was lower. However, because of the potential side effect of a serious blood disorder - agranulocytosis (loss of the white blood cells that fight infection) - individuals who are on clozapine must have a blood test every one or two weeks.

Question ID #4935: A social worker has been referred a family that fled from violence in their home country. The family consists of a father, mother, and two children. A third child was killed by land-mines just before the family fled their home. All four members of the family are showing significant stress, and the father has started drinking, although he swears that he did not drink before. The mother was a doctor, but can now only find work as a janitor in a hospital. She complains of nightmares almost nightly and says the children often wake up frightened, but can't say at what. How BEST should the social worker respond to help bridge the cultural gap? Select one: A. Use a traditional healer from the family's home culture; help the family to connect with others from their culture who have re-settled before them; encourage each of them to tell their story; assess and treat PTSD and refer to a substance abuse program. B. Connect the family with ethno-cultural community organizations and religious institutions, help the client get involved with community resources and make vocational training referrals. C. Focus on the fathers drinking initially, followed by reviewing the family's migration trajectory, use traditional healers from the family's home culture, assess and treat PTSD symptoms. D. Take an authoritative stance to increase confidence in the counseling process, normalize the family's experience, encourage story telling using narrative therapy.

The correct answer is A.The question asks about how to bridge the cultural gap, and three out of the four elements in this answer do just that. Working with a traditional healer, at least in the beginning, from the family's home culture (if available) can help bridge the cultural divide, by beginning with a framework the family knows and understands. Connecting the family to others who have resettled, especially those who have been here awhile and are doing well, can lessen the impact of dealing with a foreign culture. Encouraging the family to tell their stories can help them process what they have gone through both before they emigrated, during the immigration process, and during resettlement. The fourth, non-cultural element, is nevertheless a very good one as it addresses PTSD and substance abuse issues, which are both pervasive in the clinical presentation.

Question ID #4980: A 20-year-old unemployed Latina female comes into the social worker's office and shares about her current relationship struggles. She is 2 months pregnant and her boyfriend was recently taken to jail for domestic violence against her. The baby is safe, but she is shaken up and feeling hopeless about what to do now as she relies on him for financial support. She worries that if she does not take her boyfriend back once he is released in a few days that she will not be able to find work to support the baby. What should the social worker's FIRST response be in this situation? Select one: A. Discuss a safety plan with the client for when the boyfriend is released from jail B. Urge her to consider other options regarding her pregnancy and her relationship C. Reflect the feelings she may be experiencing such as fear, sadness, and guilt and normalize those emotions D. Offer resources available for young mothers and encourage her to consider her options

The correct answer is A.The question is asking about the social worker's first response which should be the safety of the client when the boyfriend is released.

The correct answer is A.The question is asking about the social worker's first response which should be the safety of the client when the boyfriend is released. Answer C: The social worker should communicate empathy for the client's situation; however, there is clearly a safety concern addressed first in the case.

Question ID #5002: A social worker begins working in couples therapy with a husband and wife. The couple sought help because they had been arguing daily and believe they cannot communicate with each other. The social worker initially focuses on eliciting information from the wife who is withdrawn and does not volunteer information on her own. The social worker validates the wife's feelings of frustration and tries to offer her hope they can find solutions to the couple's problems by working together in treatment In the next session. The husband says to the social worker, "You have taken my wife's side and ignored how I feel. We won't be back to see you after today". What is the social worker's BEST course of action? Select one: A. Validate the husband's concerns, admit her error, and try to re-establish the therapeutic relationship B. Explain to the couple that, even though she is seeing them in couples therapy, she views each of them as a unique person with a unique point of view C. Help the husband understand why he is resistant to treatment D. Agree to terminate treatment and give the couple referrals to other therapists

The correct answer is A.The question suggests that the social worker failed to develop a therapeutic alliance with both spouses, even though they are both her clients. When a mistake like this is made, the social worker should generally acknowledge it to their clients. Clients often respond favorably when social workers are willing to be honest in this way because it demonstrates their humanness and respect for their client's perceptions and feelings.

Question ID #4999: A social worker is meeting with a client who says she is upset because her primary care physician has suggested that she undergo tests for a possible hyperactive thyroid. The client says she believes that doctors are always looking for excuses to perform unnecessary procedures so that they can make more money. What is the social worker's BEST course of action? Select one: A. Encourage the client to see an endocrinologist to discuss the purpose of the tests B. With the client's permission, contact the primary care physician C. Deal therapeutically with the client's hostility toward doctors D. Talk to the doctor himself and then give the client his own opinion about the tests

The correct answer is A.The woman's primary need is to decide whether she will undergo tests for hyperthyroidism, a social worker cannot offer a professional opinion on a medical question. Referral to an endocrinologist both meets the woman's need in a direct way and deals with the underlying scope of practice issue (an endocrinologist is qualified to discuss these tests with the woman, but a social worker is not). Answer C: This might be an issue to pursue with the client, but it is not the priority because it doesn't address in a direct way the clients need to make a decision about undergoing the medical tests.

Question ID #5000: A social worker is working with a 22-year-old Catholic man who has sought help because he is distressed over a decision he needs to make soon. The client reports his faith is important to him and that premarital sex is wrong, but his fiance is pressuring him to have sex with her. She strongly disagrees with him despite him explaining his beliefs to her. The client's fiance is trying hard to change his mind and now he is completely confused and afraid that he might be wrong. What should the social worker do FIRST in addressing the presenting problem? Select one: A. Find out whether the client has talked with his priest about this, and if not, encourage him to do so B. Normalize the client's confusion by pointing out that his views are less modern than those of many of his peers C. Explore and discuss with the client the source of his confusion D. Find out whether the client has other problems in his relationship with his girlfriend Feedback

The correct answer is A.This answer addresses the presenting problem (the client's distress about the decision he needs to make) more directly than any of the others: The question specifies that much of the client's confusion about his decision stems from his sense of conflict between his religious training and faith on one side and what he sees others his age doing on the other side.

Question ID #5001: A couple has sought counseling because they want help improving their relationship. During the first interview, the husband is extremely critical of the wife. What is the social worker's BEST course of action? Select one: A. Ask the husband to repeat his remarks, then examine them along with the couple B. Ask the wife how she feels about the husband's destructive style of communication C. Ask the husband to be less critical D. Observe the couple for a few more sessions before broaching the topic of the husband's communication style

The correct answer is A.To some extent, a therapist's response to this situation would depend on his or her theoretical orientation, as well as on the goals of treatment. Most family and marital therapy involves improving communication in the family or couple as at least one of the goals and most experts emphasize the importance of identifying dysfunctional communication patterns early in therapy. For instance, Hepworth and Larsen (1986) stress that, in the first session, social workers working with families or couples should begin bringing repetitive dysfunctional communications out in the open and discuss with the family members whether they wish to change these patterns. This is the best answer as the social worker should identify and examine the pattern of communication in collaboration with the couple now, instead of waiting until later sessions

Question ID #4981: A 16-year-old male is discharged from the hospital and referred to a social worker for cutting his wrists with a kitchen knife. When talking to the boy about the incident he explains that cutting felt good. He also says that he does not know if he can stop since it is the only thing that really makes him feel good anymore. What is the social worker's BEST response? Select one: A. Prompt the boy to answer more exploratory questions related to the function of his self-harming behavior B. Discuss with him the dangers of cutting and tell him he'll likely die if he continues C. Have him placed on psychiatric hold D. Provide him with resources about cutting

The correct answer is A.To take a more preventative and proactive approach in working with the client, helping him to identify the function of his cutting behavior may help replace the behavior in the future.

Question ID #4890: A client with alcohol use disorder has been very motivated to quit drinking and has not had any alcohol for three weeks. One night the client drinks several beers. What is the MOST likely reason for this? Select one: A. The client was not truly motivated to quit drinking. B. A stressful event upset the client. C. The client stopped attending AA meetings. D. The client was pressured by peers to drink.

The correct answer is B.According to research, three situations are associated with the highest risk of relapse for people recovering from substance use disorders: Negative or unpleasant emotional states (e.g., anger, anxiety, depression, boredom, frustration); interpersonal conflict (e.g., interpersonal confrontations, arguments); and social pressure from other individuals or group to use alcohol or other drugs (e.g., direct pressure such as verbal persuasion or indirect pressure such as merely being around others who are using). Together, these three precipitants account for nearly three-fourths of relapse incidents; and among them, negative emotional states have been found to be the most frequent cause of relapse (Marlatt & Gordon, 1985; Shiffman et al., 1996).

Question ID #4970: In the DSM-5, mild neurocognitive disorder may be diagnosed when there is evidence of a _______________ decline from a previous level of functioning in one or more cognitive domains. Select one: A. mild B. modest C. significant D. severe

The correct answer is B.The DSM-5 distinguishes between mild and major neurocognitive disorders based on the severity of symptoms. Mild neurocognitive disorder subsumes the DSM-IV-TR diagnosis of cognitive disorder NOS and is the appropriate diagnosis when there is evidence of a modest decline from a previous level of functioning in one or more cognitive domains that do not interfere with the individual's independence in everyday activities (but may require greater effort or compensatory strategies) and does not occur only in the context of delirium. Major neurocognitive disorder subsumes the DSM-IV-TR diagnosis of dementia and is diagnosed when there is evidence of significant decline from a previous level of functioning in one or more cognitive domains that interfere with the individual's independence in everyday activities and do not occur only in the context of delirium.

Question ID #4901: According to Berry's acculturation model (1990), the acculturation mode known as marginalization is characterized by: Select one: A. low involvement in the mainstream culture B. low involvement in both the mainstream culture and the minority culture C. low involvement in the minority culture D. low involvement in the mainstream culture and high involvement in the minority culture

The correct answer is B.Acculturation is sometimes conceptualized as existing on a single continuum, with the minority culture being located at one end of the continuum and the majority (dominant or mainstream) culture at the other end. An important implication of this is that, the more a minority group member adopts the mainstream culture, the less involved the person will be in his or her own culture, and vice versa. An alternative model has been proposed by Berry (1990), who views acculturation as a multidimensional construct consisting of two independent dimensions - retention of one's minority culture and maintenance of the mainstream culture. The various combinations of high and low levels of these two dimensions produce the following four acculturation modes: a) integration - high retention of the minority culture and high maintenance of the mainstream culture; b) assimilation - low retention of the minority culture and high maintenance of the mainstream culture; c) separation - high retention of the minority culture and rejection of the mainstream culture; and d) marginalization - low retention of the minority culture and low maintenance of the mainstream culture. Berry also notes that changes related to acculturation can be highly stressful for a person, but that the level and consequences of stress are moderated by several factors. For example, in terms of acculturation mode, high levels of stress are associated with marginalization and separation; moderate levels are associated with assimilation; and low levels are associated with integration.

Question ID #4860: A client comes into your social service agency to seek help from a social worker for her 10-year-old son, who has been experiencing behavioral problems at school. She is a single mother of three children and is struggling to pay all of her expenses each month. She sometimes receives financial help from her mother, who also provides childcare when the client is at work. The son's father has been incarcerated for two years. Which of the following is a protective factor that may increase the 10-year-old child's likelihood of resiliency? Select one: A. The child's father is incarcerated, which means the child is less likely to witness criminal activity. B. The child's mother is willing to seek therapy for the child. C. The child makes friends easily. D. The child has two siblings

The correct answer is B.Although she is stretched thin, the fact that the child's mother is deeply engaged in his care indicates that he has a strong support system. This is a likely protective factor that indicates positive outcomes for him long-term.

Question ID #4971: A diagnosis of schizoaffective disorder requires the presence of delusions and hallucinations for at least __________ without symptoms of a depressive or manic episode. Select one: A. one week B. two weeks C. one month D. two months

The correct answer is B.As its name suggests, schizoaffective disorder is characterized by concurrent psychotic and mood symptoms. However, for the diagnosis, the individual must have experienced a period of at least two weeks without prominent mood symptoms. Answers A, C, and D: The individual must have experienced a period of at least two weeks without prominent mood symptoms. The correct answer is: two weeks

Question ID #4989: A social worker working in individual therapy with a depressed client decides to use Aaron Beck's cognitive therapy. Using Beck's cognitive therapy means that the social worker will rely heavily on which of the following techniques to bring about desired change? Select one: A. Skills training B. Socratic questioning C. Modeling D. Addressing ambivalence

The correct answer is B.Beck's cognitive therapy (CT) assumes that depressive symptoms can be removed by altering the cognitions that underlie them, and the majority of communications by the therapist take the form of questions designed to help the client examine relevant information. Questioning often takes the form of Socratic dialogue, or questions designed to help the client reach logical conclusions about a problem and its consequences. Answer A: Skills training would be used by the therapist using Dialectical Behavioral Therapy.

Question ID #4950: A client reports that he feels depressed, hopeless, and as though it's pointless to keep going when nothing good ever happens. Based on this, the social worker suspects that the client is self-destructive. To determine the level of risk for suicide currently posed by the client, what should the social worker do FIRST? Select one: A. Get a complete psychiatric history B. Determine if he has a specific suicide plan C. Ask him if he has ever had these thoughts before D. Find out if he has reliable social support

The correct answer is B.Direct assessment of suicide emphasizes indicators that directly suggest an elevated and more imminent risk of a suicide attempt - these indicators are intent, plan, and means. The risk to life is highest when a client has both a concrete, lethal suicide plan and the means available to carry it out. This client seems to have communicated an intent to commit suicide. Communication of intent can be either direct (I'm going to kill myself) or, as in this case, indirect (it's pointless to keep going when nothing good ever happens). Once the social worker knows that a client has thought about hurting himself, s/he should ask him whether he has ever thought about how he would commit suicide (i.e., whether he has a suicide plan).

Question ID #4895: An adult male seeks individual therapy for help in resolving longstanding feelings of personal inadequacy that have affected his personal relationships and career. The client longs to get married but has never had a relationship that lasted for more than a few months. He hasn't had a promotion at work in over five years. If the social worker approaches this case from the perspective of ego psychology, she will be concerned with all of the following EXCEPT: Select one: A. ego functions and processes B. unconscious drives and forces C. ongoing development in adulthood D. the role of the social environment Feedback

The correct answer is B.Ego psychology focuses on adulthood development and the individual's capacity to resolve problems and deal with social realities. It also emphasizes tasks that people must master during each developmental stage. Although psychoanalytic theory underlies ego psychology, the latter stresses the growth and development of ego functions and processes, independent from the unconscious drives that Freud emphasized.

Question ID #4871: In terms of emotional development, a key task in middle childhood is the development of "emotional competence," which is BEST described as the ability to: Select one: A. regulate negative emotions in appropriate ways B. experience, express, and understand emotions C. read other people's emotions and vicariously experience them D. the ability to process negative emotions

The correct answer is B.Emotional competence can be described as having two sides: intrapersonal (inside, self) and interpersonal (relationships). It refers to the ability to experience, express, and understand emotions. An emotionally competent person is aware of and recognizes his/her own emotions and regulates their expression (experiencing emotions); expresses his/her emotions in ways that are socially appropriate to the situation (expressing emotions); and is able to read other people's emotions and respond to them appropriately and understands that people have different emotional styles (understanding emotions).

Question ID #4939: A social worker begins working in family therapy with a Chinese American family who has been in the United States for one generation. While the social worker is collecting data from the family members, one of the adult children tells her that his mother often talks to the family's unborn and deceased relatives. What should the social worker do FIRST now that she has this information? Select one: A. Arrange to have the mother evaluated by a neuropsychologist in order to clarify functional deficits. B. Discuss how the family members perceive the mother's behavior. C. Shift her focus from the family as a whole to assess the mother's social functioning as she may be feeling isolated from family members and the community. D. Accept the mother's behavior as culturally sanctioned and proceed with her assessment.

The correct answer is B.Given the cultural framework presented in the question (and the fact that only one symptom is mentioned), B describes the best way to begin developing an understanding of this behavior. Within the family's culture, the mother's behavior may be sanctioned, considered normal, and have a specific meaning. Therefore, the social worker should begin assessing this symptom by exploring how each family member perceives it.

Question ID #4990: In solution-focused therapy, which of the following is considered MOST important for the therapist to do at the beginning of treatment? Select one: A. Conduct a thorough screening and history-taking B. Help the client identify and describe therapy goals in concrete, positive terms C. Educate the client about causes of the presenting problem and alternative approaches to solving it D. Identify the client's stage of change

The correct answer is B.In solution-focused therapy, the formulation of goals is critical for producing a change in context from complaint narratives to solution narratives. During the very first meeting (after a brief problem description by the client), a solution-focused therapist begins asking the client goal formulation questions designed to initiate the process of goal construction. The miracle question is often the first intervention; its purpose is to lay a foundation for follow-up questions that enable the client to visualize and express what things will be like when the miracle happens (when the problem no longer exists). Stating goals in positive concrete (behavioral) terms helps the client recognize when he or she is accomplishing the goals and has been found to be a good predictor of outcome in solution-focused therapy.

Question ID #4982: A social worker has a new client with numerous episodes of major depression. She has been hospitalized twice and has tried to commit suicide once. She was raised by an alcoholic mother and a periodically absent, abusive father. Mindfulness-based Cognitive Therapy (MBCT) would consider the client's depression as consisting of: Select one: A. a lack of self-acceptance B. a downward mood spiral that can be caused by high standards C. an inability to be present in the moment D. internalized anger

The correct answer is B.MBCT teaches clients how to stop the downward spiral that begins with a bad mood or thoughts about painful memories. MBCT teaches clients to accept negative emotions or thoughts without judgment and to shift gears to a more self-accepting, less judgmental mental space.

Question ID #5008: A client diagnosed with alcohol use disorder has been in recovery for some time but has recently had a relapse. A therapist using the relapse prevention therapy developed by Marlatt and Gordon would focus on which of the following in the client's treatment? Select one: A. The client's feelings about the relapse B. The client's attributions about the cause of the relapse C. The negative consequences of the relapse D. Personality and psychodynamic variables related to the relapse

The correct answer is B.Marlatt and Gordon (1985) refer to the typical reaction to relapse as an abstinence violation effect which involves self-blame, guilt, anxiety, and depression, and can lead to an increased susceptibility to further alcohol consumption. They propose that the potential for future relapse is reduced when the person views the episode of drinking as a mistake resulting from specific, external, and controllable factors (rather than global, internal, and stable or uncontrollable factors).

Question ID #4913: Social workers perform self-assessments: Select one: A. to recognize and correct their mistakes B. to monitor their professional strengths and weaknesses C. to identify countertransference feelings D. to recognize when a client's problem is outside their scope of competence

The correct answer is B.Regular self-assessment allows social workers to take advantage of and improve their professional skills, attitudes, and interactional patterns; like all forms of assessment, it should emphasize both strengths and weaknesses. A focus on strengths enables social workers to draw on their skills and other assets in the future. A focus on weaknesses enables social workers to recognize and correct their deficiencies.

Question ID #5028: What is the primary role of a school social worker? Select one: A. To coordinate special education services B. To link the school, home, and community C. To improve the schools culture and climate D. To deal with student misconduct

The correct answer is B.School social workers are concerned with enabling students to learn and function in the school environment, and, in working toward that goal, they draw heavily on ecological concepts and rely on an ecosystems perspective in which they focus on the reciprocal interactions of students with environmental factors. School social workers assume that each student is an inseparable part of the social systems in which he or she must function - i.e., home, school, peer group, neighborhood - and that a student's problems are due to a lack of goodness of fit between the student and his or her environment (problems are not located within the child). Therefore, school social workers emphasize issues of school-family-community partnerships and parent involvement - they seek to mobilize all facets of a student's life situation in order to foster a supportive learning environment and serve as a vital link between a student's school, home, and community.

Question ID #4873: The symptoms of shaken baby syndrome include which of the following? Select one: A. Bruising, seizures, drowsiness, vomiting, swollen eyes B. Lethargy, crying, vomiting, loss of appetite, seizures C. Crying, facial swelling, loss of appetite, seizures, apnea D. Lethargy, crying, seizures, bruising, bloodshot eyes

The correct answer is B.Shaken baby syndrome (a.k.a. shaken infant syndrome) usually doesn't produce external signs of injury; instead, the baby usually suffers bleeding of the brain and retinal hemorrhage, which can lead to permanent neurological damage, seizure disorders, blindness, deafness, and sometimes death. The typical symptoms of shaken infant syndrome include lethargy, crying, vomiting, loss of appetite, and seizures.

Question ID #4908: A social worker is meeting with a 16-year-old client with the consent of his parents. The client discloses that he wishes to transition to a female and is considering sex reassignment surgery. To be an ethical social worker, what is the BEST response? Select one: A. Tell the client that he/she is mandated to discuss with his parents as they consented for treatment. B. Encourage the client to invite his parents into session to discuss further. C. Begin helping the client research doctors to conduct the surgery. D. Discuss the concerns that this option is risky and telling the client to reconsider.

The correct answer is B.The best response in this situation of the ones given would be to encourage the client to invite his parents into session to discuss this issue further.

Question ID #4900: Typically, the first stage of a grief reaction to the death of a loved person is characterized by shock, confusion, a sense of being overwhelmed, and physical symptoms, followed by anger. After a few days or weeks, this is usually followed by a stage that is marked primarily by which of the following? Select one: A. Disorganization B. Longing C. Helplessness and despair D. Denial Feedback

The correct answer is B.The next (third) stage of grief usually involves an intense sense of longing, or yearning, and bargaining. The person may seek in some way to recover the person who died. He or she may become preoccupied and withdrawn, may wander around as though he or she is searching for the deceased person, and may report seeing or being with the deceased person. Answer A: This is typical of the first stage of grief. Answer C: This is typical of the fourth depression stage. As the reality of the loss sinks in, the person experiences feelings of helplessness, despair, depression, and fatigue. Answer D: Denial is something that occurs during the first stage of grief.

Question ID #4904: A social worker's new client is a 32-year-old male who has sought therapy to figure out how to deal with his needy and emotional mother. During the initial two interviews, he describes his mother in condescending terms and attributes her flaws to the fact that she is female. The social worker grew up with a father who held sexist views and often disparaged women, including her mother. The social worker feels very uncomfortable around this client and finds she is unable to empathize with him. What action should the social worker take in this situation? Select one: A. Get supervision. B. Offer the client a referral to another therapist. C. Explore other areas of the client's life to find reasons to empathize with him. D. Ask the client to bring his mother in.

The correct answer is B.The question describes a very poor fit between the social worker and client, which indicates that a referral is appropriate. Answer A: Although supervision is often useful when a social worker finds that his or her personal feelings are affecting work; in this case, the inability to empathize with the client makes a referral a better choice.

Question ID #5020: A social worker meets with a client who is disabled and unemployed. The client has never had a job and has almost no money. What types of resources should the social worker recommend that the client apply? Select one: A. SSDI Incorrect B. SSI C. TANF D. Unemployment insurance

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

Question ID #4892: A social worker meets with a client whose friend died recently from an opportunistic illness that developed during the late stage of HIV disease. The client has HIV disease and has not been taking his medication regularly since his friend died. The client's behavior MOST likely indicates which of the following? Select one: A. Displacement B. Grieving C. Suicidality D. Denial

The correct answer is B.This is the best answer because you know that this client has recently lost a friend. For some people, the grieving process includes self-destructive (non-suicidal) behavior.

Question ID #4962: A client joins a grief group and tells everyone that his wife died and that he just can't get over it. He says they were married 25 years and were planning on traveling around the world when she became ill. The client complains of not sleeping, eating very little, and not wanting to spend time with friends. The social worker is more likely to assign a DSM-5 diagnosis of uncomplicated bereavement to the client than a diagnosis of major depressive disorder if: Select one: A. the man's feeling of loss is accompanied by a depressed mood on most days and an inability to anticipate pleasure or happiness. B. the man's symptoms have dissipated in intensity over time and occur primarily when he thinks about his wife and their relationship. C. the man has had persistent symptoms for less than two months. D. the man's wife died less than six months ago and he considers his reaction to her death to be normal.

The correct answer is B.Uncomplicated bereavement is included in the DSM-5 with other conditions that may be a focus of clinical attention and is described as involving a feeling of emptiness or loss. Therefore, uncomplicated bereavement is not a mental disorder. The DSM-5 also states that the dysphoria in grief is likely to decrease in intensity over days to weeks and occurs in waves ... [that] tend to be associated with thoughts or reminders of the deceased (p. 161).

Question ID #4909: A social worker has been providing psychotherapy to an adult male who is on probation. The client was ordered into therapy by the court and has been cooperating. One day, his probation officer contacts you and requests information about how the client is progressing in therapy. How BEST should you handle this request? Select one: A. Release information to the probation officer with or without the client's permission because his therapy is court ordered. B. Remind the probation officer that you hold the privilege in this situation and refuse to release the information to the officer if you believe that doing so could harm the client. C. Release information to the probation officer only if you have the client's permission to do so. D. Refuse to release information to the probation officer unless there is court order that mandates you to release it.

The correct answer is C.A client retains his right of confidentiality even when his therapy is court-ordered. Therefore, the social worker needs to have a release of information signed by the client in order to discuss his case with other relevant parties, including his probation officer.

Question ID #4914: During a session, a 15-year-old therapy client says, "This guy has been stalking me." She then begs the social worker to keep this information from her parents because she's afraid that they'll get mad and think she somehow provoked the behavior. What should the social worker do FIRST in this situation? Select one: A. File a child abuse report B. File a child abuse report and call the client's parents C. Assess the situation further to determine what the client needs D. Maintain confidentiality and address the client's feelings about this

The correct answer is C.Because this girl may be in danger, the social worker must first gather more information from her so that she can better understand the situation and what she needs from the social worker. The social worker needs to know what the stalking consists of, clarify what the client means when she uses that word, who the guy is, and what danger, if any, the girl is in. Answer A: Being stalked, by itself, doesn't constitute a form of child abuse. Depending on what else you learn about this situation, however, a report may turn out to be necessary.

Question ID #5016: A social worker is using task-centered treatment with a client who is having difficulty managing her adolescent son. The boy often disobeys her when she asks him to help out around the house. In using task-centered treatment with this client, which of the following is MOST important? Select one: A. The extent to which the client is capable of acquiring insight into what is causing this problem B. The social worker's view of the problem after the client has finished describing it C. Identifying relevant problem-solving actions D. The depth and strength of the social worker-client relationship

The correct answer is C.In task-centered treatment, change is brought about primarily through problem-solving actions (tasks) undertaken by the client (and sometimes by you) between sessions. Sessions are used to lay the groundwork for these actions. A social worker's role is to help the client develop and explore alternative ways of resolving her problem, which is expected to support and stimulate the client's own problem-solving abilities. All tasks are developed based on an evaluation of obstacles to the client's problem-solving ability.

Question ID #4994: In a cross-cultural counseling situation, a social worker is MOST likely to successfully facilitate the development of rapport by: Select one: A. saying nothing about the cultural difference herself and letting the client bring it up if it matters to him B. remaining aware of the cultural difference between herself and the client C. openly acknowledging the cultural difference to the client D. downplaying the cultural difference because focusing on it may lead her to stereotype the client

The correct answer is C.Research has shown that clients in cross-cultural counseling settings tend to terminate therapy prematurely when the therapist ignores the cultural differences or other relevant cultural issues. The social worker should acknowledge the cultural difference and ask the client, in a supportive way, if he has any concerns about it. Answer A: Best practice indicates it is best to acknowledge the difference when building rapport and give the client a space to talk about it. Answer B: The social worker must do more than merely be aware of the cultural difference - they should also acknowledge the difference to the client. Answer D: This would not be an appropriate intervention and could damage the rapport building in the relationship.

Question ID #5003: The client is a 29-year-old woman who was raped two days ago by a stranger. What is MOST important for the social worker to do in the first meeting with this client? Select one: A. Have the client talk about what happened to her B. Urge the client to call the police to report the rape C. Establish a specific plan covering the next few days D. Tell the client that he (the social worker) is required to contact the police to report the rape

The correct answer is C.Therapists providing crisis intervention should participate actively and be directive in establishing activities that will help the client manage a crisis and its aftermath. For individuals who have been raped or otherwise assaulted, it can be especially useful to have a specific plan for the days following the attack so that they can begin to move from victimization toward empowerment. Answer A: The client primarily needs support and structure currently. In addition, because the rape was so recent, the client's emotions and cognitions may be chaotic. The social worker should focus on providing crisis intervention. Answer B: If this client has not filed a police report yet, the social worker can help her clarify her thoughts and feelings about filing a report but should not urge her to contact the police. Answer D: There is no appropriate basis for breaching this client's confidentiality. In addition, the decision to file a police report must be left to the client.

Question ID #4919: A social worker begins working in individual therapy with a client who is gay. In the middle of their first meeting, the client discloses that he wants to work with a gay social worker. The social worker is not gay. What should the social worker do FIRST? Select one: A. Respect the client's wishes and refer him to a gay social worker B. Let the client know that she's worked successfully with other gay clients C. Briefly explore why the client wants to work with a gay therapist D. Reassure the client that she won't allow differences between them to affect her objectivity

The correct answer is C.This client may have misconceptions about whether heterosexual social workers are able to treat gay clients, or perhaps, misconceptions about this social worker in particular. By talking with the client briefly about his reasons for wanting a gay social worker, she would have an opportunity to clear up any misconceptions he may have.

Question ID #4928: A social worker employed at a family service agency meets with a 16-year-old girl who is failing several classes and frequently truant from school. She goes out with her friends on many nights and often misses her 10:00 p.m. curfew. The girl tells the social worker that she just found out she is pregnant and is excited about having a baby to care for. She hasn't told her parents because she is sure they will force her to have an abortion. What is the social worker's BEST course of action? Select one: A. Support the girl's right to keep the baby and arrange for her to receive prenatal care B. Discuss with the girl the pros and cons of keeping the baby, and making sure she understands why an abortion may be indicated under the circumstances C. Encourage the girl to bring her parents in for a family session to disclose what's going on and discuss alternatives D. Explain to the girl that he must contact her parents about her possible pregnancy

The correct answer is C.This option is most consistent with the values that underlie social work practice. Social workers respect and promote the right of their clients to self-determination and assist their clients to identify and clarify their own goals. Social workers also recognize the central importance of human relationships. The social worker should attempt to involve the girl's parents in this important decision. (Note, too, that many states in the U.S. have laws in effect that mandate the involvement of at least one parent in the abortion decision of a minor; therefore, if the girl ultimately decided to have an abortion, at least one parent might need to be involved in order for the procedure to be performed. The social worker should be familiar with the laws in effect in the state where they practice; the social work exam, however, is a national exam, and does not test knowledge of state-specific laws.)

The correct answer is C.When a social worker is asked by a client to reveal personal information, they may share that information if comfortable doing so. It's also useful to facilitate exploration of the feelings that underlie the client's inquiry. Answer A: This answer is incomplete as it does not address why the client is asking for this information now.

Question ID #5015: A client says, "I am always helping my friends. They know I will drop everything and be there when they need me. I am tired of it." In response, the social worker says, "It sounds like you feel responsible for taking care of your friends, but at the same time, you want to be more in charge of your own life, no longer at the mercy of your friends' appeals for help. What do you think makes you feel that you are responsible for taking care of your friends?" What BEST describes the skill used by the social worker? Select one: A. Paraphrase B. Confrontation C. Interpretation D. Summarizing

The correct answer is C.While many other skills such as paraphrasing, reflecting, and clarifying remain within the client's frame of reference, interpretation goes a step further by providing a new frame of reference for the client to consider. It offers an explanatory statement that responds to something about the client's thinking or behavior that the client is not aware of yet. An interpretive response encompasses not only what the client has said, but also an inference derived from the client's message. This helps the client view a problem from a different perspective which often opens the door to new solutions. Offering relevant and timely interpretations is an important way of facilitating a client's insight.

Question ID #4886: A social worker is assessing a 4-year-old who was brought in by her parents following a recommendation by the pediatrician. The parents are worried that their child is developing too slowly. Which of the following findings, if true about this child, would reflect something that is considered developmentally appropriate for a 4-year-old? Select one: A. She is toilet training during the day but not at night. B. She has yet to develop the object concept. C. She still engages in magical thinking. D. She has yet to label herself as a girl.

The correct answer is C.You're looking for a response that would be developmentally appropriate for this child. A 4-year-old is in Piaget's preoperational stage (2 to 7 years). Children in the preoperational stage have an incomplete understanding of cause and effect. Manifestations of such transductive reasoning include both magical thinking, or the belief that thinking about something will actually cause it to occur; and animism, which is the tendency to attribute human characteristics to inanimate objects such as toys.

Question ID #4898: According to Piaget, children in the preoperational stage of development: Select one: A. carefully follow the rules when playing games B. understand that changing one dimension of an object does not change its other dimensions C. think objects disappear when they have been hidden from view D. treat objects as symbols of things (e.g., dolls as babies)

The correct answer is D.According to Piaget, children pass through four stages of cognitive development: sensorimotor, preoperational, concrete operational, and formal operational. The manipulation of symbols is an essential characteristic of the preoperational stage of development (ages 2 to 7).

Question ID #4902: The diathesis-stress theory proposes that some mental disorders are the result of genetic predisposition combined with: Select one: A. prenatal stress B. a person's interpretation of stressful events C. exposure to high stress during a critical period D. stressful situations in the environment

The correct answer is D.The diathesis-stress theory (a.k.a. stress-diathesis theory) proposes that schizophrenia and some other mental disorders are the results of genetic predisposition combined with stressful situations in the environment.

Question ID #4870: According to observational learning theory, external reinforcement may influence the cognitive processes involved in learning and the behavior itself, but a behavior can occur in the absence of external reinforcement. Bandura believed that this is because performance of the behavior may be self-reinforcing in that it increases the learner's: Select one: A. sense of well-being B. stimulus-response connection C. stimulus generalization D. feelings of self-efficacy

The correct answer is D.Bandura concluded that observational learning entails a change in cognition involving attentional, retention, production, and motivational processes. Regarding the latter, the learner must be motivated to learn and perform the modeled behavior. Motivation is increased when the learner is reinforced, but the reinforcement can be either internal, vicarious, or external. Observational learning often includes progressive performance of the behavior by the learner with assistance from a model (guided participation), and Bandura and others have suggested that the effectiveness of this approach is due to the sense of self-efficacy (personal mastery) the learner gains by successful performance of the target response.

Question ID #5009: The main purpose of case recording in direct social work practice is to: Select one: A. provide accurate information for insurance purposes B. enhance supervision C. protect social workers in the event of malpractice suits D. demonstrate and promote the quality of client services

The correct answer is D.Case records maintained by social workers demonstrate and encourage the quality of client services - they help social workers keep track of client problems, needs, and progress and the services provided to clients. Due to the type of information they contain about client services, case records provide accurate information for insurance purposes, facilitate supervision, and protect social workers in the event of malpractice suits.

Question ID #4960: A 5-year-old boy is in foster care and enrolled in a therapeutic nursery school. He and his older sister were removed from their home after they were found wandering in the park asking people for food. Their parents were both found to have a drug problem. While observing the boy at school, the social worker notices that he impulsively approaches strangers, tends to be overly familiar with people he has just met, and quickly becomes attached to any adult who pays attention to him. Before assigning a DSM-5 diagnosis of ______________ to this boy, the social worker will want to confirm that his symptoms are attributable to ______________. Select one: A. reactive attachment disorder, disinhibited type; developmental delays B. disinhibited social engagement disorder; developmental delays C. reactive attachment disorder, disinhibited type; early neglect or deprivation D. disinhibited social engagement disorder; early neglect or deprivation

The correct answer is D.Disinhibited social engagement disorder involves a pattern of culturally inappropriate and overly familiar behavior with unfamiliar people with evidence that the behavior is related to the experience of extremely insufficient care in the early years of development. Answer A: The DSM-5 diagnosis of disinhibited social engagement disorder replaces the DSM-IV-TR diagnosis of reactive attachment disorder, disinhibited type. Note that the DSM-5 does include the disorder reactive attachment disorder, but without the subtypes (disinhibited type, inhibited type) provided in the DSM-IV-TR. In the DSM-5, reactive attachment disorder is characterized by a consistent pattern of inhibited and emotionally withdrawn behavior toward adult caregivers. As with disinhibited social engagement disorder, the diagnosis requires evidence that the behavior is related to the experience of extremely insufficient care. The etiology of both disorders is due to the experience of extremely insufficient care, not developmental delays.

Question ID #4879: Most infants speak their first word between the ages of 10 and 15 months. Studies investigating language development have shown that children's first words often refer to: Select one: A. objects that are related to eating B. objects that the child can hold C. stationary objects that are static and invariable D. dynamic objects that move or change

The correct answer is D.First words are most often nominals, or labels for objects, people, or events, although action words, modifiers, and personal-social words (e.g., please) also occur. Nominals are most likely to refer to dynamic objects (dog, car) or objects the child uses (spoon). For many children, the very first word is either mama or dada

Question ID #4959: When using the DSM-5, a child with dyslexia who has not responded to interventions that target his reading problems would receive a diagnosis of: Select one: A. academic skills disorder with impaired reading B. reading disorder C. learning disorder NOS D. specific learning disorder with impairment in reading

The correct answer is D.The DSM-IV-TR diagnoses of reading disorder, mathematics disorder, disorder of written expression, and learning disorder NOS have been combined in the DSM-5 into the single diagnosis of specific learning disorder, with the type of disorder being indicated with a specifier, such as impairment in reading, as in this answer. Answer A: A learning disorder was diagnosed as an academic skills disorder in DSM-III. Answer B: A problem with reading would be a specifier of specific learning disorder, phrased as with impairment of reading. Answer C: The DSM-IV-TRs NOS (not otherwise specified) designation has been replaced in the DSM-5 with two options - other specified disorder and unspecified disorder. The correct answer is: specific learning disorder with impairment in reading

Question ID #4910: A social worker receives a subpoena requesting that she provide information about an 18-year-old client who is currently the defendant in a court case. There is no consent to release information signed by the client attached to the subpoena. The social worker contacts her client to discuss with him the implications of releasing the requested information, and he ends up refusing to give his permission for the release of confidential information. What should the social worker do NEXT? Select one: A. Withhold the requested information for now and ultimately provide the court with the information only if she is able to obtain a release from her client B. Comply with the subpoena because she is required to, and provide the court with the requested information even though the client has not consented C. Comply with the subpoena because she is required to, even though the client has not consented, but provide the court only with information that she believes will not be harmful to the client D. Withhold the requested information for now and attempt to negotiate with the party who issued the subpoena

The correct answer is D.The concept of privilege suggests that, in the absence of some other legally defined waiver or court order, the social worker should not reveal confidential information in the context of a legal proceeding without consent from the client. So far in this case, the social worker has received the subpoena, presumably determined that the subpoena is valid, and contacted the client to discuss the implications of providing the requested information. Following this discussion, the client has refused to give permission for the release of confidential information. At this point, the social worker should withhold the requested information. In addition to this, the social worker can also attempt to negotiate with the party who issued the subpoena. If that party continues to demand that the information be provided, the social worker may seek guidance from the court informally through a letter or have an attorney file a motion to quash or modify the subpoena.

Question ID #4946: A client experiences hallucinations while intoxicated. This symptom indicates that the client is LEAST likely to be intoxicated on which of the following substances? Select one: A. Cannabis B. Cocaine C. Heroin D. Alcohol

The correct answer is D.The essential feature of intoxication is the development of a reversible, substance-specific syndrome that is due to recent ingestion of a substance. An intoxication syndrome includes marked behavioral or psychological changes that are due to the effects of the substance on the central nervous system; these changes develop during or shortly after use of the substance. Although hallucinations with intact reality testing may occur during alcohol withdrawal, they are not associated with alcohol intoxication. Signs of alcohol intoxication include slurred speech, incoordination, unsteady gait, nystagmus, impaired attention or memory, and stupor or coma. Answer A: Cannabis intoxication may include perceptual disturbances; e.g., hallucinations with intact reality testing. Answer B: Cocaine (stimulant) intoxication may include hallucinations with intact reality testing. Answer C: Heroin (opioid) intoxication can include hallucinations with intact reality testing. The correct answer is: Alcohol

Question ID #5006: A client has alcohol use disorder and struggles with abstinence. What is the BEST way to approach treatment in this case? Select one: B. Provide individual psychotherapy C. Confront low motivation D. Use Gorski's relapse prevention model

Question ID #5006: A client has alcohol use disorder and struggles with abstinence. What is the BEST way to approach treatment in this case? Select one: A. Refer the client to AA B. Provide individual psychotherapy C. Confront low motivation D. Use Gorski's relapse prevention model

The correct answer is D.This client needs relapse prevention training. Terry Gorski's relapse prevention model is based on a sequence of warning signs that start long before a recovering alcoholic takes his or her first drink. Gorski's model can be individualized to any client with alcohol use disorder who is in a chronic cycle of relapse. Answer A: The client's history of relapse suggests that he or she needs more than just AA currently in order to get sober and stay abstinent. Answer B: The client could receive relapse prevention training from a social worker in individual therapy, but D is a better answer because using Gorski's approach would directly target what the question describes as the client's primary need. Answer C: Most experts in the field of chemical dependency, including Gorski, believe that a combination of factors and cues (physiological, emotional, cognitive, social, etc.) can lead a recovering alcoholic to relapse despite appropriate motivation to stay sober. Gorski's method focuses directly on the factors leading to relapse.

Question ID #5019: A client who immigrated to the U.S. from Saudi Arabia wears a veil that covers most of her face and the social worker cannot see her facial expressions. The social worker's BEST course of action is to: Select one: A. let the client know that he or she needs to refer her to a therapist who shares her background B. ask the client whether she would be willing to remove her veil during therapy sessions C. have one of the client's male relatives come in to facilitate communication D. discuss facial expressions and other nonverbal messages with the client in an effort to understand her nonverbal communications

The correct answer is D.This is the best answer offered as it will empower the client and social worker to discuss the importance of facial expressions and nonverbal messages in communication. When a social worker lacks knowledge about an aspect of a client's culture, such as the meaning of nonverbal communications, it is appropriate to discuss this openly with the client and ask her for information. This both shows a consideration that the client is the expert on her own culture and religion and opens an important channel of communication between the social worker and the client. Another appropriate action in this situation would be to seek consultation from a colleague with relevant expertise

Question ID #5011: Which message is the BEST example of an "I" statement? Select one: A. I want you to quiet down. B. I feel that you are exaggerating when you tell me that I never listen to you. C. I hear you. D. I worry when you get home late because I'm afraid you've been in an accident.

The correct answer is D.This statement adequately reflects an I statement as it adequately reflects the speaker's feelings without using defensive language. The I statement should refer to the behavior, not the person, and should reflect how the behavior affects others as well as what needs to happen next.

To take a more preventative and proactive approach in working with the client, helping him to identify the function of his cutting behavior may help replace the behavior in the future. Answer C: While the client is moderate to high risk to continue his cutting behaviors, he was recently discharged and does not need to be placed on hold at this time.

Question ID #4937: Sex traffickers often use a process called grooming to gain control over their victims. Social workers who work with at risk populations like runaways, undocumented immigrants, and LGBT youth rejected by their families need to be aware of the signs of grooming so that they can intervene in the process. The progression of gaining power through this process involves: Select one: A. grooming, trauma bonding, and dominance B. creating dependence, separating the victim from their family, threats and drugs C. ensnaring, creating dependence, taking control and total dominance D. using favors and gifts, instilling a sense of fear, creating dependence and taking control

he correct answer is C.These are the stages of the grooming process as outlined by O'Connor and Healy (2006). Ensnaring involves the trafficker making himself seem like a trustworthy and valuable person in the victim's life. The victim may be plied with gifts or drugs to create a sense of indebtedness. The trafficker gradually separates the victim from family and friends, while providing support such as housing, food, drugs, etc., thus creating dependence. The taking control stage involves the trafficker becoming possessive, threatening, or even violent. The victim is isolated from her family and friends and has nowhere to turn for support, except her trafficker, who at times, may shower the victim with loving gestures to keep them emotionally invested. Finally, total dominance is achieved when the trafficker demands that the victim prove their love by earning money through prostitution.

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