LCSW Practice Questions #2
A social worker in private practice meets with a 90-year-old man who recently lost his wife of 60 years. The client reports that since his wife passed away, he has being feeling irritated, does not have much energy, and has trouble falling asleep. A hospital social worker met with the client and conducted a clinical evaluation for depression. What should the social worker do FIRST? A. Demonstrate acceptance of the client's feelings of loss. B. Provide psychoeducation about depression. C. Complete a mental status examination. D. Contact the hospital social worker for additional information.
A. Demonstrate acceptance of the client's feelings of loss. Rationale: A is the best answer because the client has experienced a significant loss and acknowledging and accepting his feelings is an effective way to help him feel more comfortable and encourage him to discuss his feelings and symptoms. B, C and D might all be useful interventions, but not before the social worker has acknowledged the client's feelings of loss regarding his wife.
A client who is diagnosed with trichotillomania meets with a social worker after being referred by her primary care physician. The client says she feels guilty and ashamed, but is having difficulty stopping the behavior. She says that she doesn't even know why she started the behavior in the first place. What should the social worker do FIRST? A. Explore the feelings behind the behavior. B. Have the client wear a wig until she can stop the behavior. C. Reinforce that hair-pulling will likely lead to complete baldness. D. Teach the client thought stopping strategies.
A. Explore the feelings behind the behavior. Rationale: A is the best answer because understanding the psychological purpose of the behavior will best help the client understand and change the behavior. B, C, and D might all be part of the complete intervention strategy, but A is the best place to start in terms of addressing the behavior.
A young adult client has been meeting with a social worker due to a diagnosis of major depression. When discussing his childhood, the client reports that he was often bullied and humiliated by peers at school. The client reports this with a flat affect and a sense of detachment. The social worker should respond by: A. Sharing a personal experience of being teased as a child. B. Assist the client in developing awareness around his feeling related to being bullied. C. Confront the client's denial. D. Provide the client with psychoeducation on the relationship between bullying and depression.
B. Assist the client in developing awareness around his feeling related to being bullied. Rationale: B is the best answer because awareness is the first step in helping the client integrate and process his feelings. A is inappropriate; C is inappropriate and may cause the client harm. D is less therapeutic than B and may not be helpful for the client.
The parents of a 7-year-old child with developmental disabilities and cerebral palsy meet with a social worker. The parents report that their child's physical and emotional needs have had a large impact on their other children and the family's day-to-day functioning. The family is well-connected to service providers, but report that they still have unmet needs. What should the social worker do FIRST? Response: A. Suggest a family meeting to discuss the needs. B. Assist the parents in prioritizing the family's needs. C. Refer the family for intensive case management. D. Schedule a meeting with all service providers.
B. Assist the parents in prioritizing the family's needs. Rationale: B is the best answer in this case because it is important to determine the issues and needs that are most pressing for the family before proceeding. A, C, and D might all be appropriate actions, but not before the social worker understands which needs are most important for the family.
A 25-year-old shows up for a therapy session high. The client is still coherent, and able to speak with the social worker and answer questions. What should the social worker do FIRST? A. Refuse to see the client. B. Confront the client's inappropriate behavior. C. Encourage the client to attend Narcotics Anonymous. D. Initiate a behavioral intervention to address this behavior.
B. Confront the client's inappropriate behavior. Rationale: B is the best answer because until the behavior is confronted, other interventions will likely be ineffective. A, C, and D might all be useful interventions, but not BEFORE the behavior is addressed directly.
A school social worker meets with a sixth grade teacher regarding a student who was recently diagnosed with Type I diabetes. The teacher reports that the student has isolated herself from the other students, has fallen behind, and isn't interested in participating in class like she used to be. The social worker FIRST: Response: A. Meet with the student and explore her feelings about receiving the diagnosis. B. Contact the student's parents to obtain additional information. C. Help the teacher understand the effects of being diagnosed with a long-term illness during this critical stage of identity development. D. Refer the student to a support group.
B. Contact the student's parents to obtain additional information. Rationale: B is the best answer in this case because the social worker needs to understand more about the student's overall functioning and adjustment to the diagnosis; A and D might be useful, but not until after the social worker contacts the parents for more information. C will likely not affect the student's behaviors.
A social worker has been meeting with a 9-year-old child who was severely neglected by her parents. The child is in foster care and has been seeing the social worker for six months with good results. The social worker discovers that the child's parents want to get her back, however, refuse to follow the treatment plan mandated by the judge. They report that they know what they did was wrong, but state that since they are her parents they deserve to have her back. The social worker should focus on: A. A plan for reunification. B. Developing a permanency plan for the child. C. The parents' mental health treatment. D. Helping the parents change their behavior.
B. Developing a permanency plan for the child. Rationale: B is the best answer because the child's parents have had sufficient time to make changes and address their issues, but have failed to do so; at this point, the social worker should focus on finding a permanent, safe place for the child. A is not a good choice, since the parents have not met their court-ordered obligations to achieve this. C and D don't make sense in this context, since the social worker's responsibility is to the child.
A social worker in private practice meets with the parents of a young child who has recently been diagnosed with Asperger's Disorder. The parents report that the child's teacher is open to working with the child and they feel supported by the school and community. The social worker should NEXT: Response: A. Recommend that the parents advocate for a teacher's aide to assist with the child in class. B. Encourage the parents to enroll the child in a social skills group. C. Refer the parents to a gymnastics class for children with special needs. D. Help the parents identify appropriate classmates for future play dates.
B. Encourage the parents to enroll the child in a social skills group. Rationale: B is the best answer because it will help the student prepare for both C and D. A is not supported by the information in the stem; the student and teacher may not need a teacher's aide.
A mother and her 8-year-old daughter are referred to a social worker after a school counselor receives several reports that the girl has been bullying classmates. The mother is confused and says that her daughter gets along well with her two siblings and other children in their apartment complex. After completing a social and developmental history from the mother, the social worker should NEXT: A. Schedule an individual session with the girl. B. Have the mother sign a release to talk with the school counselor. C. Schedule a session with the siblings to gather additional information. D. Request the girl's school record.
B. Have the mother sign a release to talk with the school counselor. Rationale: B is the best answer because this appears to be a school-based issue and the collateral information from the school is necessary for assessment. A and C might both be good steps after the collateral information from the school is obtained. D is not the best answer because reviewing the school records will not provide as much information as contact with the counselor.
A client with a diagnosis of major depression meets with a social worker. The client reports that she has been in treatment many times before, but says, "my depression has never gotten any better." While developing the treatment plan, the client agrees with the social worker's suggested objectives saying, "I will do anything to make this go away." To develop a realistic treatment plan, the social worker should FIRST: A. Ensure the client's understanding of the treatment process. B. Help the client identify barriers to success in previous treatment attempts. C. Suggest that the client set her own objectives. D. Discuss evidenced-based treatment protocols for major depressive disorder.
B. Help the client identify barriers to success in previous treatment attempts. Rationale: B is the best answer because it is the most effective way to improve the chances of success in this treatment relationship. A, C, and D may all be part of the treatment planning process, but would not be done before the therapist understands the barriers to previous attempts at treatment.
A couple and their two children, ages two and four, come in for family counseling. They tell the social worker that the kids are "out of control". The father has a long history of alcohol abuse and the mother suffers from frequent depression. The social worker should consider referrals to: A. A child protective agency, AA, and a physician. B. Parenting classes, AA, and a psychiatrist. C. Parenting classes, substance abuse treatment, and a psychiatrist D. Substance abuse treatment, a physician, and a psychiatrist.
B. Parenting classes, AA, and a psychiatrist. Rationale: B is the best answer because it addresses the needs that are presented in the stem: parenting difficulties, alcohol abuse, and the mother's depression. A is not the best answer because there is no indication of child abuse in the stem. C is a good answer, but not as strong as B, which specifies AA instead of just general substance abuse treatment. D is not the best answer because there are no issues requiring physician care presented in the stem.
A hospital social worker is working with a 35-year-old client who was involuntarily committed to the psychiatric unit due to the risk of self-harm. The client has a long-term history of anorexia nervosa and, as a result, is experiencing many medical complications. While meeting with the social worker, the client states that she does not want to be in the hospital, and has been refusing the hospital food. The client asks to be referred to a day treatment program. What should the social worker do FIRST? A. Refer the client for a medication evaluation. B. Remind the client that her hospitalization is not voluntary. C. Support the client in her efforts to be discharged. D. Point out the impact of the client's behaviors on her overall health.
B. Remind the client that her hospitalization is not voluntary. Rationale: B is the best answer because the client is on an involuntary hold and has few options at this time. A may be needed, but is likely already part of the treatment protocol at the hospital. C is not the best answer because the client appears to be at risk of self-harm. D might be a good option, but not before discussing the nature of the hospitalization.
A family meets with a social worker after their 17-year-old son was diagnosed with schizophrenia. The psychiatrist recommends intensive outpatient treatment so that the client can remain in the family home with a support system. The family physician believes that inpatient treatment is necessary due to the presence of alcohol abuse. The client's parents are afraid and unsure what to do. The social worker should FIRST: A. Support the family in making a treatment decision. B. Schedule a conference with both the psychiatrist and physician involved. C. Try outpatient therapy with the addition of AA meetings. D. Discuss the importance of sobriety with the family.
B. Schedule a conference with both the psychiatrist and physician involved. Rationale: B is the best answer in order to help the family and achieve some agreement between professionals regarding the course of treatment. A and D might both be reasonable, but not until after trying to obtain consensus between the professionals involved. C disregards the family physician's opinion, which may be based on physical withdrawal symptoms associated with alcohol abuse.
While meeting with a social worker, a client discusses his concerns regarding the amount of time he spends playing videogames. The client reports that he has trouble paying attention to "anything else" because he's preoccupied with strategy and planning associated with the games. He states that he has tried, "but can't control it." The social worker should FIRST assess? A. How the content of the games contributes to the client's preoccupation. B. The specific ways in which the client's life is impacted. C. The quality of the client's interpersonal relationships. D. The frequency and duration of his gameplaying.
B. The specific ways in which the client's life is impacted. Rationale: B is the best answer because the social worker needs a more complete understanding of the presenting problem and its impact on the client's life. A, C, and D might all be part of the overall evaluation, but would not be clarified before the social worker understands the extent of the problem.
A social worker is in the process of creating a multidisciplinary team for a new mental health clinic. In order to facilitate collaboration between team members, the social worker should: A. Reinforce the importance of including social work as a component. B. Identify the population of clients that the team will serve. C. Define each member's contribution to the overall team. D. Identify one member to act as the team leader.
C. Define each member's contribution to the overall team. Rationale: C is the best answer because it will lay the foundation for any step taken afterward in terms of teambuilding and ensure that team members can work together; A, B, and D do not address the task of creating a collaborative team.
A crisis social worker receives a call that a man is walking through a local park naked. It has also been reported that he was seen shouting incoherently outside his home, and appeared disheveled and disoriented. His neighbors are concerned because he is a hard-working, successful individual. What should the social worker do NEXT? A. Start making phone calls to inpatient treatment programs. B. Make a home visit and complete a complete evaluation. C. Dispatch a crisis team to perform a mental status exam and arrange appropriate follow up. D. Encourage the caller to make an APS report and call police.
C. Dispatch a crisis team to perform a mental status exam and arrange appropriate follow up. Rationale: C is the best answer because the man appears to be exhibiting an inability to care for himself and may be at risk of harming herself. A does not make sense before an assessment has been made. B is not the best answer because it is likely not the crisis social worker's role to make direct visits, but rather to arrange assessment when needed. D is not the best answer because it may delay assessment and treatment, creating a safety issue.
An established client discloses to her social worker that several years ago, she had an affair and subsequently had a child. The client confessed to her husband and the two have been raising the child as their own since then. The client says that she never told anyone else and that she and her husband have not discussed the paternity of the child since her confession. Which family therapy concept does this illustrate? A. Family rules B. Enmeshed boundaries C. Family secrets D. Emotional cutoff
C. Family secrets Rationale: This is an application question; C is the best answer because the scenario fits the definition of "family secrets." A, B, and D would all be described in a different way.
A couple meets with a social worker. The woman reports that her 80-year-old father has been living with them since her mother passed away four years ago. The woman reports that her father has recently been refusing to eat meals with the couple, appears agitated, and is concerned that he may be depressed. The woman says that she and her husband are constantly arguing about whether or not they should suggest that her father move to an assisted living facility. The FIRST factor the social worker should consider is the: A. Family's cultural background and the value placed on caregiving. B. Father's decreased risk for suicide since he is living with a family member. C. Guilt associated with caregivers suggesting that the family member move out. D. Daughter's ability to withstand the father's negative response.
C. Guilt associated with caregivers suggesting that the family member move out. Rationale: C is the best answer because the guilt may both prevent the couple from reaching a consensus and be adding to the tension between them; without resolving it, it will be difficult to move forward. A may be considered, but not before the more likely issue of guilt. B is not the best answer because the stem doesn't provide enough information to determine whether there is a risk of suicide. D is not the best answer because the stem does not indicate that the father will have a negative response.
A social worker receives a referral for a 13-year-old who was sexually abused by his older cousin. Collateral contact with the child protective services worker reveals that both the client and cousin are still living in the same home, although they no longer share a bedroom. After completing the evaluation, the social worker should focus on: A. Requiring the cousin to attend individual treatment. B. Working with the parents to find alternative living arrangements for the cousin. C. Helping the client develop a safety plan. D. Facilitating a family session with the client, parents and cousin.
C. Helping the client develop a safety plan. Rationale: C is the best answer because safety is the primary objective for the child. A is not the best answer because the offender is not the social worker's client. B may not be what the family wants or is able to do. D would be inappropriate and is not supported by research (treating a victim and perpetrator together).
A 7-year-old child who was sexually abused by a family friend is being treated by a social worker. During one session, the client's mother reports that his teacher contacted her to report that the child was sexually act out with another child at school. The mother reports that she is concerned by this behavior and unsure what to do. The social worker should explain that this behavior: A. Will almost certainly decrease over time. B. Probably means the child is still being abused. C. Necessitates continued treatment. D. Substantiates child abuse.
C. Necessitates continued treatment. Rationale: C is the best answer because the behavior indicates that the child has not resolved sexual issues and needs continued intervention. A and B may not be at all true; D does not make sense since the validity of the abuse was not in question.
During an initial evaluation, a 53-year old man reports that he is upset regarding his sex life with his wife. He reports that they used to have an active sex life, but that since his wife started menopause a few months ago, she often refuses sex or says she isn't in the mood. The client has done online research that has normalized his wife's experience, but he still believes that she may be having an affair. The social worker's MOST appropriate action is to: A. Suggest that the wife have a medical evaluation. B. Provide psychoeducation about the affects of menopause on desire. C. Offer couples therapy to the client and his wife. D. Suggest individual therapy to help the husband address his frustration.
C. Offer couples therapy to the client and his wife. Rationale: C is the best answer because it will address the issue that exists BETWEEN the husband and wife. A is not the best answer because there is not enough to suggest that this is necessary at this time. Likewise, B may not be particularly helpful in this case as the husband has done some research and is more concerned with his wife's fidelity. D is not the best answer because it would not address one partner in an issue that is between the couple.
A social worker is meeting with a recently retired woman who is seeking counseling due to feelings of irritability and poor frustration tolerance. The client reports that she was looking forward to retirement so that she could do the things she enjoyed and see more of her spouse after a demanding career in the health care industry. The client says that instead she's been having trouble sleeping and just wants to be alone. She says that she doesn't enjoy the things that she used to and is confused. The social worker should FIRST inquire about: A. Any dysfunctional changes in the marital relationship. B. The impact of losing status in the community. C. Other symptoms that might indicate depression. D. Volunteer opportunities that might help the client feel useful again.
C. Other symptoms that might indicate depression. Rationale: C is the best answer because the client has indicated several symptoms of depression and the therapist should start by asking more about symptoms in this category. A, B, and D would likely all be part of the assessment and intervention plan, but only after a provisional diagnosis has been reached.
A family meets with a social worker for family therapy due to concerns regarding their 16-year-old daughter. The mother reports that their daughter was recently diagnosed with a medical condition that requires medication monitoring and a strict diet. She says that her daughter has many friends, and does well in school, however has recently been questioning her parent's authority and demanding to make her own choices. The father also reports that their daughter refuses to follow her required diet. This behavior is MOST likely due to? Response: A. Her parents misunderstanding of typical adolescent behavior. B. The client's use of illicit substances in addition to medication. C. The client's need to exert control over a part of her life. D. Noncompliance with medication in combination with irregular diet.
C. The client's need to exert control over a part of her life. Rationale: C is the best answer because the stem describes normal adolescent development. A may be true, but is not the reason for the daughter's behavior. B is not the best answer because there is nothing in the stem to indicate substance abuse. D is not the best answer because the stem does not mention noncompliance with meds, and while dietary changes may impact mood, they are not the MOST likely reason for the behavior.
A 15-year-old who was sexually abused for two years by a relative is meeting with a social worker for an initial evaluation. The social worker wants to assess the impact that the abuse has had on the client. To accomplish this, the social worker should focus on: A. The client's sexual identity. B. The client's level of repression. C. The client's psychosocial functioning. D. The client's self-care.
C. The client's psychosocial functioning. Rationale: C is the best answer because it most fully addresses the social worker's need to assess the impact of the abuse. While it is possible that A, B, and D may have all been affected, if the social worker focuses on any one of the three, he/she might miss something else. Understanding the client's current psychosocial functioning will give the social worker the best overall picture of how the abuse has impacted the client.
A social worker is developing a support group for adults who provide caregiving to their aging parents. The social worker wants to focus on coping skills to manage the stressors that accompany caregiving. In designing the group, the social worker should consider that caregiver stress is PRIMARILY linked with: Response: A. The duration of complicated hospitalizations. B. Whether or not the caregiver has a family of his/her own. C. The duration of the illness. D. The parent's age at onset of the illness.
C. The duration of the illness. Rationale: C is the best answer because duration of the illness is the factor most likely to produce stress in the caregiver. A, B, and D are not as likely to produce stress.
A hospital emergency room social worker meets with a 45-year-old man who recently immigrated from Mexico and has been experiencing severe panic attacks and anxiety. When the social worker approaches him, he says that he does not need any mental health treatment and that she can leave. The MOST likely explanation for his behavior is: A. His preference for seeking treatment from a curandero. B. His denial that he has a mental health problem. C. The negative cultural response associated with mental health treatment. D. A miscommunication due to a language barrier.
C. The negative cultural response associated with mental health treatment. Rationale: C is the best answer because many cultures associate stigma with mental health treatment. A is not the best answer because it makes an assumption that is not indicated by the information in the stem. B may be true, but is not as likely as C. D is not the best answer since the stem gives no indication that there is a language barrier between the client and social worker.
A 45-year-old client meets with a social worker due to a long history of prescription drug abuse. During the intake assessment, the client states that he has been in many treatment programs, but has been unable to stay sober for longer than a few months. The client says that he doesn't think anyone can help him anymore and is afraid that he is going to turn into his father, who passed away after overdosing on drugs when the client was a teenager. According to the relapse prevention model, what should the social worker do FIRST? A. Refer the client to Narcotics Anonymous. B. Explain the importance of involving the client's family in the recovery process. C. Discuss the genetic and environmental impact of his father's addiction. D. Ask clarifying questions to identify the client's motivation to change his behavior.
D. Ask clarifying questions to identify the client's motivation to change his behavior. Rationale: D is the best answer because motivation for change is a significant part of the relapse prevention model and will help dictate the course of intervention. A, B, and C do not relate specifically to a relapse prevention model of treatment.
A social worker is treating a mother and her 15-year-old son for frequent conflicts. At the end of one session, the mother points out how helpful her son has been around the house; the son replies by saying, "I didn't really do that much." What should the social worker do FIRST? A. Point out the son's inability to accept praise from his mother. B. Ask the mother why she's complimenting the son now. C. Suggest that perhaps the son resents having to help around the house. D. Assist the son in accepting his mother's praise.
D. Assist the son in accepting his mother's praise. Rationale: D is the best answer because it directly addresses the dynamic that has just occurred and uses a positive strategy to create change. A, B, and C might all be good interventions at a future session, but would not be done before working to help the son accept the mother's praise in the moment.
A mother meets with a social worker due to concerns with her seven-year-old son. The mother reports that her family recently survived an earthquake that destroyed their house and the surrounding area. She is worried about her son because any time he hears a loud noise he starts to cry inconsolably and won't leave her side. In behavioral therapy, what is this an example of? A. Extinction B. Negative reinforcement C. Operant conditioning D. Classical conditioning
D. Classical conditioning Rationale: This is a recall question: the stem describes an example of classical conditioning in which the client develops a conditioned response (crying and clinging to mom) when exposed to stimuli (loud noises) that represent a previously experienced event (the earthquake). A, B, and C would all be described differently.
A social worker meets with a couple who have a two-year-old and a newborn child. The mother says she feels like she is doing all the work around the house by cooking, cleaning, and taking care of the children. Her spouse says that she never makes time for him and it feels like she would rather be with the kids than with him. The couple MOST likely is: A. Endangering their children. B. In need of professional home-based support services. C. Using their children to mask deeper problems in their relationship. D. Experiencing stress associated with a life cycle change.
D. Experiencing stress associated with a life cycle change. Rationale: D is the best answer because the stem described a very typical pattern in families experiencing a life cycle change (new baby). A makes the assumption that there is a safety issue, when nothing in the stem indicates that. B is not supported by the stem, since the couple's problem, while very real, is not unusual. C is not supported by the information in the stem.
A mother brings her 16-year-old son to the emergency room stating that she does not know what is wrong with him. She reports that starting a few weeks ago, her son has been forgetful about his homework and chores around the house, has fallen down the stairs twice, and this evening attempted to make an expensive purchase from an infomercial. When asked, the mother reports that the only other change in the teen's life is that a new neighbor moved in a month ago. The MOST likely cause for the son's behavior is: A. Peer conflict B. Sleep loss C. Typical adolescent behavior D. Marijuana abuse
D. Marijuana abuse Rationale: This is a recall question; D is the best answer because the behaviors described in the stem are most associated with marijuana abuse. A is not the best answer because no social problems are indicated in the stem. B is not the best answer because it is not as likely as D and would be described differently in terms of the boy's behavior. C does not make sense given the significant changes in the boy's behavior.
Clients discharged from a local psychiatric hospital all receive monthly medication monitoring and supportive case management from a mental health center. Despite these services, the hospital social worker notices that many of these clients experience frequent crises after discharge and need to be re-hospitalized. What is the MOST likely reason for this? A. Client's families are not engaged in the discharge planning process. B. Hospitalization did not address the clients' need for coping skills. C. The program staff are overworked and unable to provide clients with individual attention. D. Sufficient follow up services are not available in the community.
D. Sufficient follow up services are not available in the community. Rationale: D is the best answer because lack of community services is the MOST frequent reason for patient's re-hospitalization. A makes an assumption that the patients' all have families; B and C both assume that the hospital is not addressing the patients' needs, when nothing in the stem would indicate this.