ASWB Exam Practice Questions fully solved & updated.

A new social worker begins to establish professional rapport with a group of school age youths. After a few weeks, the social worker discovers that their former social worker still sees the youths, gives them new school supplies, and takes them out for social events. The new social worker should FIRST: a. Tell the youths that they can no longer see the other social worker b. Report the former social worker to the local regulatory board c. Speak directly to the former social worker d. Obtain legal consultation - answer-Key: C Rationale: Professional ethics dictate speaking to the colleague before taking any other action. A parent in great distress consults a social worker. Because of having heard so much in the media about sexual abuse, the parent is unsure how to respond to recently finding her five-year-old exploring the body of another child. The parent does not know whether this is deviant behavior. The social worker should: a. Reassure the parent that this is normal for children at this age b. Advise the parent to call the appropriate authorities c. Discuss the parent's feelings about sexuality d. Suggest that the parent call the other child's parent - answer-Key: A Rationale: Sexual curiosity is a normal developmental process for children (key A), but many parents become anxious about this behavior. The social worker should reassure the parents that this is normal. Getting other authorities involved (B) and contacting the other child's parent (D) would be overreactions. It is important to discuss the parents' feelings about sexuality (C) in order for them to accept their child's behavior, but this should be done only after they have been reassured about the behavior. A social worker is the new manager of a human service organization that is simultaneously struggling with maintaining positive employee morale, increasing client services, and improving outcomes. The manager should FIRST: a. Ensure that employees know the importance of client outcomes b. Institute a flextime policy for employees c. Introduce more efficient data collection techniques d. Initiate a staff recognition program - answer-Key: D Rationale: Employees, including social workers, need recognition for their work (key D). If employees do not feel appreciated by their supervisors, their work tends to be less than optimal. By recognizing those staff members whose performance is above expectations, other employees will be encouraged to improve their performance. What is MOST important to remember about defense mechanisms? a. Defense mechanisms reduce anxiety. b. Defense mechanisms relieve conflict. c. Defense mechanisms are an unconscious process. d. Defense mechanisms are an interpersonal response. - answer-Key: C Rationale: This is an unscored question. By definition, a defense mechanism is not a conscious behavior or thought. However, its use allows the client to avoid addressing an issue that the client finds too painful to deal with directly. A 27-year-old male with a history of hospitalizations for bipolar I disorder and alcohol use disorder recently stopped taking his medication, became manic, and resumed drinking. At his landlord's request, the police take him to the hospital and arrange an involuntary admission to the acute psychiatric unit. The client has all of the following rights EXCEPT the right to: a. Refuse treatment b. Refuse to give permission to the hospital to contact his family c. Keep the record of his admission confidential d. Leave the hospital regardless of his condition - answer-Key: D Rationale: Among the rights listed, the only right not available to this involuntary patient is the right to leave the hospital when he chooses. A social worker assesses an elderly client for suicide risk. The BEST approach is to use the clinical interview and the: a. Minnesota Multiphasic Personality Inventory b. Geriatric Depression Inventory c. Beck Anxiety Inventory d. CAGE - answer-Key: B Rationale: This is a recall question that requires knowledge of appropriate assessment instruments. A couple married for 30 years seeks help at a crisis clinic. The husband described his wife's emotional and erratic behavior and radical change in appearance and dress, which is contrary to their religious beliefs. The wife talks openly and happily about spending more time outside the home with her friends and hobbies, and her desire to work for the first time. The social worker should assess the couple for evidence of: a. A longstanding marital problem b. Issues related to family transition c. Difficulties with the aging process d. Conflicts over religious beliefs - answer-Key: B Rationale: Family dynamics change as the family ages and children leave home. This requires all members of the family to adjust to these inevitable changes. Transition issues for the family (key B) is correct since (A), (C), and (D) each address only part of the underlying problem. A client is seen by a social worker at a family service agency complaining that she has been feeling depressed. She states that she shouldn't feel this way because there are no problems in her life. She has a husband, a good job, and two healthy children. The social worker should FIRST: a. Ask the client about a history of depression in the family b. Refer the client to a psychiatrist for antidepressant medication c. Identify the specific beliefs fueling the depression d. Clarify what the client means by depression - answer-Key: D Rationale: The social worker needs the client to describe in more detail what she is experiencing that has led her to believe that she is depressed, as well as the client's understanding of depression (key D). The social worker also needs to know what symptoms the client is now experiencing, if any, to determine whether the client is depressed or has another mental disorder. A social worker meets with an adolescent who frequently misses school and is having academic problems. Psychological testing found the client is above average in intelligence, but with poor impulse control and at high risk for antisocial behaviors. The social worker completes the social history to: a. Explain the client's developmental progress b. Understand factors that affect the client's behavior c. Make the most appropriate educational placement d. Assess family expectations for the adolescent - answer-Key: B Rationale: In order to identify what needs to be addressed, the social worker needs to understand what affects the client's behavior - for example, the client's reasons for missing school. A social history would provide insight about these factors. At a community mental health agency, a new social worker replaces a social worker who resigned with short notice due to a family emergency. Within a few weeks, the social worker has met with all the clients. While in the public waiting room, a social work colleague hears the new social worker say to a client that it was "unprofessional and harmful" for the prior social worker to leave the agency so suddenly. The colleague should FIRST: a. Tell a supervisory immediately about the incident b. Talk to the new social worker about the conversation c. Initiate formal actions related to ethical violations d. Consult with other colleagues in the agency about the situation - answer-Key: B Rationale: Professional ethics dictate speaking to the colleague before taking any other action. A social worker conducts a support group for adults who are caregivers for their elderly parents. During one group meeting, a member begins to describe how she behaves toward her parent when she becomes frustrated. The social worker becomes concerned that the behavior may constitute abuse. The social worker should: a. Encourage the member to provide more specific information in the group b. Explain to the group that such behavior is understandable c. Engage the other members in a discussion of what is acceptable behavior d. Meet with the member individually after the group to review the situation - answer-Key: D Rationale: Due to the nature of the disclosure, this matter should be discussed individually with the group member in order to gather more information (key D); exploration with this member should not be done in a group setting. Explaining how the client's actions are understandable (B) would sanction this potentially abusive behavior. A 14-year-old girl comes to a family service agency for help. She is four weeks pregnant, unmarried, and depressed. She lives with her parents, who are unaware of her pregnancy. Local law requires parental consent for the treatment of minors who live with their parent(s) or legal guardian. The social worker should FIRST: a. Obtain the client's informed consent to provide therapy b. Discuss the need for parental involvement with the client c. Acknowledge the client's emancipated right for self-determination d. Meet with the client's parents to discuss the case - answer-Key: B Rationale: Social workers must follow the laws around the treatment of minors and obtaining parental consent, which in this case is required (key B). Ignoring this and moving ahead with only the client's consent (A) would be illegal; there is no indication that the client is currently emancipated (C); and meeting with the parents only (D) would be inappropriate. A 25-year-old woman seeks help at a local mental health clinic. She complains of nightmares, agitation, an inability to concentrate, and weight loss. During the assessment phase, the social worker learns that the client had been recently raped and mugged. The social worker should FIRST focus on: a. The details of the rape b. The nature of the nightmares c. Potential for self-harm d. Medication for depression - answer-Key: C Rationale: Given the level of trauma experienced and the severity of symptoms being expressed, an evaluation of risk of self-harm must be the social worker's priority. All other areas may be acceptable to focus on later, but not FIRST. A social worker in private practice is temporarily moving to another city. Following consideration of the risks and benefits that may be experienced by each client, the social worker offers to continue the therapeutic relationship with several clients through email. This suggestion is MOST appropriate for clients who: a. Have completed their treatment b. Would be harmed by early termination c. Are able to cope with daytoday issues d. Are dealing with ongoing crises - answer-Key: C Rationale: The less immediate contact associated with email is more appropriate for higher functioning clients - in this item, those who are able to cope with "day to day" issues (key C). Crisis clients (D) require more direct contact, and clients who would be harmed by early termination are not necessarily the MOST appropriate group for this approach. There would be no reason to offer a therapeutic email relationship with clients who have completed treatment (A). A 49yearold woman seeks therapy, citing problems with her 74yearold mother. She reports that her mother moved to a retirement community seven years ago after the death of the client's father. The mother has adjusted well and made many new friends. Six months ago, the client's mother began dating a man and they have decided to live together. Since this decision, the client and her mother argue each time they see each other. The client states that her mother "is not thinking clearly," and "is betraying my father." The client is very upset to think of her mother being sexually active. The social worker should FIRST: a. Focus on the client's feelings about her mother's changes in behavior b. Recommend the client's mother have a psychological evaluation c. Discuss other possible living arrangements for the client's mother d. Explore the client's feelings about her deceased father - answer-Key: A Rationale: The daughter is having trouble adjusting to what appear to be normal life events for the mother, and she needs to explore her feelings around her mother's behaviors (key A). A discussion of the deceased father (D) ignores the current issue and presenting problems. Discussing other living arrangements for the mother (C) puts the social worker in a role of colluding with the daughter. There is nothing in the stem to indicate the need for psychological evaluation of the mother (B). A social worker sees a family for family therapy. During one session, the youngest family member tells the social worker, "I need to share something with you." Another family member responds by saying, "Don't talk about it." The social worker makes several unsuccessful attempts to assist family members in more open discussion. To increase open communication what should the social worker do NEXT? a. Clarify the initial symptoms presented by the family b. Talk with the youngest family member individually c. Use circular questioning with all family members d. Take a one-down position with the family - answer-Key: C Rationale: Circular questioning (key C) is a technique that can be used to explore differences between the family members, which is the social worker's NEXT task in this situation. There is no need to revisit the family's initial symptoms (A), while taking a one-down position with the family (D) does not address the issue and could in fact make things worse. Talking individually with the youngest member (B) could put that member at risk. A social worker sees a 60-year-old man who reports feeling irritable and unhappy in his 35-year-marriage. The man also describes loss of interest in his longtime hobbies, and trouble sleeping. Six months ago he had a serious heart attack and is currently on disability after working all his adult life. The social worker should FIRST: a. Suggest the client begin volunteer work b. Recommend couples therapy c. Refer the client to an exercise program d. Refer the client for a medication evaluation - answer-Key: D Rationale: The symptoms and history described in the stem indicate a diagnosis of major depressive disorder; therefore, a medication evaluation needs to take place FIRST. A social worker sees a new client referred because of heavy alcohol use. During the initial assessment, the client questions the social worker's credentials and competence. What should the social worker do NEXT? a. Confront the client about the evasive responses b. Discuss the physical consequences of alcohol abuse c. Ask how the client feels about seeking help d. Obtain more detailed information by indirect questions - answer-Key: C Rationale: During the initial assessment it is too soon to confront (A) the client. The social worker is avoiding the question (B) and (D) by addressing another issue. By asking a direct question about the client's feelings, the social worker refocuses the discussion and redirects the client back to why help is being sought (key C). A 19yearold is brought to a family service agency by the parents, who report a history of school truancy, deliberate destruction of their property, lying and stealing since age 14. According to the DSM5, which of the following diagnoses BEST describes the client? a. Antisocial personality disorder b. Oppositional defiant disorder c. Conduct disorder d. Intermittent explosive disorder - answer-Key: C Rationale: According to the DSM, deliberate destruction of another's property, lying, stealing, and symptoms of conduct disorder before the age of 15 years meet the criteria for conduct disorder, adolescent onset type, as an adult (key C). The irresponsibility and aggressiveness towards others necessary for a diagnosis of antisocial personality disorder (A) are not mentioned. Irritable or angry mood and argumentative/defiant behaviors necessary for a diagnosis of oppositional defiant disorder (B) - normally a childhood diagnosis - are not mentioned in the stem, nor are the impulsive aggressive behaviors necessary for a diagnosis of intermittent explosive disorder (D). A couple brings their four-year-old child to a social worker concerned that the child cannot yet recite the alphabet. They tell the social worker that they know other four-year-old who can say the alphabet and they have tried to teach it to their child without success. They believe something may be wrong with their child. The MOST likely explanation is that the: a. Child is experiencing developmental delays b. Parents have not spent enough time with the child c. Child may not have reached this level of cognitive development d. Parents have overly high expectations for their child - answer-Key: C Rationale: There can be great variation among children in reaching the various developmental milestones that allow children to complete certain tasks, and it is MOST likely that the child in this item has simply not yet reached the milestone (key C). The stem lacks enough information for the social worker to cite developmental delay (A), insufficient parental involvement (B), or unrealistic parental expectations (D). Parents bring a 14-year-old to a social worker because the adolescent questions authority, is late for curfew, and no longer desires to attend church with the family. The adolescent states that the parents "treat me like a baby" and that the adolescent wants to go to a "more upbeat" church. The social worker should explain to the parents that the adolescent is MOST likely: a. Seeking to identify with peers b. Trying to find a personal identity c. Engaging in a power struggle d. Exploring unresolved religious issues - answer-Key: B Rationale: The idea that the adolescent is trying to find a personal identity (key B) is correct because it reflects the developmental stage of separating and establishing a separate identity. The fact that there is not an isolated incident of defiance indicates that the issue at hand is not a power struggle (C). Though the stem mentions the adolescent desiring a different style of church, this desire does not rise to the level of an unresolved religious issue (D). There is nothing in the stem to indicate that the problem here has to do with peer identification (A). A social worker is working with a woman who was recently diagnosed with HIV. The client abruptly stopped her medication. The doctor asked that the social worker address the issue of medication noncompliance with the client. The client tells the social worker that she stopped the medication at the time her partner died of AIDS. The MOST likely explanation for the client's behavior is that she is: a. Dealing with bereavement b. Implementing a suicidal plan c. Exhibiting symptoms of depression d. Accepting her mortality - answer-Key: A Rationale: Bereavement (key A) is correct because the client initiated an action immediately after the loss of a loved one. There is not enough information to suggest that this is a suicidal plan (B), or a symptom of depression (C), or the acceptance of her mortality (D). Since this happened immediately after a death, the MOST likely explanation is bereavement. A social worker meets with a 35yearold Japanese American man who is anxious because his wife is pressuring him to move his mother into a nursing home. He prefers that she live with them. The social worker asks the man if he has any siblings and what his birth order is. This information is important to the understanding of the man's: a. Cultural perspective b. Support system c. Financial options d. Family dynamics - answer-Key: A Rationale: It is always important for a social worker to understand the cultural context of client situations, and views on siblings and birth order can reveal much about the impact of culture on a client from the broadest perspective (key A). Information on birth order and siblings is less likely to provide an understanding of support systems (B), financial options (C), or family dynamics (D). In which of the following situations may a social worker provide information without the client's consent? a. When a client is severely depressed b. During a child custody evaluation c. When a client files a malpractice suit d. When a client is unable to provide reliable information - answer-Key: C Rationale: By law, the social worker is entitled to defend against a malpractice lawsuit and therefore may disclose client information to the court without the client's consent. A client is court-mandated to see a social worker for help with anger control. The client denies having a problem and blames others for initiating fights. The client also states that attending therapy sessions is not necessary. To demonstrate acceptance of the client, the social worker should: a. Agree with the client's denial of problems with anger b. Express understanding of the client's position regarding therapy c. Show concern for the legal implications of the client's problems d. Help the client identify expectations of therapy - answer-Key: B Rationale: In cases such as the one described in this item, acceptance is best demonstrated when the social worker helps the client to see that the social worker understands what the client is saying and understands the client's position. After several months of weekly therapy sessions, a client tells her social worker that she believes she can drink responsibly and intends to do so on an upcoming vacation. The client has been recently been discharged from a rehabilitation facility and has been diagnosed with alcohol use disorder. The client admits that she has not attended Alcoholics Anonymous or talked with a sponsor. What should the social worker do NEXT? a. Insist that the client join Alcoholics Anonymous b. Conform the client's denial c. Provide information on the relapse process d. Contract with the client to abstain from alcohol - answer-Key: B Rationale: When working with this population, it is imperative to confront the client's denial immediately. Options (A), (C), and (D) may be useful at some point, but at this stage to confront the client with her behavior (key B) is the NEXT thing that must happen. An immigrant family is referred to a social worker because of the ten-year-old child's frequent absences from school. In the intake interview, the social worker asks for information from various members of the family, but all responses come from the father, who speaks sharply and whose facial expression appears angry. The social worker's BEST course of action is to: a. Ask the child's teacher if there are other behavior problems b. Meet with each family member individually c. Refer the mother to a spousal abuse counselor d. Learn about the communication styles typical of the family's culture - answer-Key: D Rationale: The social worker must understand cultural norms and issues that may be coming into play with clients (key D) in order to provide effective treatment. Finding out about other behavior problems (A) and meeting with the family member individually (B) are possible actions to take but are not the BEST approaches to take, given the immediate needs to place the family's communication style in a cultural context. Nothing in stem indicates spousal abuse (C). A married mother of two young children is referred to a social worker by her employer for depression and inability to maintain expected standards at work. The initial assessment reveals that the client has recently experienced the sudden death of her younger sister who was a single mother of two young children. The children are now in the client's care. The client's mother and one brother are in prison. The client's husband is employed, but they need her paycheck to make ends meet. The social worker's MOST appropriate practice approach is: a. Solutionfocused b. Ego psychology c. Problem-solving d. Behavioral therapy - answer-Key: C Rationale: The social worker must address the issues being presented, which demand resolution within a fairly limited time span. A problem-solving practice approach would be the most appropriate one given these factors (key C). Solution-focused therapy (A) examines how progress is made and would not provide assistance with immediate problems. Both ego psychology (B) and behavioral therapy (D) are therapeutic approaches that do not match client's problems and needs. A social worker sees a new client for severe anxiety and panic attacks. The client is a recent immigrant from Asia and has difficulty understanding and speaking English. What should the social worker do FIRST? a. Arrange for a qualified interpreter for the session b. Determine the client's specific language c. Demonstrate nonverbal relaxation techniques d. Conduct a full psychosocial assessment - answer-Key: B Rationale: Determining the client's specific language is crucial in determining next steps, whether those involve arranging for an interpreter or a referral. A social worker sees an adolescent because of poor academic performance. The adolescent also frequently lies to family members, is manipulative, and has shown a change in friendship patterns. What diagnosis should the social worker consider FIRST? a. Substance use disorder b. Reactive attachment disorder c. Specific learning disorder d. Major depressive disorder - answer-Key: A Rationale: The symptoms exhibited are consistent with substance use (key A). There is no indication that there are problems with attachment (B), and a learning disorder (C) would not account for any of the symptoms except for academic performance. Also missing is an indication of depressive symptoms (D). A 13-year-old who is being treated for depression is concerned about disclosing his homosexuality to his parents, who are homophobic. The parents also want to know the details of the treatment. The social worker should plan to: a. Meet with the parents and adolescent to share the information b. Work with the adolescent around the timing of a safe disclosure c. Advise the adolescent never to tell his parents that he is gay d. Help the adolescent understand that being gay is just a phase - answer-Key: B Rationale: Working with the client around disclosure (key B) honors self-determination and meets the client where he is. Describing homosexuality as a "phase" (D) is inappropriate. Advising the client to never tell his parents (C) is prescriptive. The client is likely not yet ready for a meeting with parents to share this information (A). A social worker sees a teenager whose family has been chronically homeless. The teenager tells the social worker that her family has to move to another shelter and that she will have to change schools. She shares how difficult it is to change schools and start all over again. What is the BEST way for the social worker to advocate for this client's needs? a. Validate the client's feelings about homelessness and changing schools b. Suggest that the client meet with the principal about staying at the current school c. Work with the parents and school to keep the client from changing schools d. Collect educational records to help with the transfer of necessary information - answer-Key: C Rationale: The involvement of both the family and the school is necessary in arriving at a solution to the problem here (key C). This client required advocacy, and a validation of feelings (A) is not a way to advocate. Arranging a meeting between the client and principal (B) doesn't involve the parents in planning or problem solving. Assisting with the transfer (D) would be a relinquishment of the advocacy role. A social worker interviews a 55-year-old man who is seeking treatment for impotence. Which of the following factors is least likely to be contributing to his condition? a. Medication for high blood pressure b. An extramarital affair c. Age d. Alcohol abuse - answer-Key: C Rationale: This item is a recall question that tests knowledge of factors that contribute to impotence in men. An elderly widower is brought for an evaluation to a geriatric clinic by his adult daughters, both of whom live a half hour away from where he still resides in the family home. The daughters are concerned that there is "no one to look after Dad." They believe he is having some difficulty with walking and memory. The neurological and mental status exams reveal no dementia. The man is ambulatory although a cane is recommended. The daughters want to place him in an assisted living facility, but the father is adamantly opposed. The social worker's BEST course of action is to: a. Offer an in-home evaluation, with the assurance to keep in touch with the daughters if he consents b. Offer to arrange a tour of several facilities for them to consider c. Request a followup appointment at the clinic with the father d. Discuss with the daughters the possibility of applying for legal guardianship of their father - answer-Key: A Rationale: It has already been determined that there is no dementia, therefore the provision of an in-home evaluation is the approach that recognizes the client's right to self-determination. A social worker meets with a client who is eligible for financial assistance. The client has just had a sex change and wants all information to be under the new name and sex. Upon entering the identifying information, the computer recognizes the client under the previous identity and will not accept the new sex designation. The client will not give the social worker permission to enter the current information under the old client file. Benefits cannot be issued unless the client is entered into the computer. What should the social worker do NEXT? a. Review the consequences of available options with the client b. Empathize with the client's right to have a sex change c. Suggest that the client seek legal representation d. Confront the client about resistance to using the old information - answer-Key: A Rationale: Computer database programs cannot be made to input information not allowed by the software programming, and these programs are difficult, expensive, and time-consuming to change. The client should be made aware of the options available, and of the consequences of each. During an initial interview, a social worker asks a client a question. The client blushes and becomes silent. What should the social worker do NEXT? a. Ask the question again in a slightly different form b. Remain silent for a few seconds c. Delay discussion of the topic at hand d. Identify the emotions the client may be experiencing - answer-Key: B Rationale: Silence allows clients to formulate their thoughts and deal with emotions. When using cognitive restructuring with a depressed 16-year-old client, the social worker should: a. Obtain a complete social history b. Involve the entire family in the initial goalsetting c. Employ desensitization techniques d. Work with the client to set a concrete, time specified goal - answer-Key: D Rationale: Cognitive restructuring involves changing the cognitive from passive to active, changing the mindset of feeling depressed to doing something. Setting concrete, time-specific goals encourages the client to move forward, to take actions, and to become more active. A child who no longer characterizes objects as "all good" or "all bad" and appears to demand an increased amount of attention from the primary caretaker is, according to developmental object relations theory, in the stage of: a. Object constancy b. Rapprochement c. Individuation d. Symbiosis - answer-Key: B Rationale: This is a straightforward recall question that requires the test taker to be able to identify developmental stages in object relations theory. A parent brings a four-year-old child to a family services agency because the child is having fantasies of being chased by a giant and a tiger, and has nightmares of running in terror. What should the social worker do FIRST? a. Ask the child to describe the fantasies b. Do a comprehensive biopsychosocial assessment c. Refer the child for play therapy d. Tell the parent that the child is developing normally - answer-Key: B Rationale: This item highlights the importance of qualifying words, such as FIRST. While asking for descriptions from the child (A) and making referrals for play therapy (C) may be appropriate at a later point, these are actions that should be implemented only after assessment (key B). Similarly, without conducting such as assessment, the social worker does not have enough information to tell the parents that the child's fantasies are normal (D). An elderly woman has been hospitalized for treatment of a stroke. The physician in a rehabilitation facility and refers the woman and her caregiver daughter to the social-worker. The daughter wants her mother to come home since she would like to continue caring for her, but she is concerned about being able to provide necessary care. The social worker should FIRST: a. Reassure the daughter that the facility can provide better care b. Confer with the mother and family members regarding placement c. Refer the daughter to her mother's physician to discuss the placement d. Suggest the daughter take a tour of the rehabilitation facility - answer-Key: B Rationale: The daughter's preference for the mother's care affects the entire family, and the social worker should FIRST discuss all options with the daughter, mother, and other family members (key B). Pressing the daughter to agree to facility placement (A) amounts to the social worker imposing his/her own agenda on the daughter. Sending the family back to the physician (C) is not helpful and avoids addressing the issue. A tour of the facility (D) may be appropriate, but only after a discussion about the preferences and options has taken place A client from a developing country sees a social worker because of depression. The client describes life changes since a parent's death two years ago. The social worker tries to help the client explore the significance of this loss, but the client can only say: "Life is harder because my family has less money." What should the social worker realize from the discussion? a. Talking about concrete changes is a symbolic way of talking about significant losses b. People from developing countries are often concrete in their thinking c. The client should be transferred to a social worker familiar with the client's culture d. The client is experiencing a negative transference to the social worker - answer-Key: A Rationale: In come cultures losses are not addressed directly but processed through discussion of more concrete issues. A social worker leads a group of pregnant adolescents with the purpose of developing the members' coping skills and decision-making capabilities. The group has met weekly for three months with minimal gains. To facilitate growth in independence, the social worker should FIRST: a. Give the group members control over as many decisions as possible b. Encourage the members to make decisions within agency guidelines c. Educate the members regarding assertiveness techniques d. Assign clear role to each of the group members - answer-Key: A Rationale: An effective approach to support growth is to allow the group to assume control of their group and make as many decisions regarding the direction and goals for the group as possible. Experience making decisions can support skill development. Accomplishing goals can lead to an increased sense of competency that can in turn lead to confidence and independence. A community mental health agency has had its budget cut. The social work staff is asked to develop a way to replenish play therapy supplies. The BEST social work action would be to: a. Call neighbors and friends asking for donations of old toys b. Develop other funding resources to purchase supplies c. Collect toys for the holidays and use the excess for play therapy d. Change their therapeutic approaches so play therapy supplies are not needed - answer-Key: B Rationale: Toy and other supplies used in play therapy are often specifically designed for that purposes and not just a general collection of the toys used in children's everyday play. For this reason, it is best that they be purchased - not donated. A social worker meets with a client who appears distraught. The client reports feeling worried about her elderly mother, who lives in a group home. The client says that her mother's glasses have been broken twice, and her legs have marks on them that look as though she has been restrained. The mother denies that any abuse has occurred, but the client notices that her mother's behavior has suddenly changed. The social worker should help the client to: a. Talk with the group home supervisor to investigate the abuse b. Talk to the mother again about the possibility of abuse c. Ask the mother's physician to verify the injuries d. Make a report to the appropriate authorities - answer-Key: D Rationale: A suspicion of elder abuse is enough to warrant making a report A 14-year-old Asian American student is referred to a family agency because of the student's recent poor academic performance and behavioral changes, including lack of paying attention and social withdrawal. During the second family therapy session, the student angrily states that she is tired of the painful physical punishment from her father for "trying to fit in with her friends at school." The father notes that the punishment is necessary to prevent his daughter from imitating the behaviors of her American friends and this bringing shame to the family. The social worker should FIRST: a. Assist the parents to explore alternative modes of discipline b. Inform the parents that their behavior requires a report of suspected abuse c. Attempt to determine the severity of the physical punishment d. Help the daughter understand her parents' behavior as culturally appropriate - answer-Key: C Rationale: The social worker must FIRST assess for abuse before taking any other actions. A social worker is seeing a client who sometimes cancels appointments at the last minute, does not show at all for some appointments, and always pays fees late. The client described frequent fights with friends but doesn't understand why this keeps happening. What should the social worker do FIRST? a. Point out the client's disrespectful behavior with the social worker b. Talk about the secondary gain from the client's behavior c. Explain that continuing the behavior will result in termination d. Relate the client's behavior with the social worker to that with friends - answer-Key: D Rationale: Information provided in the stem indicates that the client is unaware of the impact of this behavior on relationships. Relating the client's behavior with the social worker to behaviors with friends is the only option that addresses this lack of awareness. During a family therapy session with a social worker, the parents of a 16-year-old girl reveal that they have been reading her email and have become aware of her sexual activity. The social worker should FIRST: a. Discuss the parents' reasons for reading the email b. Advise the parents that they were wrong to invade the child's privacy c. Encourage the adolescent to respond to this disclosure d. Schedule an individual session with the adolescent - answer-Key: C Rationale: The adolescent's privacy has been violated. She should be provided with an opportunity to talk about how this has impacted her. A client participating in day treatment attends a clubhouse program designed to reduce the isolation of mental health patients in the community. The social worker observes that the client avoids socializing and lacks conversational skills. The social worker should FIRST: a. Explain that avoiding conversations interferes with the goal of making friends b. Begin and sustain conversations, giving feedback about the client's efforts to participate c. List elements of a conversation and identify target behaviors desired of the client d. Encourage the client to join an activities group, trusting the group process - answer-Key: B Rationale: The client needs support to practice socializing and conversing before other steps can be taken. A social worker sees a 75-year-old man whose wife died six months ago. In the intake interview, the client reports that he has lost weight, has very little energy, and has difficulty getting himself to do things. What should the social worker do FIRST? a. Complete a suicide risk assessment of the client b. Explore available family and community resources c. Suggest the client schedule an appointment with his doctor d. Refer the client to a local bereavement group - answer-Key: A Rationale: After six months the client should be further along in grief process, and his reports describe depression and risk that warrant a risk assessment (key A). Options (B), (C), and (D) are all plausible but not the FIRST action the social worker should take. After a lifetime in one house, a senior moves into an assisted living facility. Before the move, the resident was outgoing but now is reclusive and refuses to attend meals or other activities. The social work consultant should suggest the staff FIRST: a. Allow the resident time for grieving b. Insist that the resident eat with others c. Find another facility to transfer the resident d. Request a psychiatric evaluation for the resident - answer-Key: A Rationale: Adjustment to the major move described in the stem would very likely involve a grieving process, and the client should be permitted to move through that process (key A). Insisting on certain behaviors (B), and setting up another relocation (C) are both inappropriate actions. There is nothing in the stem to indicate that a psychiatric evaluation is warranted at this time. A longterm client being treated for bipolar II disorder announces her pregnancy and her intent to continue taking lithium despite possible negative effects to the fetus. Her psychiatrist has informed her of the consequences but agreed to continue monitoring her medication. The social worker has a negative emotional reaction to the client's decision. What is the BEST way for the social worker to convey this reaction? a. Disapproval b. Disappointment c. Doubtfulness d. Perplexity - answer-Key: D Rationale: This is an unscored question. This becomes a matter of weighing benefit against risk, since discontinuation of medications in this case is likely to result in severe depression, suicidal ideation, or a manic episode for this client. The social worker cannot contradict the advice of the client's psychiatrist and must be careful not to allow personal feelings to interfere with the client's decision. In the evaluation process for a client's sexual dysfunction, the FIRST consideration is to: a. Gain an understanding of the client's past sexual functioning b. Rule out any medical basis for the dysfunction c. Meet conjointly with the sexual partner to evaluate sexual communication d. Evaluate the client's history for sexual trauma - answer-Key: B Rationale: All of these options should be done at some point during the evaluation process; however, anytime there is a physical symptom, a medical cause must be ruled out first. The term "tardive dyskinesia" refers to: a. Truant behavior b. Impaired memory c. A speech disorder d. A movement disorder - answer-Key: D Rationale: This is a basic recall item that required knowledge of tardive dyskinesia. A social work supervisor is assigned a new supervisee. During the initial supervisory sessions, the supervisor discusses the purpose of supervision, the role of the supervisory, and the expectations for the supervisee. The supervisee is asked to describe past practice experience, perceived strengths and weaknesses, and goals for supervision. The supervisor and supervisee jointly formulate goals for supervision. The purpose of this process is to: a. Establish learning objectives b. Determine boundaries c. Establish outcome measures d. Establish trust - answer-Key: A Rationale: The main purpose of early supervision is to establish learning objectives. A social worker sends a client to a colleague for a second opinion. The client has been in treatment for the past three months and has a diagnosis of major depressive disorder, recurrent episode. The client believes the therapy is not working because of continuing episodes of depression. The client says that the treating social worker has suggested psychotropic medication. The client refuses to consider the medication. The colleague should NEXT: a. Conduct a literature search on the value of psychotherapy for depression b. Discuss information given by the client with the treating social worker c. Suggest the client see a psychiatrist for a medication evaluation d. Explore with the client her resistance to taking medication - answer-Key: D Rationale: After three months in treatment without improvement, refusal by the client to consider medication represents resistance. This issue needs to be explored with the client before any other options are considered. A client in short-term therapy with a social worker expresses general dissatisfaction with life. During the first few sessions, the client skirts answers to questions, avoids issues, and changes the subject often. Upon observing these behaviors, the social worker should: a. Employ ego-supportive techniques b. Respect the client's pace c. Confront the client with the resistance d. Review the social history - answer-Key: C Rationale: "Short-term therapy" means there is limited time to work on issues. While the social worker would not confront the client's resistance during the first or second session because of the importance of developing a therapeutic relationship, it would be appropriate to attempt to address important issues after the first few sessions. A social worker is conducting an insight oriented psychotherapy group. Although all parties have been briefed on confidentiality, during the group session, one individual admits discussing the group with friends and family. The BEST way for the social worker to handle this situation is to: a. Encourage group members to confront the individual regarding this breach b. See the client outside of the group setting to explain the inappropriateness of this behavior c. Have other group members vote on whether this client can stay in the group d. Have group members discuss this situation and reach a mutually satisfactory resolution - answer-Key: D Rationale: The group members need to resolve the issues themselves. Whatever is decided should be a group decision and not a decision pushed by the social worker. A social worker is called to a hospital emergency room to assist with a woman who was brought in this her deceased baby. The baby has just died of a sudden infant death syndrome. The mother, who has no history of mental illness, is refusing to let go of the baby and insists that the baby is still alive. What should the social worker do FIRST? a. Have the woman sedated while the baby is removed b. Allow the woman to let go of the baby in her own time c. Admit the woman immediately to the psychiatric unit d. Involve family and clergy in helping to reorient the woman - answer-Key: B Rationale: This is an unscored question. Denial is the first stage of grieving. The mother should be permitted to engage in this stage of grief. A social worker is contacted by a female client who initially expresses a desire to become more assertive. However once therapy begins, the client is unable to carry out treatment tasks. She indicates she is fearful of initiating change because her culture does not approve of assertive women. The social worker's FIRST response in this situation should be to: a. Support the client's efforts to pursue her original goal b. Renegotiate the goal with the client c. Discuss the client's perception of the cultural conflict d. Encourage the client to invite her family to the sessions - answer-Key: C Rationale: Engaging the client in a discussion of her perception of the cultural conflict (key C) should be the social worker's FIRST response because it addresses the client's expressed reasons for the fearfulness and starts where the client is. A renegotiation of goals (B) is a jump, and not the social worker's FIRST action. Supporting the pursuit of the original goal (A) ignores the perceived impediments to achieving them as expressed by the client, while there is no indication that it would be appropriate to invite family members to the sessions (D). In an initial interview, a five-year-old girl is anxious and emotionally constricted. In order to lower anxiety and begin a working relationship, what should the social worker do FIRST? a. Assure the child she is safe and can express feelings b. Involve the parents in the treatment c. Ask the child gently what is bothering her d. Relate to the child through the use of play materials - answer-Key: D Rationale: This is an unscored question. Young children do not often express their feelings verbally but rather act them out through play. A social work student in a social service agency reports to the supervisory that a client verbally assaults the agency receptionist during visits. The supervisor's FIRST response should be to: a. Warn the client about the consequences of this behavior b. Have the client escorted in and out of the agency c. Discuss with the receptionist ways to deal with hostile clients d. Ask the student to discuss the behavior with the client - answer-Key: D Rationale: It is important for the student to address this issue directly with the client (key D). Requiring that the client be escorted (B) is too extreme. The receptionist should not be held responsible for dealing with hostile clients (C). Stepping in to warn the client about the behavior (A) does not support the student's efforts to handle the issue. A social worker sees a teenager and her mother because of increased anger, family conflict, and defiance at home. The parent reveals that the teenager was sexually abused at an early age and has never talked about this with anyone. The teenager denies memory of the abuse. The social worker should FIRST: a. Recommend individual treatment for the teenager b. Normalize the teenager's reactions c. Develop a treatment plan for family therapy d. Provide education for anger management skills - answer-Key: B Rationale: Normalizing (key B) is correct because it serves to relieve some of the stress between parent and child. (A), (C), and (D) should all be done, but not until the teenager's feelings have been normalized. A social worker sees a university student who reports compulsive exercise, and bingeing and purging several times per week. This has been going on for four months and, in addition, the client reports having nightmares and continually feeling "on edge." The client has missed classes because she loses track of time and is sometimes afraid to walk across campus. The client says she broke up with her boyfriend over a month ago after a violent fights during which he tried to kill her. The MOST likely comorbid diagnoses are bulimia nervosa and: a. Dissociative amnesia b. Nightmare disorder c. Adjustment disorder d. Posttraumatic stress disorder - answer-Key: D Rationale: The seriousness of the precipitating event (boyfriend tried to "kill her"), in addition to the nightmares, avoidance of classes, and fear, all meet the criteria for the diagnosis of posttraumatic stress disorder (key D). In order for the adjustment disorder (C) to be correct, the stressors would be less severe and within the range of common experiences. There is not enough information to meet the criteria for nightmare disorder (B), and no indication of amnesia (A). Due to budget problems, an agency makes policy changes that include raising client fees. The social worker is concerned that poorer clients will be most affected. The social worker should FIRST: a. Support the policy through the education of clients b. Use a problem-solving model to address client concerns c. Serve as broker to link clients to alternative services d. Advocate to change the policy for low-income clients - answer-Key: D Rationale: Any changes that could result in reduced availability or denial of services to clients must be carefully considered before implementation, and the social worker should advocate on behalf of the vulnerable population. Other options should be used if advocacy for a change in the policy falls. A social worker in an outpatient setting is treating a woman diagnosed with a psychotic disorder but with no history of violence. During a session, the woman presents as delusional and paranoid. She tells the social worker that she is convinced that her husband is going to kill her. The client then becomes increasingly agitated, tells the social worker that she is going to kill her husband before he can kill her, and runs out of the office. The social worker should FIRST: a. Ask the agency's legal counsel for advice b. Contact the agency medical director to discuss interventions for the client c. Call the police to warn of the client's plan d. Document the events of the session to protect the agency from liability - answer-Key: C Rationale: Duty to warn provisions necessitate notification of police, given the level of threat witnessed by the social worker. A social worker admits to an intimate relationship with one of his clients whom he has treated for over two years. The social worker is the subject of a regulatory board investigation. He tells the investigator that he truly loves this client and would like to marry her. When interviewed, the client reports that she initiated the sexual contact with the social worker. The social worker terminated therapy with the client when she moved in with him. The social worker's actions are: a. A violation of boundaries b. Not an ethical breach because no harm was caused to the client c. Acceptable because the therapeutic relationship was terminated d. Illegal in all jurisdictions - answer-Key: A Rationale: The actions described in this item amount to a violation of boundaries based on professional ethical codes (key A). Defining actions as boundary violations does not depend on whether harm occurred (B) or whether therapy was terminated (C). This behavior may not rise to the level of criminal behavior in all jurisdictions (D). Utilizing ego psychology, a social worker would view a client's use of defense mechanisms as: a. Serving an important protective function b. Impairing the client's ability to test reality c. Operating consciously d. Ineffective at reducing anxiety - answer-Key: A Rationale: In Freudian psychoanalytic theory, the role of defense mechanisms is to protect the ego. A social worker meets with the parents of a rebellious adolescent. They say that they are very offended when he talks back. In family therapy, the MOST appropriate goal is to: a. Teach the family how to discuss problems b. Change the parents' style of discipline c. Suggest appropriate responses for the child d. Recommend that the parents ignore back talk - answer-Key: A Rationale: The skills of problem-solving are useful in any well-functioning family. Teaching the family how to problem solve with open communication skills is the correct answer. In a play therapy session with a social worker, a six-year-old girl exhibits a knowledge of sexual organs and how they function that is unusual for her age. What should the social worker do FIRST? a. File a child sexual abuse report with the proper authorities b. Ask the parents if the child has been sexually abused c. Recommend that the child be scheduled for a physical exam d. Explore with the child the sources of her knowledge - answer-Key: D Rationale: The social worker needs to get clarification from the child FIRST before taking any other action. A client who is gay assumes that the assigned social worker is heterosexual. The client adamantly insists on services from a homosexual social worker. What should the social worker do? a. Explore the client's reasons for this request b. Refer the client to an openly gay social worker c. Explain to the client that the social worker's orientation is irrelevant d. Disclose the social worker's own sexual orientation - answer-Key: A Rationale: The social worker cannot develop an appropriate course of action until there is an understanding of why the request was made (key A). While a referral may be made eventually (B), the social worker must first understand the reason for the request. Explaining how the client's concern is irrelevant (C) inappropriately challenges the client. Disclosure of the social worker's own sexual orientation (D) would be a boundary violation. A male client comes to a first session with a social worker. When the client sits down, he makes little eye contact and seems guarded, awkward, and uncomfortable. What should the social worker do NEXT? a. Inquire about how the client is feeling b. Interpret the client's discomfort as a cultural behavior c. Allow the silence to continue for a brief period of time d. Initiate an informal, personal conversation - answer-Key: A Rationale: This is an unscored question. Acknowledgment of a client's feelings is a first step in making the client feel more comfortable in a strange and stressful situation, and in the establishment of a therapeutic relationship. A new client wants to be assured that her sessions are absolutely confidential. When should the possibility of a subpoena for confidential records of a client's social work sessions be discussed? a. If it appears that the problem might involve court actions b. In the first session before the client contracts for services c. After rapport and trust are firmly established d. Whenever the social worker deems it is most appropriate - answer-Key: B Rationale: This is a recall item requiring knowledge of when to discuss limits of confidentiality with clients. A social worker sees a client who was referred after a conviction for embezzlement. The client has an extensive history of gambling but denies that it is a problem for him or his family. What type of therapy would be MOST effective in treating this client's gambling addiction? a. Individual b. Family c. Group d. Couples - answer-Key: C Rationale: This is an unscored question. Group therapy is the preferred method of treatment for all addictive behaviors, since the group process breaks down the individual client's denial and rationalizations. In an agency in which there is a suspected disparity in the pay rates of male and female social workers, the female social workers decide that the difference must be addressed. They should FIRST: a. Educate colleagues about how to file discrimination claims b. Encourage colleagues to become more politically active c. Advocate with the director to increase salaries of female workers d. Initiate a salary survey to determine whether discrepancies exist - answer-Key: D Rationale: This is a suspicion that must be objectively investigated before any other actions can be taken. Until the social worker validates the suspicion, remediation or other actions cannot be taken. A client scores high on the Beck Depression Inventory. After the social worker has reviewed the results, the social worker should NEXT: a. Discuss the results with the client at the next session b. Validate the results by having the client take another instrument measuring depression c. Share the results with the client after progress has occurred d. Share the results with the client after the client has taken the inventory several times - answer-Key: A Rationale: It is important to share the results with the client as soon as possible (key A). The results of this inventory do not have to be validated (B). It is not therapeutic to wait for progress to be made before sharing these findings (C). There is no need to engage in repeated administrations of the inventory (D). A social worker is conducting an intake interview with a client in a prison psychiatric setting. The client states that he is hearing voices that tell him he is a bad person. He states that the voices are worse in jail and that he does not want to go back to his cell. The social worker asks if the client does not want to go back because the voices get worse or because he dislikes being in the cell. The social worker is using which of the following techniques? a. Confronting b. Interpreting c. Clarifying d. Probing - answer-Key: C Rationale: The social worker warts to understand what the client has said and engages in clarifying techniques to do so. A social worker is abusing alcohol. The primary rationale for taking action to remove this colleague from direct service is to: a. Ensure quality service for clients b. Decrease the liability of the agency c. Motivate the colleague to get help d. Comply with professional standards - answer-Key: A Rationale: Client protection must be the first priority in the provision of social work services. After a long course of treatment with a client, the social worker begins the process of termination. The client's initial reaction is one of surprise. The client states a lack of readiness and appears to feel rejected by the social worker. What should be included in the ending phase of treatment? a. Focusing on the goals accomplished b. Referring to another worker or agency c. Contracting for additional sessions d. Reviewing the client's strengths and weaknesses - answer-Key: A Rationale: This is an unscored question. Clients often lose sight of the reasons for treatment, which are to reduce symptoms and improve function. Treatment planning must include recognizable goals to accomplish this and it is important for the social worker to keep the client aware of the goals and focused on them. In a treatment session, a client diagnosed with social anxiety disorder discusses having joined a new community group whose members are picketing to protest the local library's current policy for book purchases. The social worker personally agrees with the library's current policy. The social worker should: a. Explain why the policy should stay as it is b. Explore other ways to advocate for policy changes c. Advise the library staff about the new group d. Discuss the pros and cons of joining the group - answer-Key: D Rationale: The social worker's focus should be on exploring the client's decision in terms of treatment and treatment goals (key D). Explaining the value of the library's policy (A) or discussing other ways to advocate for change (B) forward the social worker's own agenda. Alerting the library staff to the group (C) is irrelevant to social work practice and violates client confidentiality. A social worker is treating a client of Asian descent for a major depressive disorder. Although the client, her husband, and his extended family all live together in one home, the client feels alone because the family does not understand her distress. What should the social worker do FIRST? a. Explore beliefs about mental illness in the client's culture b. Examine the client's expectations for her marriage c. Suggest a therapy session for everyone in the family d. Address the client's feelings about her living situation - answer-Key: A Rationale: This is an unscored question. Some cultures view mental illness very differently than does the social work profession. It is necessary to recognize and adjust for the influence of the client's cultural beliefs in order for treatment to be effective. A social worker works at an emergency shelter for women and children who are victims of domestic violence. The children are in desperate need of basic items such as socks, underwear, diapers, and school supplies. The shelter's budget has already been cut significantly, and the shelter director informs the social worker that they cannot use any agency funds to purchase these items. The social worker should FIRST: a. Apply for a grant to obtain extra supplies from a local funding source b. Call community stores for donations of needed items c. Plan a fundraising event for the needed supplies d. Contact the board of directors for funding approval - answer-Key: B Rationale: This item describes a situation in which needs are immediate, and these items can most quickly be supplied from existing community stores. All of the other options would require a great deal more time before supplies could be obtained. A social worker begins treatment with a couple by asking many questions about their marital history. The social worker is MOST likely: a. Looking for