Exam Questions

Question 1

A 40-year-old man meets with a social worker. He states he feels increasingly irritable lately. During the assessment, the client reports that he enjoys gambling, but doesn’t gamble often because he doesn’t live near any casinos. Though he spends a lot of money on gambling, he says he doesn’t think it’s a problem, because he is wealthy. Given the client’s reports about gambling, what should the social worker do?

Answer 1

The social worker need not ask further questions as the man is seeking treatment for irritability only.

Question 2

A social worker at a community mental health center meets with a mother and her seven-year-old child. The child has not been wanting to attend school due to separation anxiety from the mother. What treatment strategy is MOST likely to be effective?

Answer 2

Cognitive behavioral therapy with parent training

Research shows cognitive behavioral therapy with parent training can be effective in treating anxiety in children.

Question 3

A client is referred to a social worker by his primary care physician. The client has a fear of germs and, as a result, has difficulty being in public places. What treatment intervention is most likely to be successful?

Answer 3

Cognitive behavioral therapy

Cognitive behavioral therapy is the most effective talk therapy to treat OCD or mysophobia.

Question 4

A social worker meets with a mother who is exasperated with her six-year-old son’s behaviors. She reports that he is out of control and doesn’t listen to her. She says that she uses spanking as her main form of discipline. How should the social worker respond?

Answer 4

Discuss the pros and cons of spanking versus other discipline strategies.
It’s appropriate to provide the mother with the research about physical punishment and to discuss the potential risks and consequences of spanking.

Question 5

A social worker meets with a mother and her 16-year-old daughter. The mother tells the social worker she wants her child to be placed in a group home. The teenager has been refusing to get out of bed in the morning to get to school on time and behaves disrespectfully. What should the social worker do FIRST?

Answer 5

Try to find services that will help the mother and daughter so the child can stay in the home.
Social workers who work with adolescents should advocate for the least restrictive environment possible. This teenager appears to be exhibiting some mild behavioral issues and it would not likely be in her best interest to move her to a residential setting. The social worker should first try to help the teen remain home
In-home services, parenting classes, individual therapy, or family therapy may help address the behavior issues and allow the child to stay in the home.

Question 6

A mother brings in her four-year-old daughter to see a social worker. The daughter has recently wet the bed several times. The mother denies any other symptoms. How should the social worker intervene FIRST?

Answer 6

Explain to the child’s mother that this is normal behavior for a four-year-old.
Bed wetting is normal at age four.

Question 7

A mother meets with a social worker to discuss her son’s behavioral problems. She states that her son whines and begs until she finally gives him what he wants. According to Skinner’s theory of operant conditioning, why does the child continue to misbehave?

Answer 7

He’s receiving positive reinforcement for whining and begging.
Positive reinforcement occurs when a behavior is rewarded. When the mother gives in to her whining son, she is positively reinforcing his behavior.

Question 8

A therapist sees a couple for marriage counseling. The clinician notes that the female client rarely lets go of the male’s arm. She doesn’t speak unless asked a direct question, and then defers to her husband (“Oh, I let James decide all that,” or “I don’t know, but I’m sure James does”). How should the marriage counselor proceed?

Answer 8

Schedule individual counseling sessions with each client.
This is the best option, since the female client may be more willing to talk without her husband in the room. Meeting with the husband ensures that he doesn’t feel slighted and that he, too, gets private time to discuss his concerns.

Discharging the couple from therapy may be premature, and directing the majority of attention to the male client is likely to make the female client even more reserved. Encouraging the female client to speak up may be helpful in some cases, but in others (for instance, if the relationship is abusive), anything she says might put her in danger. Meeting with each client individually may give a broader picture of what’s going on in the marriage and what the best resolution might be.

Question 9

A 32-year-old man is admitted to the hospital following a car accident. The following morning, he tells a social worker that he is experiencing extreme symptoms, including sweating, vomiting, agitation and anxiety, and needs to get out of the hospital to get his “medicine.” What drug is the client most likely withdrawing from

Answer 9

Heroin

Opiate withdrawal, including heroin, is the most likely cause of such severe symptoms

Question 10

A social worker is employed in a residential setting where ex-convicts obtain treatment for substance abuse problems before re-entering society. The social worker meets with a woman who struggled with polysubstance dependence for many years prior to being incarcerated two months ago. The woman reports she has not used any substances in two months. What specifier should be used to reflect her diagnosis?

Answer 10

In a controlled environment
This specifier is used if the person is in an environment where access to alcohol and controlled substances is restricted

Question 11

A woman brings her 17-year-old lesbian daughter to a social worker in private practice and demands that the social worker do re-orientation therapy to “make her straight.” How should the social worker respond?

Answer 11

Decline on the basis that participating in re-orientation therapy is a violation of the social work Code of Ethics.
This is the best answer. The clinician might also go an extra step and offer supportive therapy to both mother and daughter to help them better accept the daughter’s sexual orientation.

Question 12

A woman is meeting with a social worker due to distress over her adult son’s behaviors. She describes him as a career criminal who is constantly getting himself in trouble for stealing, selling drugs, and making threats. His mother states he has been diagnosed with antisocial personality disorder. She asks the social worker if his behaviors are likely to ever improve or if she should expect him to always act like this. How should the social worker respond?

Answer 12

Antisocial personality disorder tends to peak in the late teenage years through the early twenties. People with antisocial personality disorder tend to improve around the age of thirty-five and many people in their forties and fifties report being in remission.
Tell the client that antisocial personality disorder can go into remission at any time, however, most people experience improvements after age thirty-five.
It is accurate to tell her that it is uncertain when he may improve and to provide her with information on when most people do see improvements.

Question 13

A 30-year-old female is seeking services at her doctor’s recommendation. She is morbidly obese and her doctor has declined to allow her to have gastric bypass surgery. She states that she has tried everything to lose weight and does not think anything else will help but she is willing to try anything. How might a social worker intervene?
Obesity is often linked to mental health issues, such as depression. When people struggle to control their emotions, sometimes they cope with food. Some people overeat while others undereat. Teaching clients new coping skills to regulate their emotions can help them develop healthier eating habits.

Answer 13

Help the woman identify emotions that lead to eating and help her to develop new coping skills to manage her emotions.
It is correct to teach the client coping skills that may help her manage her emotions so she does not cope with uncomfortable feelings by eating

Question 14

A social worker in private practice receives a call from a man who says he is currently receiving services through a local agency. He states that the mental health provider he is seeing is often late for appointments and does not seem to understand what he needs. He states he is interested in transferring to the social worker’s private practice. How should the social worker respond?
Clients often change service providers for various reasons. It is important that social workers consider a client’s needs carefully before agreeing to accept a client. The social worker should discuss with the client whether or not it makes sense to consult with previous service providers. Clients should be informed of risks and benefits of changing services.

Answer 14

Recommend that he talk to his current provider first to discuss his concerns, and if he’s still dissatisfied, to call back to discuss the risks and benefits of changing providers.
It’s best for the client to first talk to his current provider as he may be able to resolve the issue rather than switch providers. Since there are risks as well as benefits to changing providers, it is appropriate to help the client make an informed decision.

Question 15

A social worker has been promoted to a new position. He will no longer be doing direct service with clients and will need to terminate with a long list of existing clients in the coming month. What should the social worker do FIRST?
Self-awareness is imperative to good social work. Before discussing a major change such as discharging clients, social workers should strive to be aware of their feelings and how these feelings may impact how the change is presented to clients.

Answer 15

Examine his feelings about the promotion and terminating with his clients.
The social worker should be clear about how he feels prior to talking to his clients about the promotion. His feelings will likely influence how he presents the termination to his clients

Question 16

A client comes to a therapy session stating she has been feeling anxious, worried, irritable, restless, is unable to sleep well, and is having a hard time concentrating. She has been feeling this way for six months, but can not seem to figure out the cause. Which of the following is the correct diagnosis of her condition:
Generalized anxiety disorder is diagnosed when a person is suffering from excessive worry and anxiety that occurs for more than half the days in a six-month time period. The condition will also present with restlessness, sleep disturbances, irritability, difficulty concentrating, being easily fatigued, muscle tension, and feelings of being on edge.
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Answer 16

Generalized Anxiety Disorder
Generalized anxiety disorder is diagnosed when a person suffers from excessive worry and anxiety for more than half the days in a six-month time period, accompanied by restlessness, sleep disturbances, irritability, difficulty concentrating, a tendency to become easily fatigued, muscle tension and feelings of being on edge. The woman in question presents with five of these symptoms, and they have been occurring for more than half the days in a six-month time period

Question 17

A thirty-year-old woman is seeking outpatient treatment because she has been experiencing some depressive symptoms for the past couple of years. She reports feeling very tired and lacks motivation to participate in leisure activities. When asked about her physical health she states that she is healthy. In the past, she had some thyroid problems but she states that she thinks this is resolved. She also reports that she had a miscarriage about two years ago and has had difficulty conceiving since then. What should the social worker do first?
Thyroid problems have been linked to depression. Since the client reports a history of thyroid problems, it is important to recommend she have her thyroid levels tested prior to beginning mental health services as she may be experiencing a medical issue contributing to her depression.

Answer 17

Recommend she talk to her doctor about having her thyroid levels checked.
It is important to rule out physical health issues before treating her mental health issues

Question 18

A couple that a social worker has been seeing in couples therapy for several years have decided to get married and ask the social worker to attend. What should the social worker do?

Social workers should maintain professional boundaries with clients, taking care to avoid dual relationships and situations that might compromise client confidentiality. While some may prefer not to attend a client’s wedding, attending a ceremony and departing before the reception is the best of the answers offered here.

Answer 18

Agree to watch the ceremony only and depart before the post-ceremony celebration begins.
This option honors the clients’ wishes, celebrates the work done in therapy, but limits the risk of breaching confidentiality

Question 19

A client with schizophrenia insists that a social worker show him his file. How should the social worker respond?

While HIPAA regulations permit social workers to withhold psychotherapy notes from clients, the NASW Code of Ethics states that only in “exceptional circumstances” should clients be denied access to their records, for example, “when there is compelling evidence that such access would cause serious harm to the client.”

Answer 19

Agree to show the client his complete file.

Social workers are expected to give clients “reasonable access” to treatment records unless they social worker expects sharing records will hurt the client.

Question 20

A male social worker who identifies as gay is treating a court-ordered client whose lack of impulse control has resulted in several jail terms. The client describes a fight he got into in a bar with a man he describes as “an angry faggot.” What’s the BEST way for the social worker to proceed?

The question of how and when to address a client’s prejudices is a thorny one. The NASW Code of Ethics states that social workers should promote clients’ socially responsible self-determination, which includes working within the client’s worldview. When social workers’ values and attitudes clash with the clients’ prejudices, it’s important for social workers to assess whether the difference will impede the treatment before attempting any intervention.

Answer 20

Assess the client’s willingness to examine his homophobic attitudes.
Since the client’s attitudes have the potential to clash with the social worker’s identity, it’s important to assess whether they can work together productively.

Question 21

A token economy system is based on the principles of:

Answer 21

Operant conditioning

A token economy uses rewards to reinforce behavior, which indicates it’s based on operant conditioning.

Question 22

Foster parents meet with a social worker to discuss the pending adoption of their foster child. The foster parents report that as the adoption date grows closer, the child’s behaviors are getting worse. They state they are no longer certain they want to adopt. How should the social worker respond?

Answer 22

Reassure the parents that their ambivalence and the child’s increased misbehaviors are normal at this stage of an adoption.
Ambivalence prior to major changes and decisions is a common feeling, so it’s normal for the foster parents to be feeling somewhat uncertain about the pending adoption. The social worker should normalize their feelings.
It’s appropriate to normalize the parents’ ambivalence and to encourage them to discuss their feelings about adoption.

Question 23

A 16-year-old client meets with the school social worker and acknowledges that he has been considering killing himself. He says that he thinks about overdosing on his mother’s pills. The social worker believes that the boy is at risk for suicide. The boy asks if the social worker is going to tell his parents. How should the social worker respond?

Answer 23

Social workers should maintain confidentiality unless special criteria are met, including a safety risk. Since this teenager has expressed suicidal ideation, and has a plan and means, his parents should be informed so that steps can be taken to keep him safe. Interventions might include contacting crisis services for an evaluation, taking the client to the emergency room, or establishing a safety plan.

Question 24

A client tells a social worker that he has been prescribed amitriptyline (Elavil) by his primary care physician. What was the medication MOST likely prescribed to treat?

Amitriptyline is a tricyclic antidepressant most commonly used to treat depressive symptoms. (Sometimes–but not always–the names given to meds can be a clue to what they’re used for. In this case, “Elavil” sounds like “elevate,” which suggests that the drug helps lift a person out of a depression.)

Answer 24

Depression

Amitriptyline is a tricyclic antidepressant that is commonly prescribed to treat depression

Question 25

A father brings his four-year-old daughter to see a counselor after the death of her grandfather. The father says the child is in denial because she keeps saying things like, “Grandpa will be at my birthday party.” How should the social worker intervene?

Answer 25

Explain to the father that child is unable to understand the finality of death.
It is developmentally appropriate for the child to assume death is not permanent.

Question 26

Explain to the father that child is unable to understand the finality of death.
It is developmentally appropriate for the child to assume death is not permanent.

Answer 26

Cognitive behavior therapy
Cognitive behavior therapy tends to address a person’s thoughts and behaviors. Clients who are unable to gain perspective regarding cognitive distortions in therapy are often given behavioral experiments to help test the distortions.

Question 27

A 25-year old Asian American seeks help from a social worker. He reports he has been feeling depressed about dropping out of college. He still resides with his parents. How should a culturally competent social worker intervene?

Answer 27

Provide brief short-term, goal-oriented therapy that allows the client to maintain privacy.

Asian Americans tend to prefer addressing problems within the family and place a high value on privacy. Short-term, goal-oriented therapy is usually the most effective approach.

Maintaining privacy and providing short-term, goal-oriented therapy is usually the treatment of choice with Asian American clients.

Question 28

A social worker has started working at a medical clinic that serves foreign-exchange students who attend a private school in the United States. A Chinese teenager is referred to the social worker after he reported to the doctor at the clinic that his genitals were retracting into his body. The student appears to be in a state of panic. What is MOST LIKELY happening?

There is a culture-bound syndrome, known as koro, common in China and parts of Europe, where people fear their external organs are retracting into their body. These people additionally present with anxiety and fear of death.

Answer 28

A culture-bound syndrome called koro.

The student’s symptoms indicate koro, a culture-bound syndrome where people fear their genitals are retracting

Question 29

A teenager is referred to a social worker by the school department after the teen was caught with alcohol at school. The social worker meets with the teen and his father. The teen’s father says, “I don’t see what the big deal is. After all, it’s normal for teenagers to experiment with stuff.” What type of discipline style is the father MOST likely exhibiting?

Permissive parents tend to form a friendship bond with their children and often don’t intervene when there are behavioral issues. Chalking up misbehavior to “normal childhood” is a hallmark of permissive parenting.

Answer 29

Permissive
This father’s statement about “normal” experimentation indicates he most likely uses a permissive style of discipline. He may generally excuse his son’s behaviors and not enforce consequences.

Authoritarian
Authoritarian parents tend to avoid discussion, focusing more on punishment than teaching. If this father were authoritarian, he would likely be imposing serious consequences for his son’s behavior.

Authoritative
Authoritative parents tend to be open to discussions with their children about the logical consequences of their actions, and offer increased responsibility based on a child’s readiness for it. An authoritative parent would likely be concerned about a behavior issue and would want to deter the child from repeating the behavior.

Neglectful
Neglectful parents usually aren’t involved in their children’s lives. If this father were neglectful, he would probably not have shown up for the meeting in the first place.