MSW Licensure Part B

Excessive and insulting criticism from his boss attacking Warren's work, character and competence really offended and angered him That night he had a terrible argument with his wife about an irrelevant issue, shouted at his children, and he hung up on his best friend during a phone argument. Given these unusual circumstances we can assume that the psychological defense mechanism involved was probably. A) Displacement B) Regression C) Sublimation D) Denial

A) Displacement

A teenage girl calls a crisis hotline at 2:00 A.M. She is distraught and reports that her 22-year- -old boyfriend with whom she has lived for the past three years threw her out of their apartment because she is pregnant. The girl will be eighteen in two days. The social worker at the hotline should first A) Arrange for emergency adoption services. B) Contact a youth shelter. C) Report a case of child abuse. D) Call her parents.

B) Contact a youth shelter.

The classic features of clinical depression do not include: A) Feelings of hopelessness, sadness and worthlessness, increased anxiety. B) Depressed mood and loss of interest in usual activities. C) Loss of appetite, reduced energy, inability to complete tasks. D) Deeper and longer periods of sleep without interruption.

D) Deeper and longer periods of sleep without interruption.

Joe had seen several physicians and each confirmed the other's diagnosis that Joe was infected with the HIV virus. Despite these multiple diagnoses supporting each other Joe maintained that he was not ill and was not going the change his life. In this case the defense mechanism is A) Projection B) Displacement C) Sublimation D) Denial

D) Denial

Which of the following theories focuses on the person in the environment? A) Ego Psychology. B) Systems theory. C) Developmental theory D) Ecological theory.

D) Ecological theory.

A school social worker is observing and assessing a 10-year-old boy who was referred by his teacher for behavior and learning problems. Though the boy seems intelligent and verbal, he is inattentive in class and has difficulty absorbing certain skills in reading and math. He is easily distracted. He rarely follows instructions and does not finish assignments. The social worker should first consider that the child A) has a conduct disorder. B) may have been abused at home. C) has an impulse disorder. D has a learning disorder.

D has a learning disorder.

Larry's long-term drug habit finally led him to seek help. A therapeutic community was recommended to remove from his drug-addicted friends and the lifestyle that accompanies habitual drug dependence. Harry finally agreed to enter a residential therapeutic community that required him to stay in relative isolation from the community for a period of 12-18 months. The likelihood of Larry remaining in the program for more than one month is A) Better than 80% B) No more than 50%. C) About 10%. D) About 25%.

D) About 25%.

A 17-year-old male had a spinal cord injury due to a motorcycle accident that caused permanent paralysis below the waist. The family has been informed there is no possibility of cure or likely change in their son's condition. His father is in denial, believes a cure is possible, and refuses to participate in planning for his son. The mother is overwhelmed and in crisis. The two younger brothers are also in crisis and are unable fully to grasp the implications of their brother's injury. What type of therapy is not recommended? A) Intellectual Disability B) Bipolar Disorder C) Autism

D) Attention-Deficit Disorder

A 7-year-old girl is brought to the school social worker. She has a poor academic achievement record. While she is not disruptive in class, nor does her medical record reveal that she has a hearing or visual impairment, her test scores indicate that she does not comprehend the material at grade level. When playing with the other children, she does not seem able to follow the rules of their games. Her initial educational evaluations, including an I.Q. score do not reveal cognitive impairments. A phone conversation with the child's mother reveals that she is often forgetful and does not seem to listen to whoever is directly speaking to her. When she talks, she makes eye contact, but, her stories do not stay on one subject for long; her mother complains: "her mind seems to roam". These initial symptoms and complaints could be a result of: A) Intellectual Disability B) Bipolar Disorder C) Autism D) Attention-Deficit Disorder

D) Attention-Deficit Disorder

The director of planning presents a study of drug addicts served by the agency and notes that there are very few heroine addicts over age fifty who are involved with the agency. Yet, the agency's anecdotal observations suggest that successful treatment with Heroin addicts is quite limited. How can the results of the study be explained? A) The agency is underestimating the impact of its treatment programs. B) Many addicts simply stop using as they grow older and their work and family responsibilities grow. C) Heroine addicts tend to die earlier than non-addicts from a variety of medical conditions such as heart disease, hepatitis and liver infections. D) Older addicts are so acclimated to their addiction that they no longer seek treatment.

C) Heroine addicts tend to die earlier than non-addicts from a variety of medical conditions such as heart disease, hepatitis and liver infections.

During a clinical interview with a successful computer programmer, the session is interrupted several times by the client's cell phone. When the phone rings the client excuses himself and answers the call. After a brief conversation and without an apology, he resumes his conversation with the clinician. How should the clinician respond to this interruption? A) The clinician should not acknowledge the interruption. Cell phones are common appliances and there is no reason someone can't receive an important phone call. B) The clinician should ask the client why he didn't apologize for the interruption. C) The clinician should first explore the client's perception of a phone call interrupting the session. D) The clinician should tell the client to turn his phone off during sessions.

C) The clinician should first explore the client's perception of a phone call interrupting the session.

Emily, age 13 was transfixed by her computer. When she was given access to the internet she engaged in a flurry of e-mails and participated in numerous chat groups, often staying on line for many hours after school and on weekends. Her last quarterly school report had shown some deterioration in the quality of her work. Her online friends seemed more important to her than those she normally visited. While her parents did not wish to pry or violate Emily's privacy, they did find some disturbing, highly emotional, and suggestive e-mails from a correspondent in another state when Emily left them on the screen. This correspondent was asking Emily to meet in another city. Fearing for her safety, Emily's school social worker was asked to meet with her. Emily asked the social worker if everything she told her was private and would not be revealed. What is the social worker's best response? A) Indicate to Emily that she will respect her privacy, but there are some specific conditions under which she must act to protect Emily from harm. B) Reassure Emily that their conversations are private and inviolate. C) Warn Emily that because she is a minor anything she says can be repeated to her parents. D) Reassure her that their conversations are private but that she will be warned when she is about to say something that the social worker must reveal.

A) Indicate to Emily that she will respect her privacy, but there are some specific conditions under which she must act to protect Emily from harm.

After a lifetime of dedicated hard work as an industrial designer, Mr. Croft's employer gently but unexpectedly eased him out of his responsible job and provided him with a generous pension and termination benefits. Now 68, Mr. Croft did not have time or interest to work out a retirement plan and did not consider what it would mean to have so much free time. Though he is financially secure and his health is excellent, his forced inactivity has generated enormous tension with Mrs. Croft. She finds that his demands for her attention interfere with her varied social and community activities. Desperate, she asks him to participate in family counseling to find a solution to their growing frustration with each other. At the first family counseling session, Mr. Croft complains about Mrs. Croft's unwillingness to change her priorities now that he is home more. Mrs. Croft argues that she has developed a variety of interests during a lifetime of homemaking and she is well equipped to fill her time with rewarding activities. She suggests that Mr. Croft find activities that he enjoys. The social worker's best strategy is to: A) Acknowledge that both of them have legitimate concerns and try to work out a middle road in which both of them accept the new situation and that they both need new strategies for living together. B) The problem is largely with Mr. Croft. He needs to develop some interests that will provide him with the independence and status that he has lost since retirement. The social worker should recommend involvement with civic activities that might engage his C) Mrs. Croft is behaving somewhat selfishly. Since she did not hold a job for many years, she is well-adapted to managing her time and activities and creating a structure for herself. She should be urged to be more helpful and sympathetic to Mr. Croft's new D) Since the retirement was sudden, the social worker should urge the two of them to take a trip during which they can rediscover each other and try to work out a new way of relating.

A) Acknowledge that both of them have legitimate concerns and try to work out a middle road in which both of them accept the new situation and that they both need new strategies for living together.

Emily, age 13 is referred to the school social worker by her teacher. She has been a good student and though somewhat shy, her relationships with other students have been positive. However, she is not part of a clique and has no intimate friends as is common with girls her age. She occasionally participates in after-school activities and enjoyed the dance club and some casual sports. Uncharacteristically, she has recently started skipping classes, her grades have suffered, and her relationships with other students have deteriorated. Though previously reserved, Emily has become argumentative and negative. The social worker's first step after initially interviewing Emily is A) Arrange a conference with Emily's parents. B) Explore Emily's feelings of anger. C) Emily for substance abuse treatment. D) Arrange a conflict resolution group with Emily and the other students with whom she is arguing.

A) Arrange a conference with Emily's parents.

In a first session with a couple who are contemplating a trial separation, the wife complains their greatest marital problem is caused by her husband's nasty temper. The worker's BEST response is to A) Ask her about her husband's temper B) Ask if she'd done anything to provoke his anger C) Ask if she is more interested in discussing his temper or their separation D) Encourage the husband to respond to the comment about his temper.

A) Ask her about her husband's temper

A 17-year-old adolescent male is brought into the clinic by the police. He has been seen before and is well-known to the social worker. He was found in the hallway of his school screaming at invisible people seen only by him. He claims that "they always know where to find him" and while there was no one in the hallway with the youth when the police arrived, he seemed to be actively involved in a conversation with a group of people. He shows a knife to the social worker that he plans to use on "them" and then himself. This is not the first time the police have picked this youth up; ask that he be evaluated, and that he go "back on his meds". What is the social worker's first intervention? A) Crisis management B) Case management C) Medication management D) Stress management

A) Crisis management

The mother of a 5-year-old boy in kindergarten reports to the school social worker that her child was observed by her neighbor exposing his genitalia to other children in the playground. She is obviously upset by this behavior and notes that this has never happened before. She further states that other than difficulties at bedtime, he has shown no other behavioral changes at home. What is the social worker's best response A) Explore the sleep issue with the mother and discuss the precipitating incident and the child's behavior with the kindergarten teacher. B) Report the behavior as a suspected child abuse incident to the state child protective agency. C) Reassure the mother that this behavior may be a part of natural human sexual development and is not unusual. D) Initiate play therapy with the child.

A) Explore the sleep issue with the mother and discuss the precipitating incident and the child's behavior with the kindergarten teacher.

Tina, 21, emigrated from Yugoslavia a few years ago with her family. She is involved with a mental health agency and has been diagnosed with Bipolar Disorder. She functions quite well on medications. In the past few years she has been able to attend college as well as work part-time. Periodically, she refuses to take medications and then her mood, behavior and attitude radically change. When she is non-compliant she disappears for a few days, and cuts her classes. She refuses to discuss her activities while out of touch with her family. Her parents are worried about her safety during these periods believing that she is using drugs and alcohol and behaving irresponsibly. They ask the social worker to help the family obtain a court order to restrain their daughter's behavior. How can the social worker first assist the family? A) Help them understand the limits of the court system and work to develop. strategies through which they can help their daughter continue her medications consistently. B) Help the family find an attorney experienced in helping families of children with mental illness. C) Ask the parents to bring their daughter into the agency for evaluation. D) Reassure the family that with a diagnosis of bipolar disorder their daughter is unlikely to do anything destructive.

A) Help them understand the limits of the court system and work to develop. strategies through which they can help their daughter continue her medications consistently.

Alex, age 30, is constantly piling up credit card and gambling debt and is usually in crisis because of it. Alex seems to derive a perverse excitement from the successive crises that he must manage. He further complicates his life by engaging in many secretive romantic affairs simultaneously and fabricating elaborate stories to cover his tracks and to keep his wife and girlfriends in the dark. His work life is also unsatisfactory and Alex's relationships with his supervisors are tense and troubled. Though intelligent and competent, he squanders the goodwill he creates with his work by engaging in gratuitous arguments with people in authority. As a result he is unhappy in his work and unsure of his career direction. He feels empty and depressed and is unable to tolerate being alone. Despite recognizing that his behavior is self destructive, he is unable to change his patterns. What type of treatment is likely to apply to Alex's condition. A) Long-term psychotherapy with medication, as needed.. B) Group treatment. C) Medication. D) Short term residential treatment.

A) Long-term psychotherapy with medication, as needed..

Martin, age 18, has been in foster care with the Smith family since he was 12. The Smith family is unwilling to provide a home for him any longer as foster care benefits are ending, and they are retiring on a modest income and moving to a warmer climate. Martin is deeply upset as he had regarded the Smiths as his family. He was unprepared for an abrupt end to his relationship with them since they had assured him that they cared about him. His foster care worker needs to help him make arrangements. What is the worker's primary focus in working with Martin and helping him through this transition? A) Preparing Martin for independent living and helping him find a temporary home until he can find a way to support himself. B) Help Martin deal with his feeling of rejection by referring him for mental health treatment. C) Work with the Smiths and try to convince them to continue parenting Martin. D) Seek changes in the policy that releases foster children at the age of 18.

A) Preparing Martin for independent living and helping him find a temporary home until he can find a way to support himself.

After six months of steady progress with a patient diagnosed with borderline personality disorder, the client starts to exhibit marked anger at the therapist during sessions and claims that the therapist is judging her unfairly. How should the therapist interpret the change in behavior and the client's anger? A) The client is making progress and is anxious. B) The therapist is moving too fast and not allowing the client to discover for herself. C) The client has difficulty accepting the therapist's imperfections. D) The client is ambivalent about the therapy continuing so long.

A) The client is making progress and is anxious.

A high school social worker is told by a female student that a group of boys known to be 'outcasts', some of whom have ongoing disputes with others, is behaving very strangely. She saw one of the boys placing something that looked like a handgun in the trunk of his car and he seemed to be trying to make sure she couldn't see it. The student will not discuss her observations with anyone else and asks the social worker what she should do? What should the social worker do first? A) The worker should take the report very seriously and while protecting the girl's identity, see to it that the school authorities are informed. B) The worker should respect the girl's concerns and not take any actions until the student permits her to report the matter. C) The worker should first contact the boys to verify the report. D) The worker should talk with the parents of the boys.

A) The worker should take the report very seriously and while protecting the girl's identity, see to it that the school authorities are informed.

Mrs. R. has four children aged eight, six, four, and six weeks. Her husband is employed in a high stress, demanding aerospace engineering position. Five years ago, Mrs. R attempted suicide but received some treatment through her HMO. Nonetheless her depression did not lift. Shortly after the birth of her last child she seemed constantly fatigued and her mood changed. Her depression seemed to deepen and she grew uncommunicative, often lying on the couch for extended periods. She obsesses about her new baby's health, though the child seems healthy and normal. Mr. R. is deeply religious and busy with his work. He seems unaware of the stress' Mrs. R. is experiencing. A neighbor convinces Mrs. R. to talk with a social worker from the neighborhood health center. At the first meeting in the home, Mrs. R. seems unresponsive and guarded, but she concedes that Christ came to her and warned her that her youngest child is very ill and will die unless another child is sacrificed. Deeply concerned, the social worker must decide on a next step. How should the worker proceed? A) There is a need for immediate action and intervention. The mother is displaying symptoms of post-partum psychosis. The father should be contacted and he should be warned that the children are in danger. The mother should not be alone with the children. B) The symptoms Mrs. R. displays are consistent with Post-Partum Depression. A psychiatric consult should be arranged for diagnosis and possible medication. Some support services might also be arranged to reduce the stress on the mother. C) The mother's depression and delusions are common for women shortly after the birth of a child. Some ongoing support services might help the mother through this difficult period. D) Ongoing therapy and outreach to the family are needed until the mother's depression eases as it inevitably will over time.

A) There is a need for immediate action and intervention. The mother is displaying symptoms of post-partum psychosis. The father should be contacted and he should be warned that the children are in danger. The mother should not be alone with the children.

Michael is a troubled 8-year-old who is an only child. Diagnosed with a mild case of ADHD, he regularly receives treatment and medications. Since beginning medications, his behavior in school and at home has improved as have his grades. Yet, even as Michael's behavior improves, his stepfather seems to grow increasingly distant and remote and unwilling to deal with Michael or his special situation. Michael's mother is attentive to him but she is distraught and upset about the stepfather's rejection of Michael. She tells the school social worker that she fears that her husband wants Michael to live elsewhere. On one occasion, he said that he wanted another family member to take him. It is clear that he wants to wash his hands of a difficult 8-year-old. What should the social worker do first in this situation? A) This is probably not a situation that requires a child neglect report. The mother's continued concern and commitment are likely to keep Michael safe. Nonetheless, the family needs some opportunity to work through the issues that trouble them. B) As Michael's behavior improves, it is likely that his stepfather will find it easier to relate to him. In time, he will accept Michael as he is. The social worker should simply provide support to the mother and Michael. C) Michael is at risk of abuse or neglect because of the father's attitude. The best course is to file a child abuse report and ask the Child Protective Agency to evaluate the home. D) The social worker should meet with the father and ask him to modify his behavior and relate more warmly to Michael.

A) This is probably not a situation that requires a child neglect report. The mother's continued concern and commitment are likely to keep Michael safe. Nonetheless, the family needs some opportunity to work through the issues that trouble them.

A client has a history of chronic physical problems as well as depression. In addition, she reports parenting problems with her teenage children. After frequent visits to her primary care physician and to the emergency room, the client is referred to a mental health clinic. Which perspective would best help the client to understand the interrelated aspects of her problems? A) ecological B) strengths C) feminist D) rational emotive

A) ecological

During an intake session with a social worker in private practice, the client tells the worker that he cannot afford the fees, but desperately wants help. The social worker's BEST response is A) to try to make a satisfactory arrangement, taking into consideration his ability to pay, and if they can't work out such an arrangement, to arrange a referral to a sliding-scale agency B) tell the client that she should look elsewhere for services within his means C) ask the client if he might be able to borrow money from friends and family D) ask the client if he has explored all of the resources available to him.

A) to try to make a satisfactory arrangement, taking into consideration his ability to pay, and if they can't work out such an arrangement, to arrange a referral to a sliding-scale agency

The staff has come together to interview a new case supervisor. They are developing a list of questions to be asked of the candidate. The Director notes that the candidate has a three-month-old girl. He suggests they ask her how she will manage her responsibilities if her childcare arrangements are disrupted. His question is A) A reasonable question to ask of someone applying for a responsible position. B) Both unreasonable and illegal. C) Tacky and indiscrete. D) Appropriate and it will reveal the quality of the candidate's planning skills.

B) Both unreasonable and illegal.

A mother reports to the child welfare agency, that her children have been sexually abused by their stepfather. A protective service worker is likely to recommend an immediate strategy to protect the children. Which of the following is the BEST immediate solution? A) Family treatment to address dysfunctional and abusive behavior. B) Removal of the children until there is some certainty that they will be protected in the home. C) The confirmed abuser should leave the home under court order while treatment begins. D) Prosecution of the abuser for the severe abuse.

C) The confirmed abuser should leave the home under court order while treatment begins.

Phil was recently hired as an executive assistant to the Mayor. While initially he performed well, over time he has displayed some disturbing traits. Though he rarely complains about his workload or indicates that he feels overloaded, when under stress due to work deadlines or pressure, he develops facial ticks and tremors. Occasionally he complains of severe headaches, particularly when he feels criticized or pressured. The cluster of symptoms describes an individual whose conflicts and anxieties A) Are manifested when under pressure. B) Are somaticized probably because he is unable to express his feelings. C) Are cathected as he is unable to adapt to pressure. D) Find no healthy and effective ways of being expressed.

B) Are somaticized probably because he is unable to express his feelings.

The "strange situation" is a laboratory procedure pioneered by Ainsworth et.al. and used to assess infant attachment style. Jessie is being evaluated in the strange situation procedure. Jessie's mom places him on the floor of the playroom and he crawls away from her. He does not look back or seek her attention the whole time he is in the playroom. When his mother leaves the playroom he does not notice she is gone and when she returns he does not want her to pick him up. He cries and stiffens his back when she tries to sit him in her lap. According to Ainsworth, what type of attachment is this baby exhibiting? A) Insecure attachment B) Avoidant attachment C) Anxious attachment D) Disorganized attachment

B) Avoidant attachment

Josh is 16 and has been behaving badly in school, often reacting angrily to students and teachers or withdrawing from class activities and sitting silently. His grades are reasonably good, but he is clearly unhappy and depressed. His upper-middle class family is deeply concerned about the behavior and is willing to pay for any treatment that is necessary. Both parents work long hours in professional jobs and the family seems able to provide whatever Josh and his siblings want. During the second interview while talking about Josh's relationship to his family, he casually says that his father reads the newspaper when they are together and talking. What might the social worker say in response to Josh's statement to allow him to go further in discussing his feelings? A) Are you feeling that your father is too preoccupied with other things to be interested in what is happening to you? B) Does your father's reading the paper while talking to you concern you? C) Have you tried to discuss your concern with your father? D) Why not ask your father to put down the paper while you are talking?

B) Does your father's reading the paper while talking to you concern you?

Mona and her 14-year-old daughter, Janice have been receiving public assistance through (TANF) for a few months. Though Mona has some skills, she has only been able to find work at low-wage jobs. She was forced to seek help after her husband Ronald, a moderately successful plumbing contractor separated from her after nine years of marriage and refused any further contact with her or his daughter. Almost immediately after the separation, a relationship with another woman became public. He claimed that Janice was not his biological daughter and that Mona had lied to him about her pregnancy. He further asserted that he had no financial obligation to either of them and wanted no further contact. Mona believes Ronald should provide help and should continue to see his daughter since she considers him her father. Her case manager must advise Mona on the alternatives available to her. A) Mona has little chance of obtaining a favorable court ruling unless she first proves that Janice is his child. The social worker should advise her to obtain a DNA test to prove the biological relationship. B) For many years Mona and her husband lived together and raised Janice as their daughter. No matter what a DNA test shows the courts may require him to take greater C) This is not an issue for social work concern. The social worker should not advise Mona. D) The social worker should meet with Ronald and help him acknowledge his obligations to both Mona and his daughter Janice.

B) For many years Mona and her husband lived together and raised Janice as their daughter. No matter what a DNA test shows the courts may require him to take greater

A highly talented and creative computer programmer was refused a promotion. His supervisor's evaluation noted he did not complete a number of assignments on time, his work was occasionally not up to his capacities, and he did not seem totally committed to doing the best work possible. The supervisor said he needed more experience before a promotion could be considered, and that the supervisor would reevaluate his work in six months. The client tells his social worker that though no one has said it, he was turned down because he is gay. He has no evidence to support this idea. The workers best response is: A) Yes, you should discuss this with the company's affirmative action officer. B) It may be true that the supervisor is prejudiced, but before you come to that conclusion, we should think about the substance of the evaluation. C) Gay people often have a hard time succeeding because of prejudice D) Perhaps the supervisor's perception is correct.

B) It may be true that the supervisor is prejudiced, but before you come to that conclusion, we should think about the substance of the evaluation.

After five years as a dedicated, highly competent, and well-regarded protective service worker, Maureen appears sad and depressed and seems to have lost much of her liveliness. Her administrative work and casework practice is also suffering. She misses deadlines for filing important court ordered reports and motions and has fallen behind in making the home visits the agency requires. Uncharacteristically, she rarely talks at case conferences or confers with colleagues. In an evaluation session with her supervisor she admits that she feels tired and depressed and that her work has suffered as a result. She can find no reason in her personal life for the changes but she says she feels more hopeless about her cases than ever before and she has thought about leaving the agency. In assessing Maureen's work and developing a plan with her what framework could the supervisor use to improve Maureen's performance: A) This worker is permitting her moods to interfere with her professional obligations. The supervisor should probably encourage Maureen to either surmount her feelings and get back to work or move to another position. B) Maureen is probably suffering from burnout after so many years of working with difficult cases. The supervisor needs to work out a strategy to help Maureen regain her former enthusiasm. C) Maureen may be frustrated by the fact that she has been a protective worker for five years and has not been promoted to a higher level. The supervisor should explore this issue and encourage Maureen to be more patient. D) The supervisor should probe further and help Maureen identify problems in her life that contribute to her sadness and depression.

B) Maureen is probably suffering from burnout after so many years of working with difficult cases. The supervisor needs to work out a strategy to help Maureen regain her former enthusiasm.

Several neighborhood groups form a coalition to oppose a local airports' development of a new runway. The planned runway will place the community in the flight path of dozens of planes landing and taking off daily. Residents believe the new runway will create noise and pollution problems. Many in the community are opposed and fear that property values will decline and their community will suffer. Merrywood House, a multipurpose community agency with a long history of supporting community activism, provides meeting space for the coalition. Staff support has been requested to assist the group. The Board President of Merrywood, a major financial supporter of the agency, is also a member the Airport Authority. He strongly supports the new runway and informs the Executive Director that he is reluctant to provide any agency support for groups who oppose it and might delay construction. The Executive Director believes that the agency's responsibility is to support the community group and that its credibility with the community is at stake. What is the best way for the Executive Director to address this issue? A) Provide the requested staff support and notify the board that this activity is within the agency's arena of responsibility. B) Mobilize members of the Board to support its help to the community group and ask that the issues be discussed at the next Board meeting. C) Confront the Board President directly and inform him that support for the group is morally and administratively necessary despite his objections. D) Deny further service to the group.

B) Mobilize members of the Board to support its help to the community group and ask that the issues be discussed at the next Board meeting.

Forty-year-old William was recently diagnosed with Pancreatic cancer that metastasized to other organs. His medical oncologist is not optimistic since the cancer had spread to other organs. The available treatments could prolong his life for only a few months and he is too sick to work. His 35-year-old wife is overburdened by the tragedy of her husband's illness, her desire to maintain a normal environment for their three young children, and her concern about the future. Though trained as a dental hygienist, she had not worked for many years and is concerned about family finances and her ability to support her young family. In a first visit, the social worker should A) Help the client partialize the issues and offer to help advocate and broker support services for the family so the mother can start to address the practical problems she faces. B) Offer emotional support and allow the client to express her fears and concerns. Provide reassurance that the social worker will be at her side and will help identify services, resources and programs that can help her manage. C) Help the woman focus on the positives of her marriage and her children to enable her to face her loss and the new responsibilities she will need to address.. D) Help her to identify a support group where she can receive assistance from others experiencing similar tragedies.

B) Offer emotional support and allow the client to express her fears and concerns. Provide reassurance that the social worker will be at her side and will help identify services, resources and programs that can help her manage.

Manal and Suria are 16-year-old twins who immigrated to the US from Egypt with their family three years ago. Their mother is Egyptian and the father is a Syrian citizen who works as a taxi driver. The parents are discussing returning to Egypt where the girls were born and spent most of their lives. The twins are deeply unhappy about returning and Manal has threatened to run away if the family tries to go home. Manal tells the social worker that she was forced out of her public school at the age of 12 and isolated from other children because she is not considered an Egyptian citizen as her father is Syrian. Her sister also does not want to go back to Egypt, but she will reluctantly comply if her parents insist. Both girls are academically talented and say they would like to go to college. The social worker's best strategy is to A) Understand the girl's reaction as a normal adolescent rebellion and work with them to accept the family's decision. B) Probe further to verify Manal's objections about returning to Egypt. If they are accurate assist her to the extent feasible. C) Reassure the girls that they will simply be returning to their extended families and to their old lives. D) Emphasize to the girls that since they have lived most of their lives in Egypt, they are still Egyptian and their residence in the US for a brief period will not affect them.

B) Probe further to verify Manal's objections about returning to Egypt. If they are accurate assist her to the extent feasible.

Marian was highly competitive and believed that her coworkers were telling untrue and unwarranted stories about her. Curiously, on several occasions Marion stirred bad feelings by telling stories about others. The defense mechanism that is probably involved in this behavior is A) Substitution B) Projection C) Sublimation D) Undoing

B) Projection

Longwood Mental Health presents a plan to staff for evaluating its treatment programs for conduct disordered youths. The plan requires an experimental design in which three different treatment protocols are tested and compared. The research director proposes that all new referrals for service are randomly assigned to one of the treatment programs and a fourth group receives no service at all, but is followed up to determine what happens. The research director explains that the 'no service' group is essential for experimental research to be scientifically valid. Some social workers listening to the presentation are critical of the proposal, while others support it. Which argument is most important? A) demands of research are of a high order of priority and should determine, at least temporarily, the actions of the agency. B) Research cannot justify denying service to people in need. Some other methods must be found for evaluating the agency's programs. C) Research can never prove the value of what social worker's do. This is essentially unmeasurable and we should accept on faith that the programs do all that is possible for helping people. D) It is important to do a scientifically valid study. While there are some problems with denying service to clients, these can be overcome.

B) Research cannot justify denying service to people in need. Some other methods must be found for evaluating the agency's programs.

Positive reinforcement, a strategy employed in behavioral treatments involves A) Criticizing the client when competence is not demonstrated. B) Rewarding the target or desired behavior when the client demonstrates it. E.g., offering a token to an autistic child who vocalizes. C) Offering encouragement when the client fails at a task and knows he has failed. D) Avoiding situations that trigger the behaviors that need to be extinguished.

B) Rewarding the target or desired behavior when the client demonstrates it. E.g., offering a token to an autistic child who vocalizes.

Harriet had a serious problem telling the truth about situations and events in her life from the time she was a teenager. Inevitably, she fabricated events and exaggerated her role in them. These traits carried over to her adult life and after college. A skilled writer, Harriet eventually became a highly successful screen writer for television entertainment programs. The psychological mechanism involved in her career choice is probably A) Regression B) Sublimation C) Repression D) Conversion

B) Sublimation

The treatment modalities "Motivational Interviewing" and the "Stages of Change" are primarily used in treating: A) Mental Health. B) Substance Abuse. C) Vocational Rehabilitation clients. D) Families.

B) Substance Abuse.

In many social work-client encounters, a variety of strategies can be used to help clients express their concerns and develop an understanding of their feelings and behaviors. The goal is usually to help the client work out their own solutions in their own way. Under some circumstances, and with some problems, worker may use direct confrontation, a powerful tool in the hands of a skilled worker. Confrontation is best used when dealing with a client who suffers from A) Psychosis. B) Substance abuse or addiction. C) Depression. D) Personality Disorder.

B) Substance abuse or addiction.

A social worker at a foster care agency places an 11-year-old boy in a foster home. The child was a victim of physical abuse. In his foster home, the child is has become physically aggressive with a younger foster brother. What is the first thing that the social worker should do? A) Remove the child from the foster home. B) Explore with the 11-year-old alternatives to dealing with his anger. C) Assess the risk of harm to the younger foster brother. D) Investigate the possibility of the foster mother physically abusing the foster children.

C) Assess the risk of harm to the younger foster brother.

Though he is 20 and a sophomore in college, Jerry's parents constantly worry about him and warn him to limit his physical activities. Jerry contracted Diabetes when he was eight-years-old and his parents are concerned because of the potential risk of complications. However, Jerry is extremely diligent and responsible in self-care, and in his medication and monitoring. He self-injects insulin and is careful with his diet. As a result he experiences no complications and is quite healthy. Jerry wants to travel through Europe for two months and stay at youth hostels. He claims that through careful planning he can insure a supply of insulin and control his sugar intake. His parents object, feeling that there are too many risks and the difficulties are too great. While Jerry's relationship with his parents is normally supportive and affectionate, the dispute over his travel plans has produced severe strains. Jerry argues that his parents are overprotective and they must let go and allow him to take care of himself as he has been doing at the residential college he attends. During an appointment with his social worker, Jerry asks the worker to speak with his parents at their next conference and to urge them to trust him and accept his travel plans. The worker should: A) Absolutely refuse to discuss the matter with the parents as this might compromise their relationship. B) Suggest that Jerry reassure his parents with specific plans, but also agree to discuss their questions at the next family conference. C) Discourage Jerry as his parents are probably correct in their concerns. D) Ask Jerry to reconsider his trip and to reassure himself that the self-care he needs will be possible.

B) Suggest that Jerry reassure his parents with specific plans, but also agree to discuss their questions at the next family conference.

A protective services social worker in a small town is assigned a suspected sexual abuse case involving an influential family deeply entrenched in local politics. The complaint was lodged by a nurse at the local hospital when the family's 11-year-old daughter was diagnosed with a sexually transmitted disease that she claimed resulted from sex forced upon her on two occasions by her 22-year-old brother. When the social worker arrives at the home to speak with the family, he is told by the girl's mother that no one will talk with him and he should contact the family's attorney. What principle should guide the social worker's first actions? A) The political power of the family. B) The degree to which there is an imminent threat of harm to the child. C) The legal and administrative requirement for a quick disposition. D) Concern about damage to the family's reputation.

B) The degree to which there is an imminent threat of harm to the child.

A police investigation produces evidence that a church youth leader has sexually molested young boys over a period of many years. The District Attorney is intent on prosecuting the case and wants the cooperation of the children and their parents, as well as their testimony in court. The church leadership is apparently trying to cooperate, but their efforts have been clumsy and subject to misinterpretation. The allegations deeply disturb the church's leadership and they are concerned about the church's liability and its reputation with members. The Director of Social Services for the church is asked to produce a plan to help the children and their families, to limit the churches legal and financial liability, and to reassure congregants. How should the Director respond to the church's concerns. A) The Director should consult staff and the organization's lawyer to develop a strategy for containing the damage. B) The plan should emphasize the need for the organization to examine itself to insure that it does everything possible to prevent more occurrences, while openly responding to the victims with services and compensation and cooperating with the District Attorney C) The church should offer therapy and other spiritual help to the victims and their families, while apologizing to the congregation. D) The church should not admit any fault as this could lead to heavy damage claims against the institution.

B) The plan should emphasize the need for the organization to examine itself to insure that it does everything possible to prevent more occurrences, while openly responding to the victims with services and compensation and cooperating with the District Attorney

A mental health social worker is subpoenaed in a child custody battle between two parents involved in a bitter and sometimes violent divorce. The social worker has been treating the mother. The father's attorney asks a specific question about a statement that the mother might have made while in treatment. Which statement best reflects the social worker's legal obligation to the client and the expectations of the profession? A) The social worker should claim client-social worker confidentiality and refuse to answer the question. B) The social worker should claim client-social worker confidentiality and refuse to answer the question, unless ordered to respond by the judge. C) The social worker should ask for a temporary adjournment while she confers with the agency attorney. D) The social worker should answer any question that seems legitimate and can help her client.

B) The social worker should claim client-social worker confidentiality and refuse to answer the question, unless ordered to respond by the judge.

Helen is 89 and lives alone in her own home. Her children live a few hundred miles away and visit periodically. They are on good terms but are unaware of Helen's condition. In recent years, Helen has become vulnerable to every telemarketer and door to door salesman who calls. She is obviously a target for unscrupulous schemes. Helen has become very secretive about her purchases and will not discuss them. The elder agency social worker believes that her judgement is impaired and is concerned that she might be impoverished if she continues to respond to telemarketing schemes. What is the best course for the social worker to pursue? A) social worker cannot be responsible for a client's poor judgement. Helen has a right to spend her money as she sees fit. The social worker should do nothing. B) The social worker should contact the children and inform them of their mother's behavior. She might also suggest that they investigate guardianship for their mother. C) The social worker should try to help Helen with budgeting and discourage her from making these purchases. D) The social worker should encourage Helen's friends to provide some supervision of her spending.

B) The social worker should contact the children and inform them of their mother's behavior. She might also suggest that they investigate guardianship for their mother.

A developmentally challenged 21-year-old lives at home. His parents report he has become unmanageable and irritable, refusing to leave home for special programs designed for him and angered easily when his parents ask him to do anything. They are requesting help. The social should recommend A) residential treatment B) counseling. C) work with the client and his parents. D) referral to a specialized agency

C) work with the client and his parents.

A worker's supervisor in the County Public Assistance Agency conducts early morning daily prayer meetings in her office for staff interested in attending. The supervisor is an Evangelical Christian and while she does not specifically require attendance at these meetings, it seems to staff that she is favorably disposed to those who regularly attend. There is no evidence that staffing decisions or recommendations are influenced by anyone's religious observance. On at least six occasions she has sent notes to casework staff inviting anyone to attend who wishes. One caseworker feels uncomfortable about the repeated invitations and interprets them as a gentle form of intimidation. What should the worker do? A) The worker should discuss her concerns with the Director of Human Resources. B) The worker should discuss her concerns with the supervisor. C) The worker should do nothing as there is no evidence of favoritism. D) The worker should discuss the matter with county officials.

B) The worker should discuss her concerns with the supervisor.

A family requests service at an outpatient clinic to discuss their concerns about their oldest son's behavior at school. Though ordinarily compliant and studious, their son has recently become aggressive to his teachers and peers and his grades have deteriorated. During family therapy sessions that include the son, The social worker observes that the mother is the sole spokesperson for the family, and sets the tone and agenda for the family's sessions. Questions about the family's recent history reveal a number of stressors, as well as strains in the family's finances. Whenever the worker explores these other environmental issues with the family, the son's negative behavior escalates and the focus of the work returns to him. According to Jay Haley's Strategic Family Therapy theory, what would be a good question for the social worker to consider when working with this family? A) How do the family's boundaries influence the presenting problem? B) What is the benefit to the son for maintaining his role of the identified patient? C) Does the family perpetuate a "double-bind" or "no-win" situation within the group? D) What are the intergenerational influences on the mother's behavior?

B) What is the benefit to the son for maintaining his role of the identified patient?

When an adolescent is confronted with his drug use and refuses to admit his involvement despite definite and compelling evidence, this is known as A) repression. B) denial. C) stubbornness. D) suppression.

B) denial.

Therapy for mourning and grief are often provided through A) psychoanalysis. B) groups focused on mourning. C) behavioral treatment. D) intensive clinical social work.

B) groups focused on mourning.

The goal of case advocacy is usually to A) win public policy concessions and alter the distribution of social resources. B) secure needed services for clients. C) alter the priorities of legislative bodies. D) obtain publicity for injustices against the poor.

B) secure needed services for clients.

Lucy and Daphne have lived together for four years and are considering marrying. In counseling to work out some relationship strains, the social worker notices that Lucy is somewhat withdrawn and that Daphne often answers questions. During the course of treatment the social worker learns that Daphne has hit Lucy on a number of occasions. Lucy admitted that on one occasion she was treated at a hospital for injuries inflicted by Daphne, though she attempted to minimize the event. The social worker must decide on a course of action. What is her best choice? A) Do nothing. Both Daphne and Lucy are adults and if Lucy chooses to permit Daphne to hit her that is their personal business. B) sessions with each of them separately to discuss their relationship and to focus on the unacceptability of any violence. C) Urge Daphne to seek anger management counseling. D) Urge Lucy to seek assertiveness training.

B) sessions with each of them separately to discuss their relationship and to focus on the unacceptability of any violence.

Following a therapy session, a client with a diagnosis of borderline personality disorder stepped up to the therapist and hugged her. How should the therapist interpret the client's action? A) the client is becoming over-familiar. B) the client is not respecting boundaries. C) the client is sexually attracted to the therapist. D) the client is demonstrating gratitude for help.

B) the client is not respecting boundaries.

A client, whose primary reason for seeking treatment involves abandonment issues, is disturbed when his therapist fails to give him sufficient notice that he is leaving in one week for vacation. On the social worker's return from vacation, the client states he was very upset that the worker had been so thoughtless. The social worker should A) have the client write a journal describing his feelings about the separation. B) use the experience as a therapeutic opportunity. C) refer to another counselor. D) refer to another agency

B) use the experience as a therapeutic opportunity

Transference in social work practice is understood as A) The conscious process of constructing a relationship between the clinician and the client. B) The ability of the clinician to empathize with the client. C) An unconscious process in which the client may attribute emotions, feelings, behaviors and attitudes to the clinician. D) An unconscious process in which the clinician attributes feelings and attitudes to the client.

C) An unconscious process in which the client may attribute emotions, feelings, behaviors and attitudes to the clinician.

A 10 year old boy is referred to the social worker by his after-school tutor who reports that he has started to socially withdraw in the after-school program and regress in his verbal and written skills. He also comes to school somewhat inappropriately dressed in long sleeves and turtleneck sweaters in warm weather. In your work with him, he draws pictures that depict violence and chaos that surrounds a small figure, usually located at the bottom of the picture. His mother brings him regularly to the session. She looks distracted and sometimes appears exhausted. When you schedule family meetings, only the mother attends and she is uncommunicative about her husband, as well as in describing the family's home life. Within a short time, the child seems to trust the social worker and seems ready to discuss things of concern to him . Prior to encouraging the child to fully reveal his concerns, the most effective next step would be: A) Meeting with the child's tutor to compare notes about his behavior B) Bringing dolls and other toys to work so that he can use them to tell his secret. C) Attempt to ascertain the child's level of safety and support at home to determine if he can be protected. D) Confer with a supervisor experienced in working with children who regress.

C) Attempt to ascertain the child's level of safety and support at home to determine if he can be protected.

During an initial assessment, Martha, a 34-year-old woman who is married with two children reports a number of symptoms that are consistent with a major depressive disorder. As she continues in therapy, she discloses a long history of childhood physical and sexual abuse within her nuclear family. She also tells you that in spite of this history, she brings her children to spend time with her mother and her father once a month because "that's all in the past". Martha also tells you that she goes to visit her father alone once or twice per month on her own. Some time after she discloses this information, she also tells you that she has episodes in which she "relives the past as it were happening today" and acknowledges that she can be hyper-vigilant, startles easily and has nightmares when she isn't experiencing insomnia. The social worker's next intervention would be: A) Set up an appointment with a psychiatrist to evaluate for sleep medication. B) Further evaluate Martha's post-traumatic symptoms to revise the initial diagnosis. C) Clarify and explore the nature and content of her family visits with her parents and particularly her regular visits with her father. D) Ask her to bring her husband to the next session to collect further information about their family life.

C) Clarify and explore the nature and content of her family visits with her parents and particularly her regular visits with her father.

Alex and Cathy have been married for two years and are committed to each other. Between them they have four argumentative and rebellious children from previous marriages. Disputes between the children that are largely over trivial matters have become increasingly frequent. Two groups of warring teenage children seek to divide, conquer, and act out adolescent rebellion issues. Alex, widowed for five years, remarried despite the misgivings of his 15 and 17-year-old daughters. Cathy's 12-year-old son and 14-year-old-daughter claim they are second-class citizens and that their needs are rarely met as Alex's children seem to get a higher priority. Recently, Alex and Cathy have begun to argue with each other as their patience has worn thin with the tense atmosphere that has developed. They have now decided to seek assistance in couples therapy. During the initial meeting, Cathy seems to blame Alex and his children for much of the problem. She states that Alex has been insensitive to her children's needs and that he seems to mandate rather than negotiate. Alex replies that even if there is some truth to her assertion, Cathy has not been helpful in resolving problems as she immediately escalates issues that her children raise as questions of principle and fairness without seeking to resolve them. The social worker's best initial strategy is to: A) Bring the entire family together for sessions to work on the difficulties of bringing blended families together. B) Treat the children separately without the presence of the parents. C) Continue to work with Alex and Cathy to help them resolve their parenting and marital issues. D) Urge them to develop family activities that engage all the children.

C) Continue to work with Alex and Cathy to help them resolve their parenting and marital issues.

Shortly after Elliott had a serious argument with his closest friend, his right hand became partially paralyzed and he was unable to grip anything. There seemed to be no organic reason for the paralysis. He explained to his therapist that during the argument he felt that he wanted to punch his friend and he was frightened by the emotions. How might the therapist diagnose Elliot's symptoms A) Denial B) Dissociation C) Conversion D) Compensation

C) Conversion

In developing a DSM-5 diagnosis, a social worker observes that a 25-year-old college educated male client lives with his aged mother. The client wishes to take a trip to Hawaii, but will not do so without his mother's approval. He seems unable to make independent decisions. During joint interviews, the mother often disagrees with him in a peremptory way, but he seems too apprehensive to confront her insulting behavior directly. He frequently asks advice and seeks reassurance from her, even on minor matters. Though he performs adequately in his work, he seems unable to initiate activities and waits for others to take responsibility. The social worker observes that the client is constantly asking questions about the appropriateness of his behavior, his dress, and his relationships with others. In considering a diagnosis, the worker would consider A) a classical anxiety disorder. B) Schizoid Personality Disorder C) Dependent Personality Disorder D) Schizotypal Personality Disorder

C) Dependent Personality Disorder

Mary G. Is 24 and has a serious long-term drug addiction. She is 8 weeks pregnant. At her interview with the social worker, she asks what she should do to insure a healthy baby. The social worker's best course is to A) Advise Mary to immediately stop using drugs and go off cold-turkey if necessary. B) Help Mary enroll in a drug cessation program that emphasizes immediate and total withdrawal. C) Help Mary understand that suddenly stopping the drugs might be dangerous for the infant and that she should seek expert medical help to gradually detoxify. D) Tell Mary to wait until her pregnancy is over before attempting to do anything about her addiction.

C) Help Mary understand that suddenly stopping the drugs might be dangerous for the infant and that she should seek expert medical help to gradually detoxify.

The parents of a 15-year-old who is in treatment for cocaine abuse at an outpatient substance abuse clinic requests their child's treatment records. The youth has disclosed many intimate family relationship problems that he associates with his drug use. The youth is particularly conscious of the ways in which he feels rejected by his father because of the father's inability to express affection, his frequent criticisms and his emotional distance. The Clinical Director of the clinic should: A) Refuse the parents' request and protect the youth's right to confidentiality to the fullest. B) Contact the social worker who is treating the youth to get a summary of the treatment process so far and her perspective of the parents C) Meet with the parents to explore their need to see the youth's record and to inform them of their rights. D) Inform the youth that his parents have requested to see his records and ask for his permission.

C) Meet with the parents to explore their need to see the youth's record and to inform them of their rights.

Ana was a good student though very anxious. When she received an assignment from her instructor, she often asked the instructor either over the phone or in person to clarify the instructions. Frequently instructors became annoyed as she asked a cascade of questions - often on a dozen or more occasions. She often asked the same questions over and over until her instructors finally told her not to call again with any more questions but to submit them in writing. As Ana's therapist, what strategy would you employ to help her with her anxiety. A) Suggest that she meet with her instructors and explain to them that she often needs more information about assignments than other students and ask them to be patient with her. B) Since she has difficulty absorbing information, suggest that she submit her questions in writing so that she could refer to the answers later and not have to bother her instructors again. C) Recognize that Ana is probably suffering from a form of Obsessive-Compulsive Disorder and needs treatment which may include medication to help control her anxiety. D) Find out if Ana exhibits any behaviors or hallucinations that would suggest thought disorders.

C) Recognize that Ana is probably suffering from a form of Obsessive-Compulsive Disorder and needs treatment which may include medication to help control her anxiety.

What medication has a paradoxical effect? A) Zoloft. B) Risperdol. C) Ritalin D) Thorazine

C) Ritalin

Julie, a six-year-old, is brought to the mental health clinic by her mother. She seems very immature and clings to her mother during the interview. Her mother reports that Julie is excessively anxious at school and refuses to stay unless her mother stays at her side. At night she will not go to her room unless accompanied by her mother. Even when out of the house at stores or the zoo, Julie is afraid of getting lost or losing her mother. When her mother tries to help her anticipate a brief separation, as when she has visit the doctor, Julie's stomach becomes severely upset and she occasionally vomits. These behaviors have lasted for at least two years. The social worker might initially suspect a diagnosis of A) Severe anxiety disorder B) A very dysfunctional family situation and overly enmeshed mother-child relationship. C) Separation Anxiety Disorder D) A somatic disorder.

C) Separation Anxiety Disorder

Danielle, age 29 is a single woman who is a long term client. She has occasional episodes of depression, but has never received medication. A year ago she lost her job as a computer programmer and has been unsuccessful in locating a permanent position, though she has been able to find short-term consulting assignments. With Unemployment Insurance she has managed financially and has not experienced any emotional setbacks. Recently she met an affluent businessman who has asked her to marry him. Danielle is ambivalent about this proposal. Though she believes she loves this man, her feeling are ambivalent. Marriage would help resolve her employment problem and she fears that her decision may be influenced by her concerns about supporting herself. She does not believe that she can confidently make a decision that is independent of her practical considerations. . How can the social worker help Danielle. A) Continue discussions with Danielle and allow her to express her ambivalence. B) Consider her ambivalence as a marker for a depressive episode. C) Suggest couples counseling for Danielle and her boyfriend. D) Assist Danielle in her career issues.

C) Suggest couples counseling for Danielle and her boyfriend.

After two years of marriage without achieving pregnancy, 31-year-old Bill and 27-year-old Grace are distraught about their inability to conceive. They are anxious to have children and very stressed by their inability to conceive. Grace wants to initiate an adoption application or try in-vitro fertilization. Bill is opposed to both courses and wants to continue trying to conceive. At the meeting with the family worker they discuss their disappointment about achieving pregnancy. What should the social worker suggest to help the couple decide on a course of action. A) Suggest that they make an appointment with an adoption agency to discuss the benefits and problems of adoption. B) Propose a course of marital treatment to help resolve the stresses within their marriage. C) Suggest that they contact an infertility medical specialist to find out if there is a medical problem. D) Propose that they continue to try to achieve pregnancy since many couples require a long time.

C) Suggest that they contact an infertility medical specialist to find out if there is a medical problem.

During a mandated educational parenting skills group for parents who are currently involved with a child welfare agency, the conversation among the participants shifts from the topic of "positive discipline" to the rights of parents in the child welfare system. After a slow and hesitant start by group members, all of the parents are participating and members are expressing support for one another. In addition, the parents in the group are emphatic in their shared position that they have been treated unfairly by the child welfare system. The facilitator should: A) Allow the group participants to continue to express their feelings and their support for one another. B) Join in the discussion and express her personal views of the child welfare system C) Support the group participants in their right to express their views and opinions but eventually guide the group back to the day's topic. D) Remind them that they are mandated to participate in the group no matter what their feelings are about the child welfare system.

C) Support the group participants in their right to express their views and opinions but eventually guide the group back to the day's topic.

Bill and Martha Gibbs live in a middle class community in the Midwest. They decide to move into a 'total' religious community in another state with their family after four 'experimental visits'. The religious community has strict rules to which everyone must adhere. Sunday Sabbath observance and tithing are required. Smoking, drinking, dancing and non-religious music are not permitted. Young people cannot meet with members of the opposite sex without adult supervision and everyone must attend daily services. The Gibbs sixteen-year-old daughter and thirteen-year-old son object and demand that the parents remain where they are. Amy, their 16-year-old daughter threatens to leave home and stay with a friend's family until graduation from school. John is acting out, cutting school and has become withdrawn since his parents announced their intention. A family therapist is asked to consult with the family. How should the therapist initially respond to the family at their first meeting. A) Before the therapist can assist, the ground rules must be set and these rules must be favorable to the children's concerns about radically altering their lives. B) The therapist should work with the children to accept their parent's decision, even if they are not in favor of the move. C) The therapist needs to join with the family and establish a connection with all family members to enable a reasonable discussion of the family's problems. D) The therapist should first ask to meet separately with the children and the parents. during the information-gathering initial phase of treatment.

C) The therapist needs to join with the family and establish a connection with all family members to enable a reasonable discussion of the family's problems.

A 58-year-old male is referred by an HMO primary care doctor to mental health services for reasons for the referral. Interviewed by a young female social worker, he seems fairly open but says he wants a clinician who is male and closer to his own age. He reveals that he has emotional and physical problems that he wants to discuss, but does not feel comfortable with a young woman. Though the worker and the client talk politely for some time, he continues to insist that he is uncomfortable and will not discuss his problems with the worker. How should the social worker proceed? A) The worker should gently reassure the man of the confidentiality of the relationship and that she is fully capable of helping him with his problem, no matter how difficult or embarrassing. B) Since the referral was made to her, the worker should notify the client that arranging another referral will be time consuming and that he may have to wait quite a while for a new worker. C) The worker should accept the client's statements since they have been repeated and he seems reluctant to talk with her. She should let him know that she will honor his request and arrange for a worker closer to his preferences. D) The client is probably masking his problems and is not amenable to treatment. No further effort should be made on his behalf.

C) The worker should accept the client's statements since they have been repeated and he seems reluctant to talk with her. She should let him know that she will honor his request and arrange for a worker closer to his preferences.

Ten-year-old Marjorie had been in four foster homes since age three. After three years with her current adoptive family, she was unable to bond with them. Diagnosed with Reactive Attachment Disorder, Marjorie grew increasingly distant from her adoptive mother. Family and individual treatment did not seem to help. Family friends recommended that the family contact a local therapist who practiced a novel treatment called 'Rebirthing Therapy' that had recorded some successes with this disorder. In Rebirthing Therapy, the child is restrained and must fight her way out of restraints. The child is then symbolically reborn and is, at least in theory, more likely to bond with her adoptive mother. Marjorie's social worker was asked to participate in the therapy. The social worker was unfamiliar with this treatment approach. What should the social worker do in this situation? A) Since no other treatment seems to have worked, the social worker would have little reason to withhold a positive recommendation. The worker should agree to participate. B) Since the treatment is novel and unknown to the worker, she should recommend against it. C) The worker should talk to colleagues and research the literature on the treatment before offering an opinion. Using an unproven treatment could be potentially harmful.. D) The worker should learn how to perform this treatment and work with the family.

C) The worker should talk to colleagues and research the literature on the treatment before offering an opinion. Using an unproven treatment could be potentially harmful..

The McGurney family lived in a dilapidated storefront in an industrial area of a large city. Moving every two or three years with their family of four boys and two girls, they were unknown to schools and social agencies. The children had never been in school and the family claimed they were home-schooled. The children had no friends outside the family and were never seen playing outside. The only person regularly seen outside the home was Mr. McGurney. The family's source of income is murky as Mr. McGurney does not have a job. He is secretive and rarely speaks with others. Though questions were asked about the family by neighbors, no one had thoroughly investigated. The school social worker learned the above facts about this family from several students and their families and was concerned. What is the best course of action? A) With no substantial evidence of abuse or neglect, the social worker can and should do nothing. B) The social worker should ask for an assessment of the home schooling arrangements. C) There is sufficient evidence to warrant a neglect report and to suggest a home schooling evaluation. D) The social worker should write a report to the school principal about the family and ask for advice.

C) There is sufficient evidence to warrant a neglect report and to suggest a home schooling evaluation.

Burt returned from his second tour of duty in Afghanistan where he was wounded and hospitalized. Within a few days it was clear that Burt was experiencing difficulty readjusting to family life with his wife and young children. He experienced mood swings and was sometimes depressed and passive and at other times hyper alert, angry and impatient. He conceded to his social worker-therapist that he was having frightening dreams about his experiences while in the military and experienced flashbacks of violent encounters. He could not relax while awake. The social worker should first consider A) Whether Burt is using alcohol or drugs. B) If Burt is abusing his wife and children. C) Treatment for a PTSD diagnosis. D) Referral to a psychiatrist for medication.

C) Treatment for a PTSD diagnosis.

Harold informed his subordinate, Warren, that his work was below standard, his character was deficient, his personal habits were repulsive and his attitude was hostile and off-putting. Warren expected to be fired, yet two days later Harold sent him a gift of an expensive electronic organizer and assigned him to a highly coveted European account. What psychological defense mechanism might account for Harold's puzzling behavior. A) Guilt - Harold felt remorse about the totality of his attack. B) Repression - Harold was overwhelmed by his feelings and simply repressed his behavior. C) Undoing - By sending the gift and offering the assignment to Warren, he was trying to at least partially negate his attack on Harold. D) Substitution - Harold was attempting to substitute the negative criticism for the positive rewards.

C) Undoing - By sending the gift and offering the assignment to Warren, he was trying to at least partially negate his attack on Harold.

Kevin's family is very disorganized and dysfunctional. His father is a poly drug and alcohol abuser and his mother is clinically depressed, staying at home most of the time and watching soap operas. Kevin age 14, is a depressed and angry loner who does poorly in school and frequently cuts classes. He feels outraged that other children in school come from families that are more conventional and affluent. Kevin's 23-year-old brother is a gun dealer who makes his living buying and selling weapons at gun shows. As a result, Kevin's home resembles a militia armory. There are weapons of all kinds throughout their apartment and there is no barrier securing them. Kevin occasionally brings his few friends to the house to 'play' with the various guns in the house. While Kevin has never threatened anyone, his growing alienation, and the easy availability of weapons concerns the school social worker, who he sees regularly. What course of action should the social worker employ first. A) The disorganization of the family in combination with the easy availability of lethal weapons should be a source of concern. The social worker should file a neglect petition so that there can be some intervention in the family situation. B) The disorganization of the family in combination with the easy availability of lethal weapons should be a source of concern. However, Kevin has not threatened anyone and he has no history of violence. Therefore the social worker should not do anything exc C) While there are many things going on with this family, the issues that need to be addressed first concern safety, the social worker should ask the police to investigate and to warn Kevin's brother about securing the weapons. D) Kevin's situation is so profoundly hopeless that the social worker should seek to have him removed from the family and placed in more positive environment.

C) While there are many things going on with this family, the issues that need to be addressed first concern safety, the social worker should ask the police to investigate and to warn Kevin's brother about securing the weapons.

Maureen age 25 is upset about her high credit card balances. Uncomfortable and desperate, she tells her social worker that her current monthly payments are so high that she has barely enough money left for basic expenses. Her mood varies, but she is often depressed and says she hates being alone. Virtually every session starts with a discussion of her financial dilemma, her growing debt, and her inability to control her spending. This is often followed by a discussion of her unsatisfying relationships with friends, co-workers, boyfriends and family members. She reports that she is having several affairs simultaneously and tries to hide her infidelities from her boyfriend. Maureen's life is punctuated by crises, which are often of her own manufacture. The social worker suspects that Maureen's preoccupation with her debts and her multiple intimate relationships masks the emptiness and lack of direction that Maureen feels about her life. Shopping seems to offer her momentary relief from her feeling of emptiness. Despite recognizing that her behavior is self destructive, she continues to do the things that cause her trouble; overusing credit cards and creating tension with her boyfriend as she trips over her lies. The social worker would probably see Maureen's problem as A) an anxiety disorder B) an obsessive compulsive disorder C) a borderline personality disorder. D) a reaction to early child abuse or emotional deprivation.

C) a borderline personality disorder.

Physical complaints and illnesses associated with stress or dysfunctional family life may be viewed as A) a factitious disorder. B) malingering. C) a somatization disorder. D) an anxiety disorder..

C) a somatization disorder.

A social service agency offers assistance with client environmental problems such as securing housing, obtaining access to child care, helping clients with Food Stamp or TANF (Temporary Assistance to Needy Families) applications, securing legal representation etc. or other services that support the family or client. Another term that is sometimes used to describe these services A) task oriented. B) parallel. C) advocacy. D) indeterminate.

C) advocacy.

An adolescent confides to his school social worker that his parents will find out from the principal that he has missed several days of school. Frightened by the punishment he may receive and concerned about his parents' disappointment, he asks the social worker what to do. The BEST response is to A) tell him that since he broke the rules, he has to be willing to accept the consequences. B) encourage his parents to call her. C) encourage him to consider his prior decisions and current choices in the matter. D) tell the adolescent that she will work something out with the principle if he promises not to do it again.

C) encourage him to consider his prior decisions and current choices in the matter.

A social worker at a senior citizen center is contacted by a daughter of an elderly woman who attends the center. The daughter is trying to help her mother locate a doctor who treats diabetes, but is unsure of the insurance coverage. The social worker should inform the woman that Medicare will cover some of the cost related to doctor's visits if her mother A) has coverage through Medicare A. B) has Railroad Retirement coverage. C) has coverage through Medicare B. D) already has a diagnosis of diabetes.

C) has coverage through Medicare B.

A therapist accompanies a client to a store. The client is extremely fearful of leaving his home or any safe and familiar environment. The worker is using the technique of A) positive reinforcement B) negative reinforcement C) participant modeling D) aversive therapy

C) participant modeling

A DSM-5 diagnosis of substance abuse disorder normally does NOT require that A) the client used the substance over the course of a 12-month period B) a great deal of effort and energy is spent on acquiring the substance C) recurring legal issues regarding the use of the substance D) Continued use of the substance despite occupational or social issues due to the use of the substance

C) recurring legal issues regarding the use of the substance

A social worker supervising home care services for patients who have Alzheimer's disease and live with family members will be most concerned about A) the client's ability to pay. B) the qualifications of the home care worker. C) the ability of family members or others residing with the client to manage stress. D) the client's relationship with medical providers.

C) the ability of family members or others residing with the client to manage stress.

At about age 5, Jonathan's parents began to notice their son had developed a number of unusual symptoms. He rarely responded appropriately to family members or others. When his immediate environment was changed in any way or when new people were introduced to the environment he exhibited fear, anxiety and withdrawal. His vocalizations were not age appropriate and often incoherent, and he screamed when he was surprised or heard loud noises. He seemed overly attached to certain toys and was unable to play with other children. The social worker might first consider an evaluation for A) Schizophrenia. B) A hearing disorder. C) A developmental delay. D) Autism spectrum disorder

D) Autism spectrum disorder

Charlie, who owns a plumbing contracting business, is asked to attend a parenting class to help adjust to changes in his family and the birth of a third child. The course relies heavily on lectures. After two sessions, Charlie quits and refuses to attend any more sessions. He claims that the social worker who taught the class talked too much and didn't tell him "what to do." What kind of teaching style might have helped him more? A) Auditory B) Kinesthetic C) Observational D) Coaching

D) Coaching

The socialization and relationship-oriented group of 12 men and women in their late 20s and 30s had developed tight bonds after more than two years of weekly meetings. During an election year, a particularly heated political discussion led to an argument between Anne and Bill. Frustrated by Anne's arguments and her obviously sophisticated knowledge of politics, Bill finally told her to 'shut up' and added a few choice observations about Anne's appearance, demeanor, relationship skills, sexual orientation, and family background. He capped his assessment of her by suggesting that she was unable to sustain long term relationships with men because of her need to dominate and humiliate others. Anne was mortified and angry after Bill's outburst and sat in stunned silence. The other group members were baffled by the vehemence of Bill's attack. Clearly no one was quite ready to join in this discussion and the meeting was about to end. What should the social worker do? A) Meet with Anne after the meeting, allow her to ventilate her feelings about what had occurred and reassure her. B) Meet with Bill after the meeting and let him know that he was out of line. Suggest that he apologize to Anne and repeat the apology at the meeting. C) Meet with both Anne and Bill separately and try to mediate what had happened in a joint meeting. D) Encourage the group to express their feelings about what had just occurred and ask them to stay a few minutes longer.

D) Encourage the group to express their feelings about what had just occurred and ask them to stay a few minutes longer.

A 17-year-old male had a spinal cord injury due to a motorcycle accident that caused permanent paralysis below the waist. The family has been informed there is no possibility of cure or likely change in their son's condition. His father is in denial, believes a cure is possible, and refuses to participate in planning for his son. The mother is overwhelmed and in crisis. The two younger brothers are also in crisis and are unable fully to grasp the implications of their brother's injury. What type of therapy is not recommended? A) Family therapy. B) Grief counseling. C) Crisis counseling. D) Individual treatment.

D) Individual treatment.

Early treatment for children who have been sexually molested by their father or a male caretaker will NOT usually involve A) group treatment with other child sexual abuse victims. B) individual treatment emphasizing the child's feeling of powerlessness, victimization, and diminished self‑valuation. C) mother‑daughter treatment groups to help the child and mother deal with their anger and to reestablish a nurturing relationship. D) family therapy involving the entire family including the perpetrator.

D) family therapy involving the entire family including the perpetrator.

Some lower level staff of a very large private agency have grown increasingly concerned with management hiring and promotion policies. Promotions and new appointments seem to be based on family connections with the Executive Director. In a few instances, people who were hired did not have the qualifications normally required for employment. Several staff are deeply concerned about the agency and its staff's morale because of perceptions about the director's behavior. What strategies might social workers pursue to correct this problem? A) Meet with staff and seek agreement to hire an attorney. B) Propose to the director and the Board that the agency needs a formal hiring process to insure that the most qualified people are located to fill new positions. C) Ask supervisors to speak with the director. D) Meet with staff to discuss the issue of staff hiring and find out whether the perception of improper hiring practices is widely shared among staff.

D) Meet with staff to discuss the issue of staff hiring and find out whether the perception of improper hiring practices is widely shared among staff.

A social worker who supervises the agency's home-care program visits an elderly client to assess her continuing needs. The client receives two-hour daily visits from a home-care worker employed by the agency. The home-care worker is responsible for helping the client with routine activities including regular shopping for food, travel to medical appointments, and care of her home. The social worker observes that the apartment is well-maintained, but there is not much food in the refrigerator, the client's personal hygiene seems poor, and she complains that she missed her physical therapy appointment as the home care worker had not arrived on time. The social worker should A) Help the client with her personal hygiene and shop for food to tide her over. B) Call the home care worker and ask her to come over immediately to assist the client. C) Inform her supervisor D) Meet with the home care worker as soon as possible to discuss the work she is doing.

D) Meet with the home care worker as soon as possible to discuss the work she is doing.

The function of defense mechanisms is to A) Provide comfort and protection to vulnerable individuals. B) Save time and energy in defending against unacceptable actions. C) Protect the community against unacceptable sexuality. D) Minimize anxiety, protect the ego, and to maintain repression.

D) Minimize anxiety, protect the ego, and to maintain repression.

Which of the following conditions is not a cause of dementia in the elderly? A) Dehydration B) Korsakoff's Disease C) Cerebral vascular accident D) Osteoporosis

D) Osteoporosis

A hospital social worker accompanies the team on rounds that involve her clients on a medical floor. While in the hall, a young attending physician describes the next patient they are to see and she hears him. In this unintended way, the patient learns that she has a serious and usually fatal form of cancer. The patient reacts by becoming agitated and tearful. To the social worker, the physician seems hurried and insensitive as he leads the team away from the patient's room. What should the social worker do first in this instance to help? A) Discuss the doctor's insensitivity with him. B) Discuss the doctor's behavior with the team and try to help them learn from what they have just witnessed. C) Continue with rounds and return to the patient's room after rounds are completed. D) Stay with the patient and leave the team to help her through the shock of the news she has just received.

D) Stay with the patient and leave the team to help her through the shock of the news she has just received.

The Mahoney family altered their lifestyles after joining a small church led by a charismatic and appealing pastor. They have become vegetarians, eating only once daily and now contribute most of their earnings to the church. They recently withdrew their three pre-teen children from the public school and now send them to an unlicensed church school. The public school is anxious to avoid taking the family to court and sends the public school social worker to visit the family and convince them to return the children to the school. While at the home the social worker learns that the youngest child has become seriously ill. The worker notes that the child is feverish, pale and has lost a great deal of weight. The social worker expresses concern and is told by the mother that prayer will provide the cure. The worker learns that the church prohibits the use of medicine or doctors. How should the worker provide assistance in this case. A) The school issue needs to be resolved. The social worker should notify the family of their options and express the resolve of the school board to insure that every child is adequately educated. B) The family's reluctance to use community schools and medical care must be respected. The social worker can and should do nothing beyond seeking voluntary use of medical care. C) The social worker should visit the church and try to obtain their cooperation D) The most urgent issue in this case is treatment for the child. The worker should focus on that issue first even though the family is opposed.

D) The most urgent issue in this case is treatment for the child. The worker should focus on that issue first even though the family is opposed.

The Nortons are retired and live in a house they purchased many years ago. They come to family counseling seeking help with several family problems, particularly relating to Ed, their 19-year-old son who has recently completed high school after a lackluster academic career. Ed now seems to have difficulty finding direction. He spends most of the day at home, going out in the evenings and returning in the morning. The parents seem somewhat weak and uncertain about applying limits to Ed. At the third session, Bill, the father mentions that Ed is growing a large amount of Marijuana in the basement and that he is somewhat concerned about this. Ed says it is harmless and he is growing it for his own use. What should the worker do first. A) Explore the parent's relationship with Ed and work toward helping them set limits on Ed's behavior. B) Suggest that Ed seek individual counseling. C) Suggest vocational counseling for Ed. D) Work with the parents to immediately remove the marijuana plants.

D) Work with the parents to immediately remove the marijuana plants.

A 17-year-old misses two days of school after every weekend. He claims he has severe headaches. He tells his social worker that his parents are very critical of him, and constantly press him about his school performance, his dress, and his friends. This situation is best thought of as A) a substance abuse problem B) a conduct disorder. C) an oppositional defiant disorder. D) a breakdown in the parent-child relationship

D) a breakdown in the parent-child relationship