1 Flashcards
A 10-year-old boy is placed with a foster family that has different religious beliefs than the child. The foster parents want the foster
child to follow their religious practices. What is the social worker’s BEST course of action in this situation?
A. Tell the family to follow the child’s religion.
B. Instruct the child to follow the family’s religion.
C. Tell the child not to practice any religion to avoid conflict.
D. Identify alternate placement for the child.
D. Identify alternate placement for the child.
RATIONALE: The best option here is D. All the other options go against honoring the diversity of the people. Some
people may not pick this because they think that another option would not be available, but if it is an option on the
exam then it is available.
A family comes in with high expectations of their 10-year-old child. The child excels in school and the teacher states that he has
never had an infraction although he appears to be unhappy and has a hard time socially. The parents are likely using what kind of
parenting style?
A. Authoritarian
B. Authoritative
C. Permissive
D. Uninvolved
A. Authoritarian
RATIONALE: The clues in the stem are that the child excels and hasn’t had an infraction but seem unhappy and
has a hard time socially. This is the description of a child raised in an Authoritarian home. Children raised with
Authoritative parenting styles are the best adjusted. Both Permissive and Uninvolved children display behavioral
problems and generally have lower school performance.
Authoritarian: Strict, controlling, exert control through power.
Authoritative: Set and enforce rules with consistency and in a healthy way (so, authoritative is better than
authoritarian).
Permissive: They are often warm, accepting, lenient, avoid confrontation, and make few demands on their children.
Uninvolved: This one is what it sounds like. They demand almost nothing, but additionally give almost nothing in
return. Children have near complete freedom. This can border on neglect.
A woman has been going to therapy for the past two months. Whenever the therapist brings up emotional material the woman
dismisses it and says she isn’t interested in talking about those subjects. She talks a lot about her day to day life and says she
thinks she is ready to terminate. What should the therapist do next:
A. The client seems like she is doing fine and feels she is ready to terminate so the therapist should start the termination
process.
B. The therapist should address the client’s resistance in discussing the emotional material.
C. The therapist should give the client two more sessions to see if she still feels ready for termination.
B. The therapist should address the client’s resistance in discussing the emotional material.
RATIONALE: A client expressing disinterest in discussing emotional material is likely a sign of resistance. Nothing
indicates a readiness for termination. The question stem states the client is dismissive, and it does not state that
any goals have been met or that progress has been made.
An unlicensed social worker is meeting with an older woman for their first therapy session. The older woman reminds the social
worker a lot of her mother who she does not have a good relationship with. The social worker finds herself becoming easily
frustrated with the older woman and is having a hard time remaining calm. What should the social worker do first:
A. She should bring up the situation with the client and explain why she is becoming agitated.
B. Since it is only the first session, she should transfer her to another therapist.
C. She should talk to a supervisor about her countertransference issues.
D. She should journal about her feelings after the sessions.
C. She should talk to a supervisor about her countertransference issues.
RATIONALE: The experience the social worker is having is a countertransference reaction. Countertransference is
about our feelings as a therapist toward the client. If we experience countertransference, we should first seek
supervision. If it is something the social worker is unable to manage with supervision, they may end up referring them out, B, (but that wouldn’t be where they would start). The supervisor may also encourage doing D. A would not be appropriate; while we may discuss transference with the client (as this is about the client’s reactions in therapy), we do not discuss our own countertransference with clients.
A clinical social worker is evaluating a friendly, 5-year-old child who has difficulty making friends in school. He is very verbal, but
has a hard time answering questions about his feelings. He is eager to talk about all the different types of reptiles and knows all
about them. What should be the social worker’s next step:
A. Diagnose him with Autism Spectrum Disorder.
B. Use play therapy to try to connect with him on different topics.
C. Refer him to a social skills group.
C. Refer him to a social skills group.
RATIONALE: The best option is C. The main issue is his inability to make friends and talk about his feelings, so a
social skills group is clearly indicated. We can refer to a group if it is the most appropriate intervention based on the
client’s presenting symptoms (particularly so if the other answers don’t make sense for the issue being presented).
B suggests the social worker direct the play, which you wouldn’t do in the initial phase of treatment. For purposes of
the exam, you aren’t going to engage in play therapy (or interventions in general) in an evaluation session. Because
they are exhibiting signs of ASD, out of the answer options available C makes the most sense to address the social
issues he’s having (difficulty making friends). You could do B at some point, but wouldn’t start there. There isn’t
enough for A; while there are signs of Autism Spectrum Disorder, there is not enough to make a formal diagnosis. If
A said ‘consider a diagnosis of Autism Spectrum Disorder’ or ‘assess further for Autism Spectrum Disorder’ we
could do that.
A social worker is conducting a study on the effectiveness of group therapy in decreasing depression in teenagers recently
diagnosed with diabetes. Which of the follow refers to the extent to which the results of a study can be generalized to other
situations and people?
A. External Validity
B. Internal Validity
C. Reliability
D. Statistical Significance
A. External Validity
RATIONALE: This is a factual recall question. External validity refers to the extent to which the results of a study
can be generalized to other settings. B, C, and D would all be described differently.
An agency has chosen to use a single subject research protocol to assess their postpartum depression support groups. Which of
the following BEST describes why an agency would choose this research model?
A. It has strong external validity
B. More than one variable can be measured
C. Avoid ethical issues related to creating a control group
C. Avoid ethical issues related to creating a control group
RATIONALE: Having a control group means that some individuals are not receiving the treatment. Withholding
treatment from some individuals has ethical implications, making (C) the best answer. If an agency were to do a
true experiment (a randomized controlled trial) where individuals are randomly assigned to a control group or
treatment group, this brings up ethical concerns around the fact that some people are getting treatment while others
aren’t, which wouldn’t be ethical in a mental health treatment setting. Choosing a single-subject design means that
there is not a control group where some people aren’t getting the treatment, thereby taking away any ethical
concerns around people not receiving treatment for experimental purposes. This is the same reasoning for using a
quasi experimental design (while a quasi experimental design does have a control group, participants aren’t
randomly assigned like they are in a randomized controlled trial). This is why in a community mental health or
agency setting, a single subject design or quasi experimental group is more appropriate than conducting a
randomized controlled trial.
A social worker is part of an evaluation team assessing the effectiveness of a neighborhood outreach program targeting families with children ages 0-5. The social worker is in charge of collecting qualitative data. Which of the following is the BEST example of a qualitative measure?
A. Looking at the way variables such as age and income level impact the utilization of client services.
B. Tracking the number of clients served in a year through a specific program
C. Comparing the number of clients using a new service compared to an old service
D. Interviewing clients about their level of satisfaction with the changes in program delivery
D. Interviewing clients about their level of satisfaction with the changes in program delivery
RATIONALE: D is the best answer, because it involves gathering information directly from program participants. A,
B, and C are all examples of quantitative data. For qualitative vs. quaNtitative: I like to look at the “n” in quaNtitative
and associate that with Numbers. Quantitative data will always have to do with numerical data of some kind and
qualitative will not.
A social worker in a community agency receives a referral for her friend’s preschool-age son. The social worker should:
A. Involve the friend in a comprehensive assessment and treatment plan
B. Conduct an initial assessment and make treatment recommendations
C. Refer the son to a different therapist
D. Treat the son after getting consultation regarding confidentiality and boundaries
C. Refer the son to a different therapist
RATIONALE: Social workers should avoid dual relationships with clients. In this case, the son would be at risk of
not receiving the best treatment, as the social worker may have preconceived notions about the son or may treat
him differently due to the social worker’s relationship with the mother. Avoiding dual relationships ensures the
client’s safety and ability to receive appropriate treatment.
A client with a history of severe depression reports hypersomnolence and decreased appetite. The client reports having
discontinued his prescribed medication because he didn’t think he needed it anymore. The social worker should FIRST:
A. Question the client as to the other reasons for discontinuing the medication
B. Instruct the client to resume the medication
C. Encourage to the client to speak to his psychiatrist
D. Discuss alternative treatment options
C. Encourage to the client to speak to his psychiatrist
RATIONALE: The increase in symptoms is likely to be directly related to the discontinuation of medication and the
client should be encouraged to go back to his psychiatrist. Because they have already stopped taking their meds,
the expectation for the exam is that we refer them back to their psychiatrist immediately; this is a medical issue that
needs to be addressed (on the other hand, if they are considering stopping meds we can inquire why and then refer
them back to their psychiatrist). It would be outside of the social worker’s scope of practice to instruct the client to
resume medication. While questioning the client about the reasons for discontinuing medication and discussing
alternative treatment options may be appropriate interventions at some point, the social worker should FIRST
encourage the client to speak to his doctor regarding his increase in neurovegetative symptoms since he has
already stopped taking his medication.
A gay couple who say they are both in long-term recovery for cocaine addictions request couples’ therapy. The couple reports
frequent arguments and an increased sense of distance in their relationship. The social worker should FIRST:
A. Teach the couple communication skills.
B. Assess for a drug relapse in either partner.
C. Assign the couple intimacy exercises as homework.
D. Teach the couple anger management skills.
B. Assess for a drug relapse in either partner.
RATIONALE: B is the best answer because this needs to be assessed first. This is about what to do FIRST, in the
moment with the couple. The question specifies they are both in recovery and that there has been a decrease in
intimacy and an increase in arguments. This may be a sign that one partner has relapsed, putting stress on the
relationship. So we want to first assess whether there has been a relapse in either partner that could be leading to
the presenting issues. If a couple is in recovery, it is appropriate to assess whether relapse has occurred when
there are new symptoms. We don’t want to jump to action yet, like C, A and B do, before first assessing. A, C, and
D can all be done later.
A married couple meet with a social worker in private practice for an initial session. Afterwards, the wife calls the social worker and
states, “I have something I want to talk to you about, but my husband can’t find out.” The social worker’s MOST appropriate
response would be to:
A. Reassure the wife that what she says will be kept confidential.
B. Recommend that both husband and wife meet individually before the next couple’s session.
C. Advise the wife of the therapist’s “no secrets” policy and suggest disclosure at a future couple’s session.
D. Refer the husband and wife to separate individual therapists.
C. Advise the wife of the therapist’s “no secrets” policy and suggest disclosure at a future couple’s session.
RATIONALE: Redirecting the wife to reserve the disclosure for the marital session is the best answer, because it
will preserve the therapist’s ability to treat the couple effectively. A would potentially jeopardize the couple’s
treatment by creating a situation in which the social worker and wife are keeping secrets from the husband. B does
not make sense since couple’s treatment has already been initiated. Recommending that the couple see individual
therapists may be missing the point, as the couple has presented for marital therapy, not individual therapy, and
keeping secrets may be part of the couple’s problem.
A social worker receives a referral from parents regarding their 9 year-old daughter. A social history reveals symptoms consistent
with a diagnosis of Major Depressive Disorder. What should the social worker do FIRST?
A. Determine if the child has had a recent physical examination to rule out possible physical causes for her symptoms
B. Under the diagnosis of Major Depressive Disorder, refer the child to a psychiatrist for medication.
C. Have the parents fill out a questionnaire to confirm the diagnosis of Major Depressive Disorder.
D. Begin cognitive behavioral therapy with the child to decrease symptoms.
A. Determine if the child has had a recent physical examination to rule out possible physical causes for her symptoms
RATIONALE: While B, C and D may all be appropriate at some time in the near future, option A is the best choice
as medical conditions should always be ruled out before giving a diagnosis. There are physical diagnoses that can
look like major depressive disorder (things like an underactive thyroid, undiagnosed diabetes, or even vitamin
deficiency). Anytime we see clients with physical, emotional, or behavioral symptoms that haven’t had these
symptoms ruled out by a doctor for possible underlying biological causes, we want to start there (the only thing that
would come before this are immediate safety issues).
A couple starts seeing a social worker after the death of their two children in a car accident. The social worker’s supervisor notices
that the social worker is spending many hours on the phone with the couple and is seeing them more often than her other clients. The supervisor should:
A. Work with the social worker to assess if the level of intervention is necessary.
B. Advise the social worker that her behavior is unethical.
C. Transfer the clients immediately to a different social worker
A. Work with the social worker to assess if the level of intervention is necessary.
RATIONALE: The best place to start would be A. This is an example of the supervisor recognizing that the social
worker’s boundaries may be compromised, so the best response would be to discuss it with the social worker.
A social worker in a community clinic meets with a woman who presents with issues related to her job. She discusses a recent
incident in which she was gone from work for several days without notifying her boss or coworkers, although she has no memory of
this. The client has found a pamphlet and tickets from a Broadway show in her home, although she states that she’s never been to
New York. The client is describing which of the following conditions?
A. Depersonalization
B. Derealization
C. Delirium
D. Dissociation
D. Dissociation
RATIONALE: D is the best answer, because engaging in activities with no consciousness or memory of the
activities is a form of dissociation; A, B and C describe different phenomenons:
Depersonalization is a disorder in which the person experiences persistent feelings of unreality, detachment or
being an outside observer of themselves. They might feel like they are watching things happen to themselves.
With derealization, the person feels detached from the outside world. For example, the environment around them
may feel foggy, unreal, or disconnected. Sights and sounds might be muted or seem unreal. In these instances,
though, they still have their memory and are still aware of what is going on around them.
Dissociation is different. With dissociation, a person will be completely detached to the point that they have no
conscious memory of where they have been or what they have been doing (like in question 16).
Delirium usually occurs in hospital settings or can be due to chronic illness, changes in metabolic balance (such as
low sodium), medication, infection, surgery, or alcohol or drug intoxication or withdrawal. It has a rapid onset and
there is a marked shift in awareness, perceptions, and can result in hallucinations. Delirium can cause disruption in
people’s eating and drinking habits (during a delirious episode, clients may not feel hungry or forget to eat and
drink). For example, someone is delirious and suddenly is experiencing hallucinations and changes in perception.
A 12-year-old African-American boy has been meeting with a social worker for 2 months for feelings of depression. He recently
discovered that one of his ancestors was a slave who led a rebellion during the Civil War. He previously felt ashamed of his
background, but in sessions, starts speaking about his ancestor as being a “brave leader.” In terms of racial identity development,
the client’s experience could be best described as:
A. Conformity
B. Dissonance
C. Resistance
D. Introversion
B. Dissonance
RATIONALE: B is the best answer, because according to a minority identity development model, the stage of
dissonance includes a period in which the individual moves from feeling shame about their identity to feelings of
pride. In the stage associated with A, the individual prefers the dominant culture and devalues their own
background; in the stage associated with C, the individual rejects the dominant culture and has a sense of
appreciation for their own culture; in the stage associated with D, the individual moves toward feeling that the
dominant culture is not all bad and that there are individual differences.
A newly licensed social worker is providing outreach to a community that recently experienced a major hurricane. The social worker
goes door-to-door, asking families if they need mental health services and outlining opportunities to receive these services. At the
end of her first week, the social worker realizes that no families have expressed interest in receiving mental health services. The
social worker should next:
A. Attend upcoming community events to join with the community and understand their needs.
B. Provide informational flyers in community centers to reach people in a less threatening way.
C. Terminate the intervention since no one is interested.
D. Continue the intervention as planned.
A. Attend upcoming community events to join with the community and understand their needs.
RATIONALE: A is the best answer. The social worker should recognize that a community that has recently
experienced a stressful or traumatic event may not be open to new people or offerings. Joining with the community
and understanding their needs will assist the social worker in meeting those needs effectively. B might help but
does not do as much to create a relationship between the social worker and the community. The social worker will
not know unless s/he gets to know the community better. C is premature, and D continues with an intervention that
is not working at this time.
A 50-year-old woman in the commercial real-estate business is referred to her EAP due to interpersonal conflicts with female coworkers.
During the assessment, the social worker learns that the woman frequently minimizes her colleagues concerns regarding
sexism and sexual harassment in the workplace and during work functions. The woman says, “They need to get over it. This is just
part of the business. They’re being too sensitive.” The social worker should view this response as:
A. Expected, given the employment setting and cultural standards.
B. An internalization of the sexism the client has experienced during her career.
C. Evidence of a personality disorder.
D. An indication that long-term therapy is needed.
B. An internalization of the sexism the client has experienced during her career.
RATIONALE: B is the best answer, because the client’s behavior indicates she has internalized the sexism she has
experienced over time. A is not a good answer, because, while it may be true, it does not identify the process
through which this has occurred as well as B does. C is not indicated by the client’s statements or behavior. D may
be true, but is not clear from the information provided in the question stem.
A 45-year-old man meets with a social worker for an initial appointment. He reports that his wife is an alcoholic and becomes
verbally abusive when she is intoxicated. He indicates that his wife refuses to go to treatment, insisting that they can resolve this
problem on their own. The therapist should FIRST:
A. Provide the man with psychoeducation around substance abuse and the stages of change.
B. Explore the man’s issues and work collaboratively to develop treatment goals.
C. Explore the man’s commitment to the relationship.
D. Help the man identify the reasons behind his wife’s behavior.
B. Explore the man’s issues and work collaboratively to develop treatment goals.
RATIONALE: The best answer is B. We’re in an initial session with him; it’s not couples counseling and his wife has
refused to come to treatment. So we want to first work on exploring the issues that brought him there and develop
treatment goals. A, C, and D could be options later in treatment after a treatment plan focusing on the man has
been established, but all of these are making assumptions around what he is wanting to work on and are jumping into treatment prior to exploring and setting treatment goals.
A new client comes to treatment after losing his job of 15 years. He reports that “nothing in his life is going right,” and goes on to
note that his marriage is failing, recent investments are not paying off, and that he has “no real friends.” In addition to a risk
assessment, the social worker should focus on:
A. The client’s strengths and resources
B. A possible medical issue
C. Referring the client for employment assistance
D. A referral for couples therapy
A. The client’s strengths and resources
RATIONALE: A is the best answer, because it focuses on the client’s strengths. B is not indicated by the client’s
symptoms or presenting problem. C and D may be helpful, but the social worker should identify the client’s
strengths and resources so that interventions and treatment decisions can be made appropriately.
A social worker at a local community mental health agency started a group for adults who grew up in the Foster care system. Each
week fewer group members show up. In order to keep the group strong and ensure reasonable attendance, the social worker
should:
A. Talk to the group members to assess why attendance is dwindling and have them assist with the group structure and
future topics.
B. Cancel the group since it is not needed.
C. Change the day and time of the group to hopefully make it more convenient.
D. Have a different social worker take over the group.
A. Talk to the group members to assess why attendance is dwindling and have them assist with the group structure and
future topics.
RATIONALE: You would start by asking group members why they haven’t been attending the group. B, C, and D
are possible responses once you ask the members about their experiences.
A social worker is attending a neighborhood block party. While speaking with her neighbor, the neighbor discloses that she was so
frustrated with her child the other day that she hit her with a belt. While the neighbor is not a client of the social worker, the social
worker should first:
A. Make a suspected child abuse report
B. Report the incident according to state law.
C. Refer the neighbor to a different social worker so there is no dual relationship.
B. Report the incident according to state law.
RATIONALE: In some states, social workers are mandated reporters 24/7, while in others, they are only mandated
reporters while in their professional capacity. A would not be correct, since the law may not require this. B is the
best answer, because it allows the social worker to do whatever is legally required. The social worker could do C if
the neighbor asked for assistance.
A social worker at a day treatment facility for teens with mood disorders is asked to provide crisis intervention following the suicide
of a program participant. The social worker should FIRST:
A. Refrain from sharing information due to confidentiality.
B. Contact the residents’ parents to inform them of the situation.
C. Facilitate a group session to discuss the incident with the other participants.
D. Have individual meetings with each participant to discuss the incident.
C. Facilitate a group session to discuss the incident with the other participants.
RATIONALE: You would want to host a group meeting to ensure that all members hear the same information at the
same time so C is the best thing to do first. While you would want to be sensitive to issues of confidentiality, you
would not have to refrain from sharing any information (B) as it affects the whole community. When there has been
a tragedy at a treatment facility, school, business, etc., you want to let people know and provide them a space to
process their feelings first and foremost. You want everyone to get the information at the same time, which is why C
is better than D or B. As needed, you could do D after C. In a setting like a day treatment facility, we need to
acknowledge that there has been a tragedy. We will of course do so with respect to privacy and not divulging
details, but need to acknowledge and provide a space to process the loss similarly to when a student (or teacher)
who attends a school dies.
A social worker in a community mental health agency meets with a 14-year-old boy and his parents after 3 months of treatment.
The family first presented for treatment because the boy was experiencing feelings of anxiety and had several panic attacks. The
goal of the session is to review the client’s progress and reevaluate the treatment plan. All of the following are examples of
objective data EXCEPT:
A. The number of panic attacks the client reports in the past 2 weeks
B. The client’s score on the Beck Anxiety Inventory
C. The client’s ability to express feelings to the social worker
D. The parents’ report on how often the child avoids anxiety-provoking situations
C. The client’s ability to express feelings to the social worker
RATIONALE: C is the best answer, because it represents subjective data (information from the client’s point of view
gathered through an interview). A, B, and D are all examples of objective data: observable and measurable data.
Remember, objective (or quantitative) data has a numerical component to it. Subjective (or qualitative) data does
not have a numerical component to it.
A 41-year-old woman has been in therapy for two years for anxiety attacks and depression. She is no longer taking medication and
is currently symptom free. During recent therapy sessions she frequently laughs and enjoys herself. Which of the following actions
should the social worker take?
A. Interpret the client’s behavior as a flight into good health.
B. Confront the client regarding avoidance of underlying issues.
C. Develop a termination plan with the client to maintain progress made.
D. Identify precipitating events leading to the new symptom development.
C. Develop a termination plan with the client to maintain progress made.
RATIONALE: C is the best answer, because the client’s presenting problems have been resolved and the client is
doing well without the aid of medication both of which indicate a readiness for termination. A does not make sense
because the client has been in treatment for 2 years; a flight into good health is typically seen at the initiation of treatment. B and D are not supported by the information in the stem.
A 30-year-old man meets with a social worker for the first time and describes himself as a failure. He recently lost his job and his
girlfriend of two years broke up with him. He feels hopeless about his life and is beginning to believe his family’s criticism and
rejection of him are justified. As the interview progresses, his discouragement and feelings of worthlessness become more
apparent. The social worker should FIRST:
A. Refer the client to a psychiatrist for a medication evaluation.
B. Help the client identify why his relationship with his girlfriend ended.
C. Schedule a family session.
D. Ask the client if he’s had any thoughts about hurting himself.
D. Ask the client if he’s had any thoughts about hurting himself.
RATIONALE: Hopelessness and feeling like a failure are both risk signs for suicide. D would be the place to start.
Once that was ruled out, A, B, and C could be considered.
A 55-year-old female client is in therapy with a male social worker for help with her relationships with her grown sons. The social
worker perceives that a good working relationship has been established, but in the eighth session, the client announces that she
wants a new social worker. She states that the social worker is too young and inexperienced to help with her particular problem.
The social worker should FIRST:
A. Encourage the client to discuss her feelings about their relationship.
B. Review his professional experience to reassure the client.
C. Help the client to differentiate the social worker from her grown sons.
D. Offer a list of older social workers and facilitate a referral.
A. Encourage the client to discuss her feelings about their relationship.
RATIONALE: A is the best answer, because the social worker should be discussing the client’s feelings about the
relationship. This would be the place to begin, so A is the best answer. B, C, and D could be done once the issue
had been explored more.
A 53-year-old man comes to a social work agency for help regarding a loss of interest in sexual relations with his wife of 20 years.
In the intake interview, the client further describes decreased energy, achiness all over his body and depressed mood. The social
worker should FIRST:
A. Evaluate the client for sexual dysfunction.
B. Assess the client for depression.
C. Refer for a psychiatric evaluation.
D. Refer for a physical evaluation.
D. Refer for a physical evaluation.
RATIONALE: D is the best answer, because the client is describing physical symptoms and depressed mood; the
social worker needs to rule out a medical cause for the client’s problems before moving forward. A, B, and C could
be done after a medical issue was ruled out.
A client is being treated by a social worker. She has a history of relationship problems and suicidal gestures. In the first session,
the client tells the social worker how great she thinks the social worker is. What is the MOST important element of a treatment plan
for this client?
A. Establishment of clear therapeutic boundaries with the client.
B. Short-term cognitive therapy to work with distorted self-image.
C. Long-term psychoanalytic therapy to process painful memories of the past.
A. Establishment of clear therapeutic boundaries with the client.
RATIONALE: A is the best answer, because the client is presenting with several symptoms indicative of Borderline
Personality Disorder (relationship problems, suicidal gestures, idealization of the social worker) and boundaries are
a key component to engaging in effective treatment with a client with this profile. B and C are not specifically
related to treatment with clients with Borderline Personality Disorder.
A client who is gay tells his social worker that he wants to have a baby. He reports that his plan is to contact an adoption agency to
begin the process. What should the social worker do FIRST:
A. Assess the client’s ability to manage the potential negative response from family members.
B. Refer the client to a parenting class for single fathers.
C. Assess the client’s understanding of the steps needed to adopt a child.
D. Explore the client’s desire to become a parent.
D. Explore the client’s desire to become a parent.
RATIONALE: This is where it’s really important to imagine yourself in the moment with the client. If a client tells us
they have decided to become a parent it would be a very logical next step to ask them to share more about this and
what led to this decision. D is the best answer, because it starts where the client is and takes a nonjudgmental
stance. C suggests they haven’t done the research needed around this. They didn’t ask us for help in the steps to
adopt a child, so it wouldn’t make sense to immediately go into this. A does not make sense, since the stem does
not indicate that his family is involved or that they would be unsupportive. B might be helpful later if they are
looking for support around this, but would not happen in the moment before doing D.
A social worker is hired by a non-profit foundation to complete a process evaluation on three agencies that received grants from the
foundation. Each of the following is an example of a process evaluation question EXCEPT:
A. Was the program more successful with certain groups of people than with others?
B. Was the program well managed?
C. Was there adequate agency support for the program?
D. What specific interventions were put into place by the program?
A. Was the program more successful with certain groups of people than with others?
RATIONALE: A is the best answer, because it is not a question associated with process evaluation; it is associated
with program evaluation. The ‘Program Evaluation’ quick study defines process evaluation. Process evaluation is
part of the overall program evaluation. Program evaluation looks at the overall effectiveness and outcomes of a
program. Process evaluation is a part of this and specifically looks at whether program activities have been
implemented as intended. This could include things like the management of the program, if the agency supported
the program well, and which interventions were implemented for the program. All of these factors impact the
process of implementation and will in turn end up impacting the overall program outcomes. So process has to do
with implementation; program (or ‘outcome’ evaluation) has to do with overall outcomes.
A client with a history of interpersonal problems with co-workers has recently been fired for getting into repeated arguments with
colleagues and supervisors. The client arrives at the next session late and becomes very angry when the social worker inquires
about the client being late. The client yells, “Why are you monitoring my every move? Can’t you just trust me and leave me
alone?” The social worker should interpret the client’s behavior as:
A. Resulting from a feeling of judgment by the social worker.
B. Displaying problems that occur in workplace relationships.
C. Indicating a need for medication to stabilize the behavior.
B. Displaying problems that occur in workplace relationships.
RATIONALE: B is the best answer, because it is MOST likely that the client is exhibiting behavior that is typical in
another area of the client’s life. The question references problems in the workplace, so this is probable. Since all
the social worker has done is inquire why the client is late (which is a natural response to someone being late),
there isn’t anything to indicate the client is being judged. Because the question stem specifies she has been fired
for getting into repeated arguments with colleagues and supervisors, and then yells at the social worker when the
social worker inquires why she’s late, it is more likely that this is an example of the behaviors the client displays in
the workplace that got her fired. A and C are not supported by information in the stem.
A patient admitted into ER has his partner listed as the emergency contact. The social worker learns that the nursing staff
contacted his family instead of the partner. The social worker should NEXT:
A. Call the partner.
B. Tell the patient that his family was notified.
C. Wait until the family arrives and find out what they think is best.
D. Discuss the situation with the doctor.
B. Tell the patient that his family was notified.
RATIONALE: B is the best answer. We have to address the issue that occurred first. The hospital incorrectly
contacted the client’s family, so he needs to be notified of this first and be able to emotionally prepare for his
family’s response or arrival at the hospital. A could come after if the client still wants the partner there knowing the
family may be on the way due to the error. C would violate the client’s confidentiality and take away his self-determination.
D does not make sense, since the doctor is not mentioned in the stem and has not been a part of
this particular situation.
A school social worker is meeting with a 17-year-old Latino student as part of her post-graduation assessment/planning. During the
conversation, the student expresses a desire to go to college and then begins weeping and explains that as an undocumented
student, most colleges will be out of reach. The social worker should FIRST:
A. Assist the student in identifying colleges that will accept undocumented students
B. Explain that the social worker cannot help since the student is technically breaking the law
C. Refer the student to an immigration attorney
D. Help the student process her feelings about being undocumented
A. Assist the student in identifying colleges that will accept undocumented students
RATIONALE: A is the best answer, because it meets the student where she is and will help empower her and help
her be hopeful about her future. If a client/student expresses emotions that need to be validated, you can certainly
validate those. In this case, the client’s emotions are a result of her desire to go to college and feeling most colleges
will be out of reach due to her undocumented status (her feelings are not about her undocumented status in general
as D suggests). So A is meeting her where she’s at, empowering her, and helping her reach her goal of going to
college. D could come later, but at this point the client hasn’t expressed ongoing issues around her feelings about
being undocumented, so it doesn’t make sense to start there. B is in opposition with social work values. C may be
needed at some point, but is not indicated at this time.
An adult with Down Syndrome and diabetes is in an emergency room for treatment due to noncompliance with insulin shots.
Before releasing her, the physician asks the social worker to interview the client and her parents, with whom she lives, about the
situation. The social worker learns that the noncompliance with insulin has been an issue at home and at the client’s place of
employment. What should the social worker do FIRST?
A. Provide the parents with information about how to apply for conservatorship.
B. Explore the client’s understanding of her illness and the significance of medical treatment.
C. Discuss the effects and benefits of medication with the whole family.
D. Reframe the client’s noncompliance as an example of her seeking independence.
B. Explore the client’s understanding of her illness and the significance of medical treatment.
RATIONALE: B is the best answer, because the social worker first needs to understand what is behind the client’s
noncompliance before moving forward. The issue being presented is medication noncompliance, leading to serious
health issues. It makes sense to start by speaking with the client to see if she understands her illness and why
medical treatment (insulin shots) are needed. It could be that no one has explained why she needs to take the
insulin shots before (which could be part of why she has noncompliance). After we figure out if she understands the
importance of the shots on her health, we could do C next. We want to first ensure we know where the client is
coming from-even if they have a cognitive or developmental disability-and can then move on from there. A is too
extreme and likely unnecessary. D is not supported by the information in the stem.
The 66-year-old wife of a man with a Mild Neurocognitive Disorder seeks counseling from a social worker due to increasingly
stressful caregiving responsibilities. The wife is well-integrated into the mental health and medical care delivery systems since her
husband has been receiving a range of treatments since age 55. In order to reduce the wife’s sense of burden, the social worker
should FIRST help her:
A. Provide her with psychoeducation regarding the illness and available treatments.
B. Utilize a life review to help her identify her husband’s positive contributions.
C. Improve her response accuracy to decrease crises.
D. Re-evaluate her system of caregiving resources outside the family.
D. Re-evaluate her system of caregiving resources outside the family.
RATIONALE: D is the best answer, because it most directly addresses the client’s feelings of stress related to
caregiving duties. A is probably not necessary since the client has been integrated into delivery systems for over
10 years. B will not address her stress level; C may not be possible given the nature of her husband’s illness.
A social worker and client have been working together for 2 months. The client, a 27-year-old woman, initially presented due to
concerns about her alcohol use and its effect on her relationships and ability to perform her job duties. After the initial session, the
client began minimizing her alcohol use and typically comes to session with another topic she wants to discuss. The social worker
has attempted to confront the client about her avoidance of the topic, but the client is adamant that her drinking is not a problem at
this time. The social worker should:
A. Continue to confront the client about her alcohol use
B. Consult with a colleague about the client’s resistance to change
C. Convey acceptance and monitor the client’s readiness for change
D. Discuss termination due to lack of client engagement
C. Convey acceptance and monitor the client’s readiness for change
RATIONALE: C is the best answer, because it meets the client where she is and also monitors when she might be
ready to address her substance use. A is not the best answer, because the social worker has already attempted to
confront the client and it was not effective. Continuing to confront the client may damage the therapeutic
relationship. B might be appropriate but is not as good as C in terms of meeting the client where she is (in general,
consulting is a good option when the question stem specifies that the social worker is unsure of how to proceed,
which is not stated in this question stem). D is not indicated: the client keeps coming to treatment and may be
benefiting from it in other ways.
A client who has recently immigrated to the United States seeks therapy to adjust to the client’s culturally different spouse. To
assess the client’s level of acculturation, which of the following factors should the social worker take into consideration FIRST?
A. Newly immigrated individuals are often hesitant to challenge cultural traditions in their marital relationships.
B. Newly immigrated individuals are resistant to learning the rules of a new country.
C. Gender differences cause more discomfort than acculturation issues.
D. The pace of acculturation may vary from group to group.
D. The pace of acculturation may vary from group to group.
RATIONALE: D is the best answer, because it does not make assumptions and encourages the social worker to
understand more about this individual’s experience. A and B both make negative assumptions. C is not true.
A social worker meets with a veteran who has been diagnosed with PTSD. During a session, the client’s eyes glaze over while he
is talking about an experience in which several members of his platoon were killed. He sits forward in the chair, staring over the
social worker’s shoulder, and talks in a calm, monotonous voice. The social worker should:
A. Employ a grounding technique to reconnect the client with the present moment
B. Allow the flashback to continue so the client can express his feelings
C. Assess the client for suicidal ideation
A. Employ a grounding technique to reconnect the client with the present moment
RATIONALE: A is the best answer, because the client is experiencing a flashback and the social worker should try
to help him distinguish between what is happening now versus what happened in the past to decrease his distress.
B is not a good answer, because therapeutically it is not helpful to allow flashbacks to continue. C is not indicated in
this moment.
Social work supervisors engaging in activities that help the supervisee to: increase self-awareness, refine knowledge and skills,
develop professionally as it pertains to their specific role, deal with ethical issues that arise, as well as learn appropriate techniques
around assessment, intervention, and treatment planning is engaging in what type of supervision activities?
A. Administrative
B. Educational
C. Supportive
D. Clinical
B. Educational
RATIONALE: The activities described fall into the educational component of supervision described by the NASW
and ASWB’s document on the Best Practice Standards in Social Work Supervision:
https://www.socialworkers.org/LinkClick.aspx?fileticket=GBrLbl4BuwI%3D&portalid=0
A 38-year-old woman with Borderline Personality Disorder continually engages in scapegoating during a weekly treatment group.
After consultation, the social worker facilitating the group decides to dismiss the client from the group due to the destructive nature
of her in-group behaviors. What should the social worker to FIRST in order to facilitate termination?
A. Inform the client during a group session that she will be leaving the group in 2 weeks.
B. Ask the group whether the client should be dismissed from the group.
C. Schedule an individual appointment with the client to discuss the decision.
D. Refer the client for individual treatment before termination is discussed.
C. Schedule an individual appointment with the client to discuss the decision.
RATIONALE: C is the best answer, because this is a matter that should be handled privately and confidentially. A
and B are inappropriate and would clearly shame the client in front of other group members. D could be done as
part of the individual appointment, but would not be done FIRST.
A social worker in a community mental health agency begins working with parents and their 12-year-old son. The family has been
referred because the son’s grades are deteriorating and he’s been getting into fights at school. During the first few sessions, the
social worker notices that the parents repeatedly express anger toward their son for lying, but when the son tells the truth, they yell
at him for his “poor choices.” The social worker should NEXT:
A. Separate the child and the parents to help them each express frustration in a safe space
B. Point out this double bind to the parents
C. Ask the son to respond to the parents’ anger
B. Point out this double bind to the parents
RATIONALE: B is the best answer. We need to respond directly to what is happening and what they just said.
Starting where the client is at (the family unit is the client) would be responding to what is happening in the question
stem. B names the dynamic that is occurring in the room and may help the parents understand why the boy is not
likely to be honest with them. A is not indicated in this situation and will not help address the dynamic that is
occurring. C may be helpful, but not before the social worker helps raise the parents awareness of the dynamic
(having the son respond to the parents’ anger won’t be effective until they become aware of their pattern of
expressing anger towards the son for lying and then yelling at him for poor choices when he tells the truth).
In establishing a therapeutic alliance with a client from a different racial or ethnic background, the FIRST issue for the social worker
to address is:
A. The racial or ethnic difference and how it may impact treatment.
B. Transference issues with the therapist.
C. The therapist’s countertransference.
D. The client’s history of encounters with people of different racial or ethnic backgrounds.
A. The racial or ethnic difference and how it may impact treatment.
RATIONALE: The best answer option is A, because it deals directly with the client-therapist relationship and brings the topic up for exploration. B might be done later in treatment but not FIRST. C would be addressed in consultation or supervision if the therapist felt it was interfering with treatment but would not be done FIRST. D
would not do anything to help establish a therapeutic alliance between the client and social worker.
A white social worker at a hospital is asked to evaluate a black woman who was recently brought in by the paramedics. When the
social worker approaches the client, she refuses to tell the social worker what happened and states repeatedly that she fears
anything she says to the social worker will be used against her. The woman requests to instead speak with the Latina nurse who
has been caring for her since arrival. What is the MOST likely explanation for the woman’s behavior?
A. Cultural paranoia, which represents a healthy reaction to racism.
B. An episode of acting out of Borderline Personality dynamics.
C. Pathological paranoia regarding all social workers.
D. Resistance to assessment and treatment.
A. Cultural paranoia, which represents a healthy reaction to racism.
RATIONALE: A is the best answer, because it takes into account the cultural issues presented in the case. Cultural
paranoia is a normal, understandable reaction to racism. In this question, the client is meeting with a white social
worker and wants to speak to the Latina nurse (a non-white person). This shows cultural paranoia (a
healthy/normal/understandable reaction to racism based on her lived experience) in not wanting to meet with a
white social worker. Her reaction is not pathological paranoia, which would indicate it is not a normal reaction to
racism, which her feelings/reactions are. B and C both pathologize the client’s behavior; D makes a negative
judgment about the client’s behavior, when it may in fact be protective; nothing indicates she is resistant overall to
assessment or treatment.
A 16-year-old is brought to treatment for an eating disorder. How would a social worker using Feminist Theory Therapy view this
issue?
A. Unresolved issues of early childhood can manifest as eating disorders.
B. Her automatic thoughts cause unhealthy body-image.
C. Cultural expectations of women negatively affect their sense of self.
D. Denial of food is a defense mechanism to manage anxiety.
C. Cultural expectations of women negatively affect their sense of self.
RATIONALE: C is the best answer because it directly relates to Feminist Theory and how mental health is affected
by a patriarchal culture. A would be more of a psychodynamic view. B would be a Cognitive Behavioral view. D is
not as specific but is more psychodynamic in nature.
A social worker receives a referral for family therapy. The family consists of mother, father, a 14-year-old girl, and an 8-year-old boy.
The parents report they want the family to spend “quality time” together, but whenever they try, everyone ends of up fighting. The
daughter rolls her eyes and reports that her parents try to talk to her “like they are my friends.” The 8-year-old says he wants to
play with kids in the neighborhood and go to sleepovers, but the parents refuse, saying he can have “all of that fun right here at home.” The social worker should focus treatment on:
A. Helping the family establish appropriate roles and boundaries
B. Assisting the family in healthy communication strategies
C. Facilitating activity-based family interactions to build on relational strengths
D. Creating connection through conflict resolution
A. Helping the family establish appropriate roles and boundaries
RATIONALE: A is the best answer, because the question stem indicates that the parents are trying to interact with
their children like peers instead of parents. Helping the parents establish more appropriate roles with the children
may decrease the tension and allow for more positive family interactions. B and D may be helpful but would not be
the focus of treatment in this case. C will not be as helpful until the parents develop more appropriate boundaries
and roles for themselves.
An 8-year old child with developmental delays is currently in a regular classroom setting. He is struggling to keep up with the work
and he is noticing he is not being assigned the same work material as his classmates. The social worker should first:
A. Advocate for him to receive an aid in the classroom.
B. Transfer him to a special education classroom.
C. Assess him using the mental status exam.
A. Advocate for him to receive an aid in the classroom.
RATIONALE: The best answer is A, as you would do this before having him transferred to a special education class
(we want to keep the child in the least restrictive environment). There is no reason to do a mental status exam at
this point. He is already diagnosed with developmental delays (which a mental status exam wouldn’t diagnose
anyway). We are only going to do a mental status exam if there is a reason to do so outlined in the question stem
(tangential thinking, ideas of reference, etc.).
The mother of an eight-year-old boy calls the school social worker and says that her son has been refusing to come to school
because he is teased about being overweight. The mother demands that the school punish the students who have been teasing
her son. What should the social worker do FIRST?
A. Encourage the mother not to overreact to the child’s report.
B. Get a list of the names of the bullies from the mom.
C. Meet with the child to assess and develop problem-solving strategies.
D. Refer the mom to a parenting support group.
C. Meet with the child to assess and develop problem-solving strategies.
RATIONALE: C is the best place to start. You want to connect with your client (the child) and find out what is going
on from him directly before you proceed with any other action. A dismisses the mother and the child’s feelings; B
disempowers the client. D might be helpful at some point but not before C.
A social worker is approached by a mother regarding her 2 ½ year-old daughter. The mother is distressed by the fact that her
daughter frequently says “NO” when asked to clean up after herself, has occasional temper tantrums and wants to do “everything”
independently. The social worker’s BEST response would be to:
A. Educate the mother about child development.
B. Schedule a biopsychosocial evaluation of the child.
C. Review possible behavior modification techniques.
A. Educate the mother about child development.
RATIONALE: The child is exhibiting normal, healthy behavior for a 2-year-old. A would be the best place to start.
A 72-year-old woman has been in treatment with a social worker for 6 months for depression and anxiety. One day, she arrives
thirty minutes late for a regularly scheduled appointment. She reports that she got confused on the bus and couldn’t remember
which stop to get off at. The social worker should FIRST:
A. Call the client’s family and inform them of the incident.
B. Call the client a taxi for the ride home.
C. Encourage the client to get a physical examination.
D. Recommend immediate hospitalization for further evaluation.
C. Encourage the client to get a physical examination.
RATIONALE: The best answer is C, because it addresses the concern without taking away the client’s self-determination.
She isn’t in immediate danger and hospitalization is not warranted at this point.
