ASWB BSW Exam Questions

Correct answer: Refer the client for a medical evaluation 

When clients present reporting sexual dysfunction and/or dissatisfaction, the first step is to rule out a medical cause of the issue. There could be a hormonal imbalance, medication side effect, or medical condition that results in a decrease in sex drive. A referral for medical evaluation must be completed to rule out those potential causes prior to assessing psychological factors. 

Additionally, substance use is correlated with decreased sex drive and/or sexual satisfaction and should be assessed after medical causes are investigated. Once medical and substance-related causes have been ruled out, psychological assessment, including psychosocial stressors and a sexual trauma history, should be investigated as potential causes. The systems perspective is essential in diagnosing and treating sexual dysfunction. 

Correct answer: The risk of eviction and the need for stable housing

Maslow's hierarchy of needs assigns the following order of importance when addressing needs: 

• Physiological needs
• Safety needs
• Social needs
• Esteem needs
• Self-actualization 

The possibility of eviction and the lack of stable housing pose physiological (if temperatures are too hot or cold) and safety (protection from environmental or social harm) needs. As a result, they are the highest priority. It is essential to ensure a secure living environment before addressing other needs.

While education and employment are important for the family's financial stability and development, addressing the immediate risk of eviction and ensuring a stable living environment take precedence. Without stable housing, the family's well-being and functioning are compromised. 

Correct answer: Social activities, physical health maintenance, and promoting independence

Adults aged 65 to 75 years are faced with increasing risk of physical illness and reduced opportunities for social expression. As human beings age, their physical health requires a higher degree of maintenance and support and must be a focus of attention. However, this is not to suggest that older adults cannot fully engage in a broad range of activities and do not benefit from social interaction. It is also not to propose that older adults cannot be independent within the limits of their mental and physical health.

In most people at this stage of life, the personality has become stable, and personal identity has likely been operative for decades. Direct involvement in society by career participation generally slows down or ceases and the corresponding commitments to community decrease.

Social workers recognize that this time of life can be a continuation of contribution, enjoyment, and activity enjoyed in earlier life. Older adults continue to need and benefit from the same level of social interaction as their younger counterparts.

Correct answer: Strengths-based

Self-determination, the concept that clients are qualified to make their own decisions about their lives, is a central concept in the social work profession. It is described in the NASW Code of Ethics as one of a social worker’s primary ethical responsibilities. Using a strengths-based perspective, all clients are assumed to be competent to make their own decisions, including those about financial matters and treatment options.

The problem-solving approach is more often used in crisis and short-term situations and focuses on fixing the issue rather than on empowering clients. The cognitive behavioral perspective focuses on changing patterns of thinking in order to affect feelings and behaviors.

Correct answer: Each developmental stage stands alone and has its own unique experiences

Humans are complex beings from birth to death, and thus, our growth and development are also complex. As a result, the stages of growth and development are not always clean and neat. They are interconnected, and if one stage is disrupted, many of the other stages are likely to be disrupted as well. The stages are not independent of one another but, rather, dependent and interconnected. They do not stand alone or have their own unique experience but, rather, expand upon their distinct characteristics and build upon the skills mastered in previous stages. 

Just as every child develops their own unique personality and physical appearance, they develop at their own rate and in their own way. That being said, the general guidelines and rates are helpful for a social worker to know, as most children fall within a loosely predictable range, and if a child is widely outside that range, further investigation may be helpful to ensure there are no issues emerging.

Correct answer: Haldol

Haldol is an antipsychotic most commonly used to treat psychosis. Delusions are a symptom of psychosis and delusions can lead to aggressive behavior. As a result, an antipsychotic medication such as Haldol would be the most appropriate medication to treat Roy's symptoms. 

Effexor, Celexa, and Wellbutrin are all antidepressant medications used to treat depression and anxiety most commonly. These medications would be unlikely to be used to treat delusions or aggressive behaviors.

Correct answer: All adults are assumed competent unless legal actions have been taken to determine otherwise 

The right to self-determination is an essential facet of the social worker-client relationship, and the NASW Code of Ethics dictates that social workers must respect a client's right to self-determination as much as possible. There may be times when clients do not have the legal authority to make their own health care decisions. In order for this to be legally appropriate, legal actions must have been taken to determine that the client cannot do so, and a guardian or conservator must be appointed. In this instance, a social worker must obtain informed consent from the guardian to provide treatment. 

Emancipated minors have pursued independence through the courts and have been granted legal authority to make their own health care decisions. In this instance, the social worker must obtain informed consent from the emancipated minor themselves. While social workers can act as guardians ad litem in legal proceedings to determine whether an individual is competent to make health care decisions, they cannot simply use clinical judgment when working with clients. To have another party legally make health care decisions for a person, the legal system must be involved to appoint a decision-maker. 

Correct answer: A perceived threat

Psychosocial stress can result from any kind of perceived threat. To cause stress, the threat can be anything; real or unreal, imagined or imminent, past, present, or future. The threat is to homeostasis, safety, social status, or anything else that will disrupt normal functioning in the client system.

The other answers are incorrect. Threats that cause psychosocial stress can be known, physical, unknown, or any other perceived danger.

Correct answer: The circulatory system 

The circulatory system is also referred to as the human body's "transport" system and functions as follows: the heart pumps blood, which is transported by the veins and arteries throughout the body. 

The endocrine system is composed of glands that generate hormones (sometimes referred to as "long-distance messengers"), and these hormones regulate growth, sexual development, and metabolism. The immune system is composed of organs, cells, and tissues that defend the body against infections and diseases by responding to dangerous viruses and bacteria. The lymphatic system is responsible for filtering harmful organisms out of the body by creating white blood cells and antibodies. 

Correct answer: It should be completed after treatment plan development

Problem formulation is the process of determining a specific problem to be addressed by a specific intervention. It is a part of the treatment planning process and should not be completed prior to assessment of the client. Typically, the process is conducted in the following order: assessment, problem formulation, treatment planning, treatment, termination, follow-up. 

To gain a complete view of a client and their needs, a social worker needs to gather information via assessment and collateral information before identifying problems and linking them to interventions. Problem formulation occurs at all levels of social work practice (from direct care to community organizing), though the involved parties often vary depending on the level of practice a social worker is engaged in. It is important to remember to use the person-in-environment perspective when engaging in problem formulation and treatment planning so that blame is not placed on the clients and all strengths can be identified. 

Correct answer: Reframing 

Reframing involves a social worker sharing different perspectives with clients to demonstrate that other ways of thinking exist. This technique is particularly helpful when working to shift harmful thinking patterns to healthier alternatives (common in CBT). The social worker might say that perhaps the stranger was having a bad day and that is why they gave her a dirty look.

Reflecting involves mirroring a client's words back to them and is a form of active listening. Clarifying involves asking questions, paraphrasing, and/or reflecting to help ensure that the social worker fully understands a client's meaning. Questioning involves asking open and closed questions to obtain important information. 

Correct answer: Young childhood

During young childhood, when children are between the ages of four and six years, they grow at a slower rate than during infancy and toddlerhood, have improved motor skills, can dress themselves, and are usually fully toilet-trained. They begin to use symbols, have improved memory, have a vivid imagination and fears, and like stories. Children this age also identify more with their parents, are becoming more independent, and are sensitive to others' feelings.

Infants and toddlers typically do not have well-developed imaginations yet, their memories are lacking, and they are unable to do many tasks independently. Older children and adolescents are usually toilet-trained, but they understand the difference between fantasy and reality much better than younger children and are not so concerned about doing things independently (though they usually can do most tasks by themselves).

Correct answer: Celebrate Davina's success

In the harm reduction model, the idea is to engage the client where they are regarding their use. By celebrating Davina's small success, Tommy may reinforce further change.

The other answer options are incorrect. Harm reduction is not consistent with suggesting more formal treatment in most circumstances. Confronting Davina may not be effective and is not consistent with harm reduction. Ceasing treatment altogether as a result of Davina's use is not consistent with harm reduction.

Correct answer: Industry vs. inferiority

The industry vs. inferiority stage, which occurs from ages six to 11, is characterized by children's efforts to master new skills and tasks, leading to a sense of industry and competence. Kerrie's active participation in the school project, her enjoyment of collaboration, and her eagerness to contribute demonstrate success in this stage. 

Erikson's theory of social development includes the following eight stages: 

1. Trust vs. mistrust
2. Autonomy vs. shame and doubt
3. Initiative vs. guilt
4. Industry vs. inferiority
5. Identity vs. role confusion 
6. Intimacy vs. isolation 
7. Generativity vs. stagnation 
8. Ego integrity vs. despair

The identity vs. role confusion stage, which occurs from ages 12 to 18, involves the exploration and development of a sense of self and identity. Sarah's age and the scenario provided indicate that she is not yet in this stage. The intimacy vs. isolation stage occurs during early adulthood and focuses on the development of close and meaningful relationships with others. Sarah is too young to be experiencing this stage.

Correct answer: All of the above 

It is a common misconception that precipitating events to a crisis must be major life events. In fact, precipitating events are often "small" events that can be considered a client's "last straw" in a series of difficulties. A crisis is simply a disruption of a client's steady state, or homeostasis, and many factors can influence a client's likelihood of experiencing this type of disruption. Clients with a greater level of resilience are less likely to experience crisis due to the same event than clients with low levels of resilience. Regardless of the cause, when a crisis is addressed appropriately, all clients have the ability to emerge healthier. This is why crisis support is extremely important in social work.

Correct answer: The course of trauma is acute

Trauma is a wide-ranging, pervasive phenomenon in human beings. Though the traumatic incidents are usually time-limited, the course of the trauma itself can be lifelong and is rarely acute. 

The other options are all incorrect, as trauma can manifest in these and many other ways.

Correct answer: Temperament

Cognitive skills, defense mechanisms, coping skills, temperament, and interpersonal skills are the major domains of client strength that indicate resilience. Temperament includes factors such as belief in the goodness of others, belief in justice, high self-esteem, optimism, tolerance of ambiguity, ability to process negative events, a sense of humor, not feeling overwhelmed by anger, allowing grief, a sense of purpose, and taking responsibility for decision-making. 

Interpersonal skills are demonstrated via maintaining relationships, having confidants, solving problems, demonstrating empathy, and experiencing intimacy. Cognitive skills are demonstrated by intellectual capabilities, creativity, initiative, common sense, and foresight of problems. Coping skills are evident in a client's ability to self-soothe, manage new stressors, and regulate mood and affect.

Correct answer: Crisis

A crisis is a term that describes a time-limited state when someone is experiencing a high level of anxiety due to a specific event. During times of crisis, a person's normal coping mechanisms are not working well, and the person needs direct guidance from the social worker to help them navigate the situation.

The remaining answer options are incorrect. Relationships and separations are times when a person's coping mechanisms might or might not be working well.

Correct answer: Request that the courts narrow the scope to protect privacy 

While a subpoena legally requires the social worker to provide the requested information, ethical guidelines prioritize the client's right to have their confidential information protected. The social worker should work within legal boundaries to minimize the disclosure of sensitive information, advocate for the client's privacy, and seek legal guidance if needed. The recommended first step is to request that the court narrow the scope of the information the social worker is compelled to share in order to protect client privacy. 

Complying with the subpoena and sharing all requested client information is legal but not ethical. The client has expressed that they do not want this information shared, so ethical principles guide social workers to advocate for the client's wishes. Refusing to disclose information is ethical but not legal and would likely have harmful repercussions for the social worker. 

Correct answer: Confronts directly when evasion is detected

Empathic, therapeutic communication is a critical process in the client-provider relationship. It is characterized by "starting where the client is" and being aware of and responding to all messages (verbal and nonverbal) that the client offers. It also involves doing all that is necessary to establish communicative rapport.

Though appropriate at certain stages of treatment with specific populations, direct confrontation is not usually considered an effective means of establishing rapport early in the client relationship.