LMSW PRACTICE TEST QUESTIONS/213 QUESTIONS AND ANSWER

LMSW PRACTICE TEST QUESTIONS/213 QUESTIONS AND ANSWERS 1. According to Beck, a depressed person does not see the positive aspects of his/her situation because of: a. Precipitating factors b. Lack of support c. A dysfunctional schema d. Lack of adaptive coping strategies - Correct Answer -c. A dysfunctional schema 2. It is necessary to obtain informed consent prior to giving out data about a patient. Which of the following statements is MOST correct regarding this issue? a. You must obtain informed consent from your patient in most situations, but not in all situations. b. If a significant other requests information about your patient, you may release it without informed consent. c. If you are going to consult with a colleague, you must have informed consent from your patient. d. You must always have informed consent from your patient. - Correct Answer -a. You must obtain informed consent from your patient in most situations, but not in all situations. 3. A soldier with combat-related Posttraumatic Stress Disorder desires to return to combat. What is the first thing you should do? a. Allow the soldier full self-determination, returning when he deems appropriate. b. Inform the client that return will likely cause an increase in symptoms and is not advised. c. Contact the commanding officer to determine if this is an option for the soldier. d. Assess progress in treatment and current level of functioning. - Correct Answer -d. Assess progress in treatment and current level of functioning. 4. A man is referred by his primary care provider and presents with a diagnosis of Hypochondriasis. What is the FIRST crucial step in treatment? a. History taking b. Establishment of trust and appreciation for the patient's problems c. Education about the link between stress, emotions and lifestyle and physical health d. Treatment planning - Correct Answer -b. Establishment of trust and appreciation for the patient's problems 5. Client: "I'm depressed. I've lost my hair at a much quicker rate than I thought possible. I'm terribly embarrassed to go out in public. I'm feeling extremely anxious and uneasy about my baldness." Social Worker: "You're anxious and uneasy about the transformations that are a natural process of aging." The social worker's response is: a. Encouragement b. Summarization c. Paraphrase d. Reflection of feeling - Correct Answer -d. Reflection of feeling 6. How do you find the median of a set with an even number of items? a. The larger of the two middle numbers is the median. b. The two middle numbers are both medians. c. Find the average of the two middle numbers. d. A set with an even number of items does not have a median. - Correct Answer -c. Find the average of the two middle numbers. 7. A young, beginning social worker has some intrapersonal and interpersonal struggles with women in authority positions that stem from her poor relationship with her mother. The social worker's client is a female 50- ish successful CEO of an Internet start-up. The social worker is likely to struggle in therapy due to: a. Counter-resistance b. Counter-transference c. Transference d. Resistance - Correct Answer -b. Counter-transference 8. When treating elder adults with depression, the BEST approach to treatment is: a. Cognitive behavioral therapy coupled with family interventions. b. Significant reliance on psychiatry because medication management is most important. c. Treatment of elder adults is similar to other adults, so no significant alterations are needed. d. Coordination between medical and mental health due to the influence of medical conditions on psychiatric symptomatology. - Correct Answer -d. Coordination between medical and mental health due to the influence of medical conditions on psychiatric symptomatology. 9. Professional ethics and professional values differ in which of the following: a. Values are a subset of ethics. b. Values deal with what is right or wrong in practice, and ethics deals with the principles of practice. c. Values and ethics are basically the same and are evaluated based on the specific situation. d. When a social worker makes a judgment that is ethical, you can assume it is a judgment that also upholds professional values. - Correct Answer -b. Values deal with what is right or wrong in practice, and ethics deals with the principles of practice. 10. What is the first thing to assess in on-site basic crisis intervention, such as in the aftermath of a natural disaster? a. Immediate needs for physical safety, food and clothing b. Trauma response c. Future mental health risk d. Needs for various concrete services (e.g., transportation, alternate housing) - Correct Answer -a. Immediate needs for physical safety, food and clothing 7-year-old child is refusing to sleep in his own bed at night. When the parents sit with him in his room, he is fine. When they leave the room, he begins to cry. When they come back in, he stops crying. This is an example of Operant conditioning Classical conditioning Punishment cycles Higher order conditioning - Correct Answer -operant conditioning Older individuals are often misdiagnosed with Alzheimer's when, in fact, the more accurate diagnosis is Anxiety Depression Thyroid Disorder Delirium - Correct Answer -Depression. Approximately 55% of the elderly suffer from depression and are often misdiagnosed with Alzheimer's or Dementia. Anxiety (answer #1) is not correct, although anxiety can be a problem in older adults; anxiety is not a characteristic that would be a symptom of Alzheimer's. Thyroid disorder (answer #3) is not correct because this condition is a malfunction of the thyroid gland, resulting in a variety of medical symptoms, usually not similar to symptoms of Alzheimer's. Delirium (answer #4) is not correct, as Delirium is characterized by a disturbance of consciousness and a change in cognition that develop over a short period of time. A social worker is seeing a new client, who is a college student, for therapy. After speaking with the client about her current enrollment at the university, the social worker spent a significant amount of time urging the client to work less so she could focus on school. The social worker wants the client to get all "A" grades this semester because she reminds him of his daughter at that same stage in life, as well as the anxieties that he experienced during that time in his life. The client really wants to please the social worker because he reminds her of her dad. Which of the following is reflected in the client? Transference Counter-transference Projection A dual relationship - Correct Answer -Tranference. In a therapeutic context, transference refers to redirection of a client's feelings from a significant person to the social worker. Counter-transference (answer #2) is incorrect because this is the redirection of a social worker's feelings toward a client, or more generally speaking a social worker's emotional entanglement with a client, which was reflected in the first part of the question; however, this does not describe what is being reflected in this client. Projection (answer #3) is demonstrated when a person's own unacceptable or threatening feelings are repressed and then attributed to someone else, which is not occurring in this case example. A dual relationship (answer #4) is incorrect, as this refers to a situation where multiple roles exist (not just perceived) between a social worker and a client, such as an actual father and daughter relationship between a social worker and client. A client was recently diagnosed with Multiple Sclerosis. She immediately began to learn everything she could about the illness: reading books, journal articles, and the latest experimental research. The client's response to her diagnosis is representative of which defense mechanism? Intellectualization Regression Sublimation Repression - Correct Answer -Intellectualization A social worker has been working with a 35-year-old divorced woman who has joint custody of her son, but is the custodial parent. Her ex-husband, whom the social worker has never met, is taking the client to court in an attempt to gain full custody of the son. The social worker receives a subpoena from the husband's attorney requesting records regarding the wife's therapy sessions with the social worker. The social worker is required to do which of the following? The social worker must release the entire record of the therapy sessions to the attorney The social worker is allowed to release only those records that make direct reference to the wife's relationship with the son, not her treatment issues The social worker is required to respond to the subpoena, but is not required to release records since the subpoena was issued by the attorney and not a judge The social worker does not have to respond to the subpoena because the client's records are confidential - Correct Answer -The social worker is required to respond to the subpoena, but is not required to release records since the subpoena was issued by the attorney and not a judge A 22-year-old female client is considering having an abortion. Her social worker is pro-choice and feels passionately about the issue. Which of the following is the FIRST thing that the social worker should do in this situation? She should talk with the client about abortion alternatives She should refer the client to another social worker She should help the client obtain the services she needs to get an abortion She should ask the client to share her rationale for choosing abortion - Correct Answer -The correct answer is #4 - She should ask the client to share her rationale for choosing abortion. Keep in mind that a social worker should always seek to understand. Talking with the client about abortion alternatives (answer #1) and referring the client to another social worker (answer #2) are both not correct because once the client has provided more information, the social worker can ascertain if the client lacks information about other options or needs to be referred to another social worker. Helping the client obtain the services she needs to get an abortion (answer #3) is not correct because if the social worker helps the client obtain abortion services, she may miss an important opportunity to gain further understanding of the client's circumstances and alternatives. Remember, the question asks for the FIRST thing the social worker should do in this situation. A teacher has noticed some dramatic behavioral changes in a 7-year-old boy over the recent weeks and has referred him to the school social worker. The child appears distracted in class, no longer finishes his daily assignments, has become aggressive toward peers, has soiled his pants on two occasions, and appears apprehensive around adults. Which of the following might likely be the cause of this child's behaviors? Possible neglect at home Possible sexual abuse Onset of Conduct Disorder Recent death of a loved one - Correct Answer -Possible sexual abuse A 30-year-old gay male is seeking treatment in a mental health agency. The intake social worker begins to gather information to determine this individual's qualification for services. The client states that he has been feeling sad and hopeless, and is losing interest in activities in which he used to participate. He states that he and his partner have recently broken up and that he has been spending less time with his parents and siblings. The intake worker should refer this individual for treatment and identify his presenting problem as His Homosexuality Relationship issues Family issues Depression - Correct Answer -Depression A client asks the social worker to view his therapy records. The social worker knows that showing the records to the client will be harmful given the client's profile. What is the social workers ethical responsibility? The social worker should show the client his or her records as the client has the right to view them The social worker should limit the client's access to his records and provide assistance in interpreting the records shown to the client The social worker should deny the client access and explain the reasons for doing so The social worker should consult with a colleague - Correct Answer -The social worker should limit the client's access to his records and provide assistance in interpreting the records shown to the client A politician recently admitted his arrangement with the pharmaceutical industry, which involved writing key legislation to mandate vaccinations if the industry would, in return, finance the majority of his re-election campaign. According to Kohlberg's Theory of Moral Development, at which level of moral development was the politician operating? Pre-conventional Morality Conventional Morality Post-Conventional Morality Morality of Social Contract - Correct Answer -The correct answer is #1 - Preconventional Morality. Pre-conventional Morality is Level 1, Stage 2 and involves "you scratch my back and I'll scratch your back" types of behavior. Conventional Morality (answer #2) and Post-Conventional Morality (answer #3) are both incorrect, as they are both identified as levels involving moral reasoning that goes beyond a self-focused perspective. Morality of Social Contract (answer #4) is not correct because it is a stage, not a level, according to Kohlberg. Moreover, it involves higher moral reasoning than that demonstrated by the politician. A client has been drinking frequently since the death of his son last year. He states that he feels better physically when he drinks more, especially in the mid-morning, and that he does not feel intoxicated as often as he did immediately after his son's death. He expresses his desire to quit but says that he cannot get away from the craving. The client feels embarrassed because his sister found him unconscious one night as a result of his drinking. Which of the following would most likely be the social worker's FIRST diagnosis? Depression Alcohol Dependence Alcohol Abuse Avoidant Personality Disorder - Correct Answer -Alcohol Dependence. Depression (answer #1) is not correct because while the client may be depressed, more data would be needed to make this diagnosis. Alcohol Abuse (answer #3) is not correct because the client would need to show at least two physiological factors and five behavioral patterns over a twelvemonth period, which is severe and exceeds the requirements for Alcohol Abuse. Avoidant Personality Disorder (answer #4) is not correct because this question does not provide sufficient information to determine this diagnosis. A social worker has recently learned from the wife of a couple he is seeing that the wife believes that she is a lesbian. She states she does not want to share this with her husband. During the next session, the husband asks his wife if she likes women better than men. The wife answers "No." What is the FIRST response that the social worker should make in this situation? Encourage the wife to be honest Encourage the husband to ask the wife after the session Say nothing but plan on speaking with the wife after the session Encourage the couple to discuss the issue - Correct Answer -Encourage the couple to discuss the issue. The responsibility for establishing a relationship of honesty rests with the couple. The social worker can facilitate the process of developing such a relationship by encouraging dialogue about this and other important issues. Encouraging the wife to be honest (answer #1) is not the best answer for this scenario, as the social worker would be indicating that he has information that the husband does not have. The social worker may, at another time, need to help the wife decide how she will handle this information with her husband. Encouraging the husband to ask the wife after the session (answer #2) and saying nothing but planning on speaking with the wife after the session (answer #3) are both incorrect answers because these would be interfering with the couple dealing with their own situation. A social worker receives a new client who is seeking cognitive behavioral therapy, which is not the social worker's treatment of expertise. The social worker should Attempt this intervention Refer the client to an expert Explore the client's reasons for wanting cognitive behavioral therapy Use his own techniques as he or she is well trained to meet the client's needs - Correct Answer -Explore the client's reasons for wanting cognitive behavioral therapy. As the social worker discusses this with the client, it may become evident that the social worker is able to provide the services the client desires. Alternatively, the discussion may reveal the need to refer the client elsewhere. Attempting this intervention (answer #1) is not correct because a social worker should be trained and competent in the interventions he or she uses. Referring the client to an expert (answer #2) is not the best answer because the social worker should find out more about the client's request before referring the client to an expert in cognitive behavioral therapy. Using the social worker's own techniques as he or she is well trained to meet the client's needs (answer #4) is not correct because the client has asked specifically for cognitive behavioral therapy and should be part of the decision-making process regarding whether other techniques could be as beneficial. A 60-year-old female client has been meeting with a social worker to discuss dissatisfaction in her marriage. Over the course of the first few sessions, the social worker noticed that the client spent little time discussing substantive marital issues and instead discussed her accomplishments, even when it did not fit into the conversation. She also talked about how she felt that it was important for her to spend her time with other well-educated individuals. The client described work situations in which she became angry and then tearful when not validated for her achievements. She also tried to get a manager fired for not implementing her ideas. The most likely diagnosis for this client would fall into which category? Cluster A Cluster B Cluster C None of the above - Correct Answer -Narcissistic Personality Disorder- a Cluster B classification- is characterized by many of the behaviors the client exhibits. Cluster B Personality Disorders are evidenced by dramatic, erratic behaviors and include Histrionic, Narcissistic, Antisocial, and Borderline Personality Disorders. Cluster A Personality Disorders (answer #1) is not correct because those disorders are considered to be marked by odd, eccentric behavior and can result in diagnoses such as Paranoid, Schizoid, and Schizotypal Personality Disorders. Cluster C Personality Disorders (answer #3) is not correct because those disorders are distinguished by the anxious, fearful behavior commonly seen in Obsessive-Compulsive, Avoidant and Dependent Personality Disorders. A social worker is interested in conducting a study of drug use among adults of different ethnic backgrounds. Which of the following sampling strategies is most apt to yield a sample that reflects the ethnic composition of the area? Simple random sampling Convenience sampling Snowball sampling Stratified sampling - Correct Answer -Stratified sampling. This form of sampling is used to ensure that there are sufficient cases representing different values of a variable (in this case ethnic groups). Simple random sampling (answer #1) is not correct because simple random sampling refers to the random selection of a predetermined number of cases from a sampling frame, where each case in the sampling frame has an equal probability of being selected for inclusion in the sample. Convenience sampling (answer #2) is not correct because convenience sampling refers to cases that are selected for inclusion in a study sample because they can be readily accessed by the researcher. Snowball sampling (answer #3) is not correct because snowball sampling is a sampling strategy that involves compiling the sample as the study progresses. A 65-year-old Hispanic-looking woman walks into a clinic for her first therapy session. The social worker is a bilingual therapist. Under these circumstances, what is the FIRST thing that the social worker should do? Greet the woman in Spanish to let her know that the social worker is respectful of her culture Ask the woman if she would like to speak to the social worker in Spanish Consult with the state to see if English is the official language and inquire about related laws Greet the woman in English - Correct Answer -Greet the woman in English When writing about the duality of the "Black experience" and the dual perspective, Leon Chestang identified two systems. Which of the following is the larger, more dominant system that provides instrumental and pragmatic needs for physical survival and quality of life? The Structural System The Nurturing System The Sustaining System The System of Basic Needs - Correct Answer -The Sustaining System. Leon Chestang identified two systems: The Nurturing System and the Sustaining System. The Sustaining System is the larger, more dominant system that provides instrumental and pragmatic needs for physical survival and quality of life, such as political power, shelter, and employment. The Nurturing System (answer #2) is an incorrect answer to this question, as it relates to the person's immediate family and community environment. The other two answer choices (answers #1 and #4) are incorrect, as they are not real terms related to the information provided in the question. A social worker has completed an assessment of a client and is in the process of recommending a placement for a client's treatment. Which of the following is the FIRST consideration in selecting a treatment approach for the client? The nature of the client's problem(s) The level of care needed The treatment provider's knowledge and skill level The philosophy of the agency - Correct Answer -The level of care needed. While all of the other answer options: the nature of the client's problem(s) (answer #1), the treatment provider's knowledge and skill level (answer #3), and the philosophy of the agency (answer #4) are important, the level of care needed must be the first consideration. If the client needs hospitalization, incarceration, home healthcare, or hospice, the treatment options would be much different than if the client can receive services on an out-patient basis. A 40-year-old male client explains that he is seeking care because he suffers from panic attacks. He notes that he gets chills, nausea, dizziness, and experiences fear about once a day. A social worker's FIRST step with this client would be to Teach relaxation therapy Set goals for reduction of anxiety Arrange for a doctor's appointment Assess the client's current situation - Correct Answer -Assess the client's current situation In a Task-Centered Treatment approach, once a social worker establishes the client(s) needs, which of the following is the BEST option? As the expert, the social worker should be the primary person to establish the treatment goals The client should be the primary person to establish the treatment goals The client and the social worker should jointly establish the treatment goals A medical doctor should be included in establishing the treatment goals - Correct Answer -The client and the social worker should jointly establish the treatment goals You are called to evaluate a 64-year-old male with chronic obstructive pulmonary disease. He lives in an assisted living facility, and was brought to the emergency room by his daughter. She had taken him to lunch, and became distressed when he refused to return to the facility. He states he wants to live in his motor home, as he resents the loss of privacy at the facility. His daughter confirms he owns a working, fully self-contained motor home (i.e., stove, shower, refrigerator, etc). He has adequate funds. He plans to park the motor home in a nearby Kampgrounds of America (KOA) campground, where all utilities can be hooked up. He can have food and other supplies delivered. However, it is November and it is unseasonably cold. The doctor confirms that the patient is prone to pneumonia, and the daughter states "he will die if he doesn't return to the facility." The patient refuses to consider any other living situation. In this situation, the social worker should: a. Call the police and have them take the patient back to the facility. b. Call adult protective services for further intervention. c. Allow the patient to move into his motor home. d. Place the patient on an involuntary hold for suicidal behavior. - Correct Answer -C: Allow the patient to move into his motor home. The patient has a plan sufficient to meet his needs for food, clothing, and shelter. He has the legal right to choose where he wishes to live, even if others are not comfortable with his choice. Calling the police will not help, as they cannot force him to return to the facility. Adult protective services may have a subsequent role, if the patient begins to exhibit marked self-neglect or cognitive changes, but they cannot force the patient either. Finally, the patient is not eligible for an involuntary hold, as he is not placing himself or others in danger based upon a diagnosable mental illness, intoxication, or other substance abuse. Careful collateral planning, however, will be important (ensuring the daughter visits and checks in on him, etc) to try and maximize his potential for success. After coping with the hardships of independent living, he may willingly return to assisted living. 2. You have just had your first session with a 24-year-old college student. She is seeing you following the break-up of a two-year relationship, which occurred without warning about six weeks prior to this visit. As she explained it, "He met someone else and just moved on." She has been having trouble sleeping and concentrating on her studies since that time. Today she presents as dysphoric and tearful, but is affectively expressive and responsive to humor and other interactive stimuli. The university she attends is a considerable distance from her family and friends, leaving her with limited support during this difficult time. The most appropriate diagnosis would be: a. Primary insomnia. b. Major depression. c. Adjustment disorder with depressed mood. d. Acute stress disorder. - Correct Answer -2 - C: Adjustment disorder with depressed mood. Criteria for this disorder includes a time-limited nature, usually beginning within three months of the stressful event, and lessening within six monthseither with removal of the stressor or through new adaptation skills. Adjustment disorder is a "sub-threshold disorder," allowing for early classification of a temporary condition when the clinical picture remains vague. While the patient does have insomnia, it arises from the stressful loss and not as an independent condition. Many of the essential criteria for a major depression are absent (weight loss, psychomotor agitation, blunted affect, etc), although without successful treatment this condition could emerge. The diagnosis of acute stress disorder is not appropriate as the precipitating event did not involve threatened or actual serious injury or death. 3. You are hired by a private practice therapist who operates a courtsupervised violent offender treatment program. One of your responsibilities is to screen new client referrals, to ensure that only low-risk, first-time offenders are accepted into the program. In this process, you are to have each client sign a treatment consent form, which also includes a detailed consent for release of information. You note that instead of the usual time and target limits, the form allows information to be released at any time to "any law enforcement agency," "any spouse, ex-spouse, or significant other," "any welfare or abuse protection agency," etc. You ask about the ethics of having clients sign this form, and you are told, "It's a hassle to try and get specific information releases, and the safety of the public is at stake. Use the form." Your BEST response is to: a. Use the form as directed. b. Refuse to use the form. c. Call your licensing board and discuss the form. d. Call law enforcement and discuss the form. - Correct Answer -B: Refuse to use the form. No client or client population is beneath the ethical standards of the field. An appropriate information release form stipulates a limited period of time beyond which the form expires, the specific kind of information to be released, the specific purpose for which the information is to be provided, and a specific individual or entity to whom/which the information will be provided. While obtaining an information release is indeed a "hassle" it is the ethical standard of care in the field, and deviation from it can open a practitioner to legal liability. The fact that a given client, or client population, may be unaware of this does not excuse the therapist from using an ethically appropriate form in keeping with expected standards of care. Any limitations to confidentiality-such as mandatory reporting if a client expresses intent to commit a crime or harm another-belong on a treatment consent form, rather than on an information release form. 4. In statistical research, a "Type I Error" (also called an "alpha error," or a "false positive") refers to: a. Failing to reject the null hypothesis when the null hypothesis is false. b. A failure to randomize research participants, thereby potentially introducing bias. c. Rejecting the null hypothesis when the null hypothesis is true. d. Assuming a normal statistical distribution when it is skewed. - Correct Answer -C: Rejecting the null hypothesis when the null hypothesis is true. A failure to randomize research participants will potentially introduce bias, and may provide grounds upon which to invalidate a study, but it is not a type I error. Assuming a normal statistical distribution when it is skewed will violate the assumptions necessary to apply a proper statistical model to the analysis of data. 5. Identify the missing step in Albert R. Roberts seven-stage crisis intervention model: 1) assess lethality; 2) establish rapport; 3) ; 4) deal with feelings; 5) explore alternatives; 6) develop an action plan; 7) follow-up. The third step is: a. Evaluate resources. b. Identify problems. c. Environmental control. d. Collateral contacts. - Correct Answer -B: "Identify problems" is the third step in the Roberts crisis intervention model. 6. Self-Psychology, as postulated by Heinz Kohut, acknowledges that personality is partly formed by social structure. A cohesive self is achieved by incorporating the perceptions and functions of healthy significant others and objects into an internalized self structure through a process called: a. Empathic mirroring. b. Rapprochement. c. Differentiation. d. Transmuting internalization. - Correct Answer -D: Transmuting internalization. Empathic mirroring is the process by which the mother demonstrates ("reflects") care and understanding of the child, in turn helping the child to develop a self-identity. Rapprochement is a term from object relations theory, indicating the need for an infant to seek independence while still retaining security. Differentiation is a substage in object relations theory, where an infant begins to look at the outside world, as opposed to the inward focus common to infants younger than five months of age. 7. An early cognitive theorist, who worked directly with Freud, established a theoretical orientation that differed from Freud's in three key features: 1) an individual's personality is best perceived as a whole, rather than as having hierarchical segments or parts; 2) social relationships drive behavior more than sexual motivations; and 3) current beliefs and thoughts play a far greater role in human behavior than is suggested via psychoanalytic theory, which is based largely in the unconscious and in past experiences and beliefs. The name of this theorist is: a. Lawrence Kohlberg. b. Anna Freud. c. Albert Ellis. d. Alfred Adler. - Correct Answer -D: Alfred Adler. Adlerian theory also includes a biological view, largely absent in Psychoanalytic Theory, recognizing that hormonal changes, physical illness, chemical imbalances, and neurological disorders can dramatically influence capacity and behavior. It is important to note, however, that Alder still locates false beliefs, irrational thoughts, and misconceptions in the unconscious mind. 8. In working with a client, you become aware that she persistently behaves in ways to please or gain the approval of others. While this is not always problematic, you discover that she is obsessed with wearing the "right" clothes, living in the "right" neighborhood, and marrying the "right" person. At present, her finances are in a shambles as she tries desperately to "keep up with the Joneses," and her romantic life is suffering, as she only pursues relations that she believes others think are optimum, rather than judging relationships on more personally relevant values, such as her feelings for them, baseline compatibility, etc. Utilizing Kohlberg's Theory of Moral Development, specify the Level and Stage of moral development that applies to this individual: a. Conventional Level, Stage 3. b. Pre-conventional Level, Stage 1. c. Post-conventional Level, Stage 6. d. Conventional Level, Stage 4. - Correct Answer -A: Conventional Level, Stage 3. The Theory of Moral Development was created by Lawrence Kohlberg, to extend and enhance Jean Piaget's theory. Overall, Kohlberg felt that the process of moral development was more complex and extended than that put forth by Piaget. 9. You have been contacted by a couple to assist them with issues of marital discord. They have been married about six months. The wife presents as vulnerable, tearful, and anxious, and the husband presents as angry and overwhelmed. The wife openly claims that "he has never loved me," and expresses anger that he married her without "the proper feelings." The husband responds that he has "done everything possible" to "prove" his love (to the point of near bankruptcy and jeopardizing his employment with frequent absences), but nothing is sufficient. During the interview, you discover that she has had many short-term relationships in the past, that she has a history of suicide gestures and "fits of rage." Further, she frequently demands a divorce and then begs him to stay, is routinely physically assaultive, etc. The most likely diagnosis is: a. Intermittent explosive disorder. b. Histrionic personality disorder. c. Paranoid personality disorder. d. Borderline personality disorder. - Correct Answer -D: Borderline personality disorder. Individuals with this diagnosis will exhibit: frantic efforts to avoid real or imagined abandonment; unstable and intense interpersonal relationships (especially extremes of idealization and devaluation); an unstable sense of self; extreme impulsivity (e.g., spending, sex, drug use, reckless driving, binge eating, etc); recurring suicidal behavior (gestures or threats, or selfmutilating behavior); affective instability due to reactivity of mood; chronic feelings of emptiness; intense anger (e.g., frequent displays of temper, recurrent physical fights); transient, stress-related paranoid ideation; or severe dissociative symptoms. However, as with all Axis II disorders, this diagnosis cannot properly be made during a first contact, but must be substantiated over a course of clinical contacts sufficient to compel the diagnosis to be made (DSM-IV). 10. All but one of the following are National Association of Social Workers (NASW) standards for cultural competence: a. Social workers should endeavor to seek out, employ, and retain employees who provide diversity in the profession. b. Social workers shall endeavor to resources and services in the native language of those they serve, including the use of translated materials and interpreters. c. Social workers should develop the skills to work with clients in culturally competent ways, and with respect for diversity. d. Social workers should work with diverse clients only if they have had specific training in that client's unique cultural background. - Correct Answer -D: Although it is ideal for social workers to receive specific training regarding each of the individual minority populations they typically serve, they should still ensure that someone from an unfamiliar background receives needed services even where no staff with special training in that background is available. 11. The Diagnostic and Statistical Manual of Mental Disorders (DSM), in its current version (the DSM-IV-TR), is used to diagnosis mental disorders. It also allows for the entry of related factors through a multi-axial coding approach. Name the proper axis (in the corresponding order) for entry of each of the following: a) the Global Assessment of Functioning; b) relevant physical disorders; c) personality disorders and mental retardation; d) relevant psychosocial factors; and e) clinical disorders: a. Axis I; Axis III; Axis II; Axis IV; and Axis V. b. Axis V; Axis III; Axis II; Axis IV; and Axis I. c. Axis II; Axis IV; Axis III; Axis V; and Axis I. d. Axis IV; Axis III; Axis II; Axis V; and Axis I. - Correct Answer -B: Axis V; Axis III; Axis II; Axis IV; and Axis I. Clinicians should assess clients on all five axes to ensure a thorough evaluation. 12. You are seeing a 16-year-old youth who has, for the past year, been losing his temper frequently, is regularly argumentative with adults, often refuses to follow direct requests, is easily annoyed, and routinely uses blaming to escape responsibility. Approximately four months ago he was caught in a single episode of shoplifting. The most appropriate diagnosis for this youth is: a. Oppositional defiant disorder. b. Conduct disorder. c. Impulse-control disorder. d. Disruptive behavior disorder, not otherwise specified. - Correct Answer -A: Oppositional Defiant Disorder. Disruptive Behavior Disorder, not otherwise specified (NOS) is an umbrella term for behavior disturbances that lack sufficient clarity for the assignment of a more specific diagnosis. Impulse-Control Disorder is only appropriate when a behavior is compulsive in nature. While anger may be a part of that picture, it tends to be an overreaction to a provocation; other relevant compulsions include gambling, skin-picking, kleptomania, etc. The hallmark of Conduct Disorder is deliberate cruelty, and wanton disregard for others rights and property. This client lacks any pervasive and long-standing evidence in this regard. 13. Encopresis is defined as: a. The voluntary or involuntary passage of stool in an inappropriate place by a child over the age of four. b. The voluntary or involuntary passage of stool in an inappropriate place by a competent adult. c. Deliberate fecal incontinence only in a child over age four. d. Involuntary fecal incontinence only in a developmentally delayed adult. - Correct Answer -A: The voluntary or involuntary passage of stool in an inappropriate place by a child over the age of four (i.e., past toilet training). This is a frequently misused term. It is most frequently applied to children and developmentally delayed adults. Adults with psychosis may warrant use of the term, although the term "fecal incontinence" is more commonly used for adults. A British literature review found only one use of the term in an adult that was not either psychotic or mentally retarded-a 1932 case of a 36- year-old diagnosed with "infantile neurosis." The most typical etiology is stool impaction (constipation) compromising sphincter control and allowing leakage into the underclothing. However, emotional disorders, anxiety, or oppositional defiant disorder can sometimes underlie the behavior. Incidence of the condition drops steadily after age six. 14. The following criteria are all used to distinguish substance abuse from substance dependence except: a. Symptoms of substance abuse are usually less severe than those of dependence. b. The problematic effects of abuse are usually limited to family, finances, employment, and legal issues (e.g., driving under the influence), while dependence also involves significant physiological problems. c. Substance abuse typically involves narcotics, while dependence typically involves non-narcotic drugs. d. Abuse is typically limited to recreational use, while dependence involves the need for increasing doses for the desired effect and withdrawal symptoms of not used regularly. - Correct Answer -C: Substance abuse typically involves narcotics, while dependence typically involves non-narcotic drugs. In general, narcotics are more addictive than non-narcotic substances. Even relatively "benign" substances of abuse, such as marijuana, can produce dependence if used often enough, and mounting clinical and preclinical evidence suggests that a marijuana withdrawal syndrome also exists (however, it is not yet in the DSM). Common treatment medications include: Antabuse (disulfiram; for alcohol abuse); ReVia (naltrexone; for alcohol and narcotics); and Trexan (naltrexone; for alcohol and opioid dependence). 15. Name the four classic diagnostic "A's" of schizophrenia: a. Awareness, ambivalence, autism, and associations. b. Agitation, awareness, associations, and autism. c. Affect, anxiety, ambivalence, and awareness. d. Affect, associations, ambivalence, and autism. - Correct Answer -D: Affect, associations, ambivalence, and autism. In 1911, Eugen Bleuler coined the term schizophrenia, and defined it using his now-classic four "As:" Affect (blunted emotional response to stimuli); associations (loosening, disordered thought patterns), ambivalence (an inability to make decisions due to poor information integration and processing), and autism (a preoccupation with the self and one's thoughts). Common medications for treatment: Clorazil (clozapine), Haldol (haloperidol), Loxitane (loxapine), Mellaril (thioridazine), Prolixin (fluphenazine), Risperdal (risperidone), Stelazine (trifluoperazine), Thorazine (chlorpromazine), and Zyprexa (olanzapine). 16. You are called to see a young black man in his mid-twenties. Two adult sisters brought him for an urgent appointment. The young man is clean, neatly dressed in slacks, dress shoes, and a tweed sport coat. He is also calm, relaxed, and without any signs of agitation. The two sisters, however, appear disheveled, frazzled, and almost histrionic. They blurt out the he "has problems" and urge you to talk with him. Privately, he tells you that he is fine. Later, however, the ladies tell you he left home abruptly and traveled cross-country with no destination. He didn't sleep for three days (with them pursuing him), was spending money excessively and writing checks he couldn't cover. He ended up in a nationally famous amusement park at 3:00 a.m. (having scaled a fence), sitting on an empty roller coaster "waiting for the ride to start." When confronted, he admits all of this, but says he's now rested, and doing better. The most likely diagnosis would be: a. Brief psychotic disorder. b. Bipolar I, single manic episode, in full remission. c. Bipolar I, single hypomanic episode, in full remission. d. Cyclothymic disorder. - Correct Answer -B: Bipolar I, single manic episode, in full remission. There is no evidence of frank psychosis, thus brief psychotic disorder can be ruled out. Hypomania does not appear appropriate, as the client's behavior would likely have resulted in hospitalization had anyone been able to evaluate him during his period of mania. Cyclothymic disorder does not appear appropriate, as the client's conduct exceeded the threshold severity for hypomania, and no information is provided regarding depressive symptoms (though he may well have them). Finally, the Bipolar I, single manic episode is identified to be in full remission, as the client's manic symptoms appear to have completely resolved. 17. A therapeutic approach that views the client from a social context, that sees behavior as derived from unconscious drives and motivations, that views disorders and dysfunction as emerging from internal conflicts and anxiety, and that seeks to facilitate the conscious awareness of previously repressed information is called a: a. Cognitive approach. b. Psychoanalytic approach. c. Gestalt approach. d. Behavior approach. - Correct Answer -B: Psychoanalytic approach. This approach is built upon the concepts and theory of Sigmund Freud and others who have followed him. The approach is also sometimes called a "psychodynamic" approach. 18. The concepts of "pre-affiliation" (becoming acquainted), "power and control" (setting the roles), "intimacy" (developing cohesion), "differentiation" (independent opinion expression), and "separation" (moving to closure and termination) are all stages in: a. The lifecycle of a therapeutic relationship. b. General relationship cycles. c. Group development. d. Team cohesion. - Correct Answer -C: Group development. During these stages, the social worker needs to: 1) facilitate familiarity and elicit participation; 2) clarify roles; 3) develop group cohesion; 4) support individual differences; and 5) foster independence. The use of a "Sociogram" (a chart or diagram depicting group member relationships) can aid the social worker in revealing, monitoring, and intervening (if necessary) in group member interactions and bonding. 19. When a client seems overwhelmed or uncertain how to share further, it can help to break down the concerns at hand into smaller, more manageable parts. This communication technique is known as: a. Fragmentation. b. Sequestration. c. Downsizing. d. Partialization. - Correct Answer -D: Partialization. For example, "Well, if we take these things one at a time, maybe we can start with..." 20. "Single system" research designs involve observing one client or system only (n=1) before, during, and after an intervention. Because of their flexibility and capacity to measure change over time, single system designs are frequently used by practitioners to evaluate: a. Their practice. b. Difficult clients. c. Conformation to policy. d. Regulation adherence. - Correct Answer -A: Their practice. The evaluation process involves: 1) problem identification (called the "target" of the research); 2) operationalization (selecting indices that represent the problem that can be measured; 3) determining the "phase" (the time over which measurement will occur), including a "baseline phase" (without intervention) and an "intervention phase." This may also include a "time series design," where data is collected at discrete intervals over the course of the study. 1. A fifteen year old girl has been sent home from school on three occasions for drinking alcohol at school. Each time, the mother becomes angry and threatens to punish the girl but is convinced by the father to give her another chance. Which of the following BEST characterizes the father's behavior in this situation? a. triangulation b. enabling c. advocating d. manipulating - Correct Answer -b. enabling 2. Parents continually refuse to communicate with their child who is in a residential treatment facility. The social worker should FIRST: a. respect the parent's need for separation by not contacting them b. request that the child be discharged c. contact the parents about the child's placement d. assess the child's response to the parents' actions - Correct Answer -d. assess the child's response to the parents' actions 3. Common indicators of sexual, physical and emotional abuse include all of the following EXCEPT: a. violence against younger children b. sexualized behavior c. isolation d. stuttering - Correct Answer -d. stuttering 4. The concept of gender roles is BEST defined as: a. attitudes and behaviors attached to individuals because of their sex b. an individual's sex orientation and/or preference c. biological characteristics that influence an individual's behavior d. interplay of biological and sociocultural influences - Correct Answer -a. attitudes and behaviors attached to individuals because of their sex 5. Which type of interviewing question is MOST likely to generate client defensiveness? a. open ended b. closed c. leading d. why - Correct Answer -d. why 6. When interviewing a client whose speech patterns are different from the social worker's, the social worker's PRIMARY consideration should be that: a. communication patterns vary due to economic conditions b. speech is influenced by culture and experience c. psychosocial conditions will cause variations in speech d. speech is influenced by group taboos and norms and may indicate false beliefs - Correct Answer -b. speech is influenced by culture and experience 7. The initial symptoms of schizophrenia MOST often occur between which of the following years of age? a. 6 to 12 b. 13 to 16 c. 17 to 45 d. 16 to 60 - Correct Answer -c. 17 to 45 8. Which of the following approaches would be MOST appropriate to use in evaluating client satisfaction with the social worker's provision of services? a. using a single system design, evaluate the quality of services b. in the final interview, ask the client about their level of satisfaction c. after submitting process recordings, ask supervisor for feedback d. at termination, ask clients to complete a service evaluation and satisfaction form - Correct Answer -d. at termination, ask clients to complete a service evaluation and satisfaction form 9. When conducting an assessment of the risk factors of child abuse for a child of a different ethnic background, a social worker must FIRST: a. be aware of how personal cultural biases affect the social worker's ability to deal with issues of diversity b. realize that assessment models are not a substitute for clinical judgment or experience c. use a strengths' perspective rather than a deficit model to form a partnership with the child's family d. understand the need for appropriate eye contact, tone of voice and question techniques during the assessment - Correct Answer -a. be aware of how personal cultural biases affect the social worker's ability to deal with issues of diversity 10. A social worker is receiving a client with long-standing depression. It becomes known that the client has racist beliefs. The social worker should: a. respectfully confront the client's prejudiced beliefs b. educate the client about the negative effects of racism c. refer the client to another therapist who might have similar belief d. respect the client's beliefs and focus on the presenting problem - Correct Answer -d. respect the client's beliefs and focus on the presenting problem 1. The phase of the helping process which leads to subsequent implementation of intervention is: a. exploration and summation b. exploration, assessment and planning c. initiation of established rapport d. clarification and analysis - Correct Answer -b. exploration, assessment and planning 2. When reviewing a social worker's performance, the supervisor notes that the social worker conveys little empathy toward clients who have recently left welfare and holding first jobs. In order to help the social worker develop empathy with her clients, the supervisor should: a. explain welfare-to-work procedures from the client's perspective b. suggest the social worker enter therapy to become a more empathetic person c. model empathetic communication when engaging with the social worker d. clarify the agency's reason for supporting these clients - Correct Answer -c. model empathetic communication when engaging with the social worker 3. The purpose of feedback in a social worker interview is to: a. allow the social worker to confront distortions in the client's thinking b. summarize main points of the interview c. let the client know social worker understands the issue d. give the social worker opportunity to self-disclose for benefit of the client - Correct Answer -c. let the client know social worker understands the issue 4. A social worker is leading a women's group with the purpose of improving personal and environmental circumstances. The social worker asks the members to identify the area in which they feel most competent. The social worker is following an intervention strategy BEST described as: a. reinforcement b. endorsement c. enhancement d. empowerment - Correct Answer -d. empowerment 5. The BEST example of the educational component of supervision is: a. monitoring the caseload b. providing in-service training c. utilizing individual and group conferences d. refining knowledge and skills - Correct Answer -d. refining knowledge and skills 6. In facilitating a hospital support group for bereaved parents, a social worker can discuss a personal experience of a death of a child to: a. create empathy with the participants b. receive help from the group c. create a sense of shared experience d. establish role as expert on grief issues - Correct Answer -c. create a sense of shared experience 7. The primary role of a social worker is: a. building rapport b. providing support systems c. acting as a resource d. curing emotional or mental dysfunction - Correct Answer -c. acting as a resource 8. A client with a history of drug abuse was referred to a social worker by a concerned relative. The social worker should FIRST: a. conduct a family interview b. begin treatment, focusing on the reason for the drug abuse c. refer the client for substance abuse treatment d. evaluate the client's motivation for change - Correct Answer -c. refer the client for substance abuse treatment 9. In adult survivors of childhood sexual abuse, the most frequently encountered defense mechanism is: a. denial b. intellectualism c. suppression d. projection - Correct Answer -a. denial 10. Which of the following approaches would be MOST appropriate to use in evaluating client satisfaction with the social worker's provision of services? a. using a single system design, evaluating the quality of services b. in the final interview, ask the clients about their level of satisfaction c. through process recordings, ask the supervisor for feedback d. at termination, ask clients to complete a services evaluation and satisfaction form - Correct Answer -d. at termination, ask clients to complete a services evaluation and satisfaction form Physiological: hunger, thirst, bodily comforts, etc. - Correct Answer -Maslow's 1st Hierarchy of Need Safety and security: out of danger - Correct Answer -Maslow's 2nd Hierarchy of Need Belongingness and Love: affiliate with others, be accepted - Correct Answer -Maslow's 3rd Hierarchy of Need Esteem: to achieve, be competent, gain approval, and recognition - Correct Answer -Maslow's 4th Hierarchy of Need - birth to 12 months - primary interaction through mouth - rooting sucking is important - conflict is weaning - Correct Answer -Freud's oral stage - 1 to 3 years old - controlling bladder and bowels - conflict in potty training - learn to control body needs which leads to accomplishment and independence - Correct Answer -Freud's anal stage - discovering difference in boys and girls (genitals) - 3 to 6 years old - conflict can be castration anxiety as mother's attention is sought - Correct Answer -Freud's Phalic stage - 6 years old to puberty - libido interests suppressed - development of ego and superego can help calm these interests - exploration of peer relationships and social interactions - Correct Answer -Freud's Latent stage - Puberty to death stage - sexual interest of opposite sex - interest in welfare of others - Correct Answer -Freud's Genital stage - Birth to 1 year old - trust comes from caregivers and quality of care - trust happens and child feels safe and secure - mistrust happens and child feels inconsistent, insecure, emotionally unavailable - Correct Answer -Erikson's trust/mistrust stage - early childhood - focused on sense of personal control - toilet training is vital for independence - control over food choices, food preferences, clothing, etc. - success leads to confidence - Correct Answer -Erikson's Autonomy/Shame and doubt stage - preschool years - assert power and control over the world through directing play and social interactions - success leads to child able to lead others and have a sense of purpose - failure leads to guilt, self-doubt and lack of iniative - Correct Answer -Erikson's Initiative/Guilt stage - early school (age 5-11) - through social interactions can develop sense of pride in their accomplishments and abilities - if encouraged and commended by parents/teachers will feel competent and belief in skills - Correct Answer -Erikson's Industry/Inferiority stage - children explore independence and sense of self - receiving proper encouragement and reinforcement w/personal exploration emerge w/strong sense of self and feeling independent and control - completing this stage leads to fidelity and ability to live by society standards - Correct Answer -Erikson's Identity/Confusion stage - adulthood - exploring personal relationships - develop close/vital relationships which leads to committed, secure - strong sense of personal identity important to develop interpersonal relationships - success leads to virtue of love, forming lasting relationships - Correct Answer -Erikson's Intimacy/Isolation stage - adulthood - career and family - feel like contributing to the world by being active in home/community - develop care in this stage - proud of your accomplishments, unity w/partner, watching children grow up - Correct Answer -Erikson's Generativity/Stagnation Stage - old age - reflecting back on life - feels like life was wasted and regrets - bitterness /despair - but if proud of life will feel integrity - Correct Answer -Erikson's Integrity/Despair stage Holistic approach to look at an individual's systems and how they interact with each other - Correct Answer -General Systems Theory Constant interaction with environment and each system impacts one another - Correct Answer -Ecological systems theory Family affects individual and family functioning across life span - Correct Answer -Family systems A concept where person has ability for family member to tell difference between their experience's and identify themselves from others - Correct Answer -Differentiation of self When family identifications are fused - Correct Answer -Undifferentiated family ego mass when parents pull children closer to one side - Correct Answer -Triangulation Mutual emotional force within a family which occurs when there is a chronic family tension - Correct Answer -Nuclear family emotional process unhealthy way of dealing with family growing up or building one's own individual identity - Correct Answer -Emotional cut off people tend to have many similarities with those sharing birth order - Correct Answer -sibling position parents pour emotional problems on to child - Correct Answer -family projection process family projection process repeats itself from each generation - Correct Answer -multigenerational transmission process theory that is concerned with how internal processes such as needs, desires, emotions motivate human bx - Correct Answer -psychodynamic theory theory that believes unconscious and conscious mental activity serves as motivating force in human bx - Correct Answer -psychodynamic theory theory that believes early childhood experiences are central in patterning an individual's emotions which leads to problems in life - Correct Answer -psychodynamic theory theory that says individual's get overwhelmed with internal/external demands and use ego defense mechanisms - Correct Answer -psychodynamic theory believe healing occurs through attention to transferences and treatment relationships - Correct Answer -psychodynamic theory theories that support individual's cognitive functioning and learn through acting on their environment - Correct Answer -behavior theory / cognitive theory / learning theory behaviors learned through conditioning and we must help teach new skills and behaviors - Correct Answer -Behavior theory theory focused on internal states, such as motivation, problem solving, decision-making, thinking, attention and how we interact with the world - Correct Answer -cognitive theory - birth to 2 years old - perception of world is limited to sensory and motor - learn through sucking, grasping, listening - need to learn object permenance - Correct Answer -sensorimotor stage (Piaget) believing something exists even when you cannot see it - Correct Answer -object permanence - age 2 to 7 - language development - no concrete logic, not able to manipulate mental thoughts, not able to "put themselves in others shoes" - use symbols and role play - Correct Answer -pre-operational stage (piaget) - age 7 to 11 - think logically - have difficulty understanding abstract concepts - can reverse logics - Correct Answer -concrete operational stage (piaget) - age 12 to adult - think abstractly, logical thought, deductive reasoning, systematic planning - can understand hypothetical questions - Correct Answer -formal operational stage (piaget) - success and failure is related to sense of contribution to a new environment - Correct Answer -margin/matter community theory 6 I's in community development Introduction Interaction Involvement Influence Investment Identity - Correct Answer -Introduction - welcoming, orienting, teaching Interaction - sharing common experiences Involvement - everyone is important and needed Influence Investment - interaction is gentle and there is open honest communication Identity - there is a "we" and "us" / unity and purpose First stage of community building where everything is "fine" and everyone gets along to avoid conflict - Correct Answer -Psuedocommunity Second stage of community building where members vent frustration and disagreements and differences cannot be ignored - Correct Answer -Chaos Third stage of community building where members embrace need of group and balance - Correct Answer -Emptiness Fourth stage of community building where members have a true commitment and community and have empathy and understanding - Correct Answer -Authentic First stage of group development where you become oriented to goals and procedures of the group. Info and structure are critical - Correct Answer -Forming Second stage of group development where there is resistance and challenging of leadership - Correct Answer -Storming Third stage of group development where there is cooperation and team building. - Correct Answer -Norming Fourth stage of group development where there is functioning to achieve group goals. - Correct Answer -Performing Fifth stage of group development where there is not functioning as group much longer and you work on closure - Correct Answer -Mourning Understanding an individual and their bx in light of environmental contexts in which they live and act - Correct Answer -Person In Environment Type of addiction model where addiction acts as a "brain disease", there is neurotransmitter imbalance. The agent is the drug, the vector is the dealer and the host is the addict. They think "stamp out" disease by eliminating drugs. - Correct Answer -Medical Model Type of addiction model that looks as drug abusers as "self-medicating" and that drug abuse is a symptom of underlying psychological problems. Drug is a maladaptive coping strategy. They need to resolve inner conflict and then drugs won't be necessary. - Correct Answer -Psychodynamic model Type of addiction model where the drug use is a learned behavior and drugs are used because