Psychotherapy, Clinical Interventions, and Case Management

Question 1

Which of the following is NOT a secondary prevention strategy?
A. Regular screenings of those with risk factors for an illness or disease
B. Regular exercise and good nutrition
C. Modification of work assignments for those who are injured
D. Taking low doses of aspirin for those with heart conditions

Answer 1

B- Regular exercise and good nutrition are actions that are classified as primary prevention, helping to avoid developing diseases, injuries, and/ or illnesses. The other three response choices are secondary prevention strategies that occur after diseases, injuries, and/or illnesses have developed to mitigate or slow their progression/impacts.

Question 2

When making level of care determinations, which criterion is primarily
used in behavioral health settings?
A. Capitation
B. Medical necessity
C. Managed risk
D. Diagnostic groupings

Answer 2

B- Medical necessity is a criterion used to determine whether treatments and services are justified as reasonable, necessary, and/or appropriate, based on evidence-based clinical standards of care. Payment for services, as well as whether levels of care are justified, uses medical necessity to assess whether treatment and service requests are “reasonable and necessary” given clients’ diagnoses and/or presenting problems.

Question 3

Which of the following is the FIRST goal of assisting clients who have
suffered a life crisis?
A. Helping them to develop coping skills to deal with similar crises in the future
B. Identifying the cause of the crisis in order to prevent it from reoccurring in the future
C. Assisting them to establish a sense of equilibrium and return to prior levels of functioning
D. Linking them with others who have experienced a similar crisis to build a network of support

Answer 3

C- The FIRST goal is to immediately relieve the stress experienced, return clients to previous levels of functioning, and assist them with regaining equilibrium. A social worker may want to work with clients to identify precursors, develop coping skills, and/or link with others for mutual support, but these actions would occur after the crisis has subsided.

Question 4

Which of the following contains thoughts, feelings, desires, and memories of which a client has no awareness, even though they influence his or her daily life?
A. Preconscious
B. Conscious
C. Superego
D. Unconscious

Answer 4

D- The unconscious contains thoughts, feelings, desires, and memories of which clients have no awareness, but that influence every aspect of their day-to-day lives.
The preconscious contains all the information outside of a client’s attention, but that is readily available, if needed.
The conscious contains all the information that a client is paying attention to at any given time.
The superego is the moral component of personality. It causes clients to feel guilty when they go against society’s rules.

Question 5

After an assessment is completed, what follows according to the
problem-solving process?
A. Intervention
B. Evaluation
C. Planning
D. Engagement

Answer 5

C- The problem-solving process consists of engaging, assessing, planning, intervening, evaluating, and terminating. Thus, planning is done after an assessment is complete.

Question 6

Which of the following is a level of awareness as defined by Freud?
A. Id
B. Preconscious
C. Preconventional
D. Individualistic

Answer 6

B- Freud believed that behavior and personality derives from the constant and unique interaction of conflicting psychological forces that operate at three different levels of awareness: the preconscious, the conscious, and the unconscious.
The preconscious contains all the information outside of a client’s attention, but that is readily available, if needed. Preconscious thoughts and feelings can be brought into the consciousness easily if needed.

Question 7

Which of the following BEST describes the benefit of peer supervision in social work practice?
A. It is less expensive than individual supervision.
B. It can occur as needed, anytime and anywhere.
C. It is a reciprocal learning relationship aimed at skill acquisition.
D. It does not require “experts” in the field.

Answer 7

C- The primary benefit of peer supervision is the reciprocal learning through the sharing of experiences.
Peer supervision is based on the use of feedback to assist with self- directed learning and evaluation. Peer supervision is not always associated with cost savings and this is not its biggest benefit if they do occur. In order for peer supervision to be effective, it should occur regularly and be scheduled, not just happen “on the fly.”

Question 8

Which BEST describes the role of a social worker when engaged in crisis
intervention?
A. Short-term support focused on restoring clients’ psychological capacities
B. Long-term support to ensure clients are able to address all aspects of trauma
C. Passively involved acting as a resource for any concerns or problems
D. Highly involved and focused on meeting the clients’ basic needs

Answer 8

D- Crisis intervention focuses on the here and now, is time limited (most crises last from 4 to 6 weeks), is directive, and requires high levels of activity and involvement from social workers. Social workers’ primary goal is to return clients to equilibrium and meet their immediate needs. Although the first response choice indicates that the support is short term, it is incorrect because social workers focus on meeting basic needs, not “restoring clients’ psychological capacities.”

Question 9

All of the following are key concepts in individual psychology EXCEPT:
A. Compensation
B. Inferiority
C. Psychosexual urges
D. Perfection

Answer 9

C- Individual psychology is a theory of human behavior emphasizing the drive to overcome feelings of inferiority by compensation and the need to achieve personal goals that have value for society.
Alfred Adler believed that the main motives of human thought and behavior were a striving for superiority and power, partly in compensation for feelings of inferiority.
Adler believed that the main motivations for human behavior were not sexual or aggressive urges, but striving for perfection.

Question 10

A social worker is seeing a 69-year-old client who is a former cigarette smoker and has chronic obstructive pulmonary disease (COPD), which makes it hard to breathe. She takes several medications, including one to regulate her blood pressure. Her primary prevention needs include:
A. Participation in a support group for others with disease
B. Monitoring her blood pressure to modify her medications as needed
C. Reducing strenuous activity that causes heavy breathing
D. Receiving an annual influenza immunization

Answer 10

D- The receipt of an influenza immunization is the only response choice aimed at disease prevention. Participation in a support group and reducing strenuous activity are associated with managing or living with her chronic obstructive pulmonary disease (COPD). Such actions are tertiary prevention. Monitoring her medication is an activity aimed to slow the progression or long-term impacts of her conditions, including high blood pressure. Thus, medication monitoring is a secondary prevention activity.

Question 11

Which is the MOST important reason that self-monitoring is used as a
social work technique?
A. Clients are the most reliable sources of information.
B. It is an effective and efficient data collection method, saving time and
money.
C. It allows clients to better understand the causes and frequency of the
problem behaviors.
D. It is based on the principles of self-determination.

Answer 11

C- Self-monitoring consists of clients systematically observing their own behavior. Most clients are not entirely aware of the extent to which they engage in various behaviors and/or antecedents or consequences of their actions. When clients are provided with the opportunity to observe their own behaviors carefully, dramatic changes often occur by the mere monitoring of the behaviors themselves.

Question 12

A social worker receives a referral to provide case management to a family who just came to the United States from another country and needs to be linked to services to meet their basic needs. The 13-year- old daughter in the family speaks English in addition to her native language, which is exclusively spoken by the parents. The social worker, who only understands and speaks English, accepts the referral. This action is:
A. Ethical because the daughter will be available to translate for the parents
B. Unethical because the social worker has not determined if the daughter is willing to translate
C. Ethical because the services are time-limited and nonclinical in nature
D. Unethical because the social worker cannot speak to or understand
all family members

Answer 12

D- Because the parents do not speak or understand English, the social worker should arrange for a qualified interpreter or translator. The use
of the daughter to translate for her parents is not appropriate because the parents may be apprehensive to identify the family’s true needs to their daughter. In addition, the social worker will only hear what the parents say as per the daughter. Valuable information may be omitted or lost. The daughter also may not communicate what the social worker is saying in a manner that is appropriate or accurate.

Question 13

A client reports to a social worker that he is having problems with his wife because he feels that she does not care about him. The social worker discovers that this belief stems from her perceived distraction when the husband is talking. The social worker challenges this thought and helps him replace it with an alternative one that she “does care, but just has a lot of other demands for her attention.” The approach used by the social worker is:
A. Operant conditioning
B. Cognitive behavioral therapy C. Classical conditioning
D. Ego psychology

Answer 13

B- Cognitive behavioral therapy aims to change patterns of thinking or behavior that are responsible for clients’ difficulties. In this approach, the social worker assists the client to change attitudes and his or her behavior by focusing on the thoughts, images, beliefs, and attitudes that are held (cognitive processes) and replacing distorted thinking patterns with healthy ones (cognitive restructuring).

Question 14

A social worker observes that a client is having trouble communicating with her husband, so she often confides in her sister-in-law about her fears and concerns, hoping that the sister-in-law will be able to assist. The sister-in-law finds that she is becoming increasingly “in the middle” of the problems that exist between her brother and his wife. This situation is known as:
A. Joining
B. Differentiation
C. Familial regression
D. Triangulation

Answer 14

Triangulation occurs when there is anxiety and tension between two individuals that may cause them not to communicate directly. In this
situation, they communicate through a third person, leading to the formation of a triangle. Often the two people try to get the third to take each of their sides when disagreements arise.

Question 15

A married couple comes in to see a social worker because they are having problems in their relationship. They report feeling disconnected and having little intimacy. The husband admits that his drinking recently caused him to be fired from his job and he is currently unemployed. The wife reports that she is fearful of her husband because he often is loud when he drinks. She spends a lot of time out of the house. They have not had sex for several months and are behind in their mortgage payments. The FIRST issue that the social worker should help the couple address is:
A. The couple’s lack of emotional intimacy B. The wife’s absence from the home
C. The husband’s alcohol use
D. The couple’s financial problems

Answer 15

C- Many of the problems reported by the couple appear to be caused by the alcohol use of the husband, including his unemployment, their financial problems, and her absence from the home. The social worker should FIRST determine the husband’s willingness to address his drinking because many of the reported problems will not change if this behavior continues. Treating substance abuse and medical issues always comes first because they are often the etiological causes of negative impacts on psychosocial well-being.

Question 16

Rapprochement is a subphase of which of the following phases of child development?
A. Normal autistic
B. Object constancy
C. Separation–individuation
D. Normal symbiotic

Answer 16

C- Rapprochement occurs between 15 and 24 months. In this subphase
of separation–individuation, the child once again becomes close to the mother. The child realizes that physical mobility demonstrates psychic separateness from his or her mother and may want her in sight.

Question 17

When engaging in structural family therapy, social workers may use which of the following techniques to understand and diagnose structures that maintain families’ dysfunctional interactions?
A. Collateral information
B. Journaling
C. Enactments
D. Confrontation

Answer 17

C- Structural family therapy is based on the premise that there is an overall structure or organization that maintains family dysfunction. Restructuring is based on observing and manipulating interactions within therapeutic sessions. Enactments are suggested by social workers as ways to diagnose structure and provide openings for restructuring interventions.

Question 18

When working with an involuntary client, which of the following actions is likely to be MOST effective during engagement?
A. Reviewing the court order so the client understands why services are mandated
B. Discussing mandates of confidentiality as per the Code of Ethics
C. Explainingtheprofessionalstandardstobeupheldbythesocialworker
D. Listening to the client to understand his or her feelings and current situation

Answer 18

D- Engagement is aimed at starting to build the therapeutic alliance. When a client is involuntary, he or she may be reluctant to trust the social worker and may think that the social worker does not understand his or her
life circumstances. Thus, listening is the most effective action because it begins to build rapport. It shows the client that the social worker cares about what is being said and is nonjudgmental.

Question 19

During what ages does “latency” usually occur within the psychosexual stages of development?
A. The first year of life
B. Adolescence to adulthood
C. Between 3 and 5 years old
D. From age 5 until puberty

Answer 19

D- The oral stage occurs during the first year of life, followed by the anal stage, which occurs during toilet training (2–3 years old). The phallic stage is from ages 3 to 4 and is followed by latency, which begins at about age 5 and lasts until puberty. The genital stage begins in puberty with the source of pleasure being the genitals.

Question 20

During the first session, a client becomes very upset and hostile about his need to seek treatment. He blames others for his situation and yells in a loud manner. In order to facilitate the problem-solving process, the social worker should FIRST:
A. Listen to the client as he explains his concerns
B. Tell the client that he needs to calm down in order for the social
worker to best understand his issues
C. Develop a plan to help him deal with his anger and blame of others
D. Assess why the client is so upset and unwilling to accept
responsibility for his problems

Answer 20

A- The client’s actions are occurring during the first session. There is no indication that his outbursts are dangerous to himself or the social worker. Upon intake, clients are often upset and angry (even at themselves) for their current situations. The problem-solving process starts with engagement.
Because the case vignette is asking what the social worker should do FIRST, the answer should be directly related to engagement. Listening
to the client as a way of building rapport will help facilitate change. The other answers will interfere with development of the therapeutic alliance and/or may come later in the process.

Question 21

Upon intake, a single mother admits to binge drinking on the weekends. She states that she is not going to stop this behavior. Using a harm reduction approach, a social worker should:
A. Help the mother to prearrange for alternative child care on the weekends when she is drinking and recovering
B. Have her see a physician to assess if she has any medical problems that need to be immediately addressed
C. Refer the mother for a drug and alcohol evaluation to determine the extent of her drinking problem
D. Advise the mother of the risks and potential consequences of her actions

Answer 21

A- Although more than one of the response choices may be appropriate actions to be taken by a social worker, assisting the mother to find alternative child care is the answer that directly relates to “a harm reduction approach” as directed in the case vignette.

Question 22

A couple comes to see a social worker because they feel that they have suffered discrimination. They are blind and would like to adopt a child, but have been told by an adoption agency that it is not possible because of their visual impairments. They are distraught, but do not think that they will be able to fight the agency bias. In order to BEST assist this couple, the social worker should:
A. Assist them to identify other methods to become parents
B. Help them cope with their disappointment from being denied
C. Support them in fighting the agency bias
D. Connect them with others who have experienced similar discrimination

Answer 22

C- Social workers are charged with helping clients who have experienced discrimination by making policy and/or system changes. The social worker should not be seeking alternative methods to assist the couple to become parents because they have the right to adopt and desire to do so. Although they may need support, developing coping skills or connecting them with others will not BEST assist the couple because these actions do not help them ultimately realize parenthood through adoption.

Question 23

All of the following are methods to address resistance during
engagement EXCEPT:
A. Clarifying what will occur in treatment
B. Instilling hope that change is possible
C. Explaining the limits of confidentiality
D. Partializing action steps so clients can make incremental progress toward change

Answer 23

D- Partialization is a good technique to assist clients in breaking down problems or goals into less overwhelming and more manageable components.
However, it does not happen during engagement, but rather planning and/ or intervention. The remaining response choices do occur during engagement and are useful for helping alleviate the fears of resistant clients.

Question 24

A man is court ordered to receive an evaluation by a social worker. Although initially agreeable to participating, the client states at the conclusion of his meetings with the social worker that he “changed his mind” and wished that he had never agreed to be interviewed. He asks the social worker not to release any information to the court. The social worker should:
A. Respecttheclient’swishesandnotprovideanyinformationtothecourt
B. Inform the court that the client rescinded his consent and ask the
court to advise the social worker of the next steps
C. Complete the evaluation based on all of the information gathered
D. Release only notes from the meetings and not complete a formal
evaluation based on the wishes of the client

Answer 24

C- The evaluation is court ordered and, therefore, the social worker does not need to get the consent of the client to perform services and/or release information to the court. However, it is essential that the social worker inform the client at the onset about what he has control over and what information will/will not be released. The client not wanting the social worker to release the information does not change the legal duty to do so.

Question 25

Which of the following is NOT part of termination in social work
practice?
A. Identifying other issues that may need to be addressed in the future
B. Reviewing accomplishments that occurred during treatment
C. Anticipatinghowtoaddresssubsequentreoccurrencesofthe
problem
D. Recognizing loss on the part of the client and social worker

Answer 25

Termination is focused on reviewing accomplishments, anticipating how to address the problem if it arises in the future, and recognition of the
loss on the part of the client and social worker because the relationship is ending. Identifying new problems is NOT appropriate during termination.

Question 26

A client in a group facilitated by a social worker has a red face and appears visibly upset when he talks about his current relationship with his family. When the social worker states that he can see how the client is not happy about his current situation based upon his physical symptoms, the client says, “Everything is fine.” The client is MOST likely exhibiting:
A. Lack of congruence in communication B. Denial of his underlying psychic conflict
C. Desire to please the social worker
D. Symptomatology of a psychiatric diagnosis

Answer 26

A- Congruence is the matching of awareness and experience with communication. It is essential that a client is able to express himself/ herself and that this communication is reflective of his or her feelings. Congruence is essential for the vitality of a relationship and to facilitate true helping as part of the problem-solving process.
The client in the case vignette is saying that the relationship is “fine,” but his physical symptoms clearly indicate that it is not. This is an example of a lack of congruence in his communication.

Question 27

What is the PRIMARY goal of permanency planning?
A. Living in stable and long-term homes
B. Including all parties in case conferencing
C. Improving educational outcomes
D. Ensuring treatment decisions are individually based

Answer 27

A- Permanency planning is an approach to child welfare that is based on the belief that children need permanence to thrive. Child protection services should focus on getting children into and maintaining permanent homes.

Question 28

A man comes to see a social worker because he is sexually attracted to those of the same gender and is deeply distressed by the thought that he may be homosexual. The feelings experienced by this client are:
A. Ego alien
B. Ego-syntonic C. Coping skills
D. Fixations

Answer 28

A- When the ego is comfortable with feelings and/or behaviors, a client is said to be ego-syntonic. However, if a client is bothered by some of his or her feelings and/or behaviors, he or she would be ego-dystonic (ego alien).

Question 29

Which of the following is NOT true about a task-centered approach in
social work practice?
A. There is no assessment phase.
B. It is highly structured and time limited.
C. Termination usually begins in the first session.
D. The client takes a very active role in making change.

Answer 29

A- A task-centered approach aims to quickly engage clients in the problem- solving process and to maximize their responsibility for treatment outcomes. The focus is on the “here and now.” The problem is partialized into clearly delineated tasks to be addressed consecutively (assessment leads to goals, which lead to tasks). Termination, in this modality, begins almost immediately upon the onset of treatment.

Question 30

Which of the following is TRUE with regard to confidentiality in
group work?
A. Group members have the same protection of confidentiality that they receive in individual counseling.
B. Group members have a legal duty not to disclose information that is shared.
C. Social workers can discuss information shared in groups with others because it is not confidential.
D. Social workers cannot guarantee to group members that information disclosed in groups will be kept confidential because it may be disclosed by other members.

Answer 30

D- When social workers engage in group work, they should seek agreement among group members concerning preserving the confidentiality of information shared. However, social workers should inform members that they cannot guarantee that all group members will honor such agreements. Group members do not have the same legal obligations that social workers do to keep information private and protected. However, social workers engaged in group work should use the same professional standards with regard to their own conduct.

Question 31

A client tells a social worker that she “feels like a failure” because
she cannot seem to meet the multiple daily demands of working and parenting. The social worker states that “many people in your situation experience the same feelings.” The technique used by the social worker is known as:
A. Validating
B. Reflecting
C. Paraphrasing
D. Clarifying

Answer 31

A- Validation shows empathetic understanding of the client’s problems. It lets the client know that she is not alone and others are experiencing the same feelings or difficulties. By realizing that her belief is one that is shared by those in similar situations, the client feels less isolated and gains strength by the realization that others have worked through the problem(s) that she is experiencing.

Question 32

Which of the following statements about social work interviews is NOT true?
A. They aim to serve the best interest of clients.
B. They are uniform in nature in order to collect consistent information
on all clients.
C. They can be informational, diagnostic, or therapeutic.
D. They focus on collecting important information to be used in the
problem-solving process.

Answer 32

B- Social work interviews are always purposeful and involve verbal and nonverbal communication between social workers and clients during which ideas, attitudes, and feelings are exchanged. The aim is to gather important information used in the problem-solving process.
Social work interviews are designed to serve the interest of clients. Questions in a social work interview should be tailored to the specifics of a client, not generic, “one size fits all” inquiries.
The purpose of the social work interview can be informational, diagnostic, or therapeutic.

Question 33

D- Positive regard is BEST defined as:
A. Exploring with clients the protective factors that are present in their lives
B. Treating colleagues as equals in the treatment team approach
C. Working with clients to establish goals that will improve their
quality of life
D. Accepting and supporting clients regardless of their actions or
statements

Answer 33

Positive regard was a term used by Carl Rogers for the critical need to view clients as worthy, accepting and supporting them without judgment. It is believed to be essential for therapeutic treatment according to the humanistic approach. Social workers should set aside their own opinions and biases in order to show acceptance of clients and believe that they are
capable of change while still having value and worth without changing.

Question 34

What is the BEST definition of empowerment?
A. Helping clients obtain services needed to solve their problems
B. Providing clients with training and education to improve their
coping skills
C. Assisting clients to realize that they have strengths and resources to
solve their own problems
D.Developing a relationship with clients based on mutual respect and trust

Answer 34

C- Empowerment is a multidimensional social work process that helps clients gain control over their lives. It fosters clients to use their strengths
and skills to make changes that they desire. Only C focuses on clients solving their own problems, a fundamental concept in empowerment.

Question 35

An agency is concerned with the recidivism of its clients and hires a consultant to provide recommendations about service modifications
that may have to occur. The consultant has a doctorate and extensive experience in the field. After several weeks, the consultant generates a report advising of service changes that, in the social worker’s professional opinion, would be detrimental to clients. The social worker should:
A. Implement them as the consultant is an “expert” in the field
B. Not implement them, citing the reasons for the concerns
C. Speak to the agency director and let him or her decide whether or
not to implement them
D. Have another consultant examine the report to see if he or she
concurs with the recommendations

Answer 35

B- If the social worker has concerns about the consultant’s recommendations and thinks they will be detrimental to clients, he or she cannot ethically implement them, but must make clear why such a decision is being
made. It would be advisable for the social worker to speak to his or her supervisor and even the agency director or the consultant, if permitted and appropriate, to discuss the concerns. However, the social worker should not implement them because of the consultant’s educational background and expertise or let the agency director decide. The social worker is also not responsible for hiring another consultant because the first one was contracted by the agency. In instances like the one described, the recommendations of consultants may not ultimately be implemented by the organization, may be modified based on the concerns, and/or may be studied further for their appropriateness.

Question 36

A client comes in to see a social worker because she is having multiple issues on her job. During the initial session, she tells the social worker that she “can’t wait for advice on how to fix the problems.” In this situation, the social worker should:
A. Ignore the client’s comment
B. Remember to speak to the client about her role later in the treatment
process once rapport has been established
C. Ask the client why she feels that the social worker’s advice would
be so valuable
D. Clarify what will happen in treatment and the responsibilities of
both the client and social worker with regard to change

Answer 36

D- Social work roles in the problem-solving process include consultant, advocate, case manager, catalyst, broker, mediator, facilitator, instructor, mobilizer, resource allocator, and so forth.
Problems can arise when a client is not clear about a social worker’s role. Initial clarification should be made during engagement and should be discussed during the therapeutic process if the role of a social worker changes. The social worker in this case vignette must address this situation immediately and should not ignore the comment. In addition, the social worker should not make this a therapeutic issue and question the client further about it because it may simply result from a lack of understanding on the client’s part.

Question 37

According to self-psychology, it is essential that caregivers meet
all of the following needs of children EXCEPT:
A. Mirroring
B. Biological
C. Twinship
D. Idealizing

Answer 37

B- According to Kohut, caregivers are not always responsive, which leads to poor self-cohesion. It is essential that children receive mirroring that confirms children’s sense of greatness and perfection, idealizing of others through which children take in strength and calmness, and twinship or alter-ego that provides children with a sense of being human and
a likeness to others.

Question 38

The social worker ends a family session with, “During the last hour, each of you has had a chance to discuss your frustrations with one another and how sometimes your own actions have been perceived by each other as hurtful, though they were not intended to be so.” The social worker’s statement is MOST likely aimed at:
A. Clarifying to the family that the social worker is being objective since each member got a chance to talk
B. Demonstrating that the family members are overreacting to each other’s actions because they are not intentional
C. Summarizing what occurred in the session in order for family members to gain a new understanding of their actions
D. Praising the family members for their openness and participation in the session

Answer 38

C- Summarization seeks to bring together the important points of a discussion and to heighten awareness of progress made. It omits irrelevant information and organizes pertinent aspects of the interaction. It provides a sense of closure at the completion of a discussion. During summarization, social workers and clients strive to grasp the significance of what has been said, to formulate the meaning of the information, and to achieve new understandings.
In this case vignette, the social worker uses summarization at the end of a session to pull together the meaning of what has been said by each family member. This technique allows the family to better understand the common theme in session discussions and perhaps gain a new understanding about the behaviors of others.

Question 39

Which of the following is NOT true about feedback in social work
practice?
A. Client consent is not needed if consultation is related to client care.
B. The best insight can often be gained from those who are critical of care.
C. Feedback is especially important at key decision points in service
development and implementation.
D. Clarity should always be given about why feedback is needed and
what will be done with the information.

Answer 39

A- When social workers involve consultants or others in the feedback process related to client care, clients should provide consent.
Social workers should ask for feedback in difficult circumstances— not just when circumstances appear neutral or positive. Sometimes
the best learning can come from those who will be critical. Feedback is especially important at key decision points. Social workers must always be clear about why feedback is needed and what will be done with the information.

Question 40

When a social worker and client are NOT from the same ethnic or racial group, it is essential that the social worker:
A. Recognize the differences and understand how they may impact on the treatment process
B. Engage in supervision and/or consultation with a member of that ethnic or racial group
C. Understand the customs and beliefs that are universal to those from that ethnic or racial group
D. Ask the client if this is a problem prior to starting treatment

Answer 40

A- A social worker’s self-awareness about his or her own attitudes,
values, and beliefs concerning cultural differences and a willingness to acknowledge racial/cultural differences are critical factors in working with diverse populations. Supervision and consultation are important, but
a client is the expert of his or her experiences. There are more intragroup differences than intergroup ones, so no customs or beliefs are universal. Asking a client if this is a problem from the onset may make a client
feel that a social worker cannot assist or will not understand his or her problems because of the ethnic or racial differences.

Question 41

A social worker is struggling with treating a client with Pica. This disorder is not common among those served by her agency. The social worker believes that it is in the best interest of the client for her to obtain consultation. A colleague in the agency has shown interest in the situation and agrees to advise because she has known the social worker for many years and they both became employed at the agency immediately after graduation. In order to best assist the client, the social worker should:
A. Decline the offer in order to find a consultant with more experience in treating this disorder
B. Accept the offer because the colleague is immediately available to assist
C. Accept the offer because the colleague is knowledgeable about the social worker’s skills, which may be valuable in making treatment recommendations
D. Decline the offer because it would be a conflict of interest to use a colleague who is employed by the same agency

Answer 41

A- Social workers should seek the advice and counsel of colleagues whenever such consultation is in the best interests of clients, but should only do so from colleagues who have demonstrated knowledge, expertise, and competence related to the subject of the consultation.
Although willing, the colleague probably does not have expertise
and competence related to the disorder because both social workers began working at the agency upon graduation and this disorder is not commonly treated in this setting. There is no conflict of interest in having a colleague in the same agency provide consultation if the colleague has the requisite knowledge and skills.

Question 42

According to object relations theory, the normal symbiotic phase of development lasts until about what age?
A. 5 months
B. 2 years
C. 5 years
D. 2 weeks

Answer 42

A- The normal symbiotic phase lasts until about 5 months of age. The child
is now aware of his or her mother, but there is not a sense of individuality. The child and mother are one, and there is a barrier between them and the rest of the world.

Question 43

During the first session, a young woman sobs as she states that she does not think that she will ever get through the recent dissolution of her marriage. She ends by saying that she “is alone and nobody understands how I feel.” In order to instill hope, the social worker should:
A. Talk about how she felt the same way during her own divorce and is now happily remarried
B. Assure her that she will have the opportunity to express her feelings and work through them in the coming weeks
C. Refer her to a support group with other women who are going through divorce
D. Evaluate whether she is at risk for self-harm

Answer 43

B- Most practice situations are best handled with no self-disclosure by the social worker. In the case vignette, the social worker should not discuss her own marital breakup and remarriage. Instead, she should instill hope by providing the client with a feeling that she will be heard by the social worker and have the opportunity to address her feelings. The woman may benefit from meeting others who are going through similar experiences, but referring her at this point in the problem-solving process is not an appropriate method for instilling hope. The client’s comments are indicative of those who are in this situation and do not alone indicate risk for self-harm.

Question 44

A client starts to miss appointments with a social worker after achieving her goals. Prior to these absences, she had very good attendance and had made substantial progress. These missed appointments are MOST likely an indication of:
A. Readiness to terminate from services
B. Emergence of a new problem that needs to be addressed C. Dissatisfaction with achieved outcomes
D. Codependency that needs to be addressed as a treatment issue

Answer 44

A- Sometimes missing appointments after achieving stated goals can be an indicator that the client is ready to terminate. The client may want to practice her new skills independently and does not think that she needs to continue to see the social worker. There is no indication that a new problem has emerged or the client is dissatisfied. Codependency occurs when a client does not want to end the therapeutic relationship despite having achieved goals. The client’s behavior most likely means that she is ready to stop seeing the social worker.

Question 45

A client has just been diagnosed with Stage 4 cancer and is referred to a pain management group to minimize the discomfort associated with her illness. The provision of this service is BEST represented as which of the following?
A. Tertiary prevention
B. Primary prevention
C. Secondary prevention
D. Hospice

Answer 45

Tertiary prevention focuses on managing complicated, long-term diseases, injuries, or illnesses. The goal is to prevent further deterioration and maximize quality of life because the disease is now established. Other types of prevention strategies are aimed at preventing the development
of a disease and/or slowing its progression or minimizing its long-term impacts. Hospice is associated with care as a result of a life-limiting illness. The case vignette does not indicate that the cancer is terminal, so the management of the pain may be associated with treatment that is occurring.