ASWB BSW Exam Questions

Correct answer: Face the client and speak directly to them

It is not appropriate for a social worker to attempt to communicate without an interpreter if they are not fluent and adequately proficient in that language. When a social worker is not adequately fluent in a language, they must use an interpreter to ensure that communication is accurate and effective. When using interpreter services, it is important that the social worker faces the client and speaks directly to them as though an interpreter was not being used. This conveys that the conversation is between the social worker and the client rather than leaving the client potentially feeling left out. Social workers are not advised to ask interpreters for any opinions either.

Facing the interpreter when speaking leaves the client out and is likely to hinder the development of therapeutic rapport. Turning toward the interpreter as they translate may also leave the client feeling left out or disrupt the flow of the interview and is not best practice. 

Correct answer: Gather information to assess risks 

Once a task force has been established to complete an ethics audit and risk assessment, the next step is to gather information. This information may come from documentation, staff interviews, client interviews, and/or accreditation reports. Risk areas include client rights, confidentiality, privacy, informed consent, service delivery methods, client records, supervision issues, staff development, boundary issues, and/or conflicts of interests. The following is the appropriate order of steps in an ethics audit: 

1. Develop a committee 
2. Gather information 
3. Review information 
4. Determine level of risk 
5. Prepare a plan of correction 
6. Implement and monitor changes 

Correct answer: Co-occurrence does not refer to clients with both physical and intellectual disabilities

Co-occurring disorders, previously referred to as dual diagnoses or dual disorders, are a common phenomenon in mental health treatment. Essentially, co-occurrence can be any combination of two or more disorders in any domain; intellectual, physical, or mental. These disorders are often varied in intensity, duration, and severity and need not be equal in their presentation.

People suffering from co-occurring disorders often take longer to progress in treatment as their clinical presentation is more complex. Treatment aimed at treating all the disorders at the same time is associated with lower costs and better outcomes.

Correct answer: Adolescence

Adolescence is the stage of childhood that begins at age twelve or thirteen and lasts until eighteen or so. During this time, individuals begin to separate from their parents and families and become more attached to their peers. Adolescents also begin forming their own identities and are more concerned with appearances.

During middle childhood (ages six to eleven), children are interested in their peers but still rely on their parents for most emotional and social support. During the preschool years and infancy, children are very attached to their parents, though they may have some meaningful peer relationships.

Correct answer: Gender role theory

Gender role theory is rooted in the belief that children observe cultural and societally constructed ideologies and patterns of behavior, including variations in expectations for different genders. As a result, gender role theory asserts that differences in behaviors are the result of socially constructed ideas, and children learn them via observation and modeling as they grow up and interact with peers and adults. 

Social role theory uses the division of labor to develop gender identities and gendered roles within societies. Systems theory encourages one to consider that an individual is influenced by all the systems with which they interact and are a part of, as opposed to simply assessing biology and individual psychological health. Harm reduction theory is used in the field of substance use and refers to an intervention that seeks to reduce the risks associated with substance use without requiring the individual to engage in an abstinence-only approach to treatment.

Correct answer: Psychological abuse 

Abuse and neglect are broken into four primary types: 

• Neglect: failure to meet a child or disabled adult's needs (emotional, physical, or otherwise)
• Physical abuse: the infliction of physical injury
• Sexual abuse: inappropriate exposure to or engagement in sexual contact 
• Psychological abuse: mental, emotional, or verbal injury

Each type of abuse can exist with or without other forms of abuse. However, psychological abuse is nearly always present when another form of abuse is occurring. 

Correct answer: They must follow the recommendations the consultant provided 

The NASW Code of Ethics states, "Social workers who provide supervision or consultation (whether in-person or remotely) should have the necessary knowledge and skill to supervise or consult appropriately and should do so only within their areas of knowledge and competence." It does not indicate that the recommendations of the consultant must be followed, and the social worker retains the right to exercise their clinical judgment when deciding next steps. 

The Code of Ethics does state that the consultant must have the "necessary knowledge and skill to supervise or consult" and that consultation should fall within "their areas of knowledge and competence." It would not be appropriate to seek consultation from a social worker who is not considered an expert in the identified subject matter. As with all disclosures, client consent must be obtained prior to sharing protected information. As noted above, the consultation can occur virtually or in person. 

Correct answer: Secondary trauma

Secondary trauma is associated with burnout when social workers have been exposed to so many stressful events that they begin to respond psychologically to the events. Trinity has internalized many of her clients' experiences, leading to her having nightmares.

Paranoia is the irrational belief that someone is in imminent danger; however, there is also an exaggerated sense of self-importance which is not characteristic of Trinity's situation. The question does not indicate that Trinity is experiencing depressive symptoms. Trinity may be developing an anxiety disorder, but there is not enough information to give her that diagnosis.

Correct answer: Cocaine

Cocaine is a stimulant drug and can result in both behavioral and physical signs of use. Some of the common behavioral signs of use include increased energy, engaging in risky behaviors, feelings of euphoria, irritability, psychosis, and pressured speech. Some of the common physical signs of cocaine use include increased heart rate, decreased hours of sleep, dilated pupils, runny and/or bloody noses, increased sweating, lack of an appetite, and increase in blood pressure. The client's symptoms most closely align with cocaine use. 

LSD is a hallucinogenic drug that can cause an increase in heart rate, tremor, muscle weakness, chills, dilated pupils, intense visual hallucinations, impacts upon mood, thought distortion, and difficulties with coordination. Cannabis is most closely associated with symptoms including red eyes, speaking loudly, laughing at times that do not make sense, a lack of motivation, increased drowsiness, and increased appetite. Heroin is an opioid, and symptoms of use generally include increased sleeping at odd hours, contracted pupils, increased sweating, unexpected throwing up, decrease of appetite, and coughing.

Correct answer: Projection 

Defense mechanisms are subconscious behaviors that protect individuals from difficult emotions, such as anxiety. Projection involves unconsciously ascribing one's own unacceptable feelings or qualities to someone else and is considered primitive. 

Sublimation involves channeling unacceptable impulses or emotions into socially acceptable outlets, such as if Nathan channeled his frustration and disappointment from the poor grade into improving his study habits and performing better on the next exam. Rationalization involves using believable explanations or justifications for a person's behavior. Mark's behavior does involve justification (the test was too difficult), but the primary focus here is on attributing his feelings to the teacher rather than simply providing an alternate explanation. Repression involves pushing distressing or threatening thoughts or memories into the unconscious mind to prevent them from causing discomfort. There is no evidence that this is happening in this situation. 

Correct answer: Groupthink

Groupthink is a phenomenon of group psychology in which a group makes faulty decisions because of group pressures. A group is especially vulnerable to this phenomenon when its members are similar in background, when the group is insulated from outside influences, and when rules for decision making are lacking.

Groupthink is characterized by several false beliefs shared by the group, including collective rationalization, belief in inherent morality, and stereotyped views of others outside the group. In addition, persons experiencing groupthink may censor themselves even when they perceive the group making a bad decision if speaking out risks their status as a group member.

Correct answer: Revise the treatment contract to reflect the client's shifting goals 

It is essential that social workers and clients develop a service plan (also referred to as a treatment plan or service contract) that addresses the interventions selected, how they will be implemented, each person's responsibilities, and the client's goals. This is a working document/agreement and should be regularly updated to most accurately reflect the client's goals. As clients engage in treatment, situations may shift or new information may come to the surface, and these changes should be taken into account in the service contract. 

It is unethical, a form of false documentation, to have a service contract that depicts one set of goals and interventions while the treatment actively pursues different goals and interventions in practice. Referring the client to another provider may be appropriate if the new goals are outside the social worker's scope of practice, but unless this is indicated, it is most appropriate to modify the treatment plan to reflect the changes. Inflexibility in treatment is likely to cause resistance in clients and to disrupt the treatment process and is not advised. 

Correct answer: Provide random evaluation of documentation

In supervising social workers, it is important to identify strengths and weaknesses in performance. When evaluating performance, it is important to consider extraneous factors that may have affected performance. Much like good care plans, good social work supervision is individualized and specific.

Social work supervision should be scheduled, detailed, and above-board. In general, something like a randomly-timed evaluation of documentation runs counter to the spirit of the code of ethics.

Correct answer: An increased awareness of how the physical environment impacts individuals' beliefs, attitudes, and behaviors

Historically, social workers have paid much more attention to the influences of the social environment, as opposed to the physical, on client beliefs, attitudes, and behaviors. However, there is a growing shift, and social workers are recognizing the importance of physical and environmental issues such as water shortages, global warming, depletion of environmental resources, and catastrophic weather patterns on human well-being. Social workers are increasingly being called upon to develop and promote sustainable environmental practices. Environmental justice is now widely recognized as part of the social work mandate to engage in advocacy aimed at improving adverse conditions.

Correct answer: Sharing Maria's immigration status with law enforcement authorities

Social work ethics prioritize client confidentiality and trust. Sharing Maria's immigration status with law enforcement authorities without her consent could lead to her deportation and compromise her safety. This conflicts with the ethical principle of maintaining client confidentiality and promoting social welfare. The NASW Code of Ethics states, "Social workers should promote the general welfare of society, from local to global levels, and the development of people, their communities, and their environments. Social workers should advocate for living conditions conducive to the fulfillment of basic human needs and should promote social, economic, political, and cultural values and institutions that are compatible with the realization of social justice. . . . Social workers may disclose confidential information when appropriate with valid consent from a client or a person legally authorized to consent on behalf of a client."

Per the Code of Ethics, social workers have an ethical obligation to "demonstrate knowledge that guides practice with clients of various cultures and be able to demonstrate skills in the provision of culturally informed services that empower marginalized individuals and groups. Social workers must take action against oppression, racism, discrimination, and inequities, and acknowledge personal privilege." This obligation indicates it is ethical for you to continue to provide treatment. Social workers must sometimes act as brokers and advocates for their clients, and it is ethically appropriate to collaborate with legal and/or immigration support organizations. 

Correct answer: Burnout

Burnout occurs when care providers begin to feel cynical about how effective their efforts are in helping their clients. This manifests in a lack of satisfaction with the work and a feeling of futility.

Secondary trauma occurs when a social worker takes on some of the traumatic feelings of client experiences and results in more physical manifestations such as irritability and lack of sleep. Compassion fatigue is defined as a combination of burnout and secondary trauma, with much of the effects of both.

Transference is a different phenomenon, by which a client begins to have inappropriate feelings for their caregiver.

Correct answer: Seeking exceptions

Seeking exceptions is a useful technique to focus on strengths and positive deviations from negative patterns, which can provide insights and strategies for improving the relationship. This strategy would ask the clients to focus on the times when they were able to work together and communicate well to identify healthy patterns that they can use more often to improve their overall functioning and identify the underlying problem. 

Scaling motivation involves having the clients identify the degree that they feel hopeful and may be useful in couples therapy. However, in this scenario, there are healthy examples the couple can identify and discuss that would be of greater benefit. Scaling motivation is most helpful when there is resistance to treatment. Scaling the problem requires clients to rate the severity of the problem, which can influence interventions. 

Correct answer: Poverty levels are higher among people of color and households with male heads

Poverty creates a power differential that leads to increased exploitation (or mistreatment of an individual or group for another's benefit), and social workers are ethically mandated to actively work against exploitation and discrimination. This agency is working on a macro level and thus would emphasize societal implications of exploitation and discrimination. Within their presentation one might learn that poverty levels are higher among people of color and female-led households, not male-led households. 

Additionally, one might learn that education and employment opportunities decrease as poverty level increases, poverty is correlated with both physical and mental illness, and discriminatory practices create and exacerbate social power imbalances. The problems that society faces are often worsened by instances such as these. When an individual is not afforded the same opportunities, exploitation is inherent.

Correct answer: Schizophreniform Disorder is no longer a mental health diagnosis

The Diagnostic and Statistical Manual, or DSM-5, is the current edition of the main diagnostic instrument used in the treatment of mental health diagnosis. It replaces the previous version, the DSM-IV-R, and changes its form in many ways.

Perhaps the largest change is the discarding of the old multiaxial system of mental health diagnosis. This five-axis system (I through V) has been replaced both directly and indirectly. For instance, the Global Assessment of Functioning (GAF, Axis V) has been dropped altogether. The other axes have been absorbed into other diagnostic elements; for example, the contextual information contained in Axis IV has been distributed into significant psychosocial and contextual features.

Other changes, such as the addition of The World Health Organization's Disability Assessment Schedule (WHODAS) to the Assessment Measures section, has added new functionality.

Schizophreniform Disorder remains a valid mental health diagnosis in the current edition.

Correct answer: Identity search 

Modern models of cultural identity development break development down into three stages: 

1. Unexamined cultural, racial, and ethnic identity: a lack of identity exploration and acceptance of these concepts without critical thinking about the implications
2. Cultural, racial, and ethnic identity search: critical thinking and questioning of issues related to race and ethnicity in an effort to find belonging
3. Cultural, racial, and ethnic identity achievement: development of a clear sense of self related to race and ethnicity

Maya is demonstrating critical thinking about race and ethnicity without a clear sense of self and is thus in the identity search stage of racial identity development.