LCSW EXAM PREP
Terms in this set (169)
A new social worker begins to establish professional rapport with a group of school aged 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:
speak directly to the former social worker
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:
reassure the parent that this is normal for children this age
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:
initiate a staff recognition program
What is MOST important to remember about defense mechanisms?
Defense mechanisms are unconscious process.
A 27-year-old male with a history of hospitalizations for bipolar disorder and alcohol abuse 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:
leave the hospital regardless of his condition
A social worker assesses an elderly client for suicide risk. The BEST approach is to use the clinical interview and the:
Geriatric Depression Inventory
A couple married for 30 years seeks help at a crisis clinic. The husband describes 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:
Issues related to family transition
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:
clarify what the client means by depression
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:
understand factors that affect the client's behavior
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:
talk to the new social worker about the conversation
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:
meet with the member individually after the group to review the situation
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 treatment of minors who live with their parent(s) or legal guardian. The social worker should FIRST:
discuss the need for parental involvement with the client
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:
potential for self-harm
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:
are able to cope with day-to-day issues
A 49-year-old woman seeks therapy citing problems with her 74-year-old 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:
focus on the client's feelings about her mother's changes in behavior
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?
Use circular questioning with all family members
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:
refer the client for medication evaluation
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?
Ask how the client feels about seeking help
A 19-year-old 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 DSM-IV-TR, which of the following diagnoses BEST describes the client?
Antisocial personality disorder
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-olds 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:
child may not have reached this level of cognitive development
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:
trying to find a personal identity
A social worker is working with a woman who was recently diagnosed with HIV. The client abruptly stopped her medication. Her 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:
dealing with bereavement
A social worker meets with a 35-year-old 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:
In which of the following situations may a social worker provide information without the client's consent?
When a client files a malpractice suit
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:
express understanding of the client's position regarding therapy
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 recently been discharged from a rehabilitation facility and has been diagnosed with alcohol dependence. The client admits that she has not attended Alcoholics Anonymous nor talked with a sponsor. What should the social worker do NEXT?
Confront the client's denial
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:
learn about the communication styles typical of the family's culture
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 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?
Determine the client's specific language
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 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:
work with the adolescent around the timing of a safe disclosure
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?
Work with the parents and school personnel to keep the client from changing schools
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?
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:
offer an in-home evaluation, with the assurance to keep in touch with the daughters if he consents
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?
Review the consequences of available options with the client
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?
Remain silent for a few seconds
When using cognitive-restructuring with a depressed 16-year-old client, the social worker should:
work with the client to set a concrete, time-specified goal
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 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?
Do a comprehensive biopsychosocial assessment
An elderly woman has been hospitalized for treatment of a stroke. The physician recommends placement 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:
confer with the mother and family members regarding placement
A recent immigrant is seen in a hospital emergency room after several panic attacks. He is referred to a social worker but declines mental health treatment. The MOST likely explanation for this refusal is the:
cultural stigmas associated with treatment
A social worker is leading a group for students with conduct problems. One of the students is the informal group leader. He tends to intimidate the others and tries to control the discussion by glorifying his past crimes. What should the social worker do?
Ask the group how they feel about the student leader's comments
Which defense mechanism is MOST likely used by clients with a diagnosis of borderline personality disorder?
An insurance utilization review representative indicates that only one more session is authorized for a patient who is depressed and has suicidal ideation with no specific plan. The private practice social worker argues that at least 12 more sessions are needed to stabilize the patient, but is unsuccessful in convincing the reviewer. The client cannot afford to pay for further sessions. The social worker should:
continue to see the client and discuss an alternative payment plan
A woman explains to the social worker that her family is a recent survivor of a devastating hurricane. She is worried because every time it rains, her six-year-old daughter becomes terrified and hides in a closet. In behavioral theory, what is this an example of?
A social worker meets regularly with a young adult client who has depression related to separation and individualization issues. The client reports that his parents were often demeaning and neglectful of him as a child. The client relates his past in a flat, unemotional manner. The social worker should:
help the client become aware of his feelings about his parents
A social worker is working with a client diagnosed with kleptomania. The client expresses guilt, but says she cannot seem to stop the behavior. The client tells the social worker that she does not know why she engages in this behavior. What should the social worker do FIRST?
Explore the feelings behind the behavior
A client has established a behavioral contract to complete homework between sessions. The next two sessions the client says, "I didn't have time to get it done." The worker states, "I'm concerned that you contracted to complete your homework and yet have not done so. What do you think is going on?" The social worker's statement is an example of the technique of:
A client contacts a social worker for help with his anger over his partner's extramarital affair. During the initial session, the client states he "will do whatever it takes" to get even with his partner. What should the social worker do FIRST?
Seek further clarification of the statements
A retired person requests counseling because of "boredom and feeling worthless." As a successful middle manager, the client looked forward to retirement and to spending time with family and friends. However, the client now spends time sleeping and watching television, rather than enjoying long anticipated pastimes. The social worker should FIRST inquire about:
other symptoms that might indicate depression
A client comes to a social worker complaining of persistent and intrusive thoughts. The client asks for help to better manage his thinking. What should the social worker do FIRST?
Ask the client to describe the content of his thoughts
An 86 year old man recently widowed is encouraged to obtain mental health services by his minister. He expresses concern that since the death of his wife of 50 years, he has not been able to sleep, has little energy, and often skips meals. The social worker at the hospital conducts a clinical evaluation of the widower for depression. What should the social worker do FIRST?
Acknowledge the client's feelings of loss
A social worker is working with a family. A grandparent, who lives with them, is having trouble sleeping and may be depressed. The daughter and her husband are experiencing conflicts about whether or not to move the grandparent into a nursing home. The social worker should FIRST consider the:
guilt family caregivers may experience when considering nursing home placement
Which of the following terms BEST describes families that have diffuse boundaries between the parental and child subsystems?
A social worker is treating a young child who was sexually abused by an adolescent neighbor. At one session, the child's parent reports that the child has started to sexually act out with another child. The social worker should explain that this behavior:
needs continued intervention
Immediately following a group psychotherapy session, a group member returned to the office of the social worker to privately discuss an incident that had occurred during the session. The client reported that another member had broken a group rule by lying to the group in session and further stated that the social worker should properly deal with the matter. The BEST therapeutic response would be to:
suggest that the client consider bringing up this incident for discussion in the next group session
An adolescent student is referred to the social worker because of defiance of authority and threats to harm fellow students. The student greets the social worker with a broad smile and asks why the interview is necessary. He explains that his favorite brother is in prison, and he expects that he too will be "sent up" before long. He keeps on smiling and remains standing throughout the interview. The student seems unperturbed by any of the complaints about his behavior. This nonverbal communication is demonstrating the student's:
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?
Talking about concrete changes is a symbolic way of talking about significant losses.
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:
give the group members control over as many decisions as possible
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:
develop other funding resources to purchase supplies
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:
make a report to the appropriate authorities
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 noted that the punishment is necessary to prevent his daughter from imitating the behaviors of her American friends and thus bringing shame to the family. The social worker should FIRST:
attempt to determine the severity of the physical punishment
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 describes frequent fights with friends, but doesn't understand why this keeps happening. What should the social worker do FIRST?
Relate the client's behavior with the social worker to that with friends
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:
encourage the adolescent to respond to this disclosure
A client participating in day treatment attends a club house 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:
begin and sustain conversations, giving feedback about the client's efforts to participate
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?
Complete a suicide risk assessment of the client
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:
allow the resident time for grieving
A long-term client being treated for bipolar 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?
In the evaluation process for a client's sexual dysfunction, the FIRST consideration is to:
rule out any medical basis for the dysfunction
The term "tardive dyskinesia" refers to:
a movement disorder
The social work supervisor is assigned a new supervisee. During the initial supervisory sessions, the supervisor discusses the purpose of supervision, the role of the supervisor, 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 the supervision. The purpose of this process 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 depression. 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:
explore with the client her resistance to taking medication
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:
confront the client with the resistance
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:
have group members discuss this situation and reach a mutually satisfactory resolution
A social worker is called to a hospital emergency room to assist with a woman who was brought in with her deceased baby. The baby has just died of 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?
Allow the woman to let go of the baby in her own time
A social worker is treating a woman who is a confirmed victim of abuse. Recently, the therapeutic work has become quite intense. Suddenly, the client begins to say that the abuse never happened. What is the MOST likely reason for the client's change of opinion?
The client may be avoiding the painful subject.
A family is referred to a social worker. The mother says she is constantly tired from going to work, cooking, cleaning, running the household, and caring for her first child. Her spouse is angry with her for not spending time with him and for not keeping the baby quiet. The couple MOST likely is:
having difficulty with the new life cycle stage
According to the DSM, all of the following behaviors are characteristic of paraphilias EXCEPT:
A social worker in a mental health agency conducts an initial interview with a lesbian client who seeks treatment for depression and problems in her relationship with her partner. The social worker feels uncomfortable when the client discusses her homosexuality. At the conclusion of the session, the client expresses a desire to continue the therapeutic relationship with the social worker. The social worker should FIRST:
meet with the supervisor to discuss the discomfort
A social worker maintains client records in a way that shows awareness that the records may be disclosed in a regulatory or legal proceeding. This kind of record keeping demonstrates that the social worker is:
keeping the client's best interest in mind
A social worker sees a teenager with a diagnosis of anorexia nervosa. The family physician believes hospitalization is necessary. A psychiatrist has diagnosed a comorbid condition of major depressive disorder and recommends intensive outpatient treatment. The client and her parents are confused and frightened. The social worker should FIRST:
schedule a case conference with the professionals involved
A woman is referred to a social worker because of noticeable decline in job performance. The client describes an unhappy childhood, sexual assault at age 12 by her older sister's boyfriend, and two brief marriages which ended in divorce. She is afraid of losing her current boyfriend and attributes her job problems to her chaotic love life. She acknowledges using cocaine for several years, but minimizes it as a problem. The social worker should INITIALLY focus on:
stopping her drug use
A seven-year-old child in foster care because of severe sexual abuse has seen a social worker for several months. The child's parents, the abusers, are attempting to get their child back. They admit the abuse but refuse to follow the court ordered treatment plan. It is essential that the social worker develop an appropriate plan for:
A social worker sees a couple after the birth of their first child. They are very stressed by the demands of parenthood. What should the social worker do FIRST?
Determine what is causing the stress
A teacher asks the school social worker for professional advice about a six-year-old student who has been diagnosed with Asperger's disorder. After offering information to the teacher and discussing options with the parents, the social worker should NEXT:
refer the child to a social skills group
A social worker is assigned a client who is believed to be a victim of domestic violence. The client does not speak English and is accompanied to the interview by several members of the extended family. The social worker has a very limited ability to speak the client's language, but several nonclinical employees of the agency are fluent in it. The social worker's MOST appropriate action is to:
request the services of a professional translator
Several months into therapy, a client tells the social worker that early in her marriage her husband planned to leave her. The client has never told anyone about this before, nor did she and her husband ever discuss this crisis again. Which family therapy concept does this illustrate?
A couple is seeing a social worker for marital problems. During one session, the wife compliments her husband. The husband says, "It's nothing." What should the social worker do FIRST?
Assist the husband in accepting the compliment
A social worker treats a client who reports a desire to kill a former lover who has recently ended their relationship. Upon further questioning, the client says that although this is a desire, it is not a strong one and the client has no definite plan. The client says "I probably won't do anything." The client contracts with the social worker not to kill the former lover. The social worker should NEXT:
monitor the client's feelings at future sessions
A social worker meets with a young man who is in his first year of college. He expresses feelings of acute anxiety and distress. He was an outstanding student in high school, maintaining an A average, but his college grades are low. He says that if things do not improve, he does not know what he will do. What should the social worker do FIRST?
Assess for the risk of suicide
When sharing diagnostic information with a client, the social worker should give greatest consideration to:
describing behaviors that clarify the diagnostic information
A social worker is evaluating a 46-year-old married woman who is distressed by her husband's recent inability to sustain an erection. She reports that her husband has insulin-dependent diabetes. She says the physician has explained how diabetes causes this problem but she believes that "He doesn't love me anymore." The social worker's MOST appropriate action is to:
offer conjoint sessions to the client and her husband
A social worker sees a client who is concerned about excessive Internet use. The client worries about not being able to control online activity and feels it is harming interpersonal relationships outside of the Internet. What should the social worker determine FIRST?
The degree to which the client's life is affected
The court orders a woman to have individual therapy as a condition for her children to be returned. She attends two sessions with the social worker. She misses the next two sessions. What should the social worker do FIRST?
Contact the woman to discuss the consequences of missed appointments
A social worker is seeing a client with a diagnosis of generalized anxiety disorder. In discussing the treatment plan, the social worker suggests certain goals and interventions. The client quickly agrees, stating, "I'll try anything." The client has a history of multiple treatment failures. In developing a realistic treatment plan, the social worker should FIRST:
identify obstacles that hindered earlier treatment efforts
A social worker is seeing two young boys and their mother. The mother reported the boys' behavior problems began soon after the boys returned from a visit with their father, who lives with his girlfriend and an infant daughter. The boys' parents are involved in a bitter custody battle. During the initial interview, both boys tell the social worker that their father's girlfriend has beaten them with a fly swatter, burned the older boy with a cigarette, and threatened to kill the younger boy. The social worker should :
immediately report the allegations of abuse to the appropriate authorities
At the recommendation of the school counselor, a mother requests that a social worker treat her ten-year-old son for persistent fighting in school. The mother states that her son is well disciplined in the home and neighborhood. After obtaining a social history from the mother, the social worker should NEXT:
obtain a release to talk with the school counselor
A social worker is asked to treat a child who was sexually abused by an older sibling. The social worker learns that the victim and the perpetrator are living in the same house, with the permission of social services. What should the social worker do FIRST?
Develop a safety plan for the victim
A social worker meets with a couple who have difficulty expressing feelings. During one session, the couple begins to argue about finances. The husband yells, and the wife cries. The husband responds by saying, "Crying won't work. You need to spend less money." This interaction BEST demonstrates the:
couple's poor communication skills
A social worker is seeing an adolescent for individual treatment. The adolescent's mother asks the social worker to see her in individual therapy also. What should the social worker do?
Provide the mother with the names of several social workers
An emergency room social worker is asked to complete a psychosocial assessment. The patient is confused and unable to provide reliable information about the events leading up to the hospital admission. What should the social worker do NEXT?
Seek permission from the patient to contact relatives
A social worker at a mental health crisis hotline receives a telephone call about an adult woman who has been observed hanging laundry out while naked. She was also seen defecating in a local parking lot. What should the social worker do?
Arrange for an immediate mental status assessment
A social worker sees an adult client who was raised in a family with alcoholic and abusive parents. The client tells the social worker that she regularly avoids getting angry or upset around her parents because she is afraid of how her parents will react. The client also says she tries to keep her parents happy and that she feels this is the only way to make herself happy. The social worker should FIRST help the client to
A teacher meets with the school social worker regarding an eight year old student who has repeatedly come to school with the same injuries, which are blamed on a sibling or on outdoor sports. The student is increasingly withdrawn, depressed, and angry, and is reluctant to get on the school bus after school. What should the social worker do NEXT?
Explain to the teacher the need to report the suspected abuse
Compared to women diagnosed with borderline personality disorder, men diagnosed with the same disorder generally:
exhibit different patterns of impulse-related disorders
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:
discuss the client's perception of the cultural conflict
In an initial interview, a five-year-old girl was anxious and emotionally constricted. In order to lower anxiety and begin a working relationship, what should the social worker do FIRST?
Relate to the child through the use of play materials
A social work student in a social service agency reports to the supervisor that a client verbally assaults the agency receptionist during visits. The supervisor's FIRST response should be to:
ask the student to discuss the behavior with the client
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:
normalize the teenager's reactions
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 fight during which he tried to kill her. The MOST likely diagnosis is bulimia nervosa and:
posttraumatic stress disorder
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:
advocate to change the policy for low-income clients
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:
call the police to warn of the client's plan
During the initial interview of a recent victim of domestic violence, the social worker observes a rapid emotional decompensation as the client recalls earlier childhood abuses. She becomes intensely distressed and then withdraws into a trancelike state while seeming to respond to visual and auditory hallucinations. It is MOST likely that the client:
is reliving past trauma
A social worker is providing ongoing therapy for an adolescent who has been sexually abused. In assessing the impact the abuse has had on this client, the social worker should be MOST concerned with the client's:
A basic process in establishing a collaborative team is:
defining each member's area of expertise
A 75-year-old man is referred to a social worker by a neighbor following the loss of his spouse of 45 years, as well as the loss of two long-term friends. In the initial interview the client said he was experiencing recent difficulties with memory loss and confusion, increasing physical problems, sadness, feelings of loneliness, and a sense of uselessness. The client also noted the pain of losing a spouse. The social worker should FIRST:
assess the client for depression and suicide risk
A social worker has been asked to develop services to address caregiver burdens for families. In designing the services, the social worker should consider that the factor MOST strongly linked to caregiver stress is:
duration of the illness
During a session with a social worker, a woman complains of emotional and physical abuse by her husband. She reports that two days ago her husband slapped her during an argument. She did not have him arrested, although this was the second occurrence. He bought her a piece of jewelry and agreed to enter therapy. According to the cycle of violence theory, the husband MOST likely is motivated because he is in what phase of the cycle?
A social worker meets with a new client who is cocaine dependent. The client reports that he has abstained from cocaine for the past three days and now complains of depression. The social worker assesses that the client's depression is MOST likely the result of:
In the middle phase of alcohol treatment when recovery is well underway, the MOST difficult task for alcoholics is to:
confront psychosocial realities about themselves
A social worker in a mental health hospital sees a 78-year-old involuntary client who is being held due to the risk of self harm. The client has advanced cirrhosis of the liver and a history of alcohol abuse. The client is depressed about being in the hospital and asks to be referred to an outpatient program. What should the social worker do FIRST?
Remind the client that the hospitalization is not voluntary
A young man with a developmental disability moves into a group home upon becoming a legal adult. His parents inform the group home staff that they want nothing to do with him. What should the group home social worker do FIRST?
Meet with the parents to discuss their decision
A couple brings their 15-year-old son who is diagnosed with type 1 diabetes mellitus to see a social worker. Although he is doing well in school, the adolescent has an increasing need to be in control at home and is rebelling against family rules and his required diet. What is the MOST likely reason for this behavior?
He needs to control whatever parts of his life he can.
In sessions with a social worker, a client has established the goals of empowerment and structure in family life. Each week the client mentions concurrent involvement with homeopathic treatment, from which the client derives benefit. The social worker's PRIMARY responsibility in this situation is to:
continue working with the client toward the treatment goals
A mother brings her three year old child to a social worker because of bed wetting. This started just after a new baby was born. What should the social worker do FIRST?
Educate the mother about child development
A social worker sees a child for therapy and suspects the mother is physically abusing the child. The social worker is concerned that if a report is made to the child protection agency, the child will no longer trust the social worker. What should the social worker do NEXT?
Report the suspected abuse
A social worker on a multidisciplinary team works with a young adult who is hospitalized following a suicide attempt. The client complains bitterly about the number of staff who know the details of her hospitalization. She says that she is tired of answering the same questions from different people. She reports having had a temper outburst because of all the questions. After acknowledging the client's feelings, what should the social worker do NEXT?
Explore how the client thinks the social worker can help with the situation
A social worker works with clients recently discharged to the community after long term stays in a mental hospital. Despite the monthly medication monitoring and treatment services offered by the mental health center, the social worker notices a pattern in which many of these clients have frequent crises that require rehospitalization. What is the MOST likely explanation for this pattern?
The community lacks follow-up services.
A social worker evaluates a youth arrested for armed robbery who has had repeated drug related offenses. After the court ordered assessment of the youth, the social worker should only recommend that the youth be placed in a secure residential facility if:
the safety and welfare of the community are at risk
A single mother sees a social worker following the death of her mother. The client's mother had provided child care for her two preschool children. The client has taken leave from her job to care for her children. The client complains that she is always tired and never has any time to herself now. After empathizing with the client, the social worker should NEXT:
explore child care resources in the community
An adolescent arrives for a therapy session intoxicated, yet coherent and cooperative. What should the social worker do FIRST?
Confront the acting out behavior
A social worker is treating a client who is a painting contractor. The social worker needs someone to paint his office and offers the job to the client. This is an example of:
a dual relationship
A client meets with a social worker to work on relationship concerns with her daughter. The client has begun to act the way she thinks the social worker wants her to. She says that the social worker reminds her of her aunt. What issue should the social worker deal with NEXT?
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 violation of boundaries
Utilizing ego psychology, a social worker would view a client's use of defense mechanisms as:
serving an important protective function
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:
teach the family how to discuss problems
A social worker meets with a client at an outpatient clinic. While obtaining a psychosocial history, the social worker notes that the client frequently shifts the conversation to completely unrelated topics. The social worker should FIRST:
perform a mental status exam
A client requests that the social worker accompany her to weekly church services. The social worker should FIRST:
clarify professional boundaries
A social worker is employed by an agency that provides therapy for low income families. The agency is funded to provide weekly social work services for a maximum of five months. After providing four months of weekly therapy services the social worker realizes that the client will no longer be eligible to receive services soon. The social worker has located appropriate alternative resources for the client. What should the social worker do NEXT?
Discuss the need for termination and the client's preferences about referrals
A social worker discovers that a newly referred client is currently in individual therapy with another therapist. Before accepting this client for individual therapy, the social worker should FIRST:
advise the client to discuss the change with the other therapist
A social worker in private practice has seen a client for over six months with no apparent change in the client's symptoms. The social worker will BEST serve the client by:
Seeking consultation from an experienced colleague about the client
A social worker meets with the parent of a child with severe physical disabilities. The child's disabilities impact the family in all areas of daily life. Although the family receives support from several professionals, there are gaps in service. What should the social worker do FIRST?
Help the parent prioritize needs
In an initial marital therapy session, a husband claims his wife has poor housekeeping skills, nags him constantly, and is not interested in having sex with him. The wife claims her husband always comes home late from work, controls the household money, and is not interested in sex because he spends most evenings drinking. Which of the following issues should the social worker address FIRST?
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?
Explore with the child the sources of her knowledge
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?
Explore the client's reasons for this request
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?
Inquire about how the client is feeling
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?
In the first session before the client contracts for services
A social worker sees a client who was referred after a conviction of 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?
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:
initiate a salary survey to determine whether discrepancies exist
A client scores high on the Beck Depression Inventory. After the social worker has reviewed the results, the social worker should NEXT:
discuss the results with the client at the next session
A social worker is interviewing a client who feels depressed, overwhelmed, and hopeless about the future. The BEST way for the social worker to empower the client and create a sense of hope is to:
ask questions to identify client strengths and successes
A second grade teacher consults the school social worker about a student who has had chemotherapy and lost all hair. The student seems sad, is doing poorly in schoolwork, and is not participating in activities. The social worker should FIRST
contact the parents to gain more information
The parents of a 13-year-old boy consult with an employee assistance program social worker regarding the adolescent's marked change in behavior since entering junior high school. During the past year his grades have dropped dramatically, and he has been arrested for shoplifting, has started several small fires while smoking, and insists on having long hair and baggy clothes. The parents adopted him when he was nine months old, after he had been in two foster homes. Before this last year his behavior and development had progressed normally. The social worker should:
refer the family for assessment and treatment
A social worker works with a client who has a history of substance abuse. Although he has been through several treatment programs, he relapses. He says that nothing has worked for him and he doesn't think anything can help him. The client thinks he will become just like his father, who has a long history of substance abuse. When using a relapse prevention model, what should the social worker do FIRST?
Assess the client's motivation to change his behavior
Heavy, prolonged use of which of the following substances is MOST likely to result in seizures during withdrawal?
A social worker is conducting an intake interview with a client in a prison psychiaric 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 social worker in a vocational rehabilitation program sees a 60-year-old widow. The client is unemployed and has serious financial problems. She has made several attempts to find work since her husband's death, but has been unable to get any job interviews. She completed high school and attended college for one year, but has not worked for many years. The social worker determines that the client's career goals are compatible with her skills. In choosing a referral option, the social worker should FIRST consider the:
possibility of age discrimination
A social worker is abusing alcohol. The primary rationale for taking action to remove this colleague from direct service is to:
ensure quality service for clients
A social worker meets with a couple struggling to provide adequate housing, food, and health care for their family. The social worker should FIRST:
link their specific needs to service options
In a treatment session a client diagnosed with social phobia 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:
discuss the pros and cons of joining the group
At the end of the second session with a new client diagnosed as having a borderline personality disorder, the client hugs the social worker before leaving the office. The social worker should:
set appropriate boundaries for the therapeutic relationship at the next session
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:
call community stores for donations of needed items
A social worker is treating a client of Asian descent for depression. 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?
Explore beliefs about mental illness in the client's culture
A social worker conducts a support group for families. The families have members who were recently discharged from inpatient alcohol abuse treatment. The families report that they expected to feel happy and relieved once the family member stopped drinking. Instead, they feel depressed, frustrated, and angry. What is the MOST likely reason for this reaction?
The family begins to realize the role that alcohol played.
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?
Focusing on the goals accomplished
A 45-year-old gay man sees a social worker because of a long history of depression. He states that "in most areas of my life things are fine, but I have never had an emotional relationship that felt intimate." He also reports being distanced from the gay community because he's not political and "after all, it is no different from being straight, except that I have sex with guys." The social worker should FIRST:
conduct a comprehensive assessment
A social worker begins treatment with a couple by asking many questions about their marital history. The social worker is MOST likely:
understanding how the present problem evolved
After six months of treatment for post-divorce adjustment issues, a client abruptly stops coming to see the social worker. The social worker should NEXT:
call the client to ask the reasons for the abrupt stop
An adult client with developmental disabilities confides to her social worker that the receptionist at the community center often treats her like a child. To help the client deal with this, the social worker should:
role play appropriate responses with the client
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