LSW EXAM

The client is a 40-year-old woman who has recently moved from a shelter for battered women to her own apartment in a new city. The client left her husband of 10 years three months ago; he physically abused her for many years, and she is just beginning the process of recovery. While assessing this client, the social worker observes symptoms that are consistent with battered woman syndrome. The features of battered woman syndrome are similar to the diagnostic criteria for which of the following mental disorders? Select one: A. Major depressive disorder. B. Posttraumatic stress disorder. C. Adjustment disorder. D. Generalized anxiety disorder.

Posttraumatic stress disorder...The features of battered woman syndrome are similar to the diagnostic criteria for PTSD. Lenore Walker (1994) has stated that battered woman syndrome is characterized by a constellation of abuse-related anxiety, arousal, and avoidance symptoms that are similar to those caused by other traumatic experiences.

The difference between values and ethics is BEST stated by which of the following? Select one: A. Ethics relate to desirable conduct, while values emphasize moral judgments that codify what kind of behavior is and is not acceptable for the members of a profession. B. Ethics, but not values, result in formal standards of conduct that should be practiced by the members of a profession. C. Ethics apply to professional conduct, but values apply to only personal conduct. D. None of the above: For an ethical social worker, there is no difference between ethics and

: Ethics, but not values, result in formal standards of conduct that should be practiced by the members of a profession.....Ethics" tend to be codified into a formal system or set of rules that are explicitly adopted by a group of people (such as members of the social work profession); while "values" are the standards (e.g., customs, beliefs) by which individuals or groups make decisions about "right" and "wrong," "should" and "shouldn't," etc. Barker (2003) defines ethics as "a system of moral principles and perceptions about right versus wrong and the resulting philosophy of conduct that is practiced by an individual, group, profession, or culture" (p. 147). He defines values as, "the customs, beliefs, standards of conduct, and principles considered desirable by a culture, group of people, or an individual" (p. 453). Ethics and values are related to each other, however, in that the former are often derived from the latter; e.g., the value of privacy is reflected in the ethical standard that requires social workers to get a client's informed permission before releasing confidential information

A number of relapse prevention models have been proposed for alcoholism, cigarette smoking, and other addictive disorders. According to the model developed by Marlatt and his colleagues, what is the MOST effective way to increase the likelihood of recovery after relapse? Select one: A. Continue to promote complete abstinence. B. Emphasize the negative consequences of further acting out. C. Shift attention from internal to external antecedents. D. Clarify underlying issues

: Shift attention from internal to external antecedents....The relapse prevention model proposed by Marlatt and his associates is a cognitive-behavioral model that emphasizes the role of cognitions (especially attributions) and the situational factors that precede relapse. Marlatt and Gordon's (1985) "abstinence violation effect" (AVE) model considers recovery after relapse to be related to attributions about the cause of the relapse: Successful recovery from relapse is more likely when the person blames it on external, unstable, and specific (high-risk) factors than when he or she attributes it to internal, stable, and global factors

In a social service agency, a supervisor should: Select one: A. mostly side with and advocate on behalf of direct service workers. B. emphasize promoting the goals and interests of agency administrators. C. serve as a bridge between the interests of administrators and the interests of direct service workers. D. avoid becoming involved in disputes arising between administrators and direct service workers

: serve as a bridge between the interests of administrators and the interests of direct service workers.......This question is difficult unless you understand the hierarchical position of supervisors within an agency. Some have referred to the position of a supervisor in an agency as the "highest level employee" and the "lowest level manager." Supervisors are members of both management and the work group, and should serve as a bridge, or link, between them. They facilitate communication between direct service workers and administrators, advocate for one group with the other, and attempt to lessen mistrust and conflict between the two groups.

A 40-year-old client has been unemployed since he started having seizures about a year ago. His wife works and the family has been getting by on her income. When asked by the social worker why he has come in, the client says he wants help figuring out how to get a job. With which of the following should the social worker consult FIRST? Select one: A. The clients past and potential employers. B. The clients family members. C. A medical specialist. D. A career counselor.

A medical specialist.....A medical consultation would be most important first because the client's seizures are probably related to a medical condition. The physician (probably a neurologist) would have the expertise needed to offer an evaluation of any work-related problems that may result from the client's condition and could help you and the client understand the client's work-related limitations and how to best deal with these in the job search (including how to best advocate for the client's rights if the seizures constitute a disability). The neurologist may also be able to provide or recommend medical treatments to minimize the effects of seizures on the client's ability to work.

In the context of managed health care, the "gatekeeper" may be which of the following? Select one: A. A peer review board. B. An HMO. C. A preferred provider organization (PPO). D. A primary care physician.

A primary care physician.....The use of case managers as "gatekeepers" is one way that managed care attempts to contain health care costs. The case manager works with the patient, providers, and the patient's insurer to coordinate services and attempts to achieve the desired health outcome in a cost-effective way. The case manager may be a doctor, nurse, or social worker. In an HMO, for example, the "gatekeeper" is the patient's primary care physician (PCP), as answer "D" says. The PCP controls how the patient uses other services in the plan (i.e., the PCP evaluates a patient to determine if additional care is needed and makes referrals to specialists).

Respite care would be MOST useful in which of the following situations? Select one: A. A teenage runaway needs shelter. B. A battered woman needs protection. C. A frail older adult has no one to care for him. D. A single mother needs a break from caring for her young child.

A single mother needs a break from caring for her young child.....Respite care (e.g., homemaking services, day care, foster grandparents) is a resource offered to parents and other caregivers who need a break from their ongoing caregiving responsibilities, often because of severe stress in the home.

Which of the following statements about the need to obtain valid consent before releasing confidential information about a client is MOST true? Select one: A. A social worker must always obtain valid consent from a client or a client's legal representative before releasing confidential information. B. Before consulting with a colleague about a client's case, a social worker must always obtain valid consent from the client. C. When a social worker wishes to release confidential information to a client's family members, he or she may do so without obtaining valid consent from the client. D. A social worker must obtain valid consent from the client some of the time before releasing confidential information.

A social worker must obtain valid consent from the client some of the time before releasing confidential information...Although it might sound wrong because of the words "some of the time," answer "D" is a true statement. The general rule is to avoid releasing confidential client information to third parties without permission (valid consent) from the client or his or her legal representative. Such "permission" should consist of a signed release of confidential information (a "release"). However, there are situations in which a social worker is permitted or required to disclose confidential information without such permission. Specifically, NASW's Code of Ethics says that the assumption that you will keep information confidential does not apply when you need to disclose certain information to prevent serious, foreseeable, and imminent harm to a client or another identifiable person or when laws or regulations require you to disclose certain information without a client's consent.

A male social worker has been working in individual therapy with a female client for several months. The client is in therapy because she suffers from anxiety at work. Therapy has been progressing well. The social worker now finds himself feeling somewhat attracted to this client. What should the social worker do? Select one: A. Terminate therapy so that he can date her. B. Accept the attraction as normal and proceed with therapy. C. Refer the client to a female therapist. D. Establish a personal relationship only if he feels certain that it will not affect the therapeutic process.

Accept the attraction as normal and proceed with therapy...: Feeling "somewhat" attracted to a client is not unusual. What matters is what a social worker does as a result of such an attraction. As long as this social worker deals with the attraction appropriately by not expressing it outwardly and doesn't allow it to affect his work with this client (or seeks consultation if he thinks it might compromise his objectivity), then he doesn't need to refer this client to another therapist

A client is very quiet in the first interview, and the social worker notices that she client is slouching, often looks down at the floor, and is holding her arms close to her body. According to neurolinguistic programming, what should the social worker do to build trust with this client? Select one: A. Adjust his posture to that of the client. B. Use feeling words. C. Use thinking words. D. Attempt to make direct eye contact.

Adjust his posture to that of the client.....Neurolinguistic programming (NLP) suggests that a therapist's ability to communicate effectively with a client will be influenced by his or her ability to ascertain and then work with the client's preferred sensory mode; e.g. if a client prefers a visual mode, the therapist will use terms such as "I see," if a client prefers an auditory mode, the therapist will use expressions such as "I hear you." "A" is the best choice, because it involves reflecting the kinesthetic state of the client, which is what is emphasized in this question.

A social worker has been working in individual therapy with a 17-year-old boy. One day, the boy's parents call her, reporting new concerns about their son. They say they believe he is using drugs; he has become more secretive and withdrawn and they think he might also be depressed. They ask the social worker for an update on his progress in treatment. Specifically, they want to know what the boy has been talking about in his last few sessions. What is the social worker's BEST course of action? Select one: A. Remind the parents that everything their son discloses in therapy has to be kept confidential. B. After getting permission from the son, invite his parents to a family session. C. Avoid giving the parents specific confidential information, but reassure them that their son will be fine. D. Give the parents the information they've asked for because they have the right to receive it.

After getting permission from the son, invite his parents to a family session.

A social worker meets with a same-sex couple who wants help learning how to communicate with each other because they fight too much. In the first interview, the clients stipulate that they don't want to talk about being gay or anything else having to do with sexuality. What is the social worker's BEST course of action? Select one: A. Avoid discussing issues related to sexuality and focus on assessing the clients' communication and interaction patterns by asking them to role-play a typical fight. B. Allow the clients to present the problem as they perceive it, but let them know that she may have ideas to share about the problem once she's heard what they have to say. C. Avoid focusing on the clients' sexuality but explain that it may play a role in their problem even if they are unaware of its effects. D. Interpret the clients' request as an indicator of internalized homophobia and discuss this openly with them to facilitate trust.

Allow the clients to present the problem as they perceive it, but let them know that she may have ideas to share about the problem once she's heard what they have to say.......This is the best answer offered. Some gay clients present with concerns that relate in a direct way to their sexual orientation but the majority seek therapy for reasons that have nothing to do with their sexual orientation or are related to it only indirectly. Therefore, the couple's sexuality may have no bearing on the problem. On the other hand, before you formulate a treatment plan, you must understand your clients' problems as fully as possible, and this understanding should incorporate both how the clients initially define their problem and any other relevant issues that you uncover during assessment - e.g., issues that play a role in the problem but that the clients were not aware of when they initially sought therapy.

Cognitive dissonance theory would predict that which of the following individuals would feel best about participating in therapy? Select one: A. A wealthy individual who has no trouble paying for therapy. B. An individual whose insurance company pays 75% of his or her therapy fee. C. An individual who receives therapy for free. D. An individual who has to work overtime to pay for his or her therapy.

An individual who has to work overtime to pay for his or her therapy.......According to cognitive dissonance theory, an individual is motivated to reduce the dissonance (a negative, aversive state) that results when his or her cognitions are in conflict. Thus, an individual who has the conflicting cognitions "I am working overtime to pay for therapy" and "I am not benefiting from therapy" would experience a state of dissonance: this individual, more so than the others in the answers, would be motivated to believe that he or she is benefiting from therapy.

Which of the following best describes an "ecosystem"? Select one: A. A community and those who live in the community. B. An individual and his social support system C. An individual, other living systems, and their physical environment. D. An individual and his home and workplace.

An individual, other living systems, and their physical environment.....An "ecosystem" is a biological community of interacting organisms and their physical environment and is the unit of study in "ecology." Ecology, in turn, examines the relationship between an organism and its biological and physical environments, including how the organism adapts and functions in these environments. In social work, the "ecosystems perspective" combines ecological concepts with systems theory and proposes that human development should be viewed within a context that includes an individual's relationship with his environment and that each environment is unique. Germain, who applied ecosystems concepts to social work, advocated a "transactional" view of the person-environment relationship which proposes that a person and his environment engage in ongoing circular exchanges in which they reciprocally influence each other over time.

The clients are a family from Mexico who immigrated to the United States 18 months ago. In the first interview, the parents disclose that they recently discovered that their 16-year-old daughter has been sexually active with her 17-year-old boyfriend, who is a classmate of hers. The father then asks the social worker whether she has a daughter of her own. What is the BEST way for the social worker to respond? Select one: A. Answer the question to build rapport. B. Decline to answer the question until after rapport has developed. C. Decline to answer the question to preserve therapeutic boundaries. D. Answer the question only if she is comfortable doing do.

Answer the question to build rapport...Usually, when a client asks you a personal question, you can choose to answer it or not answer it depending on what you're uncomfortable doing. And, if you decline to give an answer, you should authentically share your reasons why. In this case, however, there is an additional consideration, other than your own comfort, that should factor into your decision about whether to answer the client's question - i.e., the family's Mexican culture. Given the family's cultural background, your willingness to answer the father's question may be important for facilitating the development of rapport.

A mother and father report that they have come in because they are concerned that their 8-year-old son has a learning problem and may fall behind his classmates. The social worker asks the parents several questions about their concerns, but they are unable to give her any information to support them. To address the parents' concerns, what should the social worker do NEXT? Select one: A. Arrange a consultation with the boys teacher. B. Help the parents arrange for screening and evaluation of their son through the school system. C. Arrange for the boy to undergo intelligence testing by a psychologist. D. Discuss the boys symptoms in more depth with the parents and recommend educational therapies tailored to his needs.

Arrange a consultation with the boys teacher...This is the best "next" action because the teacher would have the boy's academic history. As an 8 year old, the boy has been in school long enough that, if a "learning problem" exists, his school records would reflect this.

A social worker discovers that a client diagnosed with bipolar I disorder has been exhibiting symptoms of the disorder for the past week. What is the social worker's BEST course of action? Select one: A. Have the client hospitalized. B. Verify that the client has been taking her medication. C. Arrange for the client to see her psychiatrist. D. Contact the clients family for collateral information and support.

Arrange for the client to see her psychiatrist.....Because effective treatments for bipolar I disorder rely primarily on medication (e.g., lithium), you should have the client see her psychiatrist as soon as possible. In particular, patients with bipolar I disorder may not comply with their medication regimen because they feel better and think medication is unnecessary, are unwilling to give up the "highs" of mania, or do not like the drug's side-effects

A social worker employed at a hospital meets with a patient to discuss the services he will need after he's discharged. The patient requests to see his medical records. What should the social worker do? Select one: A. Arrange for the patient to see his records. B. Explain to the patient that he can see a summary of his records, but not the full record. C. Decline the patients request, in accord with federal law. D. Allow the patient to see only what she (the social worker) has entered into his records.

Arrange for the patient to see his records...HIPAA's Privacy Rule stipulates that patients must be permitted to review and amend their medical records. Under HIPAA, you may deny a patient/client access to his records only if access is reasonably likely to endanger the life or physical safety of the patient/client or another person or if the information in the record makes reference to another person (unless that person is a health-care provider) and access is likely to cause substantial harm to the other person.

During the first session, a client expresses a tremendous amount of anger. What should the social worker do FIRST? Select one: A. Call the police. B. Defuse the anger and provide an alternative outlet. C. Assess if the client is dangerous. D. Initiate involuntary hospitalization.

Assess if the client is dangerous.....There are several appropriate courses of action when a client is expressing significant anger, either verbally or nonverbally, and, in order to know what action to take, you need to know whether the client's anger poses a danger to you or other people. When a client is extremely dangerous, you can call the police (choice "A) or initiate hospitalization (choice "D"). If not, then you can work with the client to defuse his anger and provide appropriate outlets for expressing it (choice "B").

A 30-year-old client with a history of psychotic episodes from his mid-20s has been released into an outpatient program. Although part of this program involves finding a job, he tells the social worker that he's afraid to look for work because he has a hard time talking to employers and doesn't understand job applications. In addition, he doesn't feel capable of functioning at a job on a daily basis. How should the social worker address this concern? Select one: A. Assess the client's capacity to get a job and function as an employee. B. Discuss the client's employment history with him, emphasizing areas in which he has had success in the past. C. Evaluate whether the client should be rehospitalized so that he can be in a structured environment where he can acquire the skills he needs to live in the community. D. Explain how vocational counseling can help him and assist him to find and use this resource.

Assess the client's capacity to get a job and function as an employee.......Probably the key point in this question is that the client may not be ready to re-enter the world of work and, therefore, may not belong in this particular outpatient program. For this reason, the best course of action would be to assess capacity to get a job and function as an employee.

A 12-year-old girl and a 13-year-old boy are found playing sexual games with each other in a school restroom. The girl's parents are worried and seek advice from a social worker. The social worker acknowledges the parents' expressions of worry. What should the social worker do NEXT? Select one: A. Allay the parents concerns because this sounds like normal sexual experimentation. B. File a suspected child abuse report. C. Refer the child to a medical doctor and recommend that she begin individual therapy. D. Assess the situation further.

Assess the situation further...This is the best answer because you have limited information about what these children were doing. You know generally that they were "playing sexual games," but you don't know whether both children were doing this willingly or how sophisticated their sexual play was. In some cases, this type of play behavior is a sign of prior sexual abuse at the hands of another person. So, before concluding that there's been no child abuse or the children's behavior is "normal," you need to assess the situation further.

A client who has been in individual therapy for three months has recently started to make progress toward meeting her goals. The client then terminates treatment without any warning. What is the social worker's BEST response to this? Select one: A. Respect the client's right to terminate treatment when she wants to. B. Attempt to make a final contact with the client by phone or letter. C. Document in the client's case record the reasons and circumstances surrounding the termination. D. Wait for the client to contact you and then warmly encourage her to return to therapy.

Attempt to make a final contact with the client by phone or letter...When a client terminates treatment without warning (is a "no-show"), you should attempt to make a final contact with her by phone or letter. The goal of this contact may be to acknowledge her decision to terminate, encourage her to come in for a final session so that you can bring your relationship to an appropriate closure, and/or achieve the purposes of a final session through the phone call or letter. In the phone call or letter, for example, you can review the goals the client has achieved, reaffirm your regard for the client, and inform her of other services available to meet her ongoing needs. You would also document in the client's case record information about her termination ("C"), but the more important issue at the heart of this question is your awareness that you should make an effort to contact a client who is a "no-show" because doing so is in her best interests

One important guideline for the appropriate use of self-disclosure by a social worker is which of the following? Select one: A. Use self-disclosure freely in the first interview to encourage the client to speak openly about the problem. B. Never self-disclose until a client asks you to. C. Avoid self-disclosure until after rapport has developed. D. Use self-disclosure only when the client is reluctant to talk.

Avoid self-disclosure until after rapport has developed........When used properly, self-disclosure helps a client feel more comfortable with you and can make it easier for him to talk about sensitive topics. On the other hand, the improper use of self-disclosure can cause clients to question your professional competence. Although there are exceptions to what "C" says, "C" is the only correct statement in the answers: With most clients, you should avoid self-disclosure in the early stage of treatment, before rapport has develope

A 79-year-old client spends a lot of time in therapy sessions reminiscing about events from her past. What is the social worker's BEST course of action? Select one: A. Be patient and recognize that reminiscing is a healthy activity. B. Encourage the client to find ways of feeling satisfied with her life now rather than dwelling on the past. C. Refocus the clients attention on her present-day problems. D. Explore why the client is so focused on the past.

Be patient and recognize that reminiscing is a healthy activity....Older adults often engage in a process of "life review" in which they reminisce, tell stories, and think about past events. This process serves a useful function by helping an older person integrate her life in a meaningful way. When an older adult wishes to talk about her past during sessions, you should incorporate her desire to review her life into your work with her.

Which of the following is MOST associated with demonstrating a new behavior? Select one: A. Free association. B. Functional analysis. C. Behavioral rehearsal. D. Psychodrama.

Behavioral rehearsal....Behavioral rehearsal (behavior rehearsal) is used to help clients learn new behaviors so that they can better cope with interpersonal situations. The technique relies on demonstrations (modeling, role-playing) and coaching to provide clients with opportunities to practice the new behavior in a protected environment before trying it out in the real world.

Which of the following describes the social service delivery policy known as selective eligibility? Select one: A. Eligibility is based on something other than need. B. Benefits and services are provided in the same amount to all individuals in the nation. C. Benefits and services are provided only to individuals who are members of a special group, such as veterans. D. Benefits and services are provided only to individuals who meet specific, predefined criteria.

Benefits and services are provided only to individuals who meet specific, predefined criteria....With selective eligibility, benefits or services are provided only to those individuals (or families) who meet pre-established criteria. The amount of the benefit varies based on special needs, circumstances, or economic status. For instance, means testing may be used to evaluate the person's financial means based on variables such as his or her income, debts, health, and number of dependents, with the result being used to determine the person's eligibility to receive a particular benefit such as Medicaid or Food Stamps.

The MMPI-2 can be used to measure which of the following? Select one: A. Intelligence. B. Premorbid functioning. C. Family dynamics. D. Characteristic behavior.

Characteristic behavior.....The MMPI-2 is one of the most widely used self-report inventories for the assessment of personality. Its clinical and validity scales provide information about an examinee's characteristic traits and behaviors, including symptoms, major needs, perceptions of the environment, reactions to stress, self-concept, sexual identification, emotional control, interpersonal relationships, and psychological resources

A social worker meets with a mother, father, and 6-year-old son. For the past three weeks, the son has been wetting the bed nearly every night. The parents say that they are surprised and concerned by this problem because the boy has been fully toilet trained for several years. They add that they haven't observed other emotional or behavioral changes in their son. What should the social worker do FIRST? Select one: A. Facilitate the parents understanding of the problem and treatments for the problem through psychoeducation. B. Clarify the problem by identifying its underlying causes through assessing family dynamics and/or referring the boy to a psychologist for psychological testing. C. Clarify the problem by arranging for the boy to be seen by a physician for a medical evaluation to determine if the problem has a physical cause. D. Gather information to complete a family history to determine whether other family members have had this disorder and how it was handled.

Clarify the problem by arranging for the boy to be seen by a physician for a medical evaluation to determine if the problem has a physical cause.....Physiological causes for the boy's symptom, such as a medical condition, must be ruled out before you can identify what other assessments are needed, determine a diagnosis, or decide on appropriate treatments.

The client is a woman with severe migraine headaches who was hospitalized and given medication by her doctor. Each time she took the medication, she felt nauseated and several times she threw up. Although she stopped taking the medication when she left the hospital, she finds that, whenever she visits her doctor at the hospital, she begins to feel nauseated again. What does this situation illustrate? Select one: A. Response shaping. B. Classical conditioning. C. Operant conditioning. D. Negative reinforcement.

Classical conditioning...Classical conditioning is concerned with reflexive behaviors that are automatically elicited by stimuli. Classical conditioning occurs when an unconditioned stimulus (US) is paired with a conditioned stimulus (CS), until the CS comes to elicit the same response that is naturally elicited by the US. The response elicited by classical conditioning is known as a conditioned response, or CR. In this case, the medication serves as the US, the hospital visits serve as the CS, and the nausea serves as the response that the CS has come to elicit as a result of repeated pairings with the US.

A client reports experiencing fatigue and excessive nervousness. She says she has a history of periodic depression but has never felt so nervous or anxious before. She was treated for depression two years ago and says that her mood has improved since then. Now, she's just a "nervous wreck" and feels like she can never calm down. What should the social worker do FIRST in assessing this client? Select one: A. Collect a detailed history of the onset, development, frequency, and nature of the clients anxiety symptoms B. Ask the client about other symptoms she's experiencing to determine whether her depression has returned. C. Ask the client about recent events, stressors, and transitions in her life and explore her responses to them. D. Collect a medical history, including a review of medications, and refer the client for a physical exam.

Collect a medical history, including a review of medications, and refer the client for a physical exam.....This question is difficult because a social worker would do a variety of different things when assessing a client who reports symptoms of anxiety. In fact, three of the answers describe steps that are usually taken in the clinical assessment of anxiety, and "B" would be appropriate, as well, since this client has a history of depression. "D" is the best answer to a question like this one, however, because ruling out the possibility that a medical condition or substance/medication use accounts for a client's symptoms is always a top priority.

A child acquires the ability to think in logical, cause-and-effect terms, learns to solve the problems of conservation, and can adopt other people's perspectives. According to Piaget's approach to intellectual functioning, the child is in which phase of cognitive development? Select one: A. Formal operations. B. Preoperational. C. Sensorimotor. D. Concrete operation

Concrete operations.....The basic premise of Piaget's "constructivism" is that people actively construct their knowledge through interactions with the environment. Piaget proposed that cognitive development follows a predetermined sequence of four stages - sensorimotor, preoperational, concrete operational, formal operations - that is related to biological maturation. The concrete operational stage (7-11 years) is marked by the emergence of logical (cause-and-effect) thinking, including reversibility and the ability to serialize and sequence. As a result, individuals are able to classify in more sophisticated ways, understand part-whole relationships in relational terms (e.g., bigger, lighter), and conserve number, length, volume, and weight. Reversibility and decentration underlie the ability to conserve. A child in this stage is also able to adopt other people's points of view.

A social worker is leading a therapy group made up of female patients who have been ordered into treatment by the court. The patients all have alcohol use disorder. During a group meeting, one of the patients asks the social worker if she's currently dating anyone. How should the social worker respond to this? Select one: A. Redirect the focus by inviting the patients to talk about their relationships. B. Recognize this as an opportunity to build trust and answer the question. C. Decline to answer the question and reinforce the purpose of the group. D. Answer the question to reinforce the norm of self-disclosure.

Decline to answer the question and reinforce the purpose of the group...Involuntary members can be forced by court order to attend group meetings, but they can't be forced to interact in meaningful and productive ways during group sessions. Effective group work with involuntary clients usually requires a strong group leader who is skilled at confronting resistant and manipulative behavior. "C" would reinforce proper therapeutic boundaries and keep the group members focused on their treatment goals

An individual undergoing cocaine withdrawal is MOST likely to experience which of the following? Select one: A. Ideas of reference. B. Pupillary dilation. C. Depression. D. Tachycardia.

Depression...When a chronic user stops using cocaine (or another stimulant) or begins to use less of it, she may drop into a deep depression. According to the DSM, a cocaine (stimulant) withdrawal syndrome is associated with the following symptoms, which result in clinically significant distress or impairment in functioning: Dysphoric mood and two or more of the following physiological changes - fatigue; vivid, unpleasant dreams; insomnia or hypersomnia; increased appetite; and/or psychomotor retardation or agitation. These changes develop within a few hours to several days after the person stops or reduces heavy, prolonged cocaine use.

A client has been in therapy since the break-up of his marriage several months ago. He arrives for a session looking disheveled. After a few minutes, he tells the social worker that he can't eat or sleep. As he speaks, his voice quivers and he appears to be in significant emotional distress. In terms of assessing these changes in the client's functioning, what should the social worker do FIRST? Select one: A. Assess for major depressive disorder and refer the client for physical evaluations. B. Evaluate the degree of disequilibrium and immobility to determine whether the client is in crisis. C. Determine threat to life by asking direct questions. D. Identify stressful events that have occurred since the last session and explore the clients perceptions of them.

Determine threat to life by asking direct questions.....This client appears to be in acute crisis, and "C" is the only answer that immediately addresses the possibility that he may pose a danger to himself (or perhaps to others) at this time. The first thing you should do is conduct a suicide assessment, including asking the client directly whether he has thought about harming himself.

A client reports that she has been a victim of discrimination because she was denied low-cost housing. As the client's advocate in this situation, what should the social worker do FIRST? Select one: A. Determine whether the client is eligible for low-cost housing. B. Help the client file a lawsuit. C. Help the client find alternative housing. D. Determine what the client wants him to do.

Determine whether the client is eligible for low-cost housing.....The goal of client advocacy is usually to assure that a client receives the services or resources she is entitled to. An important first step is to gather information to determine if the client is, in fact, entitled to the desired service or resource. If so, then you can discuss with the client what steps she wants to take to rectify the situation. Such steps may include negotiation, mediation, or, if necessary, more confrontational tactics, such as helping the client use available appeal procedures or take legal action

The client is a recently divorced woman who has sole custody of her 14-year-old daughter. The client is distraught over her daughter's behavior and still depressed about her divorce. She tells the social worker that her daughter has been going out too much lately and becoming secretive about her behavior outside the home. The client is afraid that her daughter is sexually active. From the facts given so far, what is the MOST likely explanation for this situation? Select one: A. Multigenerational transmission process. B. Disengaged family structure. C. Enmeshed family structure. D. Developmental crisis in the family life cycle.

Developmental crisis in the family life cycle....It was important to base your answer on only the information you were given in the question. You don't have the information needed to support the explanation in "A," "B," or "C." In contrast, you do have sufficient information to infer that the client's difficulties may be due to a developmental crisis in the family life cycle: The mother is trying to adapt to a new lifestyle after her divorce, and the daughter is at the beginning of her teenage years and seems to be expressing her need for independence in a rebellious way

The term "reasonable accommodation" is MOST closely associated with which of the following? Select one: A. Special education. B. Disability laws. C. Affirmative action. D. Patients rights.

Disability laws.

The clients are a young mother and father who report feeling overwhelmed by caring for their 22-month-old son. They say that he has recently become more difficult to manage than he was before. After acknowledging the parents' feelings, what should the social worker do FIRST? Select one: A. Develop with the parents a list of support people who can be relied on to babysit and offer other support. B. Discuss the developmental stages of early childhood with the parents. C. Help the parents determine whether their sons behavior is within normal developmental limits. D. Assist the parents to identify their frustrations associated with parenting.

Discuss the developmental stages of early childhood with the parents.....Providing this education would be the best first intervention. The question suggests that these parents lack knowledge about childhood development and may have unrealistic expectations about how children behave at age 22 months (i.e., we would expect a 22-month-old to be more active, mobile, curious, and independent and, therefore, more "difficult to manage than he was before"). Depending on the specific nature of the boy's behaviors (which are not described in the question), "C" may also be indicated but this discussion will be more fruitful after the parents have accurate information about childhood developmental stages

During the first therapy session, an Asian American client tells his white social worker that he would prefer to see an Asian American therapist. What is the social worker's BEST course of action? Select one: A. Discuss this with the client and make a referral if, after the discussion, the client still wants to see an Asian American therapist. B. Reassure the client that she has experience working with members of minority groups and suggest that they see each on a trial basis. C. Realize that the clients preference may be a sign of resistance and tell him that she thinks it would be best if they saw each other for a few sessions before a referral is made. D. Tell the client that it would be discriminatory and, therefore, unethical for her to make a referral to another therapist on the basis of race or culture alone.

Discuss this with the client and make a referral if, after the discussion, the client still wants to see an Asian American therapist......This is the best response: The client will not benefit from treatment if he's not comfortable with the therapist, and it would be unethical for the social worker to try to "talk him into" additional sessions.

A social worker is meeting for the first time with a client, age 29, who tells her that he recently tested HIV positive. He's seen his doctor and has started taking anti-HIV medication. The client is gay and says he's afraid to tell his parents about his diagnosis; they are very conservative, and he hasn't even told them that he's gay. He also says he's feeling lonely and doesn't feel like seeing his healthy friends right now. The social worker spends some time with the client helping him express his feelings about this situation. What should the social worker do NEXT? Select one: A. Encourage the client to contact his family. B. Discuss ways of building the client's social support system. C. Verify that the client is receiving proper medical attention. D. Help the client sort out the pros and cons of coming out to his parents.

Discuss ways of building the client's social support system...The client's report suggests that what he needs most of all right now is additional sources of social support, such as a support group or local AIDS service organization. While it will be important for the client to receive ongoing medical care from a qualified doctor ("C"), he hasn't presented this issue as a concern. Plus, you know that he has seen a doctor and is taking anti-HIV medication. "D" has a similar problem: The client hasn't said that he's thinking about coming out to his parents right now.

At the beginning of therapy, a client's motivation for change can be BEST assessed by doing which of the following? A. Exploring what led her to seek treatment. B. Asking her how she normally copes with problems. C. Attempting to establish a therapeutic contract. D. Observing her body language.

Exploring what led her to seek treatment....While all of these approaches could tell you something about a client's motivation for change, only one of them explores the most telling factor. A client's level of motivation for change is usually best assessed by determining her reason for coming in. In general, voluntary clients are more motivated than involuntary clients. For example, a client who comes in voluntarily because she is ready to change a behavior will tend to be much more motivated than one who is in your office only because a family member has insisted that she get help.

After nine months with weekly sessions, a client in psychotherapy has made no significant progress. She and the social worker have reviewed and revised the treatment plan several times. To behave in an ethical way, what should the social worker do? Select one: A. Arrange to see the client more frequently for a specified length of time. B. Seek supervision or consultation. C. Ask the client what she would like to do. D. Discuss with the client the termination of his services to her and referral to other helping sources.

Discuss with the client the termination of his services to her and referral to other helping sources...Nine months with no significant progress is long enough for you to conclude that this client is not benefitting from your services (especially since you've already tried revising the treatment plan several times). Therefore, to behave in an ethical manner, you should now discuss the termination of your services with this client; and because termination is occurring before the treatment process is completed, you should also offer appropriate referrals to other helping sources. Although you and the client will discuss the termination, you should not leave it up to the client to decide what should be done ("C"). You have an ethical responsibility to be more proactive than that in this situation

When a child is developing language abilities, you would expect which of the following to appear first? Select one: A. First words. B. Telegraphic speech. C. Productive (vs. receptive) language. D. Expressive jargon

Expressive jargon.....In sequence, the stages of language development are the following: (a) crying; (b) cooing (vowel sounds emitted when the child is happy) and babbling (repetition of simple consonant and vowel sounds); (c) echolalia (imitation of speech sounds without understanding their meaning) and expressive jargon (vocalizations of sounds that resemble sentences but have no meaning); (d) holophrastic speech (single words that express whole phrases and sentences; i.e., first words); (e) telegraphic speech (two or more words that make up a sentence); (f) rapid vocabulary growth (especially from age 30 to 36 months); (g) grammatically correct sentences; and (h) metalinguistic awareness (the ability to reflect on language as a communication tool and on themselves as language users). Throughout these stages, receptive language (comprehension) precedes productive language.

A social worker is conducting the first interview with a couple who have been referred by the court for therapy. The social worker begins the interview by briefly describing what he knows about why the clients have been referred and then asking the clients to describe their understanding of the referral. The man responds by saying, "We don't want therapy, that's all I know," and the woman says "That's right." What should the social worker do NEXT? Select one: A. Encourage the clients to talk about their feelings about the referral. B. Explain the benefits they stand to gain from therapy. C. Remind the clients that they are required to cooperate with him. D. Offer to do something that will make the clients more comfortable in exchange for their cooperation.

Encourage the clients to talk about their feelings about the referral.......Most involuntary clients have negative feelings about being forced into contact with a therapist, and, typically, an effective approach is to address these feelings directly. You can use basic interviewing skills to help the clients express their feelings. Defending the benefits of your services ("B") is not usually recommended as a strategy for engaging involuntary clients; it may make them even more resistant or defensive. Answer "D" describes a tactic called "let's make a deal" which is something you might end up doing if your initial efforts to engage the clients fail. Of course, whatever you agree to do for the clients must be legal, ethical, and legitimate. You should never bend or break your own or an agency's rules to engage a clien

A social worker has been working in individual therapy with an adult client for five months, and the presenting problem is in remission. The client tells the social worker that he wants to terminate therapy; the social worker believes that the client would benefit from additional therapy to consolidate the gains he has made. What should the social worker do? Select one: A. Discuss with the client why he wants to terminate and why she thinks he shouldn't. B. Seek case consultation. C. Agree to terminate because the client feels ready to leave therapy. D. Explain to the client why she feels he shouldn't terminate but allow him to do so if he still wants to after that.

Explain to the client why she feels he shouldn't terminate but allow him to do so if he still wants to after that...This question illustrates why you must read every answer to a test question before choosing one. Answer "A" is fine, but "D" is better. It's in the client's best interests for you to tell him why you believe he shouldn't terminate yet so that he can make an informed decision. If he continues to want to terminate after that, then you must respect his right to do so. While seeking consultation ("B") is never a bad thing to do, it doesn't seem necessary in this common clinical situation.

A social worker refers a client with intense social anxiety to a psychiatrist for a medication evaluation and explains to him why she is doing so, including how he might benefit from beginning to take medication. The client becomes defensive when the social worker makes this referral and says, "You think I'm crazy, don't you?" What is the social worker's BEST response? Select one: A. Describe to the client her scope of practice. B. Explore the client's fears or other concerns about the referral. C. Make the initial contact herself by calling the psychiatrist while the client is with her. D. Explain to the client that, ethically, she cannot continue treating him unless he follows through with this referral.

Explore the client's fears or other concerns about the referral.....: "B" is much more empathetic than the other answers. Even a client who understands the benefits he stands to gain from using another professional's (or agency's) services may still be fearful or uncertain; when this is the case, you should explore the client's ambivalence about the referral and help him express his fears or other concerns about using the resource (i.e., about taking medication, in this case)

A social worker has been working in individual therapy with a client who has schizophrenia. The client lives in the community, is on medication, and is progressing well in therapy. During the current session, the client tells the social worker that he has some new problems. What should the social worker do FIRST? Select one: A. Check for medication side-effects. B. Refer the client to his psychiatrist. C. Explore the new problems. D. Provide crisis intervention.

Explore the new problems.....This question is simpler than many others. The best answer is "C" because you (and the social worker in the question) don't know yet what the client's "new problems" are.

While meeting for the first time with a family, a social worker observes that the 3-year-old son is exhibiting behaviors that may be consistent with a diagnosis of autism spectrum disorder. To learn more about the boy's behaviors, what should the social worker do FIRST? Select one: A. Refer to a psychiatrist. B. Refer to a psychologist. C. Explore the onset and severity of the behaviors. D. Explain the nature of autism spectrum disorder to the parents and ask for their observations.

Explore the onset and severity of the behaviors.....All you have so far are your initial observations and a hypothesis. A good way to begin testing your hypothesis is by gathering information about the behaviors you've observed (their duration, frequency, etc.). The boy's symptoms could indicate autism spectrum disorder or they could be the result of other problems or disorders, such as hearing impairment, intellectual disability, stereotypic movement disorder, etc.

A client is grieving the recent death of her husband. She is in the first phase of an active crisis state and reports difficulty sleeping and a high level of anxiety. The social worker verifies that the client is not thinking about suicide, uses sustainment to lessen her anxiety, and, toward the end of the session, recommends that she return for a few more sessions of crisis intervention, perhaps followed by grief counseling. The client rejects this and insists on being referred to a support group now. What is the social worker's BEST course of action? Select one: A. Refer the client to the group but explain to her why doing do is contraindicated. B. Refer the client to the group because it is an appropriate alternative to individual therapy in this case. C. Explore why the client doesn't want individual therapy. D. Begin individual therapy with or without the clients consent.

Explore why the client doesn't want individual therapy....Using an individual modality is recommended when a client is in the first phase of an active crisis state (i.e., before she has started to regain her equilibrium), so you should do your best to avoid referring this woman to a support group right now. A good intervention in this situation is to find out why the woman is resistant to individual work. As part of this discussion, you could explain what short-term individual therapy will entail and how it can help her. She may have misconceptions about individual therapy that you can clear up by having this conversation. You could also let her know that referral to a support group can take place after she has recovered from her present crisis state, if she still wants to join a group at that time. Answer "D" isn't a good choice because you should never proceed with therapy when the client hasn't given consent.

A social worker is beginning individual therapy with a client who has been a heavy cocaine user for a year and continues to use despite losing his job two weeks ago. He was referred to the social worker by his physician. Which of the following would be the MOST effective way of addressing the client's denial, minimization, or other defenses? Select one: A. Exploring the specific consequences of drug use for the client. B. Exploring why the client uses drugs. C. Describing the typical effects of chronic drug use. D. Providing graphic literature on the negative effects of drug use.

Exploring the specific consequences of drug use for the client...Exploring the specific negative effects of drug use for the client himself is usually more effective than offering information about the typical effects of drug use on the average user.

A social worker would be MOST likely to find which of the following effects in a client who is a long-term, heavy user of methamphetamine? Select one: A. Aggressiveness, extreme weight gain, and memory deficits. B. Olfactory hallucinations, hypersomnia, and reduced motor speed. C. Extreme anorexia, paranoia, and dental problems. D. Delusions, vision loss, and cardiovascular problems.

Extreme anorexia, paranoia, and dental problems.....Among the long-term effects of chronic methamphetamine use are extreme anorexia, paranoia, and severe dental problems, as well as aggressiveness, memory loss, visual and/or auditory hallucinations, delusions, reduced motor speed, and impaired verbal learning. Recent studies of chronic methamphetamine abusers have also revealed severe structural and functional changes in areas of the brain associated with emotion and memory, which may account for many of the emotional and cognitive problems observed in chronic methamphetamine abusers.

A social worker has been working in individual therapy with a 19-year-old client who has two younger sisters, ages 15 and 10. The client reports in a session that her father sexually abused her for over 10 years. The social worker knows that the client's sisters live at home with their father. When he asks the client if she believes that her father is molesting her sisters, the client becomes very uncomfortable and quickly changes the subject. She says she doesn't want to talk about her sisters. Regarding the filing of a child abuse report in this situation, what should the social worker do? Select one: A. File a report based on his suspicion that the client's sisters are being abused. B. Report abuse of the client, since abuse of the client began when she was a minor. C. Get more information from the client to determine whether a child abuse report is necessary. D. Maintain the client's confidentiality because she is an adult.

File a report based on his suspicion that the client's sisters are being abused.....Child abuse reporting laws generally require mandated reporters (such as social workers) to make a report whenever they, in their professional capacity or within the scope of their employment, have knowledge of or observe a child whom they know or reasonably suspect has been the victim of child abuse or neglect. This client is no longer a minor, and a mandated reporter is not required to make a report when an adult says that she was abused as a child. In this situation, however, the social worker would have very good reason to suspect that the client's sisters, who are minors, are being abused; therefore, he would be mandated to file a child abuse report regarding that (potential) abuse. As a mandated reporter, you don't have to know with certainty that abuse is occurring; a reasonable suspicion is all that is necessary for your mandated reporting obligation to take effect.

A man brings his wife to a busy community medical clinic because she is not feeling well. The woman dies while waiting to be seen by a physician. The social worker employed by the clinic is called in by medical staff to meet with the man. What should the social worker do FIRST? Select one: A. Find a private location at the clinic where the man can express his feelings and collect himself. B. Offer the man a list of qualified grief counselors. C. Advocate on behalf of the man by finding out why his wife was not seen sooner. D. Talk to the man about grief and loss and explain the stages of grie

Find a private location at the clinic where the man can express his feelings and collect himself....This man is probably in crisis. Among the four interventions listed, only this one involves an effort to immediately evaluate and begin to address the various emotional and concrete needs the man may have at this time. Social workers in health-care settings may provide crisis intervention services for patients and patients' families who experiencing medical crises and/or psychosocial emergencies. This work requires expertise in areas such as domestic abuse, homelessness, and substance abuse, as well as skills for intervening effectively in crisis situations, such as helping family members deal with the death of a patient..

A social worker is providing case management services to a client. She and the client have completed a careful assessment, established the goals that will be pursued, developed a service plan, and determined what resources are most likely to be helpful for the client. The social worker is now ready to connect the client to these resources. In using connecting activities with this client, what is the social worker's ultimate goal? Select one: A. For the client to obtain all of the resources he needs. B. For the client to report a satisfactory experience with the other providers. C. For the client to make these appointments on his own and maintain appropriate contact with these providers. D. For the client to take charge of getting and using the resources he needs.

For the client to take charge of getting and using the resources he needs.....The question asks about your "ultimate" goal. Effective case management should result in not only the resolution of the problems identified during assessment, but also in an increase in the client's own ability get and use help effectively - i.e., key signs that disengagement (termination of case management services) is appropriate are the achievement of goals, the ability of the client to help himself more effectively (increased capacity to meet his own needs and increased independence), and the client's appropriate use of help from a helping network.

A social worker determines that a client, age 36, is in the midst of a major depressive episode, and the client's history suggests that he has had other such episodes in the past. The social worker refers the client to a psychiatrist for a medication evaluation, and the psychiatrist prescribes an SSRI for the client. In terms of side-effects from this class of medication, the client is MOST likely to experience which of the following? Select one: A. Blurred vision, tremor, weight loss. B. Gastrointestinal problems, insomnia, sexual dysfunction. C. Dry mouth, tachycardia, weight gain. D. Muscle spasms, confusion, irritability.

Gastrointestinal problems, insomnia, sexual dysfunction.....Side-effects associated with the SSRIs (Prozac, Floxyfral, Paxil, Zoloft) include gastrointestinal problems (e.g., appetite loss, nausea, constipation, diarrhea); frequent urination; insomnia; anxiety; headache; dizziness; tremor; and sexual dysfunction. Compared to tricyclic antidepressants (TCAs), SSRIs are safer in overdose; less cardiotoxic; less likely to result in cognitive impairment; and have a more rapid onset.

The client is a 41-year-old married man who reports feeling tired a lot of the time and having tremendous difficulty concentrating at his job. He no longer enjoys his work and finds that he is easily annoyed by his family and friends. He adds that he thinks he's depressed but doesn't know what to do to "pick himself up." In an effort to understand the client's needs, the social worker assesses him for suicidal risk; gathers information about his health history, medication use, and health and lifestyle behaviors; and performs a mental status exam to assess his psychological status. What should the social worker do NEXT? Select one: A. Use the mental status exam findings to formulate an accurate diagnosis of the clients mental health condition. B. Identify the extent to which medical factors are affecting the clients psychological functioning and vice versa. C. Gather information on the clients cultural background, social relations, and environmental connections. D. Gather information on the clients family by using a genogram to map family patterns

Gather information on the clients cultural background, social relations, and environmental connections.....The question describes two of the three components of a comprehensive biopsychosocial-cultural assessment - "bio" and "psycho." "C" describes the third component. To complete your assessment of this client, you must gather information about his sociocultural experiences.

An individual diagnosed with narcissistic personality disorder is MOST likely to display which of the following? Select one: A. Rapidly changing and shallow expression of emotions. B. Instability in self-image, interpersonal relationships, and mood. C. Grandiose behavior and a lack of empathy. D. Excessive emotionality and attention seeking.

Grandiose behavior and a lack of empathy.....Narcissistic personality disorder involves a pervasive pattern of grandiosity, a need for admiration, and a lack of empathy. Rapidly changing and shallow expression of emotions ("A") and excessive emotionality and attention seeking ("D") are characteristic of histrionic personality disorder; and instability in self-image, interpersonal relationships, and mood ("B") are characteristic of borderline personality disorder.

A 68-year-old client who retired six months ago reports that he has been feeling isolated, useless, and a little depressed. He has seen his doctor, who ruled out a medical condition. What intervention should the social worker use? Select one: A. Help him perform a "life review." B. Modify his mistaken beliefs about aging and retirement. C. Help him identify activities that will restore meaning to his life. D. Help him resolve unfinished business.

Help him identify activities that will restore meaning to his life....The question doesn't say too much about this client's life, but it does tell you that he retired recently. "C" offers the client a specific and practical way of improving his mood and sense of well-being during this new stage of his life.

A social worker is working in individual therapy with an Asian American man who is gay. The client has been feeling increasingly anxious because his parents have been pressuring him to get married. He hasn't told his parents that he's gay and he isn't sure what to do. The social worker spends some time with the client helping him express and sort out his feelings about this situation. What should the social worker do NEXT? Select one: A. Use role-playing exercises with the client so that he can practice coming out to his parents and anticipate their possible reactions and how to handle them. B. Help the client consider whether to come out to his parents by exploring relevant cultural variables and the potential consequences and benefits of coming out. C. Encourage the client to come out to his parents because secrecy is not working for him, and offer to work with him and his parents on their reactions, including potential guilt or grief. D. Focus on how the clients culture feels about homosexuality vs. how the client feels about it.

Help the client consider whether to come out to his parents by exploring relevant cultural variables and the potential consequences and benefits of coming out......The question says that this client "isn't sure what to do." According to experts, when working with a gay client who is struggling with whether or not to come out to others, a therapist should avoid taking a position that is comfortable for him or her but inconsistent with the client's situation or needs. A therapist should neither collude with a client's worries about the negative consequences of disclosure nor advocate disclosure merely on principle if a client is not ready to tell others that he is gay. Rather, the therapist's role is to help the client identify and evaluate the actual and imagined consequences of disclosing his sexuality and compare these to the negative effects (e.g., relationship problems, harm to self-esteem) that may result from continuing to hide his sexual orientation. In the case of this client, this process should include (but not be limited to) a discussion about how members of the client's cultural group view homosexuality and how this may affect the client's decision and his parents' reaction. If the client decides to tell his parents about his homosexuality, his therapist can then help him rehearse the disclosure process and prepare him to handle the possible outcomes, as "A" suggests

: A woman comes to see a social worker after finding out that her boyfriend has been sexually abusing her young daughter. A child abuse report has been filed. During the assessment interview, the woman cries often and keeps saying that she has failed her daughter and doesn't know what to do next. The boyfriend had been supporting them financially, and she has nowhere to turn for money. She asks for referrals for vocational counseling and for a low-fee social worker for her daughter. She also asks for the name of a lawyer so that she can immediately press charges against her boyfriend. What should the social worker do FIRST? Select one: A. Arrange individual therapy for the daughter. B. Refer to income maintenance programs. C. Refer to a legal aid office. D. Help the client determine her priorities.

Help the client determine her priorities....The client is overwhelmed by her situation: She is facing a significant psychosocial stressor, reports multiple needs and problems, and has asked the social worker for many types of assistance. And, because all of the client's needs are fairly urgent, you can't really choose among the referrals listed in the incorrect answers. These facts indicate that the correct answer is that the social worker should begin by helping the woman clarify her priorities.

A social worker is working in individual therapy with a 30-year-old client who is having difficulty making decisions. The client is trying to decide whether to move back into his parents' house so that he can save money to return to college. The social worker and client discuss this decision, including using a decision matrix to consider the pros and cons of each option. The client arrives at a decision that the social worker disagrees with. What should the social worker do? Select one: A. Help the client express the basis for his decision and provide him with more information to facilitate the best decision. B. Review the decision matrix with the client. C. Support the clients willingness to make a decision, but make it clear that she has reservations about his choice and identify her reservations. D. Help the client identify what steps he needs to take to carry out his decision.

Help the client identify what steps he needs to take to carry out his decision.....Your job as a social worker is to facilitate problem solving and decision making by your clients - you don't have a right or responsibility to make decisions for them. The question indicates that you've already helped the client consider his alternatives and make a decision, including through using a decision matrix to evaluate the costs and benefits of each option. Therefore, at this time, you need to accept the client's decision, whether you agree with it or not. Although you don't know that this client needs help with carrying out his decision, "D" is the only answer that indicates you would respect his right to make his own decision.

If left untreated, diabetes mellitus can result in which of the following symptoms? Select one: A. Emotional lability, obesity, memory loss, depression. B. Accelerated heart rate, nervousness, agitation, fatigue, insomnia. C. Increased appetite with weight loss, apathy, confusion, mental dullness. D. Lethargy, slowed heart rate, depression, impaired concentration and memory.

Increased appetite with weight loss, apathy, confusion, mental dullness...The pancreas releases insulin, which is involved in the uptake and use of glucose and amino acids, and hypoinsulinism produces diabetes mellitus (excessive blood glucose). Untreated diabetes mellitus may result in increased appetite with weight loss, apathy, confusion, mental dullness, polyuria, polydipsia, and increased susceptibility to infection.

Which of the following is a major assumption of crisis theory? Select one: A. Overwhelming emotions are key motivators for change. B. Individuals can learn to cope with stress. C. Internal conflict interferes with problem-solving. D. Insight must precede change.

Individuals can learn to cope with stress...Crisis theory proposes that individuals in crisis will pass through a predictable response sequence, and that this response can be interrupted or changed through education and assistance with developing more adaptive coping behaviors. An important goal of crisis intervention is to help clients learn more effective coping behaviors so that they will be able to respond more adaptively to future crisis situations.

A patient in hospice care tells the social worker that he has decided to end his life so that he can prevent his loved ones from suffering anymore. He describes a fairly detailed suicide plan. What should the social worker do? Select one: A. Note this in the patients record and monitor him closely. B. Inform the hospice medical staff. C. Respect the clients decision because he is terminally ill. D. Offer the client incentives to keep living.

Inform the hospice medical staff.....Some terminally ill people choose to commit suicide as a way of avoiding physical pain and deterioration, dying with dignity, and/or sparing their loved ones from experiencing a lengthy dying process. Even if you believe that people should be able to choose "rational suicide," you must handle this situation as you would handle any other case in which a client expresses an intent to kill himself. As a social worker, you can be found negligent if you know that a client is suicidal but don't take reasonable steps to protect the client's safety. Depending on the level of risk, these steps can include establishing a no-suicide contract with the client, contacting family members, or having the client hospitalized. In this situation, the comparable step would be to inform the hospice's medical staff, so that the patient will be monitored.

When using the DSM-5, an individual's functioning in conceptual, social, and practical domains is evaluated to determine the appropriate severity level for which of the following diagnoses? Select one: A. Autism spectrum disorder. B. Specific learning disorder. C. Intellectual disability. D. PTSD

Intellectual disability....DSM-5 distinguishes between four levels of severity for intellectual disability (mild, moderate, severe, and profound) with severity being based on the individual's functioning in conceptual, social, and practical domains.

During the first interview, a client reports feeling extremely guilty about taking supplies from his office to use at home. After she has acknowledged the client's feelings about this, what should the social worker do FIRST? Select one: A. Identify whether the clients poor judgment is pervasive or related to only this area of functioning by assessing impulse control in other areas. B. Recognize that pervasive feelings of guilt may indicate a depressed mood and ask the client about other symptoms he has been experiencing. C. Invite the client to continue expressing himself and respond to him without judgment. D. Let the client know that people usually feel guilty about stealing in order to normalize his guilt and reduce his distress

Invite the client to continue expressing himself and respond to him without judgment....In the first meeting with a client, you should initially focus on whatever the client considers important to talk about and avoid jumping to conclusions about his problems or concerns. Unless you need specific data, you should ask mostly open-ended questions and focus on giving the client an opportunity to explore and clarify his thoughts and feelings about his behavior in a safe way. You should also focus on conveying acceptance, as this can facilitate the development of trust

A proponent of systems theory might say which of the following about the effects on a family of contact with the environment? Select one: A. The family affects the environment more than the environment affects the family. B. It has a positive effect. C. It has a negative effect. D. It will have no effect if the family has healthy boundaries.

It has a positive effect.....According to systems theory (or general systems theory), a system with a continuous information flow to and from the outside is an open system, while a system whose boundaries are not easily crossed is a closed system. Thus, an open family system has permeable boundaries that permit a high degree of interaction with and accessibility to its outside environment, while closed family system has impermeable boundaries that permit little interaction with its outside environment. A closed family system, by failing to interact sufficiently with the outside environment, lacks corrective feedback mechanisms, becomes isolated, and resists change. In contrast, an open family system, by welcoming and initiating interactions with the outside environment, is more adaptable and accessible to change; as a result of exchanges beyond its boundaries, an open family system is more able to deal with stress and change and to make necessary and enabling adaptations. Note, however, that no family system is fully open or closed, as a totally open system would have no boundaries and, therefore, would cease to exist as a separate entity; and a totally closed system would have no exchanges at all with its outside environment and would die.

A psychologist sends a social worker a check for $100 after the social worker referred two clients to her private practice in a one-week period. In this situation, the social worker should be aware of which of the following? Select one: A. It would be better if the psychologist sent a gift worth $100. B. It is unethical to accept payment for referrals. C. It is okay to receive remuneration for referrals as long as the social worker doesn't accept more than 10 percent of the other therapists fee. D. Kick-backs are a common practice.

It is unethical to accept payment for referrals.....This type of payment is unethical. Section 2.06(c) of NASW's Code of Ethics states that social workers must not give or receive payment for a referral when no professional service is provided by the referring social worker. And, whether or not "kickbacks" are common practice ("D"), they are unethical (and, in most states, they are also illegal).

A social worker is meeting with a mother who gave birth several months ago. The mother drank alcohol regularly while she was pregnant and her baby has been diagnosed with fetal alcohol syndrome. This diagnosis suggests that the baby is MOST likely to exhibit which of the following either now or as he grows older? Select one: A. Intellectual disability, cerebral palsy, growth deficiencies. B. Lower-than-average intelligence, abnormal facial features, growth deficiencies. C. Microencephaly, lower-than-average intelligence, chronic depression. D. Abnormal facial features, delayed motor development, cerebral palsy.

Lower-than-average intelligence, abnormal facial features, growth deficiencies.....Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a child whose mother drank alcohol during pregnancy, and fetal alcohol syndrome (FAS) is the most severe FASD. The symptoms of FAS vary, depending on the amount of alcohol consumed, but may include abnormal facial features, retarded physical growth, heart defects, intellectual disability, hyperactivity, irritability, and central nervous system (CNS) problems. In addition, a person with FAS may have problems with learning, memory, attention span, communication, vision, or hearing. The risk for FAS is highest, and the symptoms are most severe, when the mother drinks heavily every day or, in the early stages of pregnancy, engages in binge drinking. Most symptoms of FAS are irreversible and persist into adulthood.

To ensure that a client's consent to treatment is truly "informed," a social worker must do which of the following? Select one: A. Make sure that the client reads the entire consent form before signing it. B. Make sure that the client is aware of the potential risks related to the services before he signs the consent form. C. Make sure that the client understands the information contained in the consent form before he signs it. D. Ask the client if he has any questions before he signs the consent form.

Make sure that the client understands the information contained in the consent form before he signs it...This is a difficult question with a "best" answer because all of the answers describe conditions that would contribute to "truly informed" consent on the part of a client. Legally, three elements are necessary for informed consent: capacity, comprehension, and voluntariness. Response "C" directly describes at least one of these elements - comprehension - and, therefore, is the best answer.

In the DSM-5, the intentional production of symptoms for the purpose of obtaining an external reward is characteristic of which of the following? Select one: A. Factitious disorder imposed on self. B. Malingering. C. Somatic symptom disorder. D. Illness anxiety disorder.

Malingering.....Malingering is included in the DSM-5 with other conditions that may be a focus of clinical attention and is characterized by an intentional production of physical or psychological symptoms for the purpose of obtaining an external reward such as avoiding work, receiving financial compensation, or obtaining drugs.

A social worker's new client is a 33-year-old man who uses cocaine every day, several times a day, and is in the midst of an episode of major depression. The BEST course of treatment for this client would include which of the following? Select one: A. Inpatient program, 12-step group. B. Medical evaluation, inpatient program, 12-step group, ongoing therapy. C. Medical evaluation, 12-step group, ongoing therapy. D. 12-step group, ongoing therapy.

Medical evaluation, inpatient program, 12-step group, ongoing therapy....."B" describes the best course of treatment. First, both problems require medical attention. Second, the cocaine use disorder, because it involves heavy and frequent use, should probably be treated initially via an inpatient program, and the client would need to attend 12-step meetings as an ongoing adjunct. In addition, if the client's major depression is so severe that it needs to be stabilized before beginning addition treatment, this can also take place in the inpatient setting. And, third, because the client may have a co-occurring disorder (major depression) that persists even after he has stopped using drugs, he may need ongoing individual therapy to address residual mood symptoms and sustain his addiction recovery. This explanation shows why the other approaches would be insufficient.

A hospital social worker is meeting with an 82-year-old widow who has been diagnosed with cancer. Her prognosis is poor. The client says that she wants to stop receiving medical treatment so that she can die peacefully and with dignity, but her children disagree with her decision and want her to continue receiving medical treatment. What should the social worker do? Select one: A. Meet with the woman and her children to help them understand each others preferences and feelings. B. Verify that the woman has fully considered the consequences of her decision. C. Contact the womans physician for an opinion. D. Convey respect for the womans right to make this choice and advise her children to do the same.

Meet with the woman and her children to help them understand each others preferences and feelings.....In this situation, the social worker's role is to help the family members understand one another's feelings and preferences and then, ideally, to help the patient's relatives accept or make decisions that reflect not their own preferences but, rather, those of the person most affected by the decision - the patient.

The concept of the "privileged storyteller" is associated with which of the following? Select one: A. Solution-focused therapy. B. Narrative therapy. C. Neurolinguistic programming. D. Brief psychotherapy.

Narrative therapy....Narrative therapists believe that each client's description of a problem and its effects on his or her life and relationships is "privileged" - i.e., even though family members may have a common definition for a problem, the details about the effects of the problem and each client's experience of the problem are unique.

A social worker receives a phone call from a psychologist who has just started providing therapy to a woman who is a former client of the social worker's. The psychologist asks the social worker to give her a brief synopsis of his work with this client. The psychologist and social worker are good friends. What should the social worker do? Select one: A. Give the psychologist only objective information about the client's therapy. B. Acknowledge that he worked with the client but withhold confidential information until he has a release of information form signed by the client. C. Give the psychologist whatever information she asks for because doing so is the best interests of the client. D. Not even admit that he worked with the client until he has a release of information form signed by the client.

Not even admit that he worked with the client until he has a release of information form signed by the client...The fact that the psychologist is a friend doesn't relieve the social worker of the obligation to have permission ("valid consent") from the client before sharing any confidential information or even acknowledging that he ever saw the client for therapy. Confidentiality refers to the obligation of a social worker not to disclose any information about a client obtained during the course of a professional relationship; and the only exceptions to this are when the client (or a legally-authorized person) has consented to such disclosure; in consultations, lectures, writings, and similar circumstances if the client's identity is adequately disguised; and when the Code of Ethics and/or the law allows or requires a social worker to breach confidentiality (e.g., to report child abuse).

A social worker who has a private practice discovers that a former client has applied for the open secretarial position in her office. From an ethical standpoint, what should the social worker do? Select one: A. Hire the client only if he is the best candidate for the job. B. Meet with the client to determine whether he feels comfortable working for her. C. Hire the client whether or not he is the best candidate for the job. D. Not hire the client.

Not hire the client.....

What is the time-frame for achieving steady state on benzodiazepine A. One day to 21 days. B. Approximately two weeks. C. Three to six weeks. D. At least one month.

One day to 21 days....When a benzodiazepine is taken daily, the amount of time it takes to achieve "steady state" ranges from one day to about three weeks.

In asthma, the muscles of the walls of the bronchi contract, making it difficult to breathe. This response is triggered by which branch of the nervous system? Select one: A. Autonomic nervous system. B. Sympathetic nervous system. C. Parasympathetic nervous system. D. Central nervous system.

Parasympathetic nervous system.....The parasympathetic nervous system is associated with the stimulation of smooth muscles; in asthma, it causes bronchioles to narrow.

A legal guardian is appointed by the court for a 9-year-old boy after his biological parents are found guilty of severe child abuse. The legal guardian brings the boy to a social worker for treatment. What should the social worker do? Select one: A. Obtain permission from both of the boys biological parents before providing treatment. B. Obtain permission from one of the boys biological relatives before providing treatment. C. Obtain permission from the court before providing treatment. D. Provide the treatment to the boy as requested by the guardian.

Provide the treatment to the boy as requested by the guardian...A legal guardian of a minor has the same rights as a parent with legal custody to give consent to treatment of the minor. Approval from the court or the child's biological parents is not necessary

In what therapeutic approach does the therapist deliberately stay neutral? Select one: A. Psychoanalytic. B. Client-centered. C. Cognitive. D. Reality.

Psychoanalytic....Analytic neutrality is a key component of psychoanalysis. The therapist remains objective at all times and doesn't take sides in the client's conflicts; and the therapist's neutrality is believed to allow the client to project onto the therapist feelings he or she originally had for a significant person in the past.

After a single mother is charged with child neglect, her two young children are placed in temporary foster care. The woman eventually meets the goals of her treatment plan, and the court determines that her children can be returned to her care. A few days before the children are scheduled to come home, the woman reveals to her caseworker that she is two months pregnant. What is the caseworker's BEST course of action? Select one: A. Return the children to their mothers care but monitor the case closely. B. Return the children as planned because the woman has met the goals of her treatment plan. C. Make sure that the children remain in foster care. D. Make arrangements to recontact the family after the baby is born.

Return the children to their mothers care but monitor the case closely.....Because the woman has met her treatment goals, her children should be returned to her care as "B" suggests. Just doing this is not sufficient, however, because a pregnancy and a third child will produce additional stress for the woman; therefore, the caseworker should also provide structure for the woman by making the return conditional and monitoring the situation.

Which defense mechanism rarely appears before adolescence? Select one: A. Rationalization. B. Introjection. C. Projection. D. Denial.

Rationalization...Because it requires relatively mature cognitive abilities, rationalization rarely appears before adolescence. Rationalization occurs when an individual interprets his/her behaviors in a way that makes them seem more rational, logical, and/or socially acceptable.

A client expresses a desire to terminate therapy because she is "feeling much better" and is able to handle her problems successfully. Although this seems appropriate since the client has met her treatment goals, the social worker is reluctant to end therapy and feels like he wants to do more for the client. What should the social worker do? Select one: A. Recognize that his reluctance is normal and assist the client with termination. B. Recognize that his reluctance may indicate that the client is not ready to terminate. C. Refer the client to another therapist because he is no longer objective. D. Seek consultation to address the loss of objectivity before deciding whether the client is ready to terminate.

Recognize that his reluctance is normal and assist the client with termination.......Answer "A" is the best choice, partly because you have limited information about this case. What you probably do know is that a social worker's reaction to planned termination may sometimes include a desire to "do more" for a client even though the client has met her treatment goals. This is one reason why, as a social worker, you need to monitor not just the client's reactions to termination, but also your own. If you feel a sense of loss over ending the relationship with a client, you must be careful to continue emphasizing the client's needs over your own.

A hospital social worker is meeting with a patient who suffers from chronic pain. The patient discloses that her boyfriend has been using her prescribed pain medication. What should the social worker do FIRST? Select one: A. Confront the boyfriend about this. B. Recommend addiction treatment for the boyfriend. C. Help the patient find ways to prevent her boyfriend from accessing her medication. D. Record this information in the patients record and notify medical staff.

Record this information in the patients record and notify medical staff.....The social worker's first concern should be the patient's welfare, not the boyfriend's. NASW's Standards for Social Work in Health Care Settings state that a social worker must work to foster and maintain a patient's physical and psychosocial well-being and promote conditions that ensure the patient gets the greatest possible benefit from the services she receives. This would include informing hospital medical staff of any situation that might endanger a patient's health and recovery. In this case, if the boyfriend has been using the patient's medication, then there is a good chance that the patient has not been taking her medication as prescribed.

A 10-year-old boy reports that, lately, he's been smelling unusual odors, like burnt flesh and rotten food, but that none of those things are around him when this happens. He is also having difficulty keeping up in his classes. In assessing this boy, what should the social worker do FIRST? Select one: A. Refer him to a neurologist. B. Refer him to a psychiatrist. C. Arrange to speak to his teacher. D. Refer him to an educational psychologist

Refer him to a neurologist....This boy seems to be experiencing olfactory hallucinations, which could be caused by a neurological disorder (e.g., epilepsy, head injury).

An adult client who is distraught over the death of her mother has scheduled an appointment with a social worker. The social worker recently lost his own mother and he starts crying with the client during the first interview. From an ethical standpoint, what should the social worker do? Select one: A. Seek consultation. B. Continue working with client as though nothing has happened. C. Work with the client on grief issues but monitor himself closely. D. Refer the client to a different therapist

Refer the client to a different therapist...: Especially because this is a new client and there is no therapeutic relationship yet, it would be best to refer the client to another therapist for grief work. Section 4.05 of NASW's Code of Ethics states that social workers should not allow their own personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties to interfere with their professional judgment and performance or to jeopardize the best interests of people for whom they have a professional responsibility. It also says that social workers whose personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties interfere with their professional judgment and performance should immediately seek consultation and take appropriate remedial action by seeking professional help, making adjustments in workload, terminating practice, or taking any other steps necessary to protect clients and others. Therefore, as "A" suggests, you should seek consultation, as well. First, however, you need to meet this client's needs in an appropriate manner by referring her to a therapist who is able to help her at this time.

A social worker has been working in individual therapy with a client for several months. The client sought therapy after suffering from depression for many years. The social worker begins to notice that the client seems even more depressed than she was at the beginning of therapy. What is the social worker BEST course of action? Select one: A. Refer the client to a psychiatrist for a medication evaluation. B. Refer the client to a medical doctor for physical evaluations. C. Refer the client to a psychologist for testing. D. Point out and discuss the clients resistance.

Refer the client to a psychiatrist for a medication evaluation...The information about this client suggests that she might need alternative or additional forms of treatment such as antidepressant medication from a psychiatrist. It might seem that a therapist would have recognized earlier than several months into therapy that this client might benefit from taking medication for her depression, but this is still the best answer because the other two plausible answers ("B" and "C") describe referrals that are more useful when initially assessing a client with psychiatric symptoms: "B" to rule out physiological bases for the symptoms, and "C" to more fully understand the extent or nature of her problem. Answer "D" suggests that your first impulse would be to blame the client for feeling more depressed. It's not at all clear from the question that this client is resistant.

A gay man who has just lost a close friend to AIDS seeks therapy from a social worker. He asks for help dealing with his sadness, anger, and frustration over his loss. The social worker is well known as a specialist in grief therapy, but she's aware that she has strong personal biases against gay people. What is the social worker's BEST course of action? Select one: A. Provide therapy to this client because her personal feelings should not affect her professional decisions in any way. B. Refer the client to a therapist who can help him deal with his grief. C. Provide therapy to this client, but seek consultation if she loses her objectivity. D. Let the client decide if he is willing to work with her despite her biases.

Refer the client to a therapist who can help him deal with his grief....While social workers should never discriminate against clients or potential clients, they must also be able to recognize when they lack objectivity and, therefore, may not be qualified to provide effective therapy to a particular client. Since the social worker's biases in this case are likely to prevent her from serving this man's needs and interests, a referral to another qualified therapist is appropriate..

A social worker's new client is a woman who is very concerned because her 18-month-old daughter has not started walking or talking yet. After acknowledging the mother's feelings of concern, what should the social worker do FIRST? Select one: A. Refer the mother to a pediatrician to test the child's vision and hearing. B. Reassure the mother that the child's development is proceeding at a normal rate. C. Refer the child for psychological testing. D. Get thorough developmental and family histories and observe parent-child interactions.

Refer the mother to a pediatrician to test the child's vision and hearing...By age 18 months, a child should be walking and saying at least a few words. A plausible cause of delays in these areas of development is sensory deficits, especially visual and auditory deficits.

A social worker is beginning family therapy with a family of four, including the father, mother, and two children, ages 18 and 19. The mother was recently diagnosed with a serious mental disorder and is taking medication which is helping to control her symptoms. During the first session, the father and children focus on talking about the mother's insurance coverage. What is the social worker's BEST course of action? Select one: A. Point out and address the familys denial. B. Redirect their focus. C. Reframe the familys behavior as concern. D. Allow them to continue talking about insurance coverage until they are ready to talk about the mothers illness.

Reframe the familys behavior as concern....The question says that you're meeting for the first time with the family. The family is confronting a serious psychosocial stressor and would benefit from receiving support and guidance from you. "Reframing" is often effective for reassuring clients, especially at the beginning of treatment. Reassurance, in turn, is a form of sustainment that can be very effective for reducing anxiety and offering clients a feeling of hope about their situation. Lessened anxiety and greater hope, in turn, can help free up clients' emotional and mental energies so that they can begin to engage in problem-solving activities.

A social worker is working in individual therapy with a 19-year-old man whose father is paying for his treatment. During a session, the client tells the social worker that he's angry at his father and plans to confront him soon. A few days later, the father calls the social worker demanding to know why she encouraged his son to confront him. What should the social worker do? Select one: A. Refuse to talk with the father about this matter. B. Explain to the father how answering his question would reduce the therapeutic value of her work with his son. C. Apologize to the father and tell him that she will discuss this matter with his son. D. Encourage the father to come in for a family session

Refuse to talk with the father about this matter.....In the absence of any information about what specific arrangements you have made with the client and his father regarding sharing confidential information with Dad, "A" is the best answer. Parents or others paying for an adult client's treatment sometimes assume that they have a right to be given confidential information about the client; in fact, their involvement does not afford them this right. You should make information available to these entities only at the client's request or when the client has consented to have it released at the request of another, and only when disclosure is in the client's best interests. At the beginning of the therapeutic relationship, you should clarify with all involved persons (in this case, the client and his father) the conditions surrounding the release of information.

A social worker begins working in individual therapy with an adult male who is on probation. The client was ordered into therapy by the court and has been cooperating. His probation officer contacts the social worker, requesting information about how the client is progressing in therapy. What should the social worker do? Select one: A. Automatically release information to the probation officer because the treatment is court ordered. B. Automatically release information to the probation officer because people on probation have limited confidentiality rights. C. Release information to the probation officer if she has permission from her client to do so. D. Decline to release information to the probation officer unless presented with a court order.

Release information to the probation officer if she has permission from her client to do so.......Even though the court has ordered the treatment, the client's right of confidentiality is not waived. You would need to have a release of information signed by the client in order to discuss his case with his probation officer (or anyone else). The same is true if your court-ordered client is on parole; you'd need a release of information signed by the client in order to discuss anything about the client's case with his parole officer. Typically when a client is ordered by a court to receive therapy, the court requires that he attend a certain number of sessions as a condition of his probation, parole, or sentence, determines what information the therapist may not keep confidential, and requires that the client sign a release of information that permits his therapist to inform the court about whether or not he complies with the court's mandate. The client may choose not to comply with the court's request for the release of information, but in doing so, may be held in contempt of court. In addition, even when your services are court ordered or otherwise mandated, you should still inform the client of the nature of the anticipated services, including whether the services are court ordered or mandated and all limitations to his right of confidentiality, before proceeding.

A client reports that her elderly father has seemed rather confused lately. A physician recently evaluated the man, and all neuropsychiatric tests for a neurocognitive disorder have been negative. The physician found no major medical problems. The client says that she has decided to move her father (whose wife died 10 years ago) to an independent living facility. What is the social worker's BEST course of action? A. Review the doctors findings with the client and discourage her from taking rash action concerning her father. B. Find out why, given the medical findings, the client wants to place her father. C. Seek permission from the client to conduct an in-home assessment of her father. D. Begin helping the client locate an acceptable independent living facility

Seek permission from the client to conduct an in-home assessment of her father. .......You (the test-taker) don't know where the father is living (does he live alone?), and the question suggests that, so far, you have met with only the daughter; in other words, you haven't had an opportunity to observe or evaluate the client's father. "C" is the best answer offered because you need more information about the father's functioning before making any placement recommendations to the daughter or even forming an opinion about whether relocation is indicated.

A client begins crying during his first therapy session. What should the social worker do? Select one: A. Reassure the client that he'll feel better now that he's in therapy. B. Sit quietly with the client until he is ready to speak. C. Ask an open-ended question that invites the client to tell her why he is crying. D. Ask the client if she can come sit beside him.

Sit quietly with the client until he is ready to speak.....This question has a "best" answer. When a client cries during a therapy session, you wouldn't want to interrupt his expression, at least not right away. As suggested by "B" more than any of the other responses, you should just allow the client to cry for a little while.

The client is a 30-year-old man who was diagnosed with schizophrenia five years ago. The client has experienced several acute psychotic episodes, including full-blown delusions. He is currently in a stable phase of his illness. When developing an outpatient treatment plan for this client, the social worker is MOST likely to emphasize which of the following? Select one: A. Management of medication side-effects. B. Interpreting the delusions to minimize their effects on his functioning. C. Social problem-solving. D. Referral for vocational training.

Social problem-solving.....Many people with schizophrenia have difficulty solving problems arising from day-to-day living and stressful life events. These deficits can affect their ability to live independently and contribute to disability and poor quality of life. Problem-solving therapy is designed to improve the ability to approach problems in a systematic way, and this therapy can be used in addition to antipsychotic medication and other supportive interventions. The research suggests that, for optimal effectiveness, the remediation of social problem-solving skills with this population should focus on role-playing (nonverbal) interpersonal behaviors, rather than on verbally analyzing an interpersonal problem and clarifying alternative solutions.

A young boy expresses a metaphor during a play therapy session. How would a play therapist respond to this? Select one: A. Encourage the child to express himself more directly. B. Restate the metaphor and assess the child's reaction to this. C. Ask the child to describe the meaning of his metaphor. D. Stay with the metaphor.

Stay with the metaphor.....When a child in play therapy expresses a metaphor or other symbol in his play, the therapist will usually just stay with it, without forcing the child to explain the symbol or express himself in a more straightforward way. In play therapy, play and play materials are used to encourage a child's expressive behavior, and a play therapist generally avoids directing the child's verbal expressions or play activities (unless the child engages in dangerous play behavior).

A client arrives for her first interview while in the midst of a manic episode. The client says that she has decided to get a divorce and asks the social worker to assist her. What should the social worker do FIRST? Select one: A. Confront the client with the fact that she is not stable now and may change her mind about the divorce when the manic episode is over and arrange for her to see her psychiatrist. B. Refer the client to an attorney because a social worker is not qualified to assist a client with divorce proceedings. C. Summarize the clients wishes and arrange for her to undergo a psychiatric medication evaluation. D. Narrow the focus of the interview by asking questions that assist the client to describe her concerns about her marriage.

Summarize the clients wishes and arrange for her to undergo a psychiatric medication evaluation....Because the client should probably be taking medication such as lithium (or may have stopped taking medication that was prescribed in the past), you should arrange for her to undergo a psychiatric medication evaluation..

Ten members of a social agency's staff have been meeting as a group to make decisions that will affect many of the agency's policies. In the first few meetings, the staff members share and discuss many different ideas and perspectives. However, as their meetings continue, the group begins falling prey to the phenomenon of groupthink. This means that which of the following may be occurring in this group? Select one: A. Suppression of disagreement. B. Uncertainty about the group's mission. C. Heavy reliance on critical thinking. D. Over-reliance on input from staff members outside the group.

Suppression of disagreement.....Janis (1972) used the term "groupthink" to describe the suspension of critical thinking that can develop in a highly cohesive group. According to Janis, groups engaging in groupthink are characterized by an illusion of invulnerability and unanimity, collective rationalization, unquestioned morality, excessive negative stereotyping, strong pressure to conform, self-appointed "mindguards," self-censorship of dissenting views, and insulation from outside input. The group leader can reduce (and prevent) groupthink by encouraging skepticism and dissent among group members, appointing someone to play devil's advocate, bringing in outside opinions, reducing time pressures to reach a solution, and not stating his/her own opinion prior to a group discussion.

A common way of assessing human service needs in a community is through needs assessment. Which of the following assessment techniques is considered MOST useful for needs assessment? Select one: A. Survey research. B. Observational studies. C. Focus groups. D. Collecting service statistics.

Survey research....Needs assessment is used to evaluate the adequacy of existing services and resources for addressing a target problem, and, by doing so, to identify what improved or additional services or resources are needed. The most useful technique for needs assessment is generally considered to be survey research in which information is gathered from a representative sample of community residents about relevant issues. Data is collected through personal interviews, telephone surveys, or questionnaires; and responses are generally representative of the whole community.

A 25-year-old client who recently immigrated to the United States from Nicaragua (and speaks English well) has been convinced by his mother to seek counseling for frequent alcohol use. During the first interview, the client acknowledges that he drinks almost daily but doesn't identify any other problems. What should the social worker do FIRST? Select one: A. Take a substance use history. B. Assess for acculturation problems. C. Get permission to speak to family members about the clients alcohol use patterns. D. Refer the client to a support group

Take a substance use history...Usually the first step when assessing a suspected substance use disorder is taking an alcohol and drug history and this is true regardless of the client's cultural background. Having this information will help you determine suitable treatment recommendations, including the appropriate initial level of care. And taking the substance use history in this case could also help you determine whether or not the client's alcohol use is related in any way to acculturation problems

Two social workers are having lunch at a busy restaurant when one of the social worker's clients approaches him to say hello. What should the social worker do? Select one: A. Pretend he doesn't know the client. B. Introduce the client as his friend to the other social worker. C. Pull the client aside and explain confidentiality. D. Tell the client he'll call her later.

Tell the client he'll call her later...This is the best answer from among the four. By calling the client later, the social worker can explain confidentiality and how it impacted his response to her in the restaurant, as well as avoid breaching confidentiality by having this discussion while at the restaurant. Answers "A" and "B" would confuse the client and potentially damage the therapeutic relationship. "C" is incorrect because a busy restaurant is not the setting to explain confidentiality

The clients are a family of three, including the mother, father, and 1-year-old son. The family has been referred by their pediatrician because the child is underweight and malnourished. The pediatrician has ruled out a medical condition that could account for this. Assuming that this boy has nonorganic failure to thrive, which of the following is LEAST likely to be true about him or his parents? Select one: A. The boys temperament makes him difficult to feed. B. The parents dont understand the boys nutritional needs. C. The boys Apgar scores were low right after he was born. D. The boy had a low birth-weight

The boys Apgar scores were low right after he was born......This question required familiarity with factors that have been linked with nonorganic failure to thrive. Low Apgar scores have been associated with sudden infant death syndrome (SIDS) but not with failure to thrive. Child factors associated with nonorganic failure to thrive include a temperament that makes the baby difficult to feed; low-birth-weight or prematurity; and illness that makes the baby feel too sick to eat. Family factors include parents who don't understand their baby's nutritional needs; high levels of stress; chaotic lifestyle; depression, substance abuse, or domestic violence; weight-conscious parents who minimize their baby's fat intake; overcontrolling parents who get into "food battles" with their baby; and poverty.

A social worker is meeting with a client who is deaf. The client has brought a professional interpreter to the interview. On whom should the social worker focus his attention during the interview? Select one: A. The client. B. The interpreter. C. The interpreter and the client equally. D. Whomever is speaking

The client...The interpreter will play an important role in facilitating communication between you and the client, but you must focus your attention on the client - you need to develop a working relationship with the client (not the interpreter), and the client is the one who sought (or was referred to) your services.

A social worker providing case management services is attempting to determine the needs of a client who has been unemployed for more than a year. The client is married and has two children. To gather information about the client's financial needs and need for other social provisions, the social worker should rely the MOST on which of the following sources? A. The clients family members. B. Records and other documents concerning the client. C. The clients past employers. D. The clients report.

The clients report...A case manager should rely primarily on the client's own report to gather information about his/her needs. The other sources listed are secondary (collateral) sources of information who could be contacted or consulted, with permission from the client, to verify or supplement information the client has provided.

A social worker begins working with an American Indian couple. The couple has two young children, and the family has basic needs related to poverty. In addition, the social worker determines that the father drinks alcohol daily. She attempts to engage the couple in a discussion about the husband's alcohol use but the couple persistently avoids talking about this issue. The social worker helps the couple meet some of their basic needs for food and adequate shelter. Which of the following is MOST likely to be true about this situation? Select one: A. The couple is in denial about the alcohol problem. B. The couples basic needs are urgent and they will be willing to address the alcohol use once their basic needs are met. C. The couple does not consider alcohol use to be a problem and just wants help meeting their basic needs. D. The couple is embarrassed by the husbands alcohol use.

The couple does not consider alcohol use to be a problem and just wants help meeting their basic needs.....This is a difficult question because it requires you to be very familiar with the literature on counseling American Indian clients. So let's take a look at why "C" is the best answer: First, substance use disorders are a significant problem faced by American Indians, and a number of explanations have been proposed to explain this, especially the prevalence alcohol use disorders (Sue & Sue, 1999): One explanation is that refusing an offered drink is viewed an act of individual autonomy that disrupts group harmony; another is that alcohol use allows American Indians to release feelings that are normally kept under control (e.g., frustration and boredom). Others (e.g., Manson, Tatum, & Dinges, 1982) have pointed out that drinking is an accepted practice among many American Indians and is encouraged among family members. This information suggests, as answer "C" says, that these clients may not consider the husband's alcohol use to be a problem. Second, Sue and Sue (1999) suggest that when working with American Indian clients, a therapist may need to address basic needs first, including problems stemming from poverty such as inadequate food, shelter, child care, or employment. One reason for this is that many traditional American Indians are more oriented to the present than the future. If this is true about these clients, then they are likely to prefer interventions that work in the here and now

The client is a middle-aged man who sought therapy two days after learning that he has cancer and his prognosis is poor. His doctors have told him that his life expectancy is about six months. The client is in the first stage of Kubler-Ross's (1969) model of death and dying, which describes the stages that people go through when facing their own death. Given this information, the social worker would MOST expect the client to say which of the following when discussing his diagnosis and prognosis with her? Select one: A. I dont care; I hate my life anyway. B. Why is this happening to me? I dont deserve this. C. This must be a punishment for something I did. D. The doctor must be wrong.

The doctor must be wrong.....In sequence, the stages of Kubler-Ross's model are denial, anger, bargaining, depression, and acceptance. The statement in "D" is the best example of denial.

Family therapy is MOST likely to be contraindicated (inappropriate) in which of the following cases? Select one: A. The mother and father are thinking about getting a divorce. B. The father has a history of physically abusing the mother. C. The 15-year-old son has a substance use disorder. D. The 12-year-old daughter is the family scapegoat.

The father has a history of physically abusing the mother.....Family (or couples) therapy is usually not an appropriate modality in cases involving intimate partner violence, especially during the initial stages of treatment. In contrast, family therapy would be an appropriate treatment for the issues described in answers "A," "C," and "D." Although family therapy by itself is inadequate for clients with serious substance use disorders, it is frequently is an important adjunct to other treatments and is particularly indicated when the client lives with his family.

A hospital social worker is meeting with a Chinese-American man, age 50, and the man's mother, age 80; the mother was hospitalized one week ago. The physician has recommended that the mother be placed in a nursing home. She has become disoriented and frail and her memory is very impaired. The social worker discusses the doctor's recommendation with the man while his mother is also in the room. The man listens politely for a few moments and then says that his mother is fine and can continue living at his home. Which of the following would be the BEST way to interpret this situation? Select one: A. The man is unwilling to accept the severity of his mothers condition. B. The man is not comfortable discussing this issue with the social worker. C. The man doesn't understand the nature of nursing home care. D. The physicians recommendation was premature.

The man is not comfortable discussing this issue with the social worker.....The question doesn't tell us much about this man, other than his cultural background. This suggests that you, as a test-taker, need to interpret this situation from within a cultural framework. It also means that you have to assume that this man adheres to values that are characteristic of traditional Asian cultures. From this perspective, answer "B" is correct for two reasons: First, Asian-American individuals may be uncomfortable discussing family issues with an "outsider," such as a therapist, particularly issues concerning their parents or other elders. Second, Asian-American individuals tend to value interdependence and responsibility to the family (as opposed to independence and autonomy) and respect for their elders (as opposed to egalitarian values)

A 67-year-old accountant exhibits impairments in memory and other cognitive functions along with a depressed mood. The presence of which of the following suggests that his symptoms are due to pseudodementia (depression) rather than mild neurocognitive disorder? Select one: A. The man tends to exaggerate his cognitive problems. B. The onset of his symptoms was slow and gradual. C. The man's symptoms worsen over the course of the day. D. The man seems to be unaware of his cognitive problems.

The man tends to exaggerate his cognitive problems.....We are looking for the answer that would support a diagnosis of depression for this man. Depression is often difficult to differentiate from mild neurocognitive disorder when the depression includes prominent cognitive symptoms. However, there are some distinguishing characteristics. For example, people with depression are likely to exaggerate their cognitive problems, while those with mild neurocognitive disorder are likely to minimize or deny them. An insidious onset of symptoms ("B") and a worsening of symptoms in the evening ("C") are more characteristic of neurocognitive disorder

An African American woman brings her 16-year-old son in for therapy. They moved to a new neighborhood a few months ago. The mother reports that the boy has been feeling depressed since they moved and is having difficulty making new friends. What should the social worker assess FIRST? Select one: A. The boys academic performance at his new school. B. The racial makeup of their new neighborhood. C. How the mother is coping because she may be projecting her feelings onto her son. D. Parent-child interactions to determine communication patterns and parenting style

The racial makeup of their new neighborhood.....This boy is developmentally at a stage when the peer group is important, yet he hasn't made friends in his new neighborhood; therefore, it would be useful to begin by assessing his environment. The question specifies the race of the clients, and, although it doesn't say anything about the clients' former neighborhood, the assessment in "B" would be a good starting point for understanding adjustment difficulties that may be contributing to the boy's depression.

A social worker is providing case management services to a single mother with three young children who has been unable to find a steady job. She's having trouble supporting her family. The client suffers from frequent migraine headaches but can't afford adequate medical treatment because she has no health insurance. The only doctor she's seen recently didn't take her seriously, she reports: He said her headaches would stop if she "learned to relax." The client knows where her ex-husband is, but he's not interested in the children and won't pay child support. What is the social worker's primary purpose in providing case management services to this client? Select one: A. To improve the clients functioning so that she can use services more effectively. B. To link and coordinate the services that the client needs. C. To provide the client with support so that she can meet her own needs. D. To improve the clients access to services she is entitled to but has been denied.

To link and coordinate the services that the client needs....."B" best describes the "primary purpose" of case management, no matter who the client is. Case management is "a service that links and coordinates assistance from institutions and agencies providing medical, psychosocial, and practical support to individuals in need of such assistance" (A.J. Roberts & J. Greene, "Social Workers' Desk Reference," 2002). One of its main purposes is to achieve continuity of services to the client through the process of connecting the client to appropriate services and coordinating the utilization of those services.

A social worker begins working in individual therapy with a woman who has been physically abused by her husband on multiple occasions. The woman acknowledges the abuse but doesn't want to leave her husband. The husband has been ordered into a batterer intervention program by the court, and the woman believes that things will change now that he's finally getting help. Research on batterer intervention programs and similar court-ordered treatments for men who batter their intimate partners has found which of the following to be true? Select one: A. They are effective for terminating physical violence. B. They are effective for reducing both physical violence and more subtle forms of abuse. C. They can be effective for reducing physical violence but do not usually reduce more subtle forms of abuse. D. They have no effects at all because offenders rarely complete the program.

They can be effective for reducing physical violence but do not usually reduce more subtle forms of abuse.......This question is difficult, in part, because it requires you to be familiar with the research on batterer intervention programs (BIPs) (a.k.a. spouse abuse abatement programs, or SAAPs) and, in part, because the results of this research have been inconsistent, mostly because of differences in evaluation methods. According to a report published by the U.S. Department of Justice (Jackson et al., 2003), some available data suggest that court-ordered treatment for batterers correlates with a reduction in physical violence, but neither terminates violence in many cases nor reduces the more subtle forms of abuse. (Whether it's the treatment itself or individual motivation brought on by legal intervention that causes the reduction of violence is unclear, however.) Other studies have found that men arrested for intimate partner violence who receive treatment resume violent behaviors as often as do men arrested and not referred to treatment, and that there is no significant difference between men who complete batterer's treatment and men who drop out of the progra

Social agency administrators are responsible for monitoring the implementation of an agency's policies and for making sure that all agency staff are notified of policy changes. Which of the following word sets BEST captures the key principles associated with effective communication of policy changes to staff? Select one: A. Timely, clear, repetition. B. Timely, verbal communication, memo. C. Immediate, clear, democratic. D. Immediate, descriptive, specific.

Timely, clear, repetition.....This answer mentions all three elements that contribute to effective communication about policy changes at an agency: Administrators should communicate information about policy changes to the agency's staff in a timely way, in a clear way, and, ideally, both in written form and during staff meetings where staff can ask questions and voice their concerns such as concerns about how the new policy will affect their work. Presenting information both in written form and verbally is important because repetition promotes effective communication among those working at an agency.

In structural family therapy, what is the purpose of "unbalancing"? Select one: A. To provoke resistance from family members. B. To reframe the problem. C. To disrupt the familys homeostasis. D. To engender insight.

To disrupt the familys homeostasis.....Structural family therapists view family dysfunction as resulting from an inflexible family structure that prohibits a family from adapting to situational and maturational stressors in a healthy way and believe that improvements in the family process will lead to improvements in individuals within the family. The primary goal of therapy, therefore, is to restructure the family. Restructuring techniques (e.g., reframing, blocking) are used to deliberately unbalance a family's homeostasis (upset the ways in which family members currently relate to one another) in order to bring about a change in the family's structure. By undermining the family's existing homeostasis, the therapist creates a crisis that spurs the system toward the development of a better functioning organization.

Which of the following is the BEST definition of discrimination? Select one: A. Forming an opinion or attitude based on insufficient information. B. Unequal treatment based on arbitrary characteristics such as race or gender. C. Assuming that all the members of a group share the same characteristics. D. Forming an opinion or attitude based on negative characteristics presumed to be shared by all the members of a particular group.

Unequal treatment based on arbitrary characteristics such as race or gender.....Prejudice refers to attitudes that don't necessarily include behavioral manifestations. Discrimination, by contrast, refers to behaviors such as unequal treatment based on arbitrary characteristics such as race, gender, etc

A client reports feeling sadness and loneliness after the death of his mother several months ago. While exploring these feelings with the social worker, the client suddenly withdraws from the conversation, saying he doesn't want to talk about his feelings anymore. Later in the session, the client blurts out that he also felt relieved when his mother died. What should the social worker do FIRST in responding to that statement? Select one: A. Explore why the client felt relieved. B. Interpret the statement as a way of helping the client understand how he really feels. C. Use the technique of mirroring to reduce the client's defensiveness. D. Use the technique of universalization to let the client know that this feeling is normal.

Use the technique of universalization to let the client know that this feeling is normal.......For this question, you need to be familiar with how people may express and experience grief. Grief may be expressed emotionally in many different ways, including sadness, anger, self-reproach, anxiety, loneliness, helplessness, numbness, and, sometimes, relief or a sense of freedom. This client's behavior in the session suggests that he's uncomfortable with his sense of relief about his mother's death. While you may end up also exploring this feeling with the client, the first thing you would do is let the client know that this feeling is normal (that other people feel it, too). When applying the technique of universalization (a form of reassurance), you make statements that explain to a client that his thoughts, feelings, or behavior are similar to those of other people in similar circumstances. The purpose is to counteract the client's perception that his feelings or behaviors are strange or abnormal.

For Salvador Minuchin, "psychosomatic families" (i.e., those in which asthma, diabetes, or anorexia threaten the life of one child) are MOST likely to be characterized by which of the following? Select one: A. Frequent intense open conflicts between family members. B. Weak boundaries between family members and limited opportunities for individual autonomy. C. Family roles that are inflexible and stereotyped. D. Marked emotional distance between the husband and wife who are both emotionally immature.

Weak boundaries between family members and limited opportunities for individual autonomy...Minuchin is associated with structural family therapy, which emphasizes the nature of the family structure including the boundaries between family members. According to Minuchin, enmeshment, which involves diffuse (weak) boundaries, is common in psychosomatic families. "A" is incorrect because, according to Minuchin, psychosomatic families are characterized by a consistent avoidance of conflict. Ackerman (who was one of the pioneers of family therapy) is more associated with the importance of roles in family dysfunction ("C"); and "D" describes "emotional divorce," which is a term used by Bowen

A 40-year-old man is referred for case management services. Six months ago, the client was fired from a construction job he had held for many years due to poor performance and frequent absences that started shortly after he was injured at work. He has been unable to find new work and is in danger of losing his apartment. The client appears distracted during the interview and answers many of the social worker's questions by saying "I'm not sure," or "I don't remember." Given all of this information, what should the social worker explore FIRST? A. Whether the clients rights were violated when he was fired. B. Whether the client has had access to medical care. C. Whether the client needs financial benefits immediately. D. How the client has gone about looking for work and what assistance he needs in this area.

Whether the client has had access to medical care...As this client's case manager, you will want to identify all of his unmet needs and what barriers he has encountered in getting and using needed resources and services. However, the question suggests the possibility that the client has an organically based problem, perhaps due to the injury he suffered at work. You should find out immediately what medical care the client received after the injury and arrange for him to undergo current medical (including neurological) evaluations

A social worker is meeting with a 30-year-old woman who reports having difficulty sustaining meaningful relationships. In the first interview, the client expresses a strong desire to change and says she hopes that therapy will enable her to connect better with others. During the next two sessions, the client talks at length about her former relationships and theorizes about why they ended. She tells many detailed stories about old friends and boyfriends. When the social worker tries to redirect the client to an exploration of how she might improve her interpersonal skills, the client resists this and continues telling stories about her past. What strategy should the social worker use to redirect the client's energy toward efforts at therapeutic change? Select one: A. Point out her successes and strengths as she describes her relationships. B. Empathize as she talks about her relationship difficulties. C. Work with her to establish clear short-term objectives with time-frames for completion. D. Confront her resistance to change

Work with her to establish clear short-term objectives with time-frames for completion...It's still early in treatment. As this client's therapist, you would want to avoid both framing this problem right away as "resistance to change" and confronting the client too early. For example, rather than being resistant to change, perhaps the client misunderstands the purpose or process of therapy. Establishing clear short-term objectives, with time-frames for completion, could be very effective for mobilizing this client's energy for therapeutic change because perceiving concrete gains (i.e., reaching an objective), even small gains, could motivate her to work toward additional change.

A client says during the first interview that she regrets coming in because, deep down, she thinks people should be able to solve problems without help. The social worker recognizes this statement as a sign of ambivalence. Which of the following would be the BEST way of responding to what the client has said? Select one: A. You're right in a way; you are, in the end, the one who has to cope with your own problems. On the other hand, it may help you to cope if you talk about your problems with someone else. B. As a social worker, I agree with you; in fact, my goal is to empower you to deal with problems on your own. C. I understand your feelings; however, the fact that you came to me suggests that you are unable to cope on your own right now. D. I hear what you're saying; this might not be the right time for you to be in therapy, but you're welcome to come back when you're ready.

You're right in a way; you are, in the end, the one who has to cope with your own problems. On the other hand, it may help you to cope if you talk about your problems with someone else......"A" is best because it both acknowledges the client's feelings and addresses her ambivalence by explaining how therapy can provide her with the tools to cope on her own; i.e., it points out that she will play an active role in solving her own problems, even if she accepts your help.

Loosening of associations can be symptomatic of schizophrenia and other psychotic disorders and involves: Select one: A. abrupt shifts from one topic to an unrelated or obliquely related topic. B. delays in answering a question due to embellishment with unnecessary details and parenthetical remarks. C. a continuous flow of rapid speech with abrupt changes from one topic to another based on understandable associations. D. thinking that contains numerous contradictions and inconsistencies.

abrupt shifts from one topic to an unrelated or obliquely related topic....Loose associations are characterized by abrupt shifts from one fragmented thought to another with little if any logical connection between the thoughts. Response "B" defines circumstantiality; "C" refers to flight of ideas; and "D" describes illogical thinking

Characteristics of the child that are associated with a high risk for abuse include all of the following, EXCEPT: Select one: A. poor health. B. difficult temperament. C. adolescence. D. disability.

adolescence.....Characteristics of the child that are associated with a high risk for abuse include prematurity and low birth-weight, difficult temperament (e.g., nonresponsivity, irritability, hyperactivity), poor health, and younger age (children under age 3 are at highest risk for physical abuse). Overall, children who are perceived as "different," such as those with a difficult temperament or a disability, are at increased risk for both abuse and neglect (Goldman et al., 2003).

A social worker should never: Select one: A. breach confidentiality. B. advise a client about her medication dosage. C. diagnose a specific disorder. D. consult another professional without informing the client

advise a client about her medication dosage...The only action listed that a social can never, under any circumstances, do is advise a client about how much of a medication to take. Only trained medical doctors can prescribe medication. It is obvious that answer "C" is incorrect. Answer "A" is wrong since there are instances when a social worker may (or even must) breach confidentiality (e.g., to report child abuse). Answer "D" is less obvious, but ethical standards allow social workers to seek case consultation without informing the client as long as no identifying information about the client is revealed to the consultant.

Question ID #47157: A client has been feeling tired and having headaches but can't afford to pay for medical care. She asks the social worker whether she might be eligible for Medicaid. In response, the social worker could explain that eligibility for Medicaid is based on all of the following criteria EXCEPT: Select one: A. resources. B. income. C. age. D. health factors.

age.....Medicaid is a federal and state government funded program that provides payment for medical and hospital services to individuals who can't afford them. Eligibility for Medicaid is determined by means testing, which involves evaluating a person's financial resources and using the findings as the criterion to determine whether the person can receive the benefit. Areas considered during this evaluation usually include the person's income, assets, debts and other obligations, number of dependents, and health factors.

A 24-year-old client is referred by his family physician for help in dealing with persistent feelings of sadness and apathy that emerged when he moved from his small hometown to the city. The client says that he's had depression before but it's worse than ever now that he's away from his family and friends for the first time. If the social worker were to use the cognitive theory described by Aaron Beck, she would consider the client's depression to be attributable to: Select one: A. uncontrollable events. B. object loss. C. inadequate reinforcements. D. automatic thoughts.

automatic thoughts.....Aaron Beck's cognitive theory has been very influential in therapy with depressed individuals. Beck believes that depression is the result of negative automatic thoughts that are triggered by environmental stress. As a cognitive therapist, he focuses primarily on the role of cognitive "errors" in depression and other disorders. One of the first targets of his treatment are the "automatic thoughts" that underlie a client's maladaptive behaviors and emotions.

A social worker discovers that his client can't afford safe housing or adequate food. In the wintertime, the client has no heat. In other words, the client is having difficulty meeting her: Select one: A. expressed needs. B. safety and security needs. C. gender role obligations. D. basic needs.

basic needs.....The term "basic needs" refers to items that are considered to be essential for the maintenance of a person's well-being. These items include adequate food, clean water, shelter, clothing, heating, fuel, and security from bodily harm

For many years, a 26-year-old has had intense and unstable relationships and exhibited reckless driving, drug use, repeated suicide attempts, and uncertainty about her career goals. The MOST likely diagnosis is: Select one: A. histrionic personality disorder. B. borderline personality disorder. C. schizotypal personality disorder. D. narcissistic personality disorder.

borderline personality disorder...The essential feature of borderline personality disorder is a pervasive pattern of instability in interpersonal relationships, self-image, and affect and marked impulsivity. Histrionic personality disorder ("A") is characterized by a pervasive pattern of emotionality and attention-seeking; schizotypal personality disorder ("C") is diagnosed in the presence of pervasive social and interpersonal deficits involving acute discomfort with and reduced capacity for close relationships and eccentricities in cognition, perception, and behavior; and narcissistic personality disorder ("D") involves a pervasive pattern of grandiosity, a need for admiration, and a lack of empathy.

The primary purpose of reflection is to: Select one: A. provide support. B. focus an interview. C. interpret behavior. D. build understanding.

build understanding....."D" is the best answer offered. Reflection is used to clarify and show clients what their here-and-now feelings are and, thereby, encourage them to continue expressing themselves. This helps clients understand their feelings. And, because reflection also demonstrates to clients that you have understood their feelings, reflection is also a useful technique for establishing rapport.

When using the DSM-5, a diagnosis of major neurocognitive disorder requires the presence of a significant decline in: Select one: A. social and occupational functioning from premorbid functioning. B. cognitive functioning that interferes with independence in everyday activities. C. at least three areas of cognitive functioning. D. the ability to perform activities of daily living.

cognitive functioning that interferes with independence in everyday activities.....The DSM-5 distinguishes between major and mild neurocognitive disorders. The diagnosis of a major neurocognitive disorder requires a significant decline from a previous level of cognitive functioning that interferes with independence in everyday activities; while the diagnosis of a mild neurocognitive disorder requires a modest decline from a previous level of cognitive functioning that does not interfere with independence in everyday activities.

A supervisor of social workers who are involved in community organizing would be MOST likely to focus his efforts on: Select one: A. providing direct supervision. B. dealing with issues of organizational loyalty. C. identifying the needs of the social workers' clients. D. assigning and reviewing the work done by social workers.

dealing with issues of organizational loyalty.

A group of social workers involved in an episode of macro change have finished planning the intervention, including selecting an approach to change and establishing the intervention's goal and objectives. In the next phase of their work and prior to actually implementing their intervention, these social workers are likely to do all of the following EXCEPT: Select one: A. select a lead person or coordinator. B. acquire and organize resources needed to launch the intervention. C. hire additional personnel. D. develop a working hypothesis of intervention.

develop a working hypothesis of intervention.

The first intervention when using solution-focused therapy with a family is usually: Select one: A. discussing how things would be if the problem were already resolved. B. exploring each clients role in maintaining the problem. C. exploring the clients reluctance to try new solutions to the problem. D. identifying causes underlying the problem.

discussing how things would be if the problem were already resolved.....Solution-focused therapy is a short-term approach that seeks to shift clients from a "problem-orientation" to a "solution-orientation." During the first meeting, the therapist begins asking "goal formulation questions" designed to initiate goal construction. Goals are defined by the clients, stated in concrete (behavioral) terms so that clients can see when they are accomplishing the goals, and focus on presence rather than absence (goals are stated in positive terms). The formulation of treatment goals is believed to produce a shift in context from "complaint narratives" to "solution narratives." Answer "A" alludes to the "miracle question" which is often the first intervention used by a solution-focused therapist. Miracle questions are designed to stimulate clients' visualizing capacity to reach a goal. An example is, "Suppose there is a miracle one night and while you're sleeping, the problem is solved. How would you know? What would be different?" Answers "B," "C," and "D" each focus in some way on the cause of the problem: Solution-focused therapy de-emphasizes the causes of problems and focuses, instead, on helping clients become "unstuck" and focus on solutions.

In DSM-5, the essential feature of hoarding disorder is persistent difficulty discarding or parting with possessions, regardless of their actual value. In addition to this, the person's difficulty discarding or parting with possessions must be due to either a perceived need to save the items or: Select one: A. distress associated with parting with them. B. a loss of energy associated with a depressed mood. C. a decline in cognitive functioning. D. obsessions that lead to the compulsive hoarding behavior.

distress associated with parting with them...Hoarding disorder involves "persistent difficulty discarding or parting with possessions, regardless of their actual value" (APA, 2013, p. 247) due to a perceived need to save the items or to distress associated with parting with them. The inability to discard items causes living areas to be cluttered to the extent that the areas are not usable, and symptoms cause clinically significant distress or impaired functioning.

An Hispanic individual who recently immigrated to the United States is MOST likely to have difficulty working with a social worker who: Select one: A. adopts an eclectic orientation. B. encourages individualism. C. has an informal personal style. D. displays an interest in the client's level of acculturation.

encourages individualism.....The worldview known as collectivism is characteristic of many culturally diverse groups in the United States, including Hispanics. Collectivism assumes that groups connect and mutually obligate individuals - the personal is just one aspect of and is subordinate to the larger social group or context. Individualism, by contrast, centers on the personal - personal goals, personal uniqueness, and personal control - rather than on the social group or social context in which a person lives. Choices "C" and "D" would be advantageous when working with a recent Hispanic immigrant: An informal approach to business relationships is characteristic of Hispanic culture, and an interest in the client's level of acculturation is necessary whenever a therapist is working with a client who is a recent immigrant or refugee. Finally, an eclectic orientation is unlikely to be problematic because it implies greater therapist flexibility.

Rapport has developed between a client and his social worker. This means that the client: Select one: A. feels understood. B. expects that the social worker will self-disclose if he does. C. will begin discussing his problem. D. has been reassured that his feelings are a normal response to his problem.

feels understood...Barker (2003) defines rapport in social work interviews as the state of harmony, compatibility, and empathy that permits mutual understanding and a working relationship between the client and the social worker. In other words, when there is rapport, the client will feel understood.

A social worker is conducting an interview with a client who expresses a tremendous amount of anger about something that happened during the week at his job. The social worker realizes that she needs to help the client regain control so that his anger doesn't escalate to a point where he becomes dangerous. To achieve that goal, the social may do all of the following EXCEPT: Select one: A. admit her error and apologize if she says something that causes the client to become more angry. B. let the client know exactly what she needs from him right now. C. give the client specific advice on how to manage his angry feelings. D. give the client supportive feedback to mitigate his angry feelings

give the client specific advice on how to manage his angry feelings.......You should avoid giving advice to an angry or otherwise potentially violent client. Letting an angry client know what you need from him so that you can help ("B") may serve to lessen his anxiety by providing structure. For example, "You seem very angry. I'd like you to sit down and tell me exactly what has happened and we'll figure out how it led to your anger." And supportive feedback ("D") can mitigate the client's anger, fears, hostility, or frustration.

A man, age 33, is brought in by his sister. She reports that, following the loss of his home in a fire two weeks ago, her brother has experienced hallucinations, is incoherent, and is uncharacteristically aggressive and sloppy in appearance. In this situation, before assigning a diagnosis of brief psychotic disorder, the social worker would want to rule out alternative explanations for the man's symptoms. Therefore, the social worker would want to determine if the man: Select one: A. has been using drugs. B. is able to answer questions coherently. C. is experiencing delusions. D. is experiencing rapid shifts in mood.

has been using drugs...Although the man's history and symptoms are suggestive of brief psychotic disorder, you would want to rule out other explanations including the possibility that his symptoms are due to a substance/medication-induced psychotic disorder. Note that this question is asking you to identify the information that would rule out (not confirm) a diagnosis of brief psychotic disorder.

Research by Werner and Smith (1982) found that a high-risk baby is LESS likely to suffer long-term negative consequences if: Select one: A. he has a higher-than-average IQ. B. he is socially responsive. C. his mother doesnt work outside the home. D. he has a large family

he is socially responsive......Werner and Smith's longitudinal study found that high-risk babies are most likely to show resilience when they exhibit an "easy" temperament characterized by a high degree of social responsivity, good communication skills, and consistent eating and sleeping patterns; experience fewer stressors following birth (e.g., more negative effects are associated with chronic poverty, family instability, and maternal health problems); and are provided with stable support from a parent or other caregiver. These findings suggest that high-risk children can demonstrate resilience and that the negative effects of prenatal and perinatal stress are not always irreversible.

When leading a crisis counseling group, a social worker is likely to focus on all of the following EXCEPT: Select one: A. helping members express all feelings including those not associated with the crisis. B. exploring solutions to each member's crisis. C. helping each member understand his or her crisis situation. D. exploring social change strategies that can reduce crisis risk in the future.

helping members express all feelings including those not associated with the crisis...The conduct and content of crisis counseling groups are determined by their primary purpose, which is the resolution of members' crises by means of a group process. In crisis groups, individual historical information and feelings not associated with the members' crises are limited in group discussion. Instead, group sessions focus on the crises identified by the group members. The leader uses techniques similar to those used in individual crisis intervention, including encouraging members to express feelings relevant to the crisis event, helping them gain an understanding of the crisis situation, exploring resources and solutions to the problem, and exploring social change strategies that might reduce the risk for crisis in the future

A social worker leaves the agency where she has been employed for several years in order to set up an independent private practice. According to the NASW Code of Ethics, the social worker may refer her clients from the agency to herself: Select one: A. if she has made an agreement about this with her former agency. B. if the clients have been making progress by working with her. C. if she has made an agreement about this with her former agency and informed the clients of other options available to them. D. under no circumstances; doing so would be unethical.

if she has made an agreement about this with her former agency and informed the clients of other options available to them.......Careful - answer "A" is true but incomplete; it mentions only one of the conditions that must be met in this situation according to the Code of Ethics. If you leave your agency to set up an independent private practice (or to begin work at another agency), you should not refer your former agency's clients to yourself unless (a) you have made a specific agreement with your former agency and (b) you inform the clients of the various options available to them. These options may include transferring to another social worker in your former agency, transferring to another agency or a different private practitioner, terminating treatment, or continuing to see you in your independent private practice.

The negative impact of prolonged stress on a person's health is attributable, in part, to chronically elevated levels of cortisol and other stress hormones, which over time can compromise the functioning of a person's: Select one: A. cardiovascular system. B. respiratory system. C. immune system. D. nervous system.

immune system.....The effects of prolonged stress on health are attributable, at least in part, to chronically elevated levels of cortisol and other stress hormones, which compromise the immune system (cause immunosuppression) by decreasing the production of lymphocytes (especially T cells) and antibodies, the body's major defenses against viruses, bacteria, and other antigens.

A client complains of intense anxiety whenever he's in a crowd or an open space such as a parking lot. About a week ago, he had a panic attack while waiting in line at a store. The social worker determines that the client has agoraphobia and informs him that treatments for agoraphobia are MOST effective when they incorporate: Select one: A. cognitive restructuring. B. eye movement desensitization and reprocessing (EMDR). C. in vivo exposure with response prevention. D. relaxation training.

in vivo exposure with response prevention...Treatments for agoraphobia are most effective when they incorporate in vivo exposure with response prevention. In vivo exposure involves having a client face or confront a high anxiety-arousing stimulus repeatedly or for a prolonged period of time until his fear subsides (e.g., until he sees that none of the consequences he fears actually takes place). Exposure therapies are frequently coupled with response prevention, which, in treatments for agoraphobia, involves having the client refrain from engaging in his usual avoidance or escape behaviors during exposure trials.

A social worker determines that a main cause of his client's ongoing struggle with depression is unresolved grief about the death of her mother many years ago. In treatment, the social worker focuses on helping the client go through the grieving process and resolve interpersonal deficits so that she can overcome her loss and restore her relationships with others. Apparently, the social worker is using: Select one: A. rational-emotive behavior therapy. B. interpersonal therapy. C. object-relations therapy. D. reality therapy.

interpersonal therapy.....Although a client's unresolved grief can be a focus of many forms of treatment, only one of the therapies listed explicitly defines grief as a treatment target. Interpersonal therapy (IPT) defines four key problem areas presented by depressed patients: grief, interpersonal disputes, difficult role transitions, and interpersonal deficits. These areas are the primary targets of therapy. Practitioners of IPT view depression and other symptoms as being caused and maintained by interpersonal problems that are traceable to disturbances during early development, especially during the attachment stage. In providing treatment, they combine a variety of cognitive and behavioral techniques, including encouragement of affect, communication analysis, modeling, and role-playing.

Nonverbal barriers to effective communication with a client include all of the following EXCEPT: Select one: A. leaning forward in your chair. B. sitting at your desk during a session. C. staring at the client to encourage eye contact. D. keeping an even tone as you speak so that your voice does not reveal your reactions to the client.

leaning forward in your chair.....You needed to choose the answer that is not a nonverbal barrier to effective communication with a client. Answer "A" describes social worker "attending" behavior which usually facilitates client-social worker communication and rapport. A desk separating you from a client ("B") tends to inhibit openness and conveys that you're in a superior position to the client; and a monotonous or flat voice ("D") communicates a lack of interest.

The parents of a 10-year-old child whom a school social worker has tested ask to look at their child's school record which contains, among other things, the test protocol and the social worker's report. The social worker's policy should be: Select one: A. they cannot see the record, but the social worker can provide them with a summary of its contents. B. they cannot see the record, but they can ask the social worker questions about the test results. C. let them look at the record. D. let them look at some of the material in the record and interpret the material for them so that it doesnt cause them to worry

let them look at some of the material in the record and interpret the material for them so that it doesn't cause them to worry.....The parents have the right to review the contents of their child's school record, other than the social worker's personal notes and any secure testing material, and the social worker is obligated to interpret the content they review in language they can understand. The Federal Educational Rights and Privacy Act (the Buckley Amendment) applies to educational settings and grants parents and students over the age of 18 the right to inspect their child's/their own educational records.

A consultant's functions in client-centered case consultation include all of the following EXCEPT: Select one: A. collecting information. B. giving advice. C. problem-solving. D. mandating solutions.

mandating solutions.....When offering client-centered case consultation, a consultant works with a social worker (or other consultee) to develop a plan that will enable the social worker to work more effectively with a specific client. The consultant, who is considered an expert in the problem area, gathers information about the client and then makes recommendations to the social worker about the best course of action. The consultant is not an administrator, however. In fact, the consultant has no administrative (or other) authority over the consultee, and the consultee is free to reject his or her advice.

As defined by Freud, defense mechanisms such as regression, repression, and projection can be MOST accurately described as: Select one: A. unconscious mechanisms that help the individual resolve conflicts. B. mechanisms used by the ego to reduce feelings of anxiety. C. mechanisms used by the id to protect itself from its own threatening impulses. D. mechanisms used by the superego to keep the id from expressing its undesirable impulses

mechanisms used by the ego to reduce feelings of anxiety.....This question simply asks you to identify what defense mechanisms do. It may have been difficult to do this, however, because the answers are similar to one another. Defense mechanisms operate unconsciously and are used by the ego to prevent conscious awareness of anxiety-producing impulses, thoughts, desires, etc.

As described in the DSM-5, level of severity of alcohol use disorder and other substance use disorders is based on: Select one: A. degree of functional impairment. B. number of symptoms. C. the presence of tolerance and/or withdrawal. D. the degree of distress caused by use of the substance.

number of symptoms...The DSM-5 distinguishes between three levels of severity of the substance use disorders based on the number of symptoms: mild (2 or 3 symptoms); moderate (4 or 5 symptoms); severe (6 or more symptoms)

Two children are playing with toy trucks in a sandbox but not interacting with each other. This is an example of: Select one: A. associative play. B. onlooker play. C. constructive play. D. parallel play.

parallel play...Parallel play occurs when children play with similar toys and do similar things but do not interact with each other. This form of play is common during the early preschool years.

Client: "When my wife died, my whole life changed. I've had to work and care for my kids by myself. I miss my wife's support and love and worry that I'll fall apart without her." Social worker: "Since your wife's death, you have had to do many things on your own that you previously shared with your wife." The social worker's response illustrates: Select one: A. paraphrasing. B. reflecting. C. support. D. information-giving.

paraphrasing.....The social worker has restated the content of the client's message, which exemplifies the use of paraphrasing. A paraphrase is a selective restatement of the main idea of a client's message that resembles his message but is not identical to it. A paraphrase emphasizes the literal meaning of a client's message (the content, rather than affect) and is expressed in fewer words than the client has used.

According to Margaret Mahler (an object-relations theorist), a key developmental task of infancy is separation/individuation. The successful outcome of this task is: Select one: A. a strong bond with the primary caretaker. B. resolution of childhood psychosexual conflict. C. ability to use language to express complex, emotional feelings. D. permanent and distinct internal representations of self and other persons.

permanent and distinct internal representations of self and other persons........According to Mahler, a key aspect of social development is the progression from symbiotic fusion with the mother to the development of autonomy and the ability to distinguish self from other people. This process is referred to as separation/individuation. "Separation" refers to the development of limits or the differentiation between the infant (self) and the mother; while "individuation" refers to the development of the infant's ego, sense of identity, and cognitive abilities. In other words, individuation involves further movement away from symbiosis with the mother and toward the recognition and experience of individual, or separate, existence.

All of the following are generally appropriate when setting goals with a client EXCEPT: Select one: A. redirecting the client when his goals are unrealistic. B. discussing the potential risks associated with each goal. C. rank ordering goals according to the social worker's problem-solving priorities. D. allowing the client to have the final say in selecting the goals.

rank ordering goals according to the social worker's problem-solving priorities...Be careful: "Rank ordering" goals is important, but goals should be prioritized according the client's priorities not the social worker's (although a social worker should facilitate the client's ability to determine reasonable and feasible treatment priorities). Exceptions to this entail situations where the client is a danger to self or others; then, of course, protection is the priority regardless of the client's wishes. Another exception is when a goal is mandated

A social worker trying to build support for a new program would use co-optation to: Select one: A. expose opposition. B. exclude opposition. C. reduce opposition. D. voice opposition.

reduce opposition...Co-optation addresses opposition by absorbing target system members and other opponents into the action system. Co-optation is effective for reducing opposition because, once people become part of the action system, they are likely to assume some "ownership" of the change effort

A client, age 79, has come in alone for treatment. He is exhibiting some signs of depression. To clarify the nature of the problem in this case, the social worker should FIRST: Select one: A. ask the client how he spends his time. B. explore ways for the client to expand his support system. C. evaluate what losses the client has experienced in this stage of his life. D. refer the client to a neurologist for testing.

refer the client to a neurologist for testing....."D" is overly specific but it is still the best choice offered (be prepared to see "imperfect" answers on the exam, too). That is, you would probably first refer the man to his regular physician for a general health screening, and the physician might then recommend that the man see a neurologist. We still choose "D," however, because, before formulating the problem or planning treatment, you must determine an accurate clinical diagnosis (if any) for this man. This requires confirming or ruling out any effects of a medical problem or substance (including medication) on the client's mood and cognitive functioning. In addition, the question doesn't describe the nature of the man's depressive symptoms, but, in depressed older adults, memory loss, distractibility, disorientation, and other cognitive symptoms may be present. If the man has prominent cognitive symptoms, neurological testing could be helpful for differentiating a depressive disorder from mild neurocognitive disorder

To receive Title IV-B funding for foster care, states are required to provide certain protections to all children in foster care. These protections include all of the following EXCEPT: Select one: A. placement consistent with the childs special needs. B. a plan for attaining permanence for the child. C. regular visitation between the child and his biological parents. D. placement in close proximity to the childs biological parents.

regular visitation between the child and his biological parents.....Foster children are not guaranteed visitation with their biological parents - e.g., in some cases the parents are dangerous and/or there is no possibility of reuniting the family. When visitation is indicated, however, the parents should visit their child in foster care so that the attachment can continue and the parents have an opportunity to practice positive interactions with their child. The other answers describe some of the protections that states must provide to all foster care children in order to receive Title IV-B funding for foster care.

A client is a middle-aged man who complains of anxiety. He is feeling overwhelmed by his responsibilities at home and work and as coach of his daughter's softball team. He says things got worse when his mom broke her hip and asked him to help out at her house a few days a week. The client feels like he's spread too thin and letting people down. From the perspective of role theory, this client appears to be experiencing: Select one: A. self-role incongruence. B. role conflict. C. role overload. D. role incapacity.

role overload.....A social role problem involves either difficulties in fulfilling social role obligations or conflicts in relationships with family members and/or with people at work (or school) or in the community. One cause of social role problems is role overload which can emerge when a person occupies more roles than he can perform adequately. Because the question emphasizes the client's many social roles and his sense of being overwhelmed and unable to perform all of his roles adequately, role overload is the best answer.

A client, age 31, tested positive for HIV two months ago, and, during a therapy session, he reveals to the social worker that he has not told his girlfriend about his condition and sometimes has unprotected sex with her. In this situation, the social worker: Select one: A. must contact the clients girlfriend to inform her that the client is exposing her to HIV. B. must contact the clients girlfriend to inform her that she may have been exposed to HIV but must not reveal the clients identity. C. must contact the clients girlfriend to inform her that she may have been exposed to HIV but only if the client refuses to do so himself. D. should discuss her legal obligations with a knowledgeable colleague or an attorney.

should discuss her legal obligations with a knowledgeable colleague or an attorney.....Whether you have a duty to protect (a.k.a. duty to warn) in this situation is ambiguous, and consequently, your best course of action would be to discuss the situation with a colleague or attorney to determine how you should proceed. (Note that you would also want to inform the client of his duty to inform his girlfriend of his serostatus.)

The client is a 9-year-old girl who is brought in by her mother. The girl's grades have dropped and she has been spending a lot of time by herself in her bedroom. When the mother tries to engage the girl in a conversation about the changes in her behavior, the girl becomes upset and refuses to talk. The social worker suspects that the girl may be depressed and assesses her for the core symptoms of a major depressive episode. When doing so, the social worker keeps in mind that certain symptoms are common in children with major depressive disorder. These symptoms include: Select one: A. psychomotor retardation, social withdrawal, distractibility. B. somatic complaints, irritability, social withdrawal. C. somatic complaints, sleep disturbances, irritability. D. irritability, social withdrawal, cognitive symptoms.

somatic complaints, irritability, social withdrawal.....The symptoms of major depressive disorder vary somewhat with age. Somatic complaints, irritability, and social withdrawal are common in children; while aggressiveness and destructiveness sometimes occur in preadolescents (especially boys). In older adults, memory loss, distractibility, disorientation, and other cognitive symptoms may be present, making it difficult to distinguish depression (pseudodementia) from mild neurocognitive disorder

Formal (as opposed to informal) linkages between organizations in a community are beneficial because they tend to improve service delivery and to provide greater: Select one: A. stability. B. autonomy. C. competition for resources. D. flexibility.

stability....."Linkage" involves bringing together the resources of different agencies and coordinating efforts on behalf of a client or social objective. Although formal linkages may reduce autonomy and flexibility, they have several important benefits including improving service delivery, clarifying expectations, and facilitating the exchange of resources. Generally, formal linkages are more effective than informal ones, in part, because the latter tend to lack stability (i.e., they are undependable and unpredictable).

SOAP charting arranges client records according to four components, including: Select one: A. subjective information, objective information, assessments, and prognosis. B. systems evaluation, objectives of treatment, actions, and prognosis. C. subjective information, objective information, actions, and progress. D. subjective information, objective information, assessments, and plan.

subjective information, objective information, assessments, and plan.....The components of SOAP charting are subjective information about the client (e.g., symptoms reported by the client); objective information about the client (e.g., sociodemographic information); assessments and conclusions based on this information; and a treatment plan for addressing the problem.

According to Freud's structural theory, cultural values are part of the: Select one: A. ego. B. superego. C. id. D. self-preservation instinct

superego.....Freud's structural theory posits the personality with three structures - the id, the ego, and the superego. The superego is said to develop from a culmination of maturation, parental identification and modeling, and societal teaching. It represents the social values that are incorporated in the child's personality structure and becomes the conscience that tries to influence behavior so that it conforms to social expectations.

Group therapy might be appropriate for the client in all of the following circumstances EXCEPT: Select one: A. the clients primary problem involves difficulties with intimacy. B. the client is unmotivated to change. C. the client is psychologically sophisticated. D. the client wants to overcome her shynes

the client is unmotivated to change....Group therapy can be an appropriate modality when the client is motivated to change (not "unmotivated"); the client's primary problem involves interpersonal issues (e.g., difficulties with intimacy, shyness); the client is verbally and psychologically sophisticated; the client finds peer support and feedback beneficial; and the client has a positive view of group therapy.

The client is a 19 year old who graduated from high school and has not gone to college. He works as a house painter as a favor to his dad who is a contractor but knows that he'll never happy in that job. He feels like he should accomplish more in his life and hopes to save enough money to attend the local university one day. The social worker should expect that this client, given his age, may be dealing with all of the following issues EXCEPT: Select one: A. the development of object constancy. B. a conflict between intimacy and isolation. C. the establishment of a coherent personal identity. D. gaining more independence from his family of origin.

the development of object constancy.....While the case gives you information about this 19 year old's situation, you can find the correct answer without it (all you need to know is his age). The term "object constancy" is associated with object relations theory. As a part of her separation-individuation theory, Mahler proposed that by about 3 years of age, children develop object constancy (a permanent sense of self and object) and are able to perceive others as both separate and related. The other answers describe issues that are developmentally appropriate during adolescence and/or young adulthood.

A male client reports being a generally anxious person and, in particular, having a significant amount of anxiety for about seven weeks. His social worker learns that, two months ago, the client moved to a new city. Apparently: Select one: A. the client has an anxiety disorder. B. the move will be the focus of therapy. C. the move was a negative life event for the client. D. the move was a precipitating cause

the move was a precipitating cause.....Significant changes in a person's life situation, whether positive or negative, can disrupt his personal equilibrium to the degree that he has trouble adapting. Such events, when they result in a problem, are known as "precipitating causes" (or, sometimes, as "antecedents") and should be explored in an assessment, especially those occurring just before a client's decision to seek treatment.

The client is a recently divorced woman who sought help because she is concerned about her two children. She wants to help them adjust to the divorce with as little difficulty as possible. To help the client, the social worker could tell her that, according to research, children are more likely to adjust successfully to their parents' divorce if: Select one: A. they are given an explanation of why the divorce had to happen. B. the parents maintain a cordial relationship after the divorce. C. the parents are willing to express and work out their conflicts openly, including in front of the children. D. they move to a new house with the custodial parent when the divorce is final. Feedback

the parents maintain a cordial relationship after the divorce....Numerous findings have led many experts to conclude that conflict between the parents, rather than divorce, creates risk for children. Studies show, for example, that conflictual intact families are more harmful to a child's well-being than a stable single-parent or stepparent family (Demo & Acock, 1988) and that a lack of conflict between the parents (especially open conflict) is more important for a child's adjustment post-divorce than the frequency of the child's contact with the noncustodial parent (Amato & Rezac, 1994).

Using a standardized rating scale for summative evaluation in direct practice involves comparing the client's score on the scale before intervention begins to: Select one: A. the same clients scores during intervention. B. a list of outcome goals. C. the same clients score at the end of service. D. scores obtained by other clients on the same scale

the same clients score at the end of service.......The question asks about summative evaluation. If you use a standardized rating scale with a client during assessment, you can then use it again periodically during intervention to identify changes as they occur (formative evaluation); examining these scores can then help guide your decisions about continuing or changing the intervention plan. You can also use a standardized rating scale to summarize the results of intervention with a client (summative evaluation) - here, you'd compare the client's score on the scale before intervention begins and to his or her score at the end of service

The primary feature that distinguishes acute stress disorder from posttraumatic stress disorder (PTSD) is: Select one: A. the shorter duration of symptoms in acute stress disorder. B. a less severe precipitant in acute stress disorder. C. reliving of the trauma in dreams in PTSD. D. symptoms of increased arousal in PTSD.

the shorter duration of symptoms in acute stress disorder.....The name of the disorder - acute stress disorder - should have helped you identify the correct answer to this question. In acute stress disorder, the symptom pattern is limited to a duration of three days to one month after exposure to the traumatic event; in PTSD, the duration of the disturbance is more than one month.

An adolescent client has been experiencing frequent tics for many years and was recently diagnosed with Tourette's disorder. In providing this client with psychoeducation about his condition, a social worker would be correct if she told him all of the following EXCEPT: Select one: A. many adults with tic disorders experience diminished symptoms. B. treatment may involve administration of an antipsychotic medication. C. the symptoms cannot be voluntarily suppressed. D. the symptoms may wax and wane in frequency.

the symptoms cannot be voluntarily suppressed.....You needed to choose the answer that states something that is false about Tourette's disorder. Tourette's disorder is characterized by the presence of at least one vocal tic and multiple motor tics that may appear simultaneously or at different times, that may wax and wane in frequency but have persisted for more than one year, and that began prior to 18 years of age. According to the DSM-5, "tics are generally experienced as involuntary but can be voluntarily suppressed for varying lengths of time" (p. 82); therefore, "C" is a false statement

When establishing mutuality, the social worker communicates that she: Select one: A. wont allow the client to make decisions that harm him. B. understands the client's experience from his point of view. C. views the client as an equal partner in the helping relationship. D. takes responsibility for her own feelings and can admit when she makes a mistake.

views the client as an equal partner in the helping relationship..."Mutuality" refers to mutual efforts by a social worker and client to work on the problem. To establish mutuality, you assume a posture of professional competence, while, at the same time, communicating to the client that you and he are equal partners in the relationship and both responsible for what happens in treatment.

In behavioral therapy, extinction involves: Select one: A. removal of an aversive stimulus contingent on performance of a desired behavior. B. application of a desirable stimulus contingent on performance of a desirable behavior. C. withdrawal of reinforcement from a previously reinforced behavior. D. consistent application of a negative reinforcer for a previously positively reinforced behavior.

withdrawal of reinforcement from a previously reinforced behavior.......Extinction is a term which is used in both classical and operant conditioning. In classical conditioning, extinction refers to the fading of a conditioned response as the result of presenting the conditioned stimulus repeatedly without the unconditioned stimulus. In operant conditioning, extinction refers to the weakening of a response resulting from withholding reinforcement following the response. "A" is a definition of negative reinforcement; "B" is a definition of positive reinforcement; and "D" is not a definition of anything.