Licensure Practice Exam Questions Part 2

Which medication is most used in treating psychoses? 1. Xanax. 2. Haldol. 3. Viagra. 4. Prozac.

The correct answer is 2. Haldol is the only medication listed that is commonly used to treat psychoses.

A client who is unable to tolerate frustration and has a tendency to discharge tension is said to 1. regress. 2. somaticize. 3. decompensate. 4. act-out.

The correct answer is 4. Acting-out is a direct, impulsive, active manifestation of an unconscious wish or impulse that is expressed behaviorally

DSM-5 removes all references to 1. AxisV. 2. Axis IV. 3. Axis II. 4. All Axis references

The correct answer is 4. DSM-5 no longer uses the 5 axis model of DSM-4TR

A client suffering from a bipolar disorder would most likely receive which medication? 1. Thyroxin. 2. Seconal. 3. Indocin. 4. Lithium.

The correct answer is 4. Lithium is the only medication listed that is used for psychiatric treatment.

Many factors have contributed to the drive toward deinstitutionalization and the growth of community-based care. However, it is unlikely the movement would have developed if not for 1. aggressive advocacy by families and mental health professionals. 2. the invention and widespread use of psychotropic medications that can control the symptoms of severe mental illness. 3. improvement in case practice and case management that allowed social workers to provide better supports to clients. 4. a significant change in professional attitudes about the value and safety of community-based care.

The correct answer is 2. Deinstitutionalization was advanced as a major strategy only after psychotropic medications proved safe and effective. Prior to that time, there would have been little professional or political support for releasing seriously ill patients

A woman in an adult therapy group describes a letter she has received inviting her to interview for a position she has sought for some time. It is a substantial advancement over her current position. She begins to discuss how worried she is about the interview and her doubts about obtaining the position. The description above represents a 1. stress-related disorder. 2. stressor. 3. psychological reaction. 4. perceptual distortion.

The correct answer is 2. Stressors are life-changing events. A move to a new house, a new job or unemployment, a death in the family these are all stressors that demand some adjustment

A committee of the legislature formed to review a specific issue and make recommendations within a specific period will not be called a 1. special committee. 2. select committee. 3. standing committee. 4. legislative task-force.

The correct answer is 3. The question is asked in the negative. A standing committee is a permanent committee of the legislature. All other choices would be temporary and focused on a specific task

The Colonial Poor Laws established the principle of 1. neighborly involvement. 2. local public responsibility. 3. federal responsibility. 4. residential care for the poor.

The correct answer is 2. The Colonial Poor Laws derived from Elizabethan concepts which delegated responsibility for the poor to local government. It was not until the Social Security Act of 1935 that most of the obligation was shifted to Federal and State governments

The optimal size group for a therapy group is generally thought to be 1. 4-7. 2. 6-14. 3. 3-6. 4. 8-10.

The correct answer is 4. Most practitioners of social group work argue that a group size of 8-10 provides sufficient diversity, and allows room for non-attendance and client turnover

Susan, age 16, tells her school social worker that her stepfather has sexually molested her and Lisa, her 10-year-old sister. The worker knows the family's problems include the stepfather's unemployment, alcoholism, and occasional outbursts of anger at the children. The mother seems concerned about her children and has had productive discussions with school personnel in the past. Susan is occasionally truant from school and has intermittent involvement with drugs. What should the school social worker do first? 1. The social worker should make a sexual abuse report to the local child protective agency. 2. The social worker should talk with Lisa to ascertain the accuracy and truth of Susan's accusation. 3. The social worker should talk with the child's mother and her teachers. 4. The social worker should request a family evaluation from the mental health center.

he correct answer is 1. Question 5 is a legal and a practice question. In all states, social workers are mandated reporters obligated by statute to report child abuse. The criterion for a report is mere suspicion of abuse. The individual reporter is under no obligation to be absolutely certain when making a good faith report. Susan's statement to the social worker provides sufficient grounds

A sixteen-year-old woman reveals to her clinical social worker that she is involved in many casual and unprotected sexual relationships. Her parents ask the social worker about her treatment and request information and guidance. What is the social worker's best response? 1. Suggest the parents have a discussion with their daughter about her sexual behavior. 2. Inform the client that her parents are interested in knowing how things are going in treatment. Ask her how she would like the worker to respond to the question. 3. Notify the parents that a social worker cannot reveal anything about their daughter's treatment. 4. Refer the daughter to a sexual counselor to raise her consciousness about the necessity to protect herself and her partners.

The best answer is 2. Although confidentiality laws apply to minors, it is good clinical practice to respect the concerns of the parents and to provide at least a general response. Letting the adolescent know of the parents' interest, and enlisting her help in thinking about a response, allows her to determine the boundaries of shared material. It also reinforces the alliance between worker and client. Answer 1 reveals content of the sessions. Answer 3, while technically accurate, may serve to alienate the parents from the treatment process. Answer 4 is at best premature. It is likely the motivation behind the adolescent's behavior is complicated, and it may not reflect a lack of knowledge. The social worker can address the issues of safe sexual practices as part of the treatment process.

A social worker discovers that her female client is HIV-infected and is also sexually active. She does not inform her partners of her illness. The client maintains that she always uses safe sex techniques and would never knowingly put anyone at risk. The social worker is concerned that despite the client's precautions, she should notify her partners so they can take appropriate protective measures. Which statement best describes the social worker's options? 1. The social worker should contact the Department of Public Health and ask them to meet with the client. 2. The social worker can and should do nothing. 3. The social worker's best option is to discuss the matter fully with the client and explore the meaning of her behavior and the risks she is taking. 4. The social worker should demand that the client stop behaving in a way that puts others at risk.

The best answer is number 3. There are no good answers in a situation like this. A referral to the Department of Public Health may breach confidentiality, and it will certainly alienate the client. Demanding the client change is not productive and violates the notion of self-determination. The client's failure to acknowledge her HIV status to partners may well reflect a lack of resolution in dealing with her illness. If she maintains safe sex practices, then there is little evidence that she is endangering others. This is an emerging area of concern, and policies are likely to shift in time.

According to DSM-5, a diagnosis of insomnia disorder enables the therapist to also associate mental heath diagnosis with 1. comorbid conditions such as depression, anxiety, or physical illness 2. poor living conditions 3. some physical component. 4. unsuccessful sleep-inducing rituals.

The correct answer is 1. Another definitional question. Note that many of the new DSM-5 diagnoses cross over and allow for the elaboration of associated disorders. DSM-5 allows for more complex diagnoses

Discussions about case termination are first raised 1. when developing a case plan with a client. 2. at intake. 3. after the diagnosis is clear. 4. when the insurance coverage is down to four visits.

The correct answer is 1. As part of developing a case plan, it is useful to discuss, if only in general terms, what the client wants or needs as a goal of treatment. The possibility of terminating when certain goals are achieved can be raised during the case planning process

A social worker using a behavioral approach to assessment and treatment will usually be most concerned with a 1. interventions that are based on empirical research and produce observable and measurable results. 2. applying treatment methods that are simple to apply and easily understood by the client. 3. rapid progress that encourages further change. 4. changing the clients thought patterns through repetitive exercises.

The correct answer is 1. Behavioral treatment is the most empirical of all treatment methods, relying heavily on research-based treatment that alters observable behaviors

While many variables affect suicidality among teenagers, which item below has been a particularly powerful predictor? 1. A chaotic, abusive, and unhappy family environment. 2. Transfer to a new school in a new neighborhood. 3. A history of occasional drug use. 4. A change in family economic status.

The correct answer is 1. Chronically stressful family lives, abuse, and discord are markers for aggression against self and others. While suicidal behavior often occurs in the context of a variety of stressors, the ability to contextualize stress and develop coping strategies is, in part, related to family experiences. Children whose families are dysfunctional, filled with discord, and violence, often have few resources to deal with stress and may act out violently

Voluntary organizations that serve the community to improve the general welfare are generally called 1. civic associations. 2. social clubs. 3. settlement houses. 4. social welfare agencies.

The correct answer is 1. Civic associations generally have broad improvement purposes while social welfare and social service organizations have more specific and targeted purposes

A social worker treating a disturbed 17-year-old adolescent male feels that the treatment goals and plan need to be revised. In considering changes in the client's treatment plan, the worker should: 1. discuss the changes with the client, and secure his agreement and cooperation. 2. prepare a written draft for discussion with the client and ask him to initial it if he agrees. 3. discuss the changes with the boy's parents before discussing it with the client. 4. recognize that changing treatment goals is unusual after treatment has commenced.

The correct answer is 1. Client-centered therapy requires the client's involvement in the process of determining treatment goals and plans to achieve them. If the worker believes a change is indicated, it must be discussed with the client

A social worker who believes that systems theory provides a useful basis for assessing and diagnosing clients will be most interested in 1. the client's work, family, professional, and social relations. 2. evidence of abnormal development throughout the lifespan. 3. the client's social class, place of residence, and level of ambition. 4. ideas expressed by the client that express a worldview and personal values.

The correct answer is 1. Clinicians using systems theory will be concerned about the clients' networks of relationships and the interactions between them

A young single mother appears frequently at a health center with concerns about her 14-month- old child's health. There is usually no clinical corroboration of her observations. Many invasive tests have been done and one hospitalization for diagnostic purposes was inconclusive. The mother now claims the child has painful urination and blood in her urine. Some blood is found in urine samples brought from home, though none was found when the child voided at the clinic. More invasive tests may be necessary. The social worker might explore 1. a factitious disorder imposed on another. 2. a possibly toxic home environment. 3. helping the mother deal with the possibility of hospitalization. 4. methods to help the mother with her anxiety.

The correct answer is 1. Factitious disorder imposed on another, replaces the previous diagnosis of Munchausen's by proxy. It is similar to other factitious disorders except another person is used to produce the symptoms and secure the wanted attention. A mother with an ill child will attract sympathy and attention from doctors and health personnel. The feature in this vignette that reveals the probability of this diagnosis is that there is no clinical corroboration of findings. Parents have sometimes been barred from a child's hospital room because medical tests only show anomalies when parents are present, i.e., blood in the urine

What are the outward characteristics of a narcissistic personality? 1. Grandiosity and self absorption. 2. Shyness and social inhibitions. 3. Dishonesty and mendacity. 4. Stubbornness and arrogance.

The correct answer is 1. Grandiosity, self absorption, and an inability to empathize with others or to understand how others respond to them are all attributes of narcissistic personalities

Which factor is most critical to a successful clinical outcome? 1. The therapeutic alliance between clinician and client. 2. The clients' ability to accept adverse judgements. 3. Shared values between the clinician and client. 4. The client's educational level.

The correct answer is 1. In most clinical practice, the relationship or clinical alliance is a key factor in helping clients improve

A client's treatment plan is always preceded by one of the following: 1. A psychosocial evaluation. 2. A clinical diagnosis. 3. A generic assessment. 4. A feasibility study.

The correct answer is 1. In social work, the treatment plan is informed by the psychosocial evaluation which takes into account the internal workings of the individual as well as their social and environmental milieu

A young college woman from a small community seeks help at a hospital emergency room. She complains of loss of control of her right arm and occasional partial paralysis in her fingers. The ER physician finds no evidence of substance abuse and no physical basis for her symptoms. Upon referral to social services, the social worker might first consider 1. if the patient is deliberately producing the symptoms for some reason. 2. if the physician has overlooked some physical reasons for the symptoms. 3. the patient's family medical history. 4. events in the patient's life that might suggest a history of emotional deprivation.

The correct answer is 1. In this question, the best answer is 1. The client may be exhibiting Munchausen's syndrome or may be malingering. None of the other responses are responsive to the stem of the question. There are other psychiatric reasons that might explain these symptoms (i.e., a hysterical paralysis), but they are not mentioned as possibilities

If psychotic symptoms appear for the first time after age 40, it is likely that the client will 1. recover from the psychosis within a short period. 2. provide positive results to a test for tertiary syphilis. 3. have a history of occasional drug use. 4. continue to decompensate.

The correct answer is 1. Late onset psychoses tend to be short-lived and have a good prognosis for complete recovery. Psychoses that appear in late adolescence are likely to be more durable

Organizations whose main purpose is to fulfill governmentally determined goals, that mainly receive support from public agencies, and are under the control of government through the board and executive staff appointments are often called 1. quasi-public organizations. 2. civic associations. 3. federations. 4. public institutions.

The correct answer is 1. Many cities and smaller communities establish organizations whose purposes and activities are guided by public decision-making processes. While strictly speaking they are nonprofit organizations, they are also more generally described as quasi-public organizations or institutions because of the close relationship they maintain with government

The most usual physical symptoms in a major depressive episode are 1. sleep problems, loss of appetite, decreased energy. 2. hopelessness, feelings of worthlessness, anxiety. 3. unrealistic self-assessments, grandiosity, rage. 4. hallucinations, delusions, magical thinking.

The correct answer is 1. Notice that the stem of the question asks for the most frequent symptoms. Answer 1 is the only response listing physical symptoms.

Select a federal program administered and funded totally by the federal government with no state or local participation by either government or nonprofit organizations: 1. Social Security Old Age and Survivor's Insurance. 2. Headstart. 3. Public Housing. 4. Public Assistance.

The correct answer is 1. Old age insurance under the Social Security Act is administered totally by the federal government with no local participation. The other programs listed are either administered at the local level or require local funds.

A social worker is assigned the task of developing a budget for a new program that will be funded by a state agency. In producing the budget the social worker charges 27% of the budget to "overhead." The term that best describes overhead is 1. those costs for administration, planning, program development, and miscellaneous charges and categories that are not accounted for in line items. 2. the surplus that the agency expects to realize from delivering the services. 3. funds designated for a reserve to be used for program startup or closure. 4. rent and utility costs.

The correct answer is 1. Overhead incorporates non-program or service delivery expenses such as management costs, accounting fees, general insurance, rent, telephone, and some office expenses. While all agencies use this category, the exact items incorporated in overhead may vary considerably

A hospital social worker runs groups whose purpose is to help cancer patients and their families understand the disease. The groups provide information about the expected physical and emotional consequences of treatment. These groups can best be described as 1. psychoeducational groups. 2. therapy groups. 3. heterogeneous groups. 4. remedial groups.

The correct answer is 1. Psychoeducational groups are designed to provide information and education to clients. Groups are tailored to the informational needs of clients and are essentially preventive, rather than remedial.

A client has a documented history of sexual offenses. One of the treatment goals is to locate an appropriate treatment program for the client. When evaluating the client, the least reliable method of obtaining accurate information is 1. the client's statements and observations. 2. worker observations of the client's pattern of interactions. 3. police reports. 4. family statements and observations.

The correct answer is 1. Sexual offenders often exhibit profound denial or minimization about their sexual behavior and, therefore, their statements cannot always be accepted at face value. Moreover, they are highly motivated to dissemble since if they reoffend, it could lead to imprisonment

A white teenage mother is referred to an older African-American social worker in a community- based family agency. The social worker might initially 1. suggest the client tell her about how the agency and the social worker can help. 2. refer the case to another worker. 3. talk about their differences. 4. note that she has worked with many young women with children.

The correct answer is 1. Social services provisions should be both racially and ethnically neutral, unless the client has a preference. The answer suggests the worker should begin the interview in the same way any other interview would begin, without reference to different ethnic or racial backgrounds

A social worker is very active during family therapy sessions in confronting the family and addressing symptoms. The worker meets with the family and with individual members. The worker is probably using techniques drawn from a 1. structural model. 2. Bowen model. 3. conjoint therapy. 4. psychodynamic model.

The correct answer is 1. Structural family therapists are often very active in sessions with families and are likely to use individual as well as family sessions. The goals of therapy focus on reorganizing the family structure to reflect a parental hierarchy, and to create clear and flexible boundaries between family members.

The concepts of preaffiliation, power and control, intimacy, differentiation, and separation are associated with 1. the Boston Model of Group development. 2. the life cycle theories offeminist scholars such as Carol Gilligan. 3. the process offamily therapy. 4. adolescent development.

The correct answer is 1. The Boston model of group development uses these terms to describe group development phases. There are other models, but they tend to be quite similar in their descriptions of the phases of groups development

A 45-year-old patient is recently divorced from his wife of 15 years. He is employed as a mail carrier, and complains that his memory and logic skills have diminished. He has recently been assigned a new delivery route. Now he is embarrassed that he is unable to visualize fully the exact boundaries of the route, or to plan the special characteristics of various sites that in the past helped him to calculate his loads and schedules. These are important issues. In a long route, the mail carrier must calculate drop-offs so as not to have to double back and waste time. The client feels this problem acutely. He has developed a slight limp and complains of tiring easily. A social worker might first consider 1. a referral for a medical and a neurological examination. 2. a primary diagnosis of early onset ofAlzheimer's disease. 3. the possibility of substance abuse. 4. a factitious disorder.

The correct answer is 1. The decrease in memory, spatial functioning, and organizational ability is suggestive of a possible medical condition. A thorough medical and neurological work up is indicated. While the client may be found to have an early onset of Alzheimer's disease, this diagnosis could not and should not be made in the absence of a medical work up

A 16-year-old adolescent girl engages in binge eating several times a week. Following each episode she self-induces vomiting to avoid weight gain. She claims that she has no control over eating and that the behavior has been occurring for the past year. The most likely diagnosis is 1. bulimia nervosa. 2. anorexia nervosa. 3. eating disorder-NOS. 4. primary eating disorder.

The correct answer is 1. The descriptions in the question stem are the classic symptoms for bulimia

The mission statement of an agency represents 1. a broad statement of the agency's goals and social purposes. 2. an absolute commitment to specific activities. 3. a basis for planning next year's program. 4. a fund-raising device that has little bearing on what the agency does.

The correct answer is 1. The mission statement of an agency is an important document that determines the way the agency's present and future are implemented and planned. The mission is also the public face of the organization. It identifies the agency for all its publics, its constituents, employees, board members, funding agencies, certifying and licensing bodies, and clients.

Which statement is true about a contract between a client and the social worker? 1. It is a mutual agreement on goals, limits, and expectations that may change overtime. 2. It is always written. 3. It is legally binding and can lead to a lawsuit for malpractice if it is violated. 4. Completing the contract during the initial interview is essential.

The correct answer is 1. The only correct statement is 1. Note that the contract is fluid and can be changed as the issues change

After two months, an adolescent client ordered by the court to see a social worker complains he sees no reason for continuing the sessions. He says he has avoided trouble for two months and that the worker should trust him by now. The worker's best response is: 1. "It is frustrating to have to do something you don't want to do. Have you had other experiences like this before?" 2. "Two months isn't long enough to judge your trustworthiness." 3. "You broke the law and now must suffer the consequences." 4. "Sometimes we have to do things we don't want to do."

The correct answer is 1. The problem described in the stem often occurs with clients who are coerced into treatment through court orders or other means. Answer 1 provides the client with an empathic response from the social worker. It allows the social worker to join with the client rather than assuming an adversarial stance.

In the 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 state: 1. "Tell me more about your husband's temper." 2. "Have you done anything that might provoke his anger?" 3. "Are you exaggerating when you claim he has a nasty temper and that this is the biggest marital problem?" 4. "We can talk at a later time about the temper issue, but for now I'd like to hear from your husband about his complaints about you."

The correct answer is 1. The worker's task is to remain neutral and allow both partners an opportunity to express their feelings. The worker should not validate the wife's claim by assuming its truth, or alternatively accept the accusation and suggest the wife is responsible. The worker's task is to facilitate discussion of the issue that has been raised, without providing opportunities for either partner to erect defenses against participation in the process

A young Muslim woman refugee from the Balkans reports that she and her family were badly mistreated and harassed by paramilitary forces as they left their country. She states that there were "many things" that happened, but she seems reluctant to fully discuss them with the worker. Finally, she reveals she was raped and sexually humiliated many times, but she will not reveal these things to her family. What factors should the worker understand to help this woman? 1. The cultural and social milieu in which she lives. 2. Her own psychological resilience. 3. The historical and political issues that her ethnic group has experienced. 4. The unconscious conflicts that led her to delay reporting her experiences.

The correct answer is 1. There are many cultures that believe the family's honor has been permanently stained when female members of the family are raped. Many Moslem cultures do not hold men accountable for rape, and may in fact punish the woman. Women in situations like this are at grave risk if they admit to their families that they've been assaulted. They may be expelled from their families or, in some instances, they may be killed by family members

A disturbed female patient in an inpatient psychiatric unit is HIV-infected. Despite rules forbidding sexual contact between patients, the woman is involved sexually with another patient who does not know of the HIV infection. The worker's best strategy is to 1. inform both clients of the hospital's rules and obtain compliance with the hospital's regulations. 2. inform the uninfected patient that he is at-risk. 3. arrange to have one patient transferred to another hospital. 4. report the case to public health officials.

The correct answer is 1. There are no good answers here. It is assumed when an individual places him/herself into a hospital, the hospital will protect and care for the patient. If a member of the staff knows an individual is at risk and does nothing to protect the patient, the hospital can be held negligent. Since sexual contact among patients is prohibited, enforcing the rules against sexual contact can protect both patients.

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 1. "If we can't make a satisfactory arrangement, I will do my best to arrange a referral to an agency where you can receive the help you need." 2. "I'm sorry, but you'll have to look elsewhere for services." 3. "This is an important service for you and it may be worth borrowing money from family or friends." 4. "Have you really explored the resources available to you?"

The correct answer is 1. This is an ethical and a practice question. The social worker should not simply abandon clients if they are unable to pay. The client should be reassured that the worker will do everything possible to assist them.

A gay client who is diagnosed with schizophrenia takes his medication intermittently. When off his medications, he becomes disorganized and hallucinates. At those times, he is agitated and argumentative. He stops attending therapy and he is sporadic in his attendance at the day treatment center he attends. He is able to contract for safety. He has never hurt himself nor anyone else, and he usually voluntarily returns to therapy and the day treatment program. He speaks of this as this "special alone time" and he is zealous about protecting it. His partner calls to report the client is once again off his medication and he is more irritable and uncooperative at home. The partner does not wish to live with him anymore and asks the social worker to hospitalize the client. What is the best course of action? 1. Acknowledge one's right to refuse medication and treatment and seek to maintain a relationship with the client. 2. Seek an involuntary commitment because the client will continue to deteriorate. 3. Continue to insist the client takes the medication and note that previous episodes have caused him to be committed to a hospital. 4. Suggest the partner care for him for a short period until he is more stable.

The correct answer is 1. This response seeks to create an alliance between the client and the social worker. Maintaining the relationship is extremely important. The information provided does not indicate there are grounds for an involuntary commitment. Hallucinations and noncompliance with treatment plans alone are not sufficient to involuntarily hospitalize. Answer 3 potentially puts the worker in an adversarial relationship with the client who might interpret this response in a paranoid way, i.e., that the therapist doesn't respect or is against the client. It can sever the relationship. Answer 4 is unacceptable. To ask the partner to care for the client when he obviously does not wish to, is inappropriate.

A social worker works with a clientele with varied substance and chemical dependencies, and decides to establish a new group focusing on drug and alcohol rehabilitation. In the first stages of the group, the worker might expect 1. denial, rationalization, projection. 2. low self-worth, acceptance, projection. 3. surrender, delusions, rationalization. 4. denial, rationalization, compliance.

The correct answer is 1. This trio of defense mechanisms is featured prominently in people with addictive disorders. They are especially apparent in the earlier stages of recovery. One would expect that a group composed of people with addictions issues would, in the aggregate, reflect those traits.

The budget described above also has a group of line items described as below-the-line costs. These are normally 1. fringe benefits, vacation time, and staff training. 2. non-staff or indirect costs such as utilities, telephone, rent, public relations, etc. 3. program development costs. 4. third party reimbursements.

The correct answer is 2. "Below-the-line" costs always reflect the costs of program operations without staff and fringe benefits. Staff costs are usually listed "above-the-line," as are other personnel related expenses. Thus, "below the line" costs usually include such items as rent, office supplies, telephone, public relations, transportation, training, etc

The most significant clinical purpose for maintaining social work records in a family agency is 1. to facilitate worker accountability for the quality of treatment. 2. to assess client progress continually, and to revise and update treatment planning. 3. to provide documentation that can protect the agency and the worker from malpractice suits. 4. to provide continuity of service and to simplify transfer in the event the social worker leaves.

The correct answer is 2. All the reasons cited are important, but the most important clinical purpose is to allow the clinician to assess progress and revise treatment strategy

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 worker's best response is: 1. "Yes, you should discuss this with the company's affirmative action officer." 2. "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." 3. "Gay people often have a hard time succeeding because of prejudice." 4. "Perhaps the supervisor's perception is correct."

The correct answer is 2. Answer 1 is incorrect because it is premature to make a discrimination charge and there is no evidence to support the allegation. Answer 2 does not invalidate the client's perception and invites consideration of the objective facts. The negative evaluation may provide an opportunity for self-exploration and growth. Answer 3 merely expresses sympathy without offering any help, while answer 4 is likely to arouse a defensive reaction

A recent MSW graduate has displayed excellent diagnostic skills and a strong commitment to clients. Her supervisor recognizes that the worker has difficulty in translating diagnostic insights and goals into specific treatment plans. The supervisor should 1. point out the problem and urge her to work on it. 2. support and acknowledge her strengths while providing concrete help in areas that require improvement. 3. urge her to consult a more experienced worker to help her. 4. provide written guidelines and ask the worker to follow them.

The correct answer is 2. Answer 2 is the only response that offers concrete assistance while also acknowledging the worker's strengths. It is the most supportive and practical response. The other responses essentially tell the worker she has to improve without supervisory help

Untreated family problems such as those described in Question 5, are thought to lead to 1. eventual alcoholism among some of the children. 2. replication of the dysfunctional family structure as the children create their own families. 3. suicide attempts by the victimized children. 4. sexual dysfunctions.

The correct answer is 2. Answers 1, 3, and 4 reflect symptoms or behaviors which may in fact represent a replication of or response to earlier family dysfunctions.

The goal of case advocacy is usually to 1. win public policy concessions and alter the distribution of social resources. 2. secure needed services for clients. 3. alter the priorities of legislative bodies. 4. obtain publicity for injustices against the poor.

The correct answer is 2. Case advocacy focuses on the needs of the client. Other forms of advocacy may focus on broad social policy or institutional change

Therapy for mourning and grief are often provided through 1. psychoanalysis. 2. groups focused on mourning. 3. behavioral treatment. 4. intensive clinical social work.

The correct answer is 2. Clinicians have found that clients who suffer profound losses seem better able to discuss feelings and move toward recovery more rapidly in group situations. Mourning groups focused on grief work have become increasing common as the treatment of choice

A clinical social worker whose primary therapeutic concern is a client's conscious motivation is probably 1. using psychoanalytic theory. 2. a behavioral therapist. 3. a structuralist. 4. using crisis intervention theory.

The correct answer is 2. Cognitive behavioral treatment strategies focus attention on the client's observable behaviors, and attributes and seek to treat these. Unconscious or preconscious motivations would be a focus of more classical methods

A clinician whose work emphasizes the use of cognitive-behavioral treatment strategies is likely to treat clients with severe depression by 1. encouraging a major environmental change such as a new job or a move to a new neighborhood. 2. identifying, testing, and changing negative ways of thinking about self; and developing alternative and more flexible ways of thinking. 3. insight-oriented individual or group psychotherapy meeting at least four times per week. 4. a change of diet and the use of moderate doses of antidepressant medication.

The correct answer is 2. Cognitive theories of depression hold cognitive dysfunctions lie at the core of depression and symptoms such as low energy levels ensue from depression. The CBT strategy is to try and change the clients' characteristic ways of thinking about themselves and their expectations of themselves. Clients are helped to rehearse new cognitive responses that redefine and soften their images of self, and develop new behavioral responses. Techniques include structured activities, readings, identification of irrational beliefs, and skills teaching

What is the treatment usually recommended for habitual sexual offenders who seek young childrai? 1. Psychotropic drugs. 2. Long-term treatment groups. 3. Individual treatment. 4. Family therapy.

The correct answer is 2. Generally, the recommended treatment for pedophiles and other sexual offenders is group treatment with other sexual offenders. These groups are often confrontational and have an unusual capacity for piercing the veil of denial that often characterizes sex offenders.

Severe grief and mourning reactions are sometimes accompanied by 1. sensory deprivation. 2. hallucinations. 3. hypothermia. 4. hysterical mutism.

The correct answer is 2. Hallucinations sometimes accompany severe grief reactions. These tend to be of limited duration and eventually disappear.

Following an emotional therapy session, the client skips an appointment. At the next session, the client says that she wishes to end treatment. The social worker should 1. help arrange a referral to another therapist. 2. suggest the client discuss her feelings about the last session. 3. follow the client's wish and terminate therapy. 4. state that the client is running away, just as her relationship with the therapist is showing results.

The correct answer is 2. It is possible the emotional session that preceded the client's statement was experienced as threatening, or awoke deep feelings that frightened the client. The social worker's goal in this case is to address these feelings and understand how they affected her desire to terminate.

When an adolescent is confronted with his drug use and refuses to admit his involvement despite definite and compelling evidence, this is known as 1. repression. 2. denial. 3. stubbornness. 4. suppression.

The correct answer is 2. One of the most compelling features of drug usage is the use of denial as a defense mechanism. Indeed, the strong and persistent use of denial even in the face of evidence to the contrary may be part of the assessment leading to a diagnosis of substance use or abuse.

After a complaint was dismissed by the NASW Ethics Committee, a client sues a social worker for malpractice. The client claims the social worker willfully revealed the details of her treatment program and the nature of her problems, though not authorized to do so. The social worker's malpractice insurance company insists the social worker testify to defend against the claim. In this instance, which statement is most true about the professional obligation to maintain confidentiality? 1. Confidentiality is an absolute requirement, and the social worker must not reveal details of the client's treatment in open court, even to defend against the suit. 2. When a social worker is sued for malpractice, confidential information supplied by the client during treatment may be used in defense, even if revealing such information would normally be considered a breach of confidentiality. 3. When the requirements of confidentiality conflict with the need to defend, the social worker may request a private, off-the-record hearing with the judge. 4 The social worker should insist that only information that is not damaging to the client may be introduced in evidence.

The correct answer is 2. One of the permissible waivers of confidentiality occurs when a client sues a worker for malpractice and the worker's defense demands reference to conversations that are normally confidential. Breaching confidentiality, however, is still selective and focused only on those points needed to vindicate the worker

During a serious psychotic episode, a patient who lives alone voluntarily signs himself into an inpatient unit. After three days, the patient decides to leave and refuses to consider a longer stay, though the social worker and the medical staff agree that he needs more inpatient treatment. The social worker's best option is to 1. recommend continued hospitalization despite the patient's wish to leave. 2. help the patient plan for aftercare living arrangements. 3. seek a court order. 4. enlist the family's aid to convince the client to stay.

The correct answer is 2. Since the client entered the hospital voluntarily, he cannot be held if he wishes to leave. The best course for the worker is to try and maintain the relationship, and help the client develop and implement the best possible plan. Simply exhorting the client to stay might make it difficult to continue assistance and introduce more resistance to the worker.

Social casework is historically linked most closely to 1. Social Settlements. 2. the Charity Organization Movement. 3. the U.S. Sanitary Commission. 4. Colonial Poor Laws.

The correct answer is 2. Social Settlements are closely linked to group practice. The Charity Organizations of the late 19* century were the precursors of modem social work in that they advocated "scientific casework" designed to rehabilitate the poor, rather than humanitarian aid for its own sake. The Colonial Poor Laws are best understood as a translation of Elizabethan Poor Law to an American context. They were not fully altered until many forms of public assistance became a federal function in 1935, with the passage of the Social Security Act.

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? 1. The social worker should claim client-social worker confidentiality and refuse to answer the question. 2. The social worker should claim client-social worker confidentiality and refuse to answer the question unless ordered to respond by the judge. 3. The social worker should ask for a temporary adjournment while she confers with the agency attorney. 4. The social worker should answer any question that seems legitimate and can help her client.

The correct answer is 2. Social worker-client communications are confidential. The social worker cannot reveal information without written client consent (with some exceptions). Occasionally, judges order social workers to reveal material without consent, in effect asserting that the court's need for information trumps worker-client confidentiality. At that point, the social worker has a choice: obey the judge or risk a contempt citation and imprisonment

A woman admits to a social worker that her husband has been beating her for several years, but she is afraid to report the violence and reluctant to leave him. Twice, the police have responded to neighbors' complaints and arrested him, but the abuse only stops for a short time. The social worker might first consider 1. helping the client understand that she has options and work with her to explore moving to a protected women's shelter, if she is willing. 2. assessing the reasons (both conscious and unconscious) which might contribute to keeping the client in an abusive marriage and providing information about resources, should she choose to make a change. 3. referring the woman to a battered women's group allowing her to identify with other women in similar situations. 4. requesting that the agency attorney discuss the client's legal rights with her.

The correct answer is 2. The client presents the abuse as a long-term problem with two previous police calls. Ordinarily, police inform victims of their legal rights and provide information about shelters or women's advocacy groups. It is usually not poor information holding a woman in an abusive situation. Often victims believe they deserve abuse; sometimes, there is fear of being alone. The social worker's responsibility is to intervene on two levels: the psychological one (i.e.,to evaluate what role emotional and cultural factors play in the maintenance of an abusive relationship) as well as a practical educative level.

Child development research suggests that verbal abilities such as comprehension and speech development in early childhood correlate most directly with 1. family genetic characteristics. 2. parent or caretaker communication with the child. 3. social class. 4. parents' education.

The correct answer is 2. The evidence mounts every year that the best predictor of communication skills development in children is the extent to which they communicate with adults. Children who are talked to and read to develop more rapidly and achieve higher levels of comprehension than children who do not receive this stimulation.

A social worker in a child mental health agency who is told by a 10-year-old client that she has been sexually abused by a relative should 1. notify the family ofthe allegation. 2. make an official child abuse report. 3. suggest that the child move in with friends or neighbors. 4. advise the girl to call Child Protective Services to request help.

The correct answer is 2. The first goal is to protect the child' and telling the family may actually increase the danger to the child. The social worker's legal obligation is to make a report

In the first interview conducted in a family agency with a voluntary client, the primary purpose of asking questions is to 1. establish a warm and accepting atmosphere to insure the client will return. 2. delineate the presenting problem so a decision can be made on the appropriateness, scope, and direction of additional interviews or treatment. 3. direct and focus the conversation on the client's family history. 4. find out if the client really wants help and can use it.

The correct answer is 2. The first phase of treatment usually involves identifying the presenting problem and making a decision as to whether the client's problems fall within the agency's scope and the worker's competency. Establishing an accepting atmosphere is essential to help the client freely discuss problems with the worker.

The notion that the poor remain poor due to inherent personal, behavioral, or social characteristics; or self-defeating patterns of adaptation that inhibit their ability to use available social resources and opportunities, is sometimes described as 1. iatrogenic adaptation. 2. blaming the victim. 3. cultural dissonance. 4. stereotyping.

The correct answer is 2. The idea that the cause of poverty rested in the larger society rather than within the attributes of the individual gained currency during the 1960s. The term "blaming the victim" came to be used to attack the culture of poverty theory. A popular text at the time was Blaming the Victim, by Ryan, (Vintage Books, 1971) further developed this alternative view.

In a clinical setting the most likely statistically significant research design to evaluate a program would be 1. experimental. 2. quasi-experimental. 3. single subject. 4. Type 2.

The correct answer is 2. The key word in this question is "statistically significant." An experimental design is ordinarily not possible in a practice setting, as there are ethical, policy, and practice constraints against denying service to people in need. Since a control group requires an equivalent population that did not receive the intervention, an experimental design is usually impractical for most practice settings. Quasi-experimental designs, the correct response, allow variations in the intervention, in time, and in the population served, and are more generally used in systematic evaluations. Single subject research is not a statistical procedure and can only provide very limited evidence. Type 2 is a nonsense choice since it refers to a category of statistical error

A client begins therapy with a social worker. During the intake interview, the client reveal some reservations about discussing sensitive issues. In explaining confidentiality, the worker 1. provides information about the limits of confidentiality as the need arises. 2. provides a general but thorough explanation of the limits of confidentiality at the initial treatment session. 3. does nothing until a specific question is raised by the client. 4. provides information initially regarding the limits of confidentiality, but only as it relates to the worker-client relationship.

The correct answer is 2. The right to privacy is one of the more sensitive practice-issues. Clients need to be aware of the limits at the start of tteatment. Full disclosure can actually be helpful in building trust, and it is ethically imperative

Case advocacy is generally associated with 1. social group work. 2. case management. 3. settlement houses. 4. managed care.

The correct answer is 2. The term case advocacy is often contrasted with institutional advocacy. Case advocacy bears on an individual case, while institutional advocacy focuses on organizational change for an entire class of clients. One of the roles that case managers play is developing resources necessary to fulfill the service agency's component of the case plan. This is one form of case advocacy

In assessing risk factors for child abuse, a social worker would consider as most important 1. life style-and marital status. 2. parents' attitudes toward discipline, family history, child's injuries. 3. social class, substance abuse, family size. 4. family history.

The correct answer is 2. There are no tricks in this question. The only possible correct answer is 2 since it includes physical signs. However, all three variables listed in answer 2 are markers for child abuse. People who abuse children often have a consistent view of correct discipline that developed from their own childhood experiences. In short, many abusive parents believe that society is wrong, rather than their methods of discipline. Many have also experienced neglect or abuse as children and have no models for less violent, more developmentally appropriate styles of child-rearing

The parents of a nine-year-old girl divorce. Both agree that the mother will have primary custody. The father, who lives in the same neighborhood, is allowed frequent overnight visits. There are many arguments between the parents concerning the mother's use of child support payments and her allegedly loose discipline. These arguments often occur when the father arrives to pick up the daughter. The daughter's school work has recently declined. She seems sad and exhibits some aggressive behavior in school. The parents seek help at a mental health clinic. In developing a strategy, the social worker will be most concerned with 1. the developmental issues confronting the daughter. 2. developing a means for the parents to address their conflicts more constructively and to focus on the daughter's needs for security and affection. 3. the initial custody decision and the father's generous visitation rights. 4. the possibility of child abuse or sexual abuse.

The correct answer is 2. There is a body of clinical research that focuses on the impact of divorce on the child. Often, when parents are still in contact following divorce and maintain conflicts over time, the child may exhibit behavioral and social problems. The correct response focuses attention on the continuing parental conflict. Since the father is a responsible parent who is paying child support and seeks visitations, there are positive elements in the relationship that should not be abandoned. The social worker might try to develop some method for communicating with both parents that reduces conflict and lowers the level of anger.

After several months of couples therapy with a social worker in private practice, Mr. and Mrs. J. notify the social worker that they are ending treatment as they cannot afford the sessions and their insurance will no longer provide a co-payment. The social worker's most appropriate option is to 1. terminate treatment and suggest that the J'.s seek help from a clinic. 2. enter into a discussion with them about alternative options that will help them continue receiving treatment. 3. offer the J.'s a referral to a competent clinician who accepts a lower fee. 4. ask the J.'s if they are simply uninterested in continuing treatment and are using money as a device to terminate.

The correct answer is 2. This answer is the most general and flexible response, and allows for a wide range of options. The ethical principle is that clients should not be denied services because of inability to pay. Social workers should help clients consider alternate options and assist with referrals, if necessary. The statement indicates concern, allows an exploration of the family's reasons, and permits the worker to offer reduced or deferred fees, or to make a referral if that seems appropriate.

Chronic hair pulling that is not accoimted for by a medical condition, results in hair loss, and causes distress for the patient, or significant social or occupational impairment, may be diagnosed as 1. Pilorrhea. 2. Trichotillomania. 3. Hobson's disorder. 4. an anxiety disorder.

The correct answer is 2. This is a definitional question.

A clinical social worker in his 40s finds that he is sometimes impatient with elderly clients and begins to feel that perhaps he is not equipped to work with this population. When one of his patients suffers a stroke and is partially paralyzed, the worker becomes anxious and uncomfortable when visiting the client. The mechanism involved is most likely 1. resistance. 2. counter-transference. 3. introjection. 4. over identification.

The correct answer is 2. This is a definitional question. Countertransference,is defined as an unconscious excessive libidinal or aggressive feeling toward a client. In this case, the worker may have his own concerns about aging or he may have aged and frail parents, and thus his response to his clients may reflect his feelings about these developmental issues in his own life. These feelings are then displaced (or transferred) onto the client

A social worker's report of child abuse by a prominent mental health center client led to a protective services investigation. The child protective worker visited the child's school and spoke with the child's teachers and the principal. The client is irritated and angry with the social worker for "causing" the investigation, and claims that his reputation has been damaged and his privacy violated. During an interview, he says he is planning to sue the agency and the worker. In responding to the client, the social worker might 1. suggest the client discuss the alleged violation of privacy with the agency's attorneys. 2. discuss the legal obligations of the social worker to report child abuse, and inform him that the agency will continue to provide help to his family, if he wishes. 3. suggest a joint meeting with the protective worker who did the investigation. 4. ask the client if he is concerned about his child.

The correct answer is 2. This is a practice answer that is grounded in social policy. A child protective investigation can cause embarrassment and may anger clients. Yet, a social worker is obligated to report "suspicion" which is a low threshold for a report. If the report is made in good faith based on true suspicion, the social worker and the agency are immunized from liability for the consequences of the report, whether it is found to be true or not. This is an essential feature of the law, without which few social workers would file reports. If a social worker does not file a report when there is reasonable suspicion, most state laws indicate penalties. There are very few reported instances of prosecution of social workers for failure to report

Jorge Mendes is a recent immigrant from rural Guatemala. He finds a low paying but a steady job. For 24 months he functions well in an immigrant community largely composed of Latin American refugees. He occasionally abuses alcohol, but it does not seem to affect his job performance or social relations. Mr. M. learns English in an ESL program and then enrolls in a vocational course for refrigeration mechanics. He lives modestly but is alone much of the time. Mr. M. corresponds with family members and sends money home regularly. One weekend, Mr. M. is brought into a hospital emergency room by police after shouting abusively at a police officer. He alternatively shouts at police and nurses and cries. At one point, he acts aggressively toward a nurse and is restrained to prevent further attacks. He says he wants to kill himself but calms down when close friends arrive and reassure him. In diagnosing this client, a social worker would consider 1. a severe anxiety or panic attack. 2. a possible culture-bound syndrome. 3. a psychosis. 4. an acute anxiety disorder.

The correct answer is 2. Though a panic attack is possible with the symptoms described in this question, the more likely possibility is that Mr. Mendes is exhibiting the classic symptoms of an "attaque de nervios," an expression of emotional distress found among people from Latin America. One significant clue to Mr. Mendes behavior is the relatively solid adaptation he has exhibited by learning English and seeking to advance himself. Another clue may be drawn from the calming effect of friends on his behavior and emotions

When testifying in court, a social worker is asked a specific question concerning his client who is a defendant in a criminal case. What concept should guide the social worker? 1. The licensed worker has social work privilege and cannot be asked to provide confidential case information. 2. The social work privilege is not absolute and the worker may be required to testify if ordered by the judge. 3. The social work Code of Ethics requires the worker to refuse to testify. 4. Agency policy requires the worker to maintain absolute confidentiality.

The correct answer is 2. While social workers can and should express a right to confidential communication, they may nonetheless be ordered by a judge to answer questions in court. They can be held in contempt if they still refuse to answer. As a matter of conscience, some social workers have refused to testify when they felt the answers might endanger clients

A narcissistic injury is most apt to be experienced by a client under what conditions? 1. When terminating a relationship with a therapist. 2. When psychotropic drugs are used. 3. When the client feels devalued or misunderstood by the therapist. 4. Shortly after being accepted for therapy by a mental health agency.

The correct answer is 3. A client is most likely to feel injured when their sense of worth or value is thought to be at stake. It is possible that a client could feel injured in any of the above situations; however, the overarching issue which gives rise to a narcissistic injury is feeling unheard or unappreciated

A social worker would not normally recommend continuation in family therapy if 1. family history includes severe physical and emotional disabilities. 2. there is a parentified child and dependent parents. 3. family members are verbally and emotionally abusive to one another in and out of the treatment, and often there is an escalation of abuse at home following a session. 4. the couple wishes to discuss divorce.

The correct answer is 3. A therapy situation which allows abuse to occur is unacceptable. If members of the family are not able to demonstrate enough impulse control to provide a safe place for themselves and each other, family therapy is contraindicated. Physical disabilities, dependency issues and family structure would not normally preclude the use of family methods.

A hospital social worker receives definitive information that a social work colleague is engaged in a sexual relationship with a client. In deciding on a course of action, the social worker must first consider 1. the impact on the client. 2. the impact on the profession. 3. the social work code of ethics. 4. the views of the supervisor and the administrator.

The correct answer is 3. All the issues are important considerations, but the Code of Ethics is the primary guide for social workers when confronted with value and ethical questions

A social worker informs a colleague that he has frequent sexual thoughts and occasional fantasies about a very attractive and vulnerable client. In advising the social worker, the colleague should suggest 1. that he terminate the client and refer her to someone else before the problem gets out of control. 2. that he discusses his feelings with the client to relieve the tension. 3. that he continues discussing the problem with a consultant or supervisor to keep the problem manageable. 4. that he seek therapy to help him maintain a professional distance.

The correct answer is 3. Anecdotal evidence suggests fantasizing about clients is common. Usually these fantasies can be controlled and managed. The best answer is 3, since the social worker can benefit from airing his feelings with a consultant or supervisor. There is no reason to end treatment, unless the worker believes the fantasies interfere with the therapeutic relationship. The fundamental principle is to do what is best for the client. Ending treatment would not be of help at this point

What family traits are likely to accompany a diagnosis of anorexia nervosa in an adolescent? 1. An impoverished multi-problem family with many personal and social difficulties. 2. A family whose relationship to their children borders on neglectful. 3. A close family with a history of depression, eating disorders, and alcohol abuse. 4. A reflective and remote family focused on personal growth and self-improvement.

The correct answer is 3. Anorexia is 10-20 times more likely in girls than boys. In the recent past, it was believed that anorexia was more Common among high-achieving families. Recent research has found a less predictable pattern, suggesting individuals with very close but troubled family relations, and a family history of depression, eating disorders, or alcoholism, have a higher incidence. Anorexia is supported by social maxims supporting thinness and self-restraint around food

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 say: 1. "Since you broke the rules you have to be willing to accept the consequences." 2. "Why don't you ask your parents to call me?" 3. "Let's discuss your choices in this matter." 4. "If you promise not to miss school again, I'll talk to the principal."

The correct answer is 3. Answer 1 is an exhortation which is sure to cause the adolescent to withdraw. Answer 2 removes responsibility from the child, and answer 4 has a similar effect. Answer 3 returns the discussion to where it belongs. The client eventually has to choose a course of action. The process of making the choice will help him become aware of his own motivation and may help him internalize reasons for not missing school

In developing an alliance with the client, the social worker should 1. gently assure the client that the agency's treatment goals are appropriate for the client. 2. assure the client that everything the client says is confidential. 3. demonstrate that the client's preferences and goals are heard by the social worker and will be included in the development of the treatment plan. 4. assure the client that the social worker is experienced and can be helpful.

The correct answer is 3. Answers 1 and 4 ask the client to accept the authority of die agency or the social worker based on external factors rather than on the relational experience of the client, answer 2 is incorrect because it is not true. There can be circumstances when client-worker privilege is overruled

Someone who curses or gesticulates uncontrollably and without premeditation is likely to suffer from 1. Lou Gehrig's disease. 2. Huntington's disease. 3. Tourette's syndrome. 4. an organic brain dysfunction.

The correct answer is 3. Clients with Tourette's syndrome typically make involuntary movements, sounds, or gesticulations that they are unable to control. Both Lou Gehrig's Disease and Huntington's Disease are degenerative diseases that lead to progressive loss of motor function and eventually death.

Most typically, panic disorders strike people in certain age categories. Indicate the ages at which panic disorders are most prevalent: 1. over age 40. 2. between ages 16 and 25. 3. between late adolescence and mid 30s. 4. over age 65.

The correct answer is 3. Clinicians have observed that panic disorders are often found in people between the ages of 17-35. There is no explanation. However, panic attacks can occur at any age and are sometimes associated with other disorders. Panic disorders are often associated with agoraphobia

A patient complains of sleeplessness, loss of appetite, feelings of hopelessness, and general apathy. To help in diagnosing the client, a clinician would most need to know 1. medications the client is taking. 2. family history of depression. 3. how long the symptoms have persisted. 4. if the patient lives alone.

The correct answer is 3. Duration is important for treatment reasons. The DSM-5, for example, provides duration criteria for depressive disorders. All the depressive disorders have been subsumed under the title major depressive episode which replaces dysthymia and persistent depressive disorder. A brief episode may be situationally induced or related to a specific but temporary crisis such as relocation, job loss, or marital problems. With an understanding of the duration of symptoms, the clinician then might pursue other factors, such as medications or family history

A diagnosis of enuresis is appropriate when 1. the patient voids urine frequently and occasionally wets the bed at night. 2. medications may be causing the problem. 3. it occurs at least twice weekly and the patient is at least chronologically or mentally five years old. 4. it is associated with other physical symptoms.

The correct answer is 3. Enuresis, or accidental urination, is a DSM-5 elimination disorder. The disorder among children decreases with age. and by age five approximately 93% of children have attained full control or lose control very occasionally. Organic or medical conditions usually call for a diagnosis other than enuresis.

Food Stamps, Medicaid, and Public Housing are examples of 1. categorical grants. 2. block grants. 3. in-kind assistance. 4. grants-in-aid.

The correct answer is 3. In-kind assistance is aid provided instead of cash for specific purposes. Reduced cost housing, food, medical care, and transportation are forms of in-kind assistance

The idea that no person receiving welfare should receive benefits that exceed the wages of the lowest paid worker dates historically from policies established through the Elizabethan Poor Laws. The policy is called 1. the Speenhamland principle. 2. adverse selection. 3. lesser eligibility. 4. outdoor relief.

The correct answer is 3. Lesser eligibility, a principle drawn from Elizabethan Poor Laws, holds no welfare recipient should receive benefits that exceed salaries earned by the lowest paid worker

A drug-addicted client believes that his anger and thoughts of revenge concerning a former girlfriend led to her becoming HIV-positive. The client is demonstrating 1. a psychotic delusion. 2. primary ego damage. 3. magical thinking. 4. brain damage.

The correct answer is 3. Magical thinking, or primary process thinking, is characteristic of very early stages of child development and certain forms of mental illness. It is exemplified by the belief that external events or people's behavior can be influenced by thoughts.

A client stubbornly believes that his life has been disrupted by men who follow him in black vans. He claims they have put something bitter in his coffee, caused his milk to turn sour in the refrigerator, tampered with his checking account, erased files on his computer, and caused his car battery to fail. He is unable to point to any concrete evidence to support his beliefs. The client is probably suffering from 1. hallucinations. 2. narcissistic injuries. 3. delusions. 4. a drug-induced psychosis.

The correct answer is 3. Most certainly the client is suffering from delusions. Delusions ordinarily have an element of the possible within the thought system. The facts of the question - a failed car battery, an erased file, sour milk, checking account errors, and bitter coffee are all possible events. The delusional component is the idea that these events are not random and unrelated, but are deliberately caused by someone trying to disrupt the client's life.

Mrs. J. has a three-year-old child and is a protective services client. She was previously in an abusive relationship with a violent male partner who also abused her child. The abusive relationship has ended and Mrs. J. has made significant progress in treatment. She says she would like to get a job. She also notes that her father buys her food, pays her rent, and drives her to the market. Mrs. J. has asked if she can continue her treatment, though she will be terminated shortly as a protective services client. If she were to remain in treatment, her treatment plan would have to be updated. One goal of treatment in this case might be 1. to bring the father to treatment and help him understand that he is infantilizing J. 2. to help Mrs. J. assert her independence by helping her to understand the dynamics of her dependency on her father and, by implication, other men. 3. to work with Mrs. J. on developing more independent patterns of behavior such as finding employment, purchasing a car, and gradually moving toward self-reliance. 4. to continue the family as protective clients until the worker is satisfied that the mother has worked through her dependence on men.

The correct answer is 3. Mrs. J.'s stated goal is to get a job. It is a specific and concrete goal. The appropriate focus for treatment then would be for the social worker to help the client develop the necessary skills to do so, which would include changing her patterns of dependent behavior.

A client is diagnosed with obsessive-compulsive disorder. With this diagnosis, it is likely that 1. his personal life will not be affected. 2. he will be excessively studious. 3. he will experience performance problems at school and work due to an inability to finish tasks on time. 4. he will not have low self-esteem.

The correct answer is 3. Obsessive compulsive disorder is associated with a drive toward perfectionism and a preoccupation with rules, details, and formulas that is so pronounced that the point of the activity is lost. Clients with this disorder are often overconscientious and inflexible about moral issues. They often have difficulty completing tasks, as the work is never good enough to satisfy unrealistic criteria

Dysfunctional families that try to maintain the appearance of open, reciprocal relationships with each other are best described by the term 1. enmeshment. 2. mystification. 3. pseudo-mutuality. 4. disoriented.

The correct answer is 3. Pseudomutuality occurs when dysfiincftional families mask emotional expressions that are threatening to the family. Often, these families develop their own private modes of expression that are not comprehensible to outsiders

A social worker supervising home care services for patients who have Alzheimer's disease and live with family members will be most concerned about 1. the client's ability to pay. 2. the qualifications of the home care worker. 3. the ability of family members or others residing with the client to manage stress. 4. the client's relationship with medical providers.

The correct answer is 3. Since Alzheimer's Disease is progressive and patients rarely improve, the pressures on families tend to grow more intense as the disease worsens. Each increment in the disease will increase demands upon family members for care and supervision. Moreover, some Alzheimer's patients may become demanding and aggressive. If the pressures on the family grow too intense, higher levels of care may be needed. Social workers can help by obtaining respite care and other kinds of assistance designed to help the family cope

A group of clients in a mental health agency group is encouraged by the group leader to socialize even when not participating in regular group sessions. The group is probably 1. an analytically oriented group. 2. a behavioral group. 3. a supportive group. 4. a transactional group.

The correct answer is 3. Supportive groups are normally encouraged to socialize outside of group meetings. Often, these groups are designed to decrease social isolation and to introduce people to others with similar characteristics

The concept of "friendly visitors" is associated with 1. religious outreach. 2. the Seebohm Report. 3. Charity Organization Societies. 4. the Society for the Prevention of Cruelty to Children.

The correct answer is 3. The 19* century Charity Organization Societies were precursors to social casework. To individualize charity, they sent "friendly visitors" to offer guidance to the poor and to provide follow-up to the planned giving that was an essential component of scientific charity.

In defining and cataloging, DSM-5 uses 1. an etiological approach. 2. a psychodynamic approach. 3. a descriptive approach. 4. a research approach.

The correct answer is 3. The DSM-5 does not explain the causes, nor does it focus on the progression of diseases, except as it aids the diagnosis of psychiatric disorders. It simply categorizes and describes diagnoses and enables clinicians to talk a common language. The newer version does promote a research approach to further refine diagnostic criteria.

To qualify for a diagnosis of persistent depressive disorder the symptoms must 1. appear after age 35. 2. follow a major life crisis. 3. last at least two years. 4. last at least four weeks.

The correct answer is 3. The DSM-5 requires a duration of two years for a diagnosis of persistent depressive disorder..

If Susan's allegation of sexual abuse is later confirmed, a protective service worker is likely to recommend an immediate strategy to protect the children. Which of the following is the best immediate solution? 1. Family treatment to address the dysfunctional behavior of the stepfather and other family problems. 2. Removal of Susan and Lisa until there is some certainty that they will be protected in the home. 3. The stepfather should vacate the home under court order while treatment begins. 4. Prosecution of the stepfather for sexual abuse.

The correct answer is 3. The answer is grounded in practice experience. The key to protecting the child in a sexual abuse situation is often to separate the offender from the victim. Family treatment is initially not feasible as a method of protection. Removing Lisa from the home may prove necessary, but this in effect punishes her for the stepfather's misbehavior. Separating the father from the family is a good alternative since it places responsibility where it belongs, while providing protection. This alternative would not normally be pursued unless the other caretaker is willing and able to cooperate. In this case, the mother has shown her concern about the children. Prosecuting the father is a legal decision, and while it may be employed, it does not provide protection from an immediate threat to the child

An administrator of a large public multipurpose agency with eight separate divisions, each headed by an assistant administrator, receives new instructions from the governor's office shortly after the beginning official year. The administrator is told that the agency's budget must be reduced by 10% for the next two fiscal years. The administrator is disturbed by the budget reductions and believes that the reasons are political and not substantive. Anxious to respond without unduly disrupting agency services, the administrator might first 1. tell each assistant administrator to make a 10% across-the-board cut in each unit as they plan the next two annual budgets. 2. institute a freeze in hiring in the current fiscal year so carryover funds can be used to reduce the impact of budget reductions. 3. set up an administrative/planning group to identify functions that might be reduced or eliminated, and make an assessment of the impact of each possible budget reduction on services before making decisions. 4. inform the press and advocacy groups and encourage them to mobilize their members to oppose the governor's actions.

The correct answer is 3. The best answer to this question uses participation and planning as the primary strategies. The agency has two years to implement the cuts, and the director seeks to find the least destructive ways to implement them. Across the board cuts are essentially administrative meat cleavers that indiscriminately reduce all services. Hiring freezes hurt morale and have accidental consequences on units that are expanding or that experience resignations. Advocating against the governor's decision in public can have only one consequence: termination of the administrator

Mrs. W. has a long history of alcohol abuse. Though she has made several failed attempts to quit, she is now convinced that alcohol is affecting her heart and liver and she decides to stop drinking. She refuses medical supervision and several days after deciding to quit, she arrives at the mental health clinic without an appointment and demands to see her social worker. She is loud and aggressive with waiting room staff. She seems inattentive, disheveled, and uncoordinated. Mrs. W. is quickly distracted and though she said she wanted to see the social worker, she abruptly leaves the clinic. The social worker might conclude that Mrs. W. 1. is probably experiencing alcohol withdrawal and needs medical attention. 2. wants the social worker's help in managing her discomfort and reassurance that she is on the right path. 3. is intoxicated. 4. may be experiencing delusions because of her long-term alcoholism.

The correct answer is 3. The client is exhibiting classic signs of intoxication. It is unlikely that aggressive, demanding behavior would be a feature of withdrawal

A worker reached agreement with an elderly woman on public assistance to move to an assisted- living facility for the aged. The client talks about her fear of moving to a place where she will not know anyone and will be alone. The worker's best response is: 1. "Don't worry, you'll make new friends." 2. "I guess you'd rather stay where you are." 3. "It seems like part of you wants to move to a more comfortable place and another part feels scared and wants to stay with people you know." 4. "Most older people feel just like you, but then feel better after they move,"

The correct answer is 3. The correct response does not impose closure on the woman's discussion, but opens up another avenue for her to understand her response to the move in the here-and-now. The other answers all seem to offer false or irrelevant reassurance about an imagined future state that trivialize her feelings

A social worker in a neighborhood center receives definitive information that a 14-year-old boy from the area has a pistol that he carries to school. The worker's information suggests that the boy intends to intimidate others with whom he is feuding. The worker has a legitimate fear that he could shoot someone. He is known to the agency, has an angry disposition, and is predisposed to fights. The worker's first action is to 1. talk with the boy and urge him to surrender the weapon or dispose of it voluntarily. 2. discuss the matter with the boy's parents and ask them to intervene before something happens. 3. notify school officials and the police. 4. discuss the matter with the agency's attorneys.

The correct answer is 3. The key to this problem is the worker's knowledge and belief about imminent danger to others. The worker's obligation is to do everything possible to prevent harm and do it immediately. Talking with the boy might be dangerous and would not protect the proposed victim.

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 1. a classical anxiety disorder. 2. passive-aggressive disorder. 3. personality disorder—Trait Specified (PD-TS) Dependency 4. borderline personality disorder.

The correct answer is 3. The most likely diagnosis, Personality Disorder—Trait Specified (PD-TS) dependent personality, is supported by the client's inability to make decisions without his mother's approval and his unwillingness to incur her displeasure by disagreeing with her. His inability to make independent decisions or to show initiative at work are classic configurations for this disorder. The PD--TS diagnosis is new to DSM-5

The welfare reform bill includes policies that many social workers oppose. One of the most controversial features of the law are 1. residency requirements. 2. a limit on health care for children over five. 3. a lifetime limit on the number of years that welfare assistance will be available. 4. the introduction of surprise home visits for single mothers to ensure that there is not a man in the house.

The correct answer is 3. The recent welfare reform law mandates a lifetime limit for welfare assistance, a feature that many in social work find short-sighted. Though the law also anticipates support services to help welfare families achieve independence, these supports have not been uniformly available. As states implement more restrictive policies, welfare caseloads have declined. As more clients reach their time limits for assistance, it is anticipated that welfare rolls will decline further.

A 50-year-oId man complains that for the past year he has felt apprehensive, tense, worried and restless most of the time. He has difficulty sleeping and concentrating. He occasionally leaves work as his anxiety is so extreme that he feels faint and believes he might be having a heart attack. There is no clinical evidence of heart disease. The most likely diagnosis is 1. high blood pressure or heart disease. 2. a social phobia. 3. generalized anxiety disorder. 4. acute stress disorder.

The correct answer is 3. The stem provides a classic description of symptoms for Generalized anxiety disorder. The powerful unfocused anxiety is associated with physical manifestations. Acute stress disorder would require a specific stressor such as a traumatic event associated with the anxiety attacks. A social phobia might be indicated if there were specific fears about contacts with unfamiliar people or fears about being observed by others. Heart disease is specifically ruled out in the stem.

In a first interview at a family agency with parents referred by child protection for severely beating their child with a cane, the worker would 1. confront the family on their inappropriate use of physical discipline and urge them to accept parenting help. 2. meet separately with each family member to assess the type of help needed. 3. discuss their concerns and feelings about being referred for treatment. 4. indicate that they could lose their child if they do not cooperate.

The correct answer is 3. This family was referred by the child protective agency. The worker needs to establish a helping relationship, and deal with the possibility that the family feels coerced into treatment or feels threatened by the possibility of losing their children. If they are angry or feel humiliated, the worker's sensitivity may reassure the family that the worker's goal is to help, not to facilitate the removal of their children

A male or female patient suffering from Dyspareunia is likely to suffer from 1. a skin condition associated with stress. 2. a reaction to psychotropic medications. 3. painful sexual relations. 4. a phobic reaction to rigid time schedules.

The correct answer is 3. This is a definitional question

Splitting is defined as . . 1. the process of separating children from their parents in child placement situations. 2. placing unwanted aspects of the self on others. 3. dividing people into categories of all good or all bad. Abrupt changes in definition are often made. 4. introjection.

The correct answer is 3. This is a definitional question. Splitting is a narcissistic defense in which people are categorized into good and bad. Nuances in feelings about other are lost in the extremes, and feelings about others can be quickly reversed. It is a primitive defense that is frequently found in children and in psychotic adults. Splitting occurs when an individual deals with emotional conflict or internal or external stressors by compartmentalizing opposite affect states. Thus, self and other images tend to alternate between polar opposites. The individual is unable to hold onto ambivalent or mixed feelings simultaneously.

Physical complaints and illnesses associated with stress or dysfunctional family life may be viewed as 1. a factitious disorder. 2. malingering. 3. a somatization disorder. 4. an anxiety disorder..

The correct answer is 3. This is a definitional question. The essential feature of somatization disorder is a pattern of recurring, multiple, clinically significant somatic complaints. The individual must receive treatment (i.e., medication) for the presenting symptoms. Factitious disorder is the intentional production of symptoms to inhabit the sick role. Malingering is characterized by the intentional production of false or grossly exaggerated physical or psychological symptoms for a purpose (i.e., to be relieved of an onerous task)

According to DSM-5, conduct disorders usually manifest themselves 1. during the first three years of life. 2. between ages three and six. 3. between ages six and sixteen. 4. during late adolescence.

The correct answer is 3. This is a fact question based on DSM criteria. The DSM delineates two subtypes of conduct disorders: Childhood-onset type and adolescent-onset type. They are differentiated both by age and by the types of behaviors that characteristically appear. The disorder may be mild, moderate, or severe depending on the number and severity of behaviors. The criteria remain unchanged from DS-4TR

A patient experiencing a persistent depressive disorder as described in DSM-5 will 1. vividly describe olfactory hallucinations that began at least three months ago and have regularly continued. 2. have associated eating disorders that began at least six months ago. 3. experience chronic depression. 4. probably be drug dependent.

The correct answer is 3. This is a fact question. The correct answer is the DSM-5 descriptor that replaces dysthymic disorder

A social worker in a convalescent facility organizes a group of inactive and passive patients. The group focuses on inviting speakers and discussing issues of interest to members. After a time, the group initiates discussions of staff courtesy, food quality, and the recently implemented no-smoking policy. Several members urge the group to request a meeting with the director of the facility to air their concerns. Which statement describes the social worker's best response? 1. "The purpose of this group is not to address community problems, but to focus on larger political issues. I suggest that we form a new group with a different focus." 2. "The idea of meeting with the director will only stimulate resistance since I was assigned to help this group with different goals in mind." 3. "Several members of the group should develop an agenda and some questions for discussion, and then the group can invite the director to attend a meeting." 4. "Much of the complaining that occurs is because people are bored. Let us continue with our regular agenda and develop some new discussion topics."

The correct answer is 3. This is the most facilitative and empowering answer of the choices provided.

An obsessive-compulsive personality does not usually 1. have trouble deciding. 2. take a job seriously. 3. finish work on time. 4. have low self-esteem.

The correct answer is 3. This question is asked in the negative. Obsessive-compulsive personality disorder is characterized by orderliness, perseverance, indecisiveness , inflexibility, and a strong perfectionist drive. Clients usually have difficulty making decisions, have low self esteem, and are totally dedicated to their work, often to the exclusion of other activities. The perfectionism can be so prominent that it prevents the person from completing tasks since the work never achieves a sufficient level of quality.

A newly established activity group of 11-year-old boys displays behaviors that are noisy disruptive and uncooperative at their third and fourth meetings. The social worker thinks this is a reflection of the stage of group development. We might assume that the group is demonstrating behavior characteristic of which stage of group development? 1. Affiliation 2. Termination 3. Power and control 4. Intimacy.

The correct answer is 3. This question tests knowledge of group development theory. The second stage of group development is that of power and control wherein group members jockey for status, compete for power among themselves, and test the authority of the group leader. The behavior described reflects the manner in which 11-year-old boys typically communicate

A researcher observes an autistic child every hour for five minutes for three days. After three days, a therapist alternatively offers the child candy or a new toy if the child is able to sit still. The researcher continues to observe and then reports on the observations. This type of research design is called 1. construct validity research. 2. program evaluation. 3. single-subject design research. 4. quasi-experimental design research.

The correct answer is 3. Though considered highly questionable by many researchers, single subject research has become increasingly common. The key in this question is the obvious reference to only one subject

The type of group in which members typically provide emotional support, and the opportunity to share with and gain from others coping with similar problems is most appropriately called 1. a task-oriented group. 2. an instrumental group. 3. a self-help group. 4. a therapy group.

The correct answer is 3. While many groups provide mutual aid and support, self-help groups such as AA and ALANON, and disease or life phase specific groups (new parents, cancer sufferers, for example) are designed precisely to allow individuals with similar problems to benefit from associations with others. These groups often have a therapeutic or curative component; however, the primary method is mutual aid. Many operate without professional guidance.

A patient presents at numerous hospital emergency rooms with apparently serious physical symptoms that require invasive diagnostic procedures or exploratory surgery. The cause of these symptoms is not immediately identified. Eventually, it is discovered that the symptoms are the result of the patient ingesting small, non-lethal doses of poison. The psychiatric diagnosis would most likely be 1. Sancter Disease. 2. somatization disorder 3. malingering. 4. factitious disorder

The correct answer is 4. A Factitious Disorder while not common is frequently enough to warrant concern. In some cases, patients appear at different hospitals under assumed names to obtain the medical attention they crave. Often they present challenging medical symptoms that are self- induced and can only be addressed by highly invasive procedures

One goal of individual alcoholism treatment is 1. to reduce driving while drinking. 2. to involve the family. 3. to provoke childhood memories that led to using alcohol as an escape. 4. to confront denial and help the client face reality.

The correct answer is 4. A major dilemma in treating alcohol dependence is the degree of denial that clients express. Many claim they do not have a problem and are not abusing alcohol even in the face of a job-loss or family dissolution. The worker's major task is to address the denial, a first step forward in enabling the client to seek help for the problem. The other responses are not relevant to treatment of this disorder.

Client self-determination generally includes 1. a professional diagnosis and social history. 2. the obligation of the clinician to inform the client of his or her rights and responsibilities. 3. the right to refuse to reveal disturbing facts about the client's life. 4. encouraging the client to make choices on the problems that will be addressed.

The correct answer is 4. Client self-determination is a practice principle in social work. It holds that the client is at the center of the treatment enterprise. Clients have both the right and responsibility to make fundamental choices about their lives. There are some exceptions, (e.g., when clients are a danger to themselves or others). One social work role is to help clients make choices on their own behalf

What joint characteristic shared by a couple is essential for considering the use of couples therapy? 1. A reasonable understanding of the problem that is inhibiting communication. 2. A highly trained therapist. 3. The ability to empathize with the other. 4. A shared purpose (i.e., the desire to find a way to remain together).

The correct answer is 4. Couples therapy is useful when both parties share similar goals for the treatment. The goals may be such issues as reducing tension around money management or staying together but they must be shared

A mental health agency that seeks to match clients with workers according to ethnic identity and language proficiency is demonstrating 1. due diligence. 2. affirmative action. 3. compliance with Title 7A of the Employment Act of 1983. 4. cultural sensitivity.

The correct answer is 4. Cultural sensitivity, among other things, suggests agencies will do their utmost to insure clients of varying backgrounds will feel comfortable and welcomed. For persons whose English is limited, it is important to provide help through workers who can communicate easily with the client.

Jane is a client at a mental health clinic who complains of violent attacks from her boyfriend. She appears one day with her face badly bruised. Though she has previously been to court and her boyfriend has been ordered by a judge to stay away, he continues to harass and threaten her. In advising her, the social worker should be aware that 1. court orders are rarely violated because offenders are afraid of arrest and incarceration. 2. the police will react swiftly and will vigorously enforce orders of protection. 3. women often accuse men other than their attackers because of fear of retribution. 4. battered women sometimes do not protect themselves and will permit violent men to reenter their lives even when a court order prohibits contact.

The correct answer is 4. Either out of fear, or because they believe themselves responsible for provoking the violence, some abused women permit violent men to reenter their lives even after they have sought the protection of the court. Social workers who work with victims of violence need to be alert to signs that the woman is allowing the man to reenter the situation

A 25-year-old male client employed at a computer software company is supervised by an attractive woman of 30. He tells his social worker and others that she is interested in having an affair with him. As time goes on, he maintains the woman is in love with him, though he has no evidence to support this statement. The supervisor is distressed by his claims and maintains she has never made any overtures to him that would suggest a romantic interest. It is likely that the young man is 1. hallucinating. 2. suffering from a delusion of reference. 3. dissociating. 4. experiencing an erotomanic delusion.

The correct answer is 4. Erotomania is a delusional belief that someone is in love with the person. The stem of the question should be taken at face value when it states that there is no evidence to support the young man's belief. (Also known as Clerambault-Kandinsky Complex)

Characteristics of fetal alcohol syndrome include 1. albino coloration. 2. aggressive and acting-out behavior. 3. slow moral development. 4. mental retardation, slow or reduced growth, and abnormalities in the shape and size of the head.

The correct answer is 4. FAS, which is caused by maternal alcohol abuse, particularly during the early months of pregnancy, can produce physical abnormalities as well as mental retardation. Limb and heart defects are also common. It is believed that alcohol abuse is the leading cause of mental retardation.

A school social worker is observing and assessing a lO-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 1. has a conduct disorder. 2. may have been abused at home. 3. has an impulse disorder. 4. has a learning disorder.

The correct answer is 4. First consideration should be given to the possibility that the behavior problems stem from the boy's difficulties in learning. Persistent learning deficits can lead to behavioral problems as the child's self-esteem erodes, and he becomes (or believes he is) an object of derision in class

In establishing a professional relationship, a social worker must convey 1. a neutral attitude. 2. a sense of objective observation. 3. healthy skepticism. 4. positive acceptance.

The correct answer is 4. For the client to feel free to express feelings - and hear feedback - the worker must be seen as someone who accepts and has regard for the client

Early treatment for children who have been sexually molested by their father or a male caretaker will not usually involve 1. group treatment with other child sexual abuse victims. 2. individual treatment emphasizing the child's feeling of powerlessness, victimization, and diminished self-valuation. 3. mother-daughter treatment groups to help the child and mother deal with their anger and to reestablish a nurturing relationship. * 4. family therapy involving the entire family including the perpetrator.

The correct answer is 4. Group, individual, and mother-daughter treatment is often employed in families recovering from sexual abuse. Mother-daughter treatment may be important if either or both feel betrayed by the other and need to repair their relationship. The perpetrator is not ordinarily involved in family treatment except at a point when the perpetrator may be brought in to take full responsibility for the abuse, and relieve the child of any sense that they contributed to their own victimization

A patient with chronic schizophrenia is released from inpatient care and is in treatment at a community mental health program. The patient is stabilized and participates in group treatment. In deciding on a treatment plan, what type of group is the social worker likely to recommend? 1. Short-term crisis-oriented group therapy. 2. An activity group. 3. A behavioral group. 4. A supportive group.

The correct answer is 4. Helping seriously mentally ill clients sustain themselves in the community often requires structured opportunities for social contacts to break down isolation and to provide ongoing support. Regular group meetings also impose some structure on clients' lives, without which they would have little to do.d\

The goal of a therapeutic milieu in a residential treatment center for an eighteen-year-old adolescent from a chaotic family environment is to 1. protect the youth from an abusing family. 2. return the youth to the family and the community when feasible. 3. provide a family-like environment. 4. prepare the youth for. independent living.

The correct answer is 4. It is unlikely that an 18-year-old would return to a chaotic family after residential treatment. By late adolescence, most agencies will work with adolescents to prepare them for independent living, work, or advanced education

A person who displays magical thinking 1. is able to make illogical leaps into wild fantasies. 2. has the capacity to be artistically creative. 3. shows increased resistance to treatment, as interpretations focus on problematic areas. 4. believes that thoughts, words, or actions have the power to cause or prevent events.

The correct answer is 4. Magical thinking is a kind of primary process thinking in which the client has an illogical belief that their thoughts or actions can alter the behavior of others or change events. Piaget also describes this as the pre-operational phase in children

The growth of managed care has altered social work practice by 1. requiring increased training. 2. eliminating diagnostic interviews. 3. introducing the use of medications. 4. emphasizing short-term strategies and requiring practitioners to specify services, their duration, and the goals that will be met.

The correct answer is 4. Managed care has changed social work practice for many agencies and practitioners. The emphasis on cost effectiveness, clear goals, and timetables, has the effect of focusing workers on short term treatment strategies targeted to solving specific problems.

Which of the following questions is not evidence of discrimination in a job interview or job application process? 1. Please send a photograph with the application. 2. What is your birth date? 3. What is your husband's occupation? 4. List your last three jobs.

The correct answer is 4. Marital status and age should not be factors in a job interview. Submitting a picture with an application is now seen as suspicious, since pictures can be used to screen for race. Listing previous jobs is a legitimate question as it suggests experience and competence for the position.

A social worker with 10 years experience working in a court clinic is asked to testify in a criminal case. The defendant was evaluated and referred for treatment by the social worker. During her court appearance, the social worker was asked about her experience and training by the prosecutor. Afterwards, the social worker was asked her opinion about the client's behavior and mental state. The social worker is probably 1. a hostile witness. 2. a witness for the defense. 3. a witness for the prosecution. 4. an expert witness.

The correct answer is 4. Normally, a witness can testify only about facts. An expert witness, one whose training and credentials equip them with special knowledge, is permitted to provide opinions in court

J a young, recently married high-achieving professional, experiences a schizophrenic breakdown at the age of 28. Following the breakdown, he lost his job and, though placed on medication, loses another job. J and his wife are now expecting a child, and he is becoming very anxious about his future. In planning treatment for J, the social worker should 1. urge him to continue to take his medication. 2. refer J to a day treatment program. 3. explore the underlying meaning of the anxiety. 4. offer continuing supportive therapy.

The correct answer is 4. Supportive therapy has been shown to be very effective for people with schizophrenia. The client is an individual who has a capacity for self-observation and who wishes to discuss his concerns. A supportive and educative response (as needed) as the client struggles to adjust to his illness is the best clinical response.

TQM (Total Quality Management) methods are generally employed by organizations to 1. maximize reimbursement for services and identify unmet needs that can improve revenue recovery. 2. review organizational professional behaviors to streamline administration while improving efficiency. 3. assess the quantity of services that agencies provide and suggest methods for maximizing utilization. 4. improve client services and focus attention on mediating between efficiency, effectiveness, and client satisfaction.

The correct answer is 4. TQM, a method that was popularized in the 1980s and 1990s, emphasizes mediation between the organization's need to satisfy clients by providing effective services with the organization's need to provide these in the most cost effective and efficient way.

A therapy patient with a history of drug abuse seems euphoric, excessively restless, and far more talkative than usual. He speaks rapidly, relating many ideas quickly without explaining their relationship to each other. He seems suspicious of everything the social worker says and relates a grandiose scheme for marketing a new product he says he can develop. The social worker might suspect 1. a psychotic episode. 2. alcohol intoxication. 3. dissociation. 4. amphetamine intoxication.

The correct answer is 4. The behaviors described are among the signs of amphetamine use and are similar to those of cocaine. Grandiosity, euphoria, and high energy often accompany amphetamine use. Other behaviors include hyper-vigilance, impaired judgement, heightened sensitivity, and changes in sociability. The symptoms usually disappear within 24 hours

A client is upset and disappointed at not being called back after a job interview and he vents his anger at the job interviewer. At his therapy session, the social worker's best response is: 1. "You have to be patient in a job search." 2. "I can see you're upset about this." 3. "I wonder how you feel about this." 4. "I guess you are hurt and angry about not getting the job."

The correct answer is 4. The correct answer encourages the client to continue, while acknowledging the underlying legitimacy of the client's feelings

A fearful social work client in a mental health agency is repeatedly asked for money by his drug- addicted son. Recently, the son has threatened violence and has begun calling the father at all hours of the day and night. How should the social worker advise die father? 1. Suggest he disconnect the phone or get an answering machine. 2. Ask the patient to tell the son to come into the agency and discuss his problems with the social worker. 3. Do nothing as it is likely that the behavior will stop on its own. 4. Suggest he has a right to be fearful and should probably call the police if his son does not stop.

The correct answer is 4. The fact that the person threatening the father is his son complicates the situation, but doesn't change the basic facts. When an individual has a reasonable fear, they should take action on their own behalf to protect themselves. The social worker would be correct in advising the client to call the police

A 17-year-old high-achieving student is interviewed at a child mental health clinic. She mentions extreme anxiety about grades, pressures from her professional parents, and her fear that she will not be accepted into the high status college that both she and her parents believe she should attend. She seems excessively concerned about being marked as a failure by friends and fanuly. The clinician might initially 1. explore recent life events that might have altered the student's selfperception. 2. consider psychological or neurological changes associated with maturation. 3. work on problems of self-esteem. 4. explore family relationships, particularly the parent's relationship with the student.

The correct answer is 4. The problem the client presents is defined as anxiety about achievement and fear of failing to meet parental expectations (which have been internalized and are now the client's own). An exploration of family relationships and the degree to which the client feels she can be valued and accepted by family (and self) for who she is, rather than what she achieves, is important

Chatham is a community with many difficulties. High unemployment and rising crime rates, a growing birth rate among unmarried teenagers, few community resources, and a poorly funded school system have left many with a sense of despair. The Chatham Community Center has decided to seek a $2.5 million foundation grant for a community improvement program to try and change these dismal dynamics. What factor is likely to be most important in persuading the funding agency that the project can succeed? 1. The agency's political influence. 2. The agency's history of accountability and probity. 3. A creative, well-written program with clear time lines and realistic goals that has not yet received a firm commitment from other community institutions. 4. The level of commitment, cooperation, and financial support for the program from other major community agencies and local government.

The correct answer is 4. The question suggests a large-scale community change project that will attack problems on a number of fronts. This type of program requires broad community institutional support if it is to succeed. Even the most carefully crafted plan has a smaller chance of success without broad support

A social worker is hired by an adolescent residential school and treatment agency that accepts referrals from public sources. Shortly after starting work, she realizes that the agency is permeated with treatment ideas and management concepts that are weird and seem nonsensical. Rocks and amulets placed in dorms are alleged to have magical powers to calm the atmosphere. Staff hired to do treatment is qualified solely by their beliefs in the efficacy of the agency s novel and unproved theories, and have no significant professional credentials. The agency has become ingrown, and severed all contacts with professional bodies such as professional schools and professional organizations. Referring agencies are unaware of the organization's policies and treatment ideas, and these are not publicly disclosed. The treatment ideas are supported by the board, the agency director, and the top personnel of the agency. The agency's strategies are deceptive and potentially harmful. Which statement provides the best strategy for the worker? 1. She should immediately resign and find employment in a more standard setting. 2. She should try to convince the agency director and others that their theories are unscientific and lacking in merit. 3. She should discuss the matter with her supervisor. 4. She should consult a professional association or regulatory body about her observations.

The correct answer is 4. The vignette describes a pervasive pattern of strange behavior that is ingrained in the agency. The question involves professional ethics and client safety. Normally, a worker would first try to stay within the agency's administrative boundaries if malfeasance is suspected. However, in this case, the entire agency structure is involved. The board is either complicit or incompetent. Management is unlikely to respond to internal complaints, since they are deeply involved in advancing the novel and secretive treatment theory. The worker's best choice is to go outside the agency.

A social worker who attempts to impose judgments on clients is most likely to elicit 1. acquiescence 2. cooperation. 3. appreciation. 4. resistance.

The correct answer is 4. There is little question that attempts to dictate to clients or to anyone for that matter will have predictable results. The individual will resist. There will also be a failure of trust and reduced likelihood the client will remain open and forthcoming

A social worker meets a recently widowed 55-year-old friend at the supermarket and talks with her briefly. She seems sad, and says she has little appetite for food and reduced interest in her usual activities. She says she has a much diminished desire to visit with friends, though she is normally very social. She says that she rarely answers the telephone as she does not really want to talk to anyone. The most probable diagnosis is 1. depression. 2. postmenopausal depression. 3. grief reaction. 4. unknown, as there is insufficient or inappropriate information available to make a diagnosis.

The correct answer is 4. This is a bit of a trick question. A responsible mental health professional should not construct a diagnosis from a social contact. Indeed, any diagnosis based on other than a professional relationship can be deemed highly questionable. The information available to the social worker is of necessity incomplete and limited, and what is most important, the purpose of the interaction is social rather than professional

A DSM-5 diagnosis of substance abuse disorder normally does not require 1. repeated episodes of substance intoxication. 2. substance-related relationship difficulties at work or within the family. 3. legal difficulties related to substance use. 4. a period of at least two years of involvement.

The correct answer is 4. This is a fact question asked in the negative. The DSM-5 criteria require that the consequences of a substance abuse disorder occur during a one-year period

A client at a mental health clinic is asked to participate in a funded research project during which therapy sessions will be observed through a two-way mirror. Clients in the research project will pay lower fees. At the start of the project, clients sign an agreement indicating they understand the research program and what will be required of them. Six months after the project begins, one participant, William, tells his social worker he does not want to be observed. He will not discuss this issue and wants to be released from his agreement and dropped from the project, but he also wants to continue treatment. The social worker's best response is 1. silence until William is willing to discuss the issue. 2. to point out that William received certain benefits and he is morally obliged to fulfill the terms of the agreement. 3. to indicate that continuation in treatment is linked to continued participation. 4. to point out the client can make a choice to end participation, and the worker will help by referring him for continued treatment.

The correct answer is 4. This is an ethical, as well as a practice question. The client has the ultimate right to determine how treatment will be provided. The agreement can be terminated and the worker should assist in finding an alternative resource

A social worker in a community mental health agency is assessing a family concerned about changing behavior of their 14-year-old son. Though usually affectionate and involved with his family, the son has recently distanced himself. He rarely spends time at home in the afternoons and appears to focus most of his attention on friends. He grows angry when questioned and when his parents ask him to spend more time at home. His schoolwork does not appear to have deteriorated, and there is no suggestion of illegal or deviant behavior. In developing a strategy for helping this family, the social worker should 1. address the presenting system: the boy's rebellion and refusal to spend time at 2. help the parents understand the boy's developmental age, stage of development, and the need to loosen their control. 3. consult the school to find out if the boy is exhibiting behavior problems 4. suggest that the parents focus on their own relationship since the boy's behavior reflects tensions in the family.

The correct answer is number 2. The parents' response to the boy's growing independence is quite common. It suggests they are responding to loss that parents often experience as their children grow more independent and separate from them. The boy's resentment is normative and may be addressed if the parents alter their expectations