Mock test

Question 1

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.

Answer 1

C

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.

Question 2

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

Answer 2

A

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.

Question 3

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

Answer 3

C

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.

Question 3

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

Answer 3

C

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.

Question 4

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.

Answer 4

B

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.

Question 4

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

Answer 4

D

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.

Question 4

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

Answer 4

B

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.

Question 4

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.

Answer 4

A

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).

Question 5

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.

Answer 5

B

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.

Question 5

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.

Answer 5

A

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.

Question 5

Which of the following therapies is present-focused and short-term, that helps the client identify, challenge, and replace self-defeating thoughts and feelings that interfere with life goals with more productive, helpful behaviors that help with the attainment of goals and positive relationships:

A. Rational Emotive Behavior Therapy

B. Dialectical Behavior Therapy

C. Humanistic Therapy

Answer 5

A

RATIONALE: This is a recall question. Rational Emotive Behavior Therapy is a short term therapy that helps clients identify and replace self-defeating rigid thought patterns, beliefs, and unhealthy behaviors that interfere with their life goals with healthier thoughts and behaviors that help them achieve their goals. Some tools used in REBT include: cognitive reframing, visualizations, self-help tools, and homework assignments. All other therapies listed would be described differently.
Incorrect

Question 6

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.

Answer 6

C

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.

Question 6

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.

Answer 6

C

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.

Question 6

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.

Answer 6

A

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.

Question 7

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.

Answer 7

D

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

Question 7

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?

Answer 7

A

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.

Question 8

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.

Answer 8

A

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.

Question 9

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.

Answer 9

A

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.
Incorrect

Question 10

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.

Answer 10

D

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.

Question 10

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

Answer 10

A

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.

Question 11

A client diagnosed with an aggressive and painful cancer discloses his wish to end his life because of his terminal illness. How should a social worker with strong beliefs and opinions on this issue manage ethical responsibilities toward this client?

A. Refer the client to a social worker who has expertise working with terminal illness.

B. Encourage the client to discover a new commitment to living with illness.

C. Discuss the different moral values between the social worker and the client.

D. Seek consultation to provide treatment within the client’s value system.

Answer 11

D

RATIONALE: D is the best answer, because it reflects the ethical values of supporting a client’s right to self-determination and providing treatment to clients regardless of their differences from the social worker. A may be necessary if the therapist, with the aid of consultation and other supports, was unable to provide adequate treatment to the client. B and C are both inappropriate.

Question 11

A 23-year-old woman seeks treatment from a social worker through her university following a dramatic breakup with her girlfriend. During the assessment, the social worker notes that the client seems to have abandonment issues that stem from a long history of fragmented relationships. If the social worker operates from a client-centered therapy model, all of the following interventions apply EXCEPT:

A. Empathizing with the client’s experience

B. Exploring the client’s cultural background and expectations in relationships

C. Matching the tone and pacing of the client’s verbal communication

D. Maintaining a positive stance toward the client

Answer 11

B

RATIONALE: A, C, and D are all interventions that are associated with client-centered therapy. While B may be a helpful thing to do, it is not specific to the client-centered therapy model, which empathizing with the client’s experience, matching the tone/pacing of their communication, and maintaining a positive stance are.
Incorrect

Question 11

An emergency room social worker is asked to evaluate an 18 year-old pregnant female who was admitted after an accident at her job. The woman reports to the social worker that she hasn’t seen a doctor “in a year or so,” gets most of her meals at the fast-food restaurant where she works, gets very little sleep and enjoys “partying” with her friends on the weekends. The social worker should FIRST:

A. Assess the client’s knowledge of the effects of her behavior on the fetus.

B. Refer the client to support services for teen mothers.

C. Provide psychoeducation about the effects of alcohol on fetal development.

D. Immediately report the client for suspected abuse of her unborn child.

Answer 11

A

RATIONALE: D is out because you do not report child abuse on an unborn child. If you put the other options in order, A is the best answer. It would be important to assess her understanding of her behavior before intervening.

Question 11

A social worker is working with a family with three children, the oldest of whom, age 14, is in a wheelchair because of cerebral palsy. The parents describe the child’s lack of interest in family activities and believe that he is depressed. The child remarks that his mother hovers over him, and they never let him go anywhere alone. He expresses an interest in going to special needs summer camp, but his parents shake their heads. What should the social worker do FIRST?

A. Support the parents’ understandable need to be protective.

B. Refer the 14-year-old for a medication evaluation.

C. Provide psychoeducation about normal adolescent development.

D. Encourage parents to support their son’s independence.

Answer 11

C

RATIONALE: The parents are concerned about the 14-year-old’s behavior, but his behavior sounds healthy for his age. Of the answers given, C would be the best place to start. A sides with the parents and ignores that what the child is looking for is developmentally appropriate. By FIRST providing information about normal adolescent development (including that as children move into their adolescent years, there is a desire for greater independence), this will help us move into doing D after that. At the moment, the parents think he is depressed based on his behaviors, so jumping into encouraging his independence wouldn’t make sense yet based on their conceptualization of what is happening. So we want to first explain that what he is presenting with is developmentally appropriate/normal, and then once there is that understanding we can encourage them to support his developmentally appropriate independence. There is no need to do B at this time.
Incorrect

Question 11

A mother seeks treatment for her 16-year-old daughter. The mother is concerned that until now the daughter was a good student and enjoyed involvement with their family, church and school. They rarely disagreed. For the past three months, however, the daughter has wanted to spend all her time with her friends. The daughter has kept her grades up, but arguments have occurred around when she has to spend time with the family and how often she can talk on the phone with her friends. What should the social worker do FIRST?

A. Suggest family therapy to find compromises.

B. Support the mother’s efforts to maintain structure and discipline.

C. Refer the daughter for individual therapy.

D. Provide the parents with education about normal adolescent behavior.

Answer 11

D

RATIONALE: The daughter’s behavior demonstrates typical adolescent development and the parents may be more successful in intervening with her if they understand this; A may not be necessary if the parents’ understand the daughter’s behavior better; B will probably only serve to cause more conflict; C is inappropriate since the presenting problem is a family dynamic.

Question 12

A social work intern is presenting a case to a multidisciplinary diagnostic team for review. During the presentation, the social worker identifies social, cultural, physiological, economic, and environmental factors that interconnect and impact her client’s current problem. The intern is using:

A. Biological Perspective
B. Ethical Perspective
C. Policy Perspective
D. Ecological Perspective

Answer 12

D

ecological perspective is a framework that emphasizes the interaction between individuals and their environments, highlighting the importance of social, cultural, and physical contexts in shaping human behavior. This viewpoint recognizes that problems are often rooted in environmental factors and that effective solutions must address both individual and systemic issues.

Question 13

A social worker is facilitating a group for survivors of childhood sexual abuse. During the most recent session, one of the group members reports drinking excessive amounts of alcohol and taking pain pills to sleep through the night. The social worker should NEXT:

A. Provide the group with psychoeducation around substance use and trauma

B. Encourage group members to share their reaction about this disclosure

C. Meet with the group member individually to discuss a referral for substance use treatment

D. Refer the group member for a medical evaluation

Answer 13

C

RATIONALE: The social worker should address the group member’s substance use needs on an individual basis. When issues like substance use come up in a non substance use group, this is something to discuss individually. Remember: Group work is all about the group process, but if there is an extenuating circumstance that comes up in group (someone shares something that is going to result in a child abuse/neglect report, someone is actively suicidal, someone is abusing substances and in need of a referral, or you are removing someone from the group) then you can talk one on one with them. Otherwise, you always want to bring issues/concerns back to the group and allow them to share their feelings about difficult situations and dynamics. Things like group conflict or confidentiality breaches should definitely be brought back to the group to be discussed, as it is part of the group process. While our intention is not to cause shame, if shame is a byproduct of the group addressing a member breaking the group rules, that is okay. That also can be processed within the group. A might be a useful intervention, but does not address the individual needs of this group member. B may shame the group member by focusing specifically on the behavior and will not get him/her the referral the group member needs for substance use treatment. D may be appropriate at some point but not before the client is referred for substance use treatment.

Question 14

A social worker facilitates an interdisciplinary team that is holding an emergency meeting to discuss a 27-year-old man with an intellectual disability. The majority of the team feels that the client is in need of some type of psychotropic medication because of seriously escalating aggressive and impulsive behaviors. The physician member of the team refuses to consider that suggestion and states that team members are “outside of their scope of practice.” The social worker’s BEST course of action is to:

A. Remind team members that decisions involving medication must be made by a physician.

B. Arrange to meet with the physician individually to address his concerns.

C. Reexamine the need for psychotropic medications.

D. Refocus the team’s discussion on the client’s behaviors.

Answer 14

D

RATIONALE: When a multidisciplinary team disagrees about how to intervene, refocusing the conversation on the client’s behaviors and progress is often helpful. A may be true but will not help the team move forward. B would potentially damage the team’s cohesiveness and ability to work together. C does not make sense, since the stem clearly tells us that the team disagrees about medication.

Question 15

In an initial session of family therapy, parents of two teenagers begin complaining about their children’s attitudes, reporting that the two have no respect for their authority. The teenagers respond by reporting that “there isn’t anything there to respect” and blame their bad attitudes on the parents. The social worker should FIRST:

A. Take a neutral stance by acknowledging everyone’s feelings.

B. Have individual meetings with the parents and the teenagers.

C. Use circular questioning.

Answer 15

A

RATIONALE: In family therapy, it is important for the therapist to develop a therapeutic alliance with all family members. B does not make sense as it splits the family up when the issue is a family dynamic. C may be useful at a later time to facilitate a conversation within the family but only after A has been done.

Question 16

A hospital-based social worker receives outcome data that indicates a large percentage of geriatric patients with knee replacements are functioning at lower levels one year after surgery. As part of the medical team’s response, the social worker is asked to develop a psychosocial program that will enhance functioning. The social worker’s BEST approach is to:

A. Provide pre-operation workshops to highlight challenges.

B. Coordinate the group with the medical director.

C. Recommend additional physical rehabilitation.

D. Create a drop-in support group.

Answer 16

D

RATIONALE: Since the question is asking the social worker to develop a psychosocial program that will enhance functioning, we need to be looking for two things in our answer: something that has a psychosocial component AND something that will enhance functioning post surgery. A doesn’t address their functioning after surgery, which does not address the presenting problem. C does not make sense, since it refers to physical rehab. A does not address the patients’ functioning after surgery. B is an incomplete answer.

Question 17

A school social worker has received a referral for a 6-year-old boy who is having behavior issues in the class. As part of the assessment, the social worker asks the parents to sign a consent for a classroom observation, but the parents refuse, stating they are uncomfortable with this. What should the social worker do NEXT:

A. ​​​​​​Point out the benefits the observation could have on the situation

B. Inquire about the parents’ resistance to the observation

C. Facilitate a meeting with the parents and school administration regarding the boy’s behavior
Should have chosen

D. Acknowledge the parents’ right to make the decision

Answer 17

D

RATIONALE: Reinforcing the parents’ right to make the decision supports their self-determination and the relationship. In general, if a question asks what to do FIRST/NEXT and there is an answer option that acknowledges their right to self-determination, we can start there (for example, in question #90 above, if there was an answer option that acknowledged their right to make the decision around putting their child on medication, we could start there FIRST and then move on to exploring their specific concerns). A could be construed as coercive and could damage the relationship. B and C may both be helpful, but not before the social worker supports their self-determination.

Question 18

A social worker in a community clinic meets with a 27-year-old woman who was referred after experiencing domestic violence. The woman shares that she is pregnant and plans to return home after staying with her sister while her boyfriend “cools down.” The social worker should FIRST:

A. Convey acceptance of the client’s decision to return home

B. Report the client to CPS for child endangerment

C. Provide psychoeducation around the potential escalation of domestic violence during pregnancy

D. Express concern about the client’s plan to return home

Answer 18

C

RATIONALE: C is the best answer, because it FIRST helps the client understand the potential consequences of returning home while pregnant. While the social worker might do A at some point, it would not be done before discussing the potential for the violence to escalate. You want to keep in mind that accepting a client’s decision is different than acknowledging their right to make the decision. If in question 94 A said “acknowledge her right to make this decision” vs “accept” we could choose A. As it is written, we could do A at some point, but because of the legitimate safety issues it’s not what we would lead with. She is expressing that since her boyfriend has cooled down, she can return home-it is implied that she thinks it is safe to go back with him since he’s “cooled down” which indicates a lack of understanding on the cycle of violence (as though things are okay since he has now cooled down). We want to educate her that pregnancy is a time that DV can escalate. B is not appropriate since we do not report on unborn children. D is coercive and may negatively impact the client-social worker relationship.

Here are some general guidelines for working with survivors of DV on the exam:

If there is an answer to acknowledge ambivalence (and they’ve expressed ambivalence) and it asks what to do FIRST you can always start there. Keep in mind that acknowledging acceptance is different than starting off by accepting their decision.

If someone is in a DV situation, but says they don’t want to talk about it (or denies there is a problem), then safety planning or psychoeducation are not options, as they are going against the client’s self-determination. When the client is denying there is a problem or says they don’t want to talk about it, a DV shelter referral is a good option to address the safety issue (which we can’t ignore) without encroaching on their self-determination. A DV shelter referral can be given quickly and discreetly, it provides the client with a resource, and they can choose what they want to do with it (if anything).

Safety planning is appropriate when a client is acknowledging there is violence, but isn’t ready to leave the person. If a client is returning to an abusive situation and it asks what is BEST/MOST important/PRIMARY/what we MUST do, it is generally going to be to safety plan.

Psychoeducation would be appropriate if someone is acknowledging their is an issue, but seems to not understand the dynamics of DV. For example, they express fear of the person and know that what that person is doing is wrong, but go on to state how sweet and apologetic the person is after the abuse, bringing them gifts and flowers etc. Then we could provide psychoed on the honeymoon phase, stages of violence, etc.

Question 19

A social worker in a community mental health agency meets with a 16-year-old client for the first time. During the session, the social worker asks open-ended questions about the client’s history and the presenting problem; the social worker clarifies certain statements but also allows the client to talk uninterrupted. This approach serves all of the following purposes EXCEPT:

A. Building therapeutic rapport

B. Obtaining diagnostic information

C. Assessing for insight

D. Developing a treatment plan

Answer 19

D

RATIONALE: D is the correct answer, because the therapist’s approach serves the purpose of achieving A, B, and C, but not D. Asking open ended questions about the history and presenting problem and then clarifying certain statements but also allowing the client to talk uninterrupted would help us build rapport, it would help us obtain diagnostic information, and it would help us assess for insight. None of these things are directly helping us create a treatment plan, though, which is what makes D the correct answer for this EXCEPT question.

Question 20

A woman seeks therapy 2 months after miscarrying for the second time. The client reports recurring dreams about losing the baby and feelings of anger when she sees women with healthy babies in public. Her husband is refusing to attend therapy, saying that “everything happens for a reason.” The social worker’s primary task is to:

A. Provide psychoeducation on the grieving process.

B. Explore the client’s sadness.

C. Support the client through her grieving.

D. Explore the client’s relationship with her husband.

Answer 20

C
RATIONALE: Start where the client is. A may be helpful, but is not the primary task. D is related to the husband who is not in the room. B is not indicated. C is the only answer that addresses the client’s presenting problem.

Question 21

A social worker is facilitating a group for single adults with depression. During a session, one group member shares that he recently started dating a woman but is unsure if he should keep seeing her. He reports that the woman has taken him shopping, changed his wardrobe, and has insisted that he cut his hair and start reading certain books. What should the social worker do NEXT:

A. Meet with the client individually to discuss this relationship

B. Explore why the client is allowing his new girlfriend to exert so much influence on him

C. Encourage group members to share their reactions to his new relationship

D. Encourage the client to identify how he wants to respond to his girlfriend

Answer 21

D

RATIONALE: D is the best thing to do NEXT. There will be times in group where individuals will be speaking about themselves and their situations-that is okay and part of group therapy (this is different from meeting one-on-one to discuss his relationship with his girlfriend). Since he may not have decided how he would respond yet, we can give him space to help identify how he wants to respond to her. This should happen first since he is talking about his uncertainty regarding the relationship. After he identifies how he wants to respond to his girlfriend we could do C and give group members a chance to respond. A is not the best answer, since the client is bringing the issue up in group and there is no reason to separate him to address this. B makes a judgment about the client’s choices and behavior.

Question 22

A woman comes into session angry because she found out that her boyfriend is cheating on her. She gets enraged and screams ‘I’m going to kill him’ and runs out. What should the social worker do first?

A. Notify the authorities

B. Notify the boyfriend

C. Call the client

Answer 22

C

RATIONALE: You would FIRST want to attempt to contact the client and determine the seriousness of her threat, so C is the best answer. For a situation like 102, it’s really important to imagine the scenario playing out and this being your client. There is no history of violence specified and the client has just found out her boyfriend is cheating on her. She gets upset and runs out making this threat. So we want to try to call the client first to determine whether she actually plans on killing him (and wasn’t just saying that as an expression of her anger, without any real intent) before calling the authorities. If we can’t get ahold of her, or if she confirms she is truly planning on harming him, we would then immediately notify the authorities (A) and then notify the boyfriend (B).

Question 23

A 72-year-old was brought into the ER by his daughter. The daughter reports that recently her father has started to leave the oven on, refuses to leave the house, and frequently has loud outbursts. She reports that today he became increasingly agitated and threw a knife at the wall while she was making dinner for him. What should the social worker do NEXT?

A. Gain an understanding of the client’s personality before the change occurred

B. Explore the daughter’s feelings around her father’s decline

C. Refer the client for a medical and psychiatric evaluation

D. Explore assisted living home options with the client and his daughter

Answer 23

C

RATIONALE: Since the client has recently had a change in mental status, it’s necessary to have the client assessed for a medical and psychiatric evaluation. A is not important in having the client’s immediate safety needs met first. B may be important for the social worker to do once her father has been assessed; however, an assessment needs to occur first. D may also be an option at a later point to ensure the client’s safety.

Question 24

A woman is in school to be a nurse and is currently studying about stomach cancer. She starts getting severe pains in her stomach and goes to the ER who medically clears her. She keeps experiencing the same pains and sees 5 other specialists who all medically clear her. She goes to a social worker and complains that the Doctors aren’t ‘doing their job’. What should be the first intervention the social worker should take:

A. Empathize how frustrating it must feel.

B. Confront her about her denial.

C. Help her to find another Doctor who will be more sympathetic to her ailments.

D. Provide psychoeducation about what she is experiencing.

Answer 24

A

RATIONALE: The best answer is A. You would want to empathize with her feelings. You could go on to do D. B would be dismissing the client’s experience. And you would not be expected to do C.

Question 25

A school social worker meets with an 18-year-old high school senior whose teacher referred them. The teacher reported the client seemed distracted in school, was turning in assignments late, and had a noticeable drop in grades despite having previously been a good student. When meeting with the student, she reports that she doesn’t want to be seen for counseling and says that, “only crazies go to therapy.” She says she just wants to get out of school and is ready to go away to college. What should the social worker do FIRST?

A. Explore the client’s strong desire to leave school and go to college

B. Explore any psychosocial stressors that are occuring in school or at home

C. Complete a comprehensive assessment

D. Explore the client’s negative connotations around being in therapy

Answer 25

D

RATIONALE: D is the best thing to do FIRST. The client just said she doesn’t want to be seen for counseling and ‘only crazies go to therapy’, so that needs to be responded to before jumping into anything else (including the assessment). A, B, and D are all ignoring what she has said and going against her self-determination.

Question 26

A social worker in private practice receives a referral for a five-year-old child who is having behavior problems at school and home. During the initial interview with the parents, they disclose that the child has a different biological father than his 3 older siblings and that everyone in the family knows about this except the five-year-old. The parents request that the social worker disclose this to the child. The social worker should FIRST:

A. Meet with the child individually to assess his behavior problems.

B. Tell the child the truth during an individual session.

C. Meets with the parents to understand why they want to tell their child the truth now.

D. Encourage the parents to disclose the truth.

Answer 26

C

RATIONALE: C is the best because the social worker should collect more information about the presenting issue (exploration is often a good place to start). This is important to again really imagine being there with the clients and to think about what the just said and asked of us (for FIRST/NEXT questions, we want to meet them where they’re at and respond to what they just said). The parents disclosed that they want to share about the child’s biological father with the child, so you want to start by understanding what is motivating them to tell their child that now (which is meeting them where they are at). This discussion may lead us to doing D, or based on what they share (and the current behavior issues), we may not want to encourage them to disclose the truth at this moment. The key is we want to find out more information before making a recommendation like D. Jumping to A is ignoring what they just asked us to do. A, B, or D could all be done later.
Incorrect

Question 27

A social services agency wants to expand their services to meet the needs of the local Muslim community. The Director of Social Services is assigned the task of identifying the most appropriate services. During the initial phase of planning what is the BEST thing for the director to do?

A. Convene a focus group with members of the local community.

B. Contact the local mosque and request a meeting.

C. Consult with experts in the field of Muslim mental health.

D. Survey current Muslim clients to find out what services they need.

Answer 27

C

RATIONALE: The best place to start would be C. You would want to consult with experts first, because they would be the best at directing you how to move forward with any of the options presented in A, B or D. It will be important to speak with an expert so that when you do A, B, or D, you can structure questions and groups appropriately and in a culturally sensitive way (so, it’s less about them being an expert in mental health, but more about them being an expert in Muslim mental health). The expert could tell you important things like how to word your questions, who to include in the discussion, how to structure focus groups, so you would want to consult with them first to make the most effective plan. If one answer will lead to doing a better job with the other steps that follow, that is a good option. This is a challenging question as all answers would be good to do at some point, but getting some expert guidance would be the best place to start.

Question 28

A high school student has been killed in a gang-related shooting. A social worker is assigned to help students deal with the sudden death of their classmate. What should the social worker do FIRST?

A. Identify other at-risk students in the school who may be involved in gangs.

B. Develop a gang prevention program within the school.

C. Provide students with the space to express how they feel.

D. Empathize with the student’s feelings.

Answer 28

C

RATIONALE: The best place to start is to find out how the students are feeling about the incident (C). D would come next. A and B could be done once clients had processed their feelings.

express then empathize

Question 29

A young mother brings her 2-year-old son to the emergency room for treatment of burns to the hands and face. The mother states that the injury occurred when the child pulled a cup of hot coffee off of a table when she was not looking. The medical report shows third degree burns to the hands and face, as well as several bruises on the child’s buttocks and back that are in various stages of healing. After hospitalizing the child, the medical staff makes a report of suspected child abuse. The child welfare social worker should FIRST:

A. Remove the child from his home and arrange for alternative care.

B. Follow through with the report of suspected abuse and conduct an investigation.

C. Refer the mother to a parenting class.

Answer 29

B

RATIONALE: B is the first place to start. You want to be sure to look at what role the social worker is in; this question specifies that it is a child welfare social worker. So it is their job to follow through with reports and investigate. A and C can be done later.
Incorrect

Question 30

A school counselor refers a family to a social worker after finding their 7-year- old child pretending to have sexual intercourse with another child at recess. The mother states, “I’m so embarrassed about this happening at school, and not sure what to do.” What should the social worker do FIRST:

A. Report suspected child abuse to the proper authority.

B. Provide psychoeducation on normal child development.

C. Assess for further signs for sexual abuse.

D. Consult with the school counselor to obtain further details about the incident.

Answer 30

C

RATIONALE: This is outside of normal behavior for a 7-year-old, so B is out. Ruling our sexual abuse would be the first step. A is premature and D could be done after talking with the parents.

Question 31

A social worker meets with a new client who describes feelings of anxiety and depression that began soon after she got married. The client’s affect is flat and she keeps her eyes averted for much of the session. When asked about recent pleasurable experiences, the client states offhandedly that she is “not allowed to go out much.” The client becomes more visibly anxious toward the end of the session and keeps touching a bruise on the side of her face. The social worker should NEXT:

A. Encourage the client to attend marital counseling with her partner.

B. Encourage the partner to meet with the social worker for an individual session.

C. Educate the client about the cycle of violence.

D. Refer the client to a psychiatrist.

Answer 31

C

RATIONALE: The client is showing signs of DV, so C is the best answer. Once it was ruled out, the social worker could consider A, but only if there was no DV. D would be helpful to do at a later point. There is no reason to do B.

Question 32

A social worker is working with a client who recently came out as transgender to his parents. The client has expressed fear around transitioning because he is afraid of disappointing his family. The social worker is transgender and feels strongly about the client owning his transition, but is also aware that this countertransference may affect the development of a treatment plan. Which of the following is the MOST important component to keep in mind while developing a treatment plan?

A. Ensuring the client is aware of the countertransference

B. Keeping the family’s perspective in mind

C. Making sure an outside supervisor has consulted on the treatment plan

D. Ensuring the professional code of ethics is followed

Answer 32

D

RATIONALE: It’s MOST important to be aware of the professional code of ethics, as this will allow the social worker to remain impartial as the treatment plan is developed. The question is asking what is MOST important to keep in mind when developing a treatment plan – and our ethical code is the most important thing. A would not be beneficial for the client in terms of developing his treatment plan and would be inappropriate. B would undermine the client’s wishes. C is incorrect because the question isn’t asking what you would do FIRST or NEXT in response to realizing the countertransference (if that were the case, then C would be a great place to start). While seeking supervision for countertransference may be helpful, making sure an outside supervisor has consulted on the treatment plan isn’t something that is MOST important compared to following the code of ethics.

Question 32

A white social worker receives a referral from a school counselor for a 5 year-old black male. The counselor reports that the child refuses to stay in his seat, is disruptive to his peers and is oppositional with the teacher. When the social worker meets with the boy’s parents, they offer one-word answers to questions and the father sits with his arms folded across his chest. He states, “You people are always targeting us. I bet you don’t see any white kids getting referred!” What should the social worker do FIRST?

A. Refer the parents to a black social worker.

B. Suggest behavioral modification techniques to address the behaviors.

C. Clarify the parents’ understanding of the reasons for the referral.

D. Explore the parents’ perceptions of their child’s behavior.

Answer 32

C

RATIONALE: When clients are referred by a 3rd party and appear hostile or resistant in the initial session, it is important to make sure they know WHY they have been referred. They have just stated that they feel they are being targeted and that white kids aren’t getting referred; so we want to stay focused on the referral and seeing what their understanding is of why their child was referred. From there we could do D. This is all about order. With FIRST/NEXT questions all four answer options may occur within the course of a single session, so it is about identifying the order they will go in.A is premature; B and D may both be appropriate, but not before a relationship is established.

Question 33

A client meets with a social worker and states that she has a medically frail child who is 3-years-old. The client states that she feels hopeless that things will change, and is angry at how it’s affecting her family. The client feels that the needs of this child are impacting the client’s other children who are oppositional and having problems in school. What should the social worker do FIRST?

A. Refer the client to a support group for parents of children with medical problems.

B. Work with the family as a unit.

C. Coordinate with school social worker to address problems with other children.

D. Work with the client around ways to reduce her stress.

Answer 33

B

RATIONALE: The problem is affecting the whole family, so that is the best method of treatment. The key for this question is that if an individual presents for therapy and family (or couples) therapy is what is needed, we can make that recommendation. This is an initial session and it is okay to make a recommendation for family therapy when that is what is most appropriate to address the presenting concerns. The client is concerned about how her medically frail child is affecting her family as a whole (this is what is causing her stress). Since she is concerned about the whole family (and this is what is causing her stress), addressing them as a unit makes the most sense to alleviate her stress. That would be the first thing we would do. If it said she was coming in with symptoms of depression or anxiety, then we would address that with her. But what she is presenting with are family related issues. A, C, and D could all be done as part of the treatment.

Question 33

A social worker meets with a 22-year-old client who recently immigrated from Iran to attend college. The client is uncomfortable in social situations and is having difficulty finding friends. In one session, the social worker reflects the client’s stated feelings about disconnection and missing home. The client becomes offended at the social worker’s comments and says, “You have no idea what I’m talking about.” The social worker should NEXT:

A. Restate the reflection so the client feels understood.

B. Explore any cultural issues that are coming up.

C. Refer the client to a Persian social worker.

D. Encourage the client to further clarify his statement.

Answer 33

D

RATIONALE: Asking the client what s/he means is the best answer. If the client mentions a cultural issue, then B would be next. You cannot do A until you understand what the client means.

Question 34

A social worker has been working with a client who abuses alcohol. After a month, the client begins to acknowledge that his drinking is having a negative impact on his life and wants to make his life better. During the preparation stage of change, all of the following are possible interventions EXCEPT:

A. Clarify client’s goals and strategies.

B. Mobilize support systems.

C. Discuss treatment options.

D. Explore family history of abuse.

Answer 34

D

RATIONALE: This is a factual recall question; A, B, and C are all possible interventions during the preparation stage of change.

Question 34

A man has been hospitalized for a month following a car accident that has resulted in him needing a wheelchair while he relearns to walk. The patient’s elderly parents would like the client to move in with them so they can help him while he regains his mobility to which the client agrees. In developing discharge plans, the social worker should FIRST evaluate which of the following factors?

A. Financial stability.

B. Access to physical therapy and community resources.

C. The parent’s ability to provide adequate care to their son.

D. The accessibility of the parents’ home for a wheelchair.

Answer 34

C

RATIONALE: It is most important that the social worker evaluate overall how well the parents would be able to care for their son. Care is about more than just wheelchair accessibility (D). Once C has been determined, the social worker can then assess other factors.
Incorrect

Question 35

When discussing the fee with a potential new client the social worker learns that the client recently lost her job and is living off her savings. Even after sliding the fee to the lowest amount, the client states that she only thinks she can afford four or five sessions. The social worker should:

A. Agree to see her at the reduced rate.

B. Lower the rate to accommodate her situation.

C. Find out what issues the client hopes to deal with in therapy.

D. Refer the client to a low-fee mental health services.

Answer 35

D

RATIONALE: Since no relationship has been established with the client yet, the social worker should provide the client with referrals to a low-fee mental health agency (D). A and B would be inaccurate because four or five sessions at a reduced rate would most likely not be effective for the client. C is inaccurate because it doesn’t address the client’s inability to pay for therapy.

Question 35

A mother brings her 3-year-old daughter to therapy. The mother shares that she recently divorced her spouse and that she shares custody of her two kids with her ex-husband. The children stay with the mother during the week and are with their father on the weekends. Recently, her 3-year old daughter has started wetting her bed even though she was toilet trained before. She also cries when she needs to go to her father’s house. What is the social worker MOST appropriate response?

A. Tell mother that this is a normal response when dealing with parent’s divorce.

B. Find out if there are any child abuse issues going on.

C. Ask mother about her relationship with ex-spouse.

D. Take developmental history of the child.

Answer 35

A

RATIONALE: The child’s behavior is a normal reaction to the recent changes she has experienced. It would be good to start with A and normalize it for the mother. You want to be sure to look at the behavior in the context of what is happening in the child’s life. Regression is a normal reaction to significant changes in a child’s life. So a divorce could lead to a development regression and is likely the cause of the bed wetting. So you would want to start with normalizing this. B, C, and D could all be done, but if leading with those you could cause the mother to feel that there is something wrong with her child, when it fact this is a very common reaction to the stressors, which should be emphasized along with further assessment.
Incorrect