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Question 1

At what age is separation anxiety most likely to occur?

Answer 1

12 months. According to Mahler, the stage between 10-16 months is called “Practicing” and this is the age when babies experience upright locomotion and separation anxiety, as they begin to realize, as they start to walk, that the primary caregiver may not be right behind them. In this phase birthing parent is homebase.

Question 2

A client meets with a social worker at at crisis center. The client is living with a sibling and reports the sibling’s boyfriend is threatening to force the client out of the house and the client feels unsafe. What should the social worker do first?

Answer 2

a) call the police for the client
b) develop a safety plan
c) try to locate housing for the client
d) determine the nature of the danger
The answer is D) determine the nature of the danger, because the social worker’s FIRST task is to assess the situation further. Although the other answers are action steps that may be done later, taking those actions without filly assessing the situation is akin to reaching a conclusion before you know all the facts. As a reminder:
Crisis intervention focuses on the resolution of an immediate problem to prevent further deterioration and return to at least a pre-crisis level of functioning. There are 7 stages:
1. PLANNING AND CONDUCTING A THOROUGH ASSESSMENT including any acute risk of harm to self or others. If possible, allow this to emerge as the client’s story unfolds. Look for the client’s environmental supports and stressors, medical needs and medications, current use of drugs and alcohol, and internal and external coping methods and resources.
2. RAPIDLY ESTABLISHING RAPPORT through showing concern for the problems that are being experienced and a desire to assist with basic needs. Instill trust and confidence in the client through good eye contact, nonjudgmental attitude, creativity, flexibility, positive mental attitude, reinforcing small gains, and resiliency.
3. IDENTIFY VARIOUS DIMENSIONS
OF THE CURRENT PROBLEM—the biopsychosocial domains; clients will present a wide range of problems that are not new—the social worker needs to organise these in his or her mind and not be overwhelmed. The question asked from a variety of angles is “Why now?”
4. ACTIVE LISTENING WHILE EXPLORING PRIOR COPING STRATEGIES AND SUCCESSES and resources available—their strengths and social network; celebrate the successes of positive coping if evident. There are two aspects: (i) allow the client to express feelings, to vent and heal, and to explain her or his story about the current crisis situation; (ii) challenge the client’s perception by giving information, reframing, offering alternatives.
5. GENERATE AND EXPLORE ALTERNATIVE STRATEGIES FOR MANAGING
THE PROBLEM—summarise the issues, suggest some can be dealt with later, look at the most recent, gently search for solutions with the client. This stage can often be the most difficult to accomplish in crisis intervention. Clients in crisis, by definition, lack the equanimity to study the big picture and tend to doggedly cling to familiar ways of coping even when they are backfiring. Hospitalisation may be necessary if the client cannot engage in problem-solving and the risk, for instance of suicide, remains high.
6. ACTION PLAN Restore functioning through developing and formulating an action plan with the client; generally, the client and social worker have some responsibilities in the plan.
7. FOLLOW UP Establish follow-up plans—these tend to be short-term in crisis intervention, e.g., client can agree to phone the social worker the next day.

Question 3

A social worker meets with a new client who is diagnosed with depression. The social worker observes that client is ambivalent, non-trusting and passive. What should the social worker do next?

Answer 3

(a) Focus on directly engaging the client. This is the only option that helps build rapport and for the client, self-determination. This should be done before taking additional steps such as suggesting a task to improve mood, encouraging recall of better times, and/or educating about depression.

Question 4

An adolescent who has diabetes is admitted to the hospital for the second time in three weeks after significant changes to the clients insulin levels. The physician believes the adolescent is intentionally non compliant with diabetes care and wants to be readmitted. The physician refers the patient to the social worker. What should the social worker do next?

Answer 4

The first step for the social worked is to complete an assessment. Obtaining a family and social history is the only action that involves understanding the situation better. Reviewing the medical management plan, contracting with the adolescent to avoid readmission or calling CPS may be necessary later, depending on what is learned during the assessment.

Question 5

Parents of a 24 month old child report their only concern is their child only plays alongside of, but not with, other children. What should the social worker do?

Answer 5

The role of the social worker is to educate the parents about typical developmental behavior. This requires a basic knowledge of parallel play.

Question 6

A new social worker receives a court order to disclose client records. The social worker notices there are grammatical and minor errors regarding dates and events in the recordings. What should the social worker do first?

Answer 6

When a court order is received to disclose client records, supervision must be obtained first. Depending on the circumstances, the records may. need to be sent or a claim for confidentiality may need to be made. Making alterations or corrections to the record SHOULD NOT be done.

Question 7

What practice has the most positive effect on service delivery?

Answer 7

Central to the mission of social work is the importance of clients being the center of service. While options may support positive policies without a client centered focus, they will not be effective.

Question 8

A social worker provides treatment to people on the sex offender registry. Some clients are discouraged when they are fired from a job after their SO status becomes known. What should the social worker do to best support clients?

Answer 8

Teaching clients to proactively disclose their backgrounds offers the best support because it involves empowerment and demonstrates respect for the dignity and worth of the person. Referring clients to a human rights agency would occur only after potential human rights violation is identified. Requiring empathy is unrealistic and discouraging clients from pursuing employment until treatment is completed is also unrealistic, does not promote self-determination, and is not a supportive strengths based approach.

Question 9

During an assessment, a social worker is trying to understand a client’s perspective. At the same time, the social worker is maintaining the perspective of an objective observer. What concept is best reflected?

Answer 9

Empathy

Question 10

Several clients who have disabilities attend a social worker’s life skills class. The clients express doubt about voting in an upcoming election because they have heard the polling places are not accessible. After determining that the clients’ concerns are valid, the social worker should:

Answer 10

Empower the clients to educate local officials on the needs of voters with physical disabilities. Obtaining legal advice and/or obtaining ballots for the clients would not help the clients develop life skills. While the clients rights should be respected, the clients have not said they do not want to vote, but rather that polling places are not accessible: empowering the clients would assist the clients with life skills and increase self-efficacy which is the goal of the social worker’s class.

Question 11

What is most likely the reason a patient in an outpatient alcohol program would be prescribed the drug naltrexone I conjunction with counseling?

Answer 11

To decrease cravings for alcohol.

Question 12

A social worker creates a job readiness program for young people transitioning to adulthood. The program is based on developmental theory. What is the primary goal of the program?

Answer 12

Learning the basics of how to find employment. Tracking number of participants is an evaluation of the program, not the goal of the program . Ensuring connections to community resources may be a goal but that is secondary to them learning how to find employment.

Question 13

A client is in treatment with a social worker in a fee for service setting. After paying in full and on time for the first ten sessions, the client begins to make partial payments or no payments at all. Assessment of risk indicates that the client poses no danger to self or others. According to ethical standards of social work practice, what is the social workers best response?

Answer 13

Since the client poses no danger to self or others and is in arrears, services can be terminated after the discussion of financial obligations has occurred. Negotiating a non monetary compensation system (a) suggests bartering, which is NOT the best response. Termination after a third time of non payment uses an arbitrary number of incidents to make a decision about termination.

Question 14

A social worker is providing therapy to a family. The couple have been arguing and are considering a separation. Recently, the oldest child began acting out at school. With attention focused on the child’s problems, arguments between the parents have subsided. What concept best describes this family’s situation from a systems perspective?

Answer 14

The oldest child is exhibiting behavior that is moving attention away from parental arguments. Triangulation is resulting in lessened parental conflict since the parents’ attention has become focused on the older child’s behavior.

Question 15

A social worker facilitating change at an human services organization recognizes that clients are not assigned to the most appropriate personnel. Case assignments are based only on caseloads, with no attempt to match clients needs with workers skill sets. On what aspect of the agency is the social worker focused.

Answer 15

On the agency’s organization structure: this is the aspect of the agency that involves staff roles and responsibilities, including the process by which case assignments are based.

Question 16

An agency social worker becomes aware that their coworker frequently consumes alcohol on their lunch break. When this occurs, the coworker does not appear intoxicated. The individual is responsible for driving foster children to and from specialized services throughout the day. What should the social worker do first?

Answer 16

Discuss the drinking directly with the coworker. As noted in the code of ethics, SWers should discuss possible impairment directly with a colleague and assist in remedial action if appropriate. Informing the supervisor and consulting with the jurisdictional social work board may occur, but only after the concern has been directly addressed between colleagues.

Question 17

A social worker assesses a client with an eating disorder. The client expresses ambivalence about changing eating habits. What should the social worker do next?

Answer 17

Validate the client’s concern. While advocating for change, confronting resistance and exploring the clients values may be appropriate actions, the NEXT step is to value the clients concerns.

Question 18

A social worker provides opportunities to community members to increase political participation. The goal is to affect policy and improve socioeconomic conditions. What approach is the social worker most likely using?

Answer 18

Empowerment (is most strongly associated with policy and socioeconomic change). Networking and coalition building are specific actions and not approaches. Program development is more closely associated with organization change and growth, not community level actions.

Question 19

A social worker works in a community where gangs and drugs are a major problem. The mayor requested the social worker develop a plan involving the community to gang violence and drug related problems. What should the social worker do first?

Answer 19

Organizing a task force is the first step in social action and involves those affected in addressing the issues and promoting solutions. Hiring community leaders and conducting a workshop are steps that could be taken later, but only after a task force is organized first.

Question 20

What is the most effective action that can be taken by a social work supervisor to reduce liability resulting from acts or omissions of supervisees?

Answer 20

Document/The documentation of topics covered in supervision is the most important action a supervisor can take to reduce liability. Documentation will provide evidence of topics discussed and actions recommended.

Question 21

A client is discharged from inpatient treatment for substance use. A mental health social worker meets with the patients family for a follow up session and observes the family avoids discussing the problem. What should the social worker do first?

Answer 21

Determine the extent of denial within the family system. The social worker should first follow up on the use of denial as a coping strategy within the family. Only after doing so, and clarifying this approach, should the social worker offer interventions such as (a) confronting the family about the long term nature of a substance problem, (b) educating the family about the kind of harm involved in substance use or (c) explaining that relapse is possible.

Question 22

A social worker meets with an adolescent client who wants to run away from home. The client gives several reasons for this desire. What is the best technique for the social worker to use?

Answer 22

Partialization. The social worker needs to help the client gain a better understanding of the individual elements that are leading to the desire to run away. By partializing, issues are broken into manageable components that would facilitate further discussion and problem solving. Confrontation and exception exploration would be counter productive. Rationalization is a defense mechanism.

Question 23

A social worker is working with a client who has self-enrolled in treatment to manage chronic and escalating anger. During the initial session, the client tells the social worker of instances in which she was verbally abusive to an individual in her care who uses a wheelchair. The client is remorseful and says the incidents have occurred on only two or three occasions. What should the social worker do next?

Answer 23

During the initial session the social worker should assess further before taking action such as collecting collateral information or developing a n anger management treatment program. Explaining the need to report may occur later, based on what is learned in the further assessment.

Question 24

What is a social worker required to do before beginning work with a client that include electronic transfer of records?

Answer 24

Provide the client with the agency privacy policy. It is the ethical responsibility of social workers to ensure that clients understand the risks and limits of privacy when electronically transferring records. Obtaining insurance releases would occur after ensuring that clients understood the agency’s privacy policy.

Question 25

To take into account the information processing deficits of a client with schizophrenia, what should the social worker do to best structure group treatment?

Answer 25

Schedule a variety of brief activities. Because of the characteristics of schizophrenia, encouraging the free flow of ideas, using expressive therapy tools, or engaging a rigid group agenda are not indicated.

Question 26

What of the following factors is most helpful in assessing clients ability to use insight oriented psychotherapy?

Answer 26

Insight oriented therapy depends on the internal work of the client: without MOTIVATION TO CHANGE, the client will be unsuccessful. Insight oriented therapy is client centered talk therapy and guides clients towards developing an improved understanding of self and take a deeper look at issues.

Question 27

A social worker in a high school is asked to facilitate a treatment group. What consideration would be most important for planning the group?

Answer 27

Conflict with authority is a characteristic of adolescence. Effective group facilitation with this population requires developmental knowledge and tasks as described by Ericson. While adolescents can form cliques, are media influenced and may be using drugs and alcohol it is MOST important to recognize there will be a conflict with authority in adolescent group therapy.

Question 28

A hospital social worker assists a patient who is scheduled for d/c. The patient and family feel the patient needs more time in the hospital, to regain strength before returning home alone. What should the social worker do next?

Answer 28

Arrange a meeting to discuss aftercare options. This is the only correct option because it relates to determining appropriate steps following d/c. Education the family, explaining hospital rules or asking for an extension not the d/c date may occur later based on the outcome of the meeting to discuss after care options, but would not occur NEXT.

Question 29

A social worker is working with a 16 YO client who was sexually abused by a former step parent. The social worker believes it is important the client be able to talk about the abuse in order to deal with the complicated feelings the client has already expressed. The clients tells the social worker that talking about the abuse is painful and asks not to proceed in this way. What is the social worker’s best response?

Answer 29

The social worker should change the course of treatment as the client requests, because this is respectful of the clients self determination and is likely to further engage the client. reiterating the importance of talking through feelings and the abuse or referring the client to a support group to hear from other survivors may be appropriate but are not the BEST actions as the do not allow the client a voice in the intervention process.

Question 30

A social worker at a family services agency has been working with a parent and an eight year old child. The child is enrolled in the same school as the social workers child. On the first day of school, the social worker finds out the children are assigned to the same classroom. What should the social worker do next?

Answer 30

Talk to their supervisor, to address the potential dual relationship and discuss alternatives.

Question 31

A social worker at a chemical depdnecy treatment center devotes time after each session to complete case notes. In recording the clients progress toward specific treatment goals, what information should the social worker include in each note?

Answer 31

The actual service or treatment provided in each session. While content of case notes may vary, from objective to subjective information, each case note should minimally include actual services provided during the session. The client’s level of treatment investment, development of insight or compliance with program requirements may be included in some notes but not in each note.

Question 32

A 16 YO adolescent meets with a social worker while being admitted to an inpatient psychiatric facility. The adolescent reports alcohol use and sniffing paint on a daily basis. The adolescent’s family relationships are strained, and school performance is poor. In the process of completing the assessment, what should the social worker recommend next?

Answer 32

Further psychological testing is warranted, given that the adolescent is being admitted to an inpatient facility. Testing is immediately available and necessary to further assess the individual’s condition. Family sessions and observation may occur after further testing, but the seriousness and types of abuse that are reported indicate the need for further testing.

Question 33

A social worker is assisting a client with problem resolution. The problem has been identified, solutions have been explored, and pros and cons have been considered. What is the next step toward resolving the problem?

Answer 33

Developing specific goals. (Establishing a timeline, and identifying termination criteria occur after goals have been set. Highlighting the clients strengths would have already occurred in the assessment phase.)

Question 34

A social worker meets with a client who is 15 YO and struggles with self esteem and is sexually promiscuous. The client describes symptoms of an eating disorder. What should the social worker assess for FIRST?

Answer 34

Promiscuity, low self esteem and eating disorders are strongly associated with sexual abuse.

Question 35

What theory of addiction is used by AA as the primary way of explaining alcoholism?

Answer 35

Disease. The disease model used to explain addiction in AA.

Question 36

During a session, a social worker becomes increasingly frustrated by a client’s denial of issues. The social worker choses to end their session early. What concept best fits this action?

Answer 36

Countertransference.

Question 37

Both the general public and decision makers have very little awareness of a community issue brought to the attention of a social worker. What strategy can best facilitate the development of programs or policies to correct the problem?

Answer 37

Using multiple forms of media communication addresses the concern about community awareness.

Question 38

A social worker who works in an assisted living facility meets with a resident prior to a family meeting. The resident says that his daughter is upset about his new romantic relationship. What is most important for the social worker to consider when planning the meeting?

Answer 38

The social worker should be focused on the resident and his feelings. Understanding the client/resident’s feelings about his daughter’s objections is most important; i.e. we can’t assume he wants to maintain his independence and support his self-determination if we don’t first know his feelings.

Question 39

A social worker wants to assess the impact of heritage and belief systems on a family’s interactions. What form of assessment best accomplishes this goal?

Answer 39

A culturagram.

Question 40

A social worker refers a client to an agency for additional services the social worker cannot provide. The social worker says “call me after your meeting to let me know what happened.” What best describes the social worker’s statement?

Answer 40

The social worker is attempting to increase the client’s chance of success. By taking this supportive action on the client’s behalf, they are increasing the likelihood the client will feel confident and/or supported in utilizing the additional services.

Question 41

What is the best definition of informed consent?

Answer 41

Decisions made by the client after receiving all relevant information.

Question 42

A hospital social worker investigates why a patient with home health services was admitted with severe wound infection and malnutrition. They call the HHA and talk with the person who ensures the agencies obligations and ethical duties and rules are followed. What is this persons role in the agency?

Answer 42

Ombudsperson.