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Quiz Session - Attempts With Random Questions

ASWB LCSW Exam Questions

Page 2 of 50

21.

Rosa is a 13-year-old girl who has been referred to you, the school social worker, for a recent change in her behavior. Rosa's teachers have noticed that she cries easily, seems more tired than normal, and sometimes goes days without showering. Her teacher also reported to you that Rosa has been wearing long sleeves, even on days over 80 degrees, and thought she saw a cut on Rosa's wrist. 

Which of the following suspicions might you have, based on everything you have been told about Rosa, even before meeting with her?

  • Rosa is being sexually abused.

  • Rosa must have recently broken up with a romantic partner.

  • Rosa must have recently started her menstrual cycle.

  • Rosa is being physically abused at home.

Correct answer: Rosa is being sexually abused.

Possible indicators of sexual abuse in children include a depressed mood as exhibited by Rosa's frequent crying, fatigue, poor personal hygiene, a sense of shame about one's body, and self-harming behaviors such as cutting. Additional indicators that were not included in the information offered in the question include sexually explicit behavior, a change in appetite, somatic complaints, and fearful or startled responses when touched.

While breaking up with a boyfriend/girlfriend or starting one's menstrual cycle might result in mood changes, neither would explain extremely poor hygiene or self-harming behaviors. Indicators of physical abuse include noticeable injuries, frequent absences from school, aggressive or extremely withdrawn behavior, and poor memory and concentration. These were not indicated in the information offered in the question.

22.

If Kyle, a client, states that he is experiencing confusion, restlessness, chills, nausea, and dilated pupils, what substance is MOST likely causing his condition?

  • Cocaine

  • Opioids

  • Alcohol

Correct answer: Cocaine

The symptoms associated with cocaine use include visual hallucinations, confusion, restlessness, chills, nausea, and dilated pupils.

The other options are incorrect because dilated pupils are not a symptom of alcohol use, and restlessness, chills, and dilated pupils are not generally symptoms that are associated with opioids.

23.

Brad, a client, discusses his concern about his wife’s recent behavior. Brad states that his wife is working long hours, is irritable with him and the children, and constantly wants to be left alone. He self-reports that he is having a hard time dealing with his wife’s behavior because he knows that it is emotionally hurting their children.

You should FIRST:

  • Discuss the intricacies of Brad's immediate situation

  • Explore why Brad's wife may be reacting in this manner

  • Discuss additional family support for the children

  • Assess Brad's wife’s mental health history

 Correct answer: Discuss the intricacies of Brad's immediate situation

In order to help Brad, it is important that you discuss the intricacies of Brad's immediate situation before taking further action.

The other options might be appropriate steps for Brad's treatment, but not until you fully understand the intricacies of the immediate situation. Additionally, Brad's wife is not your client, Brad is, so you should focus on him.

24.

A mother of two nine-year-old boys with autism spectrum disorder works full-time and often self-reports and describes herself as "tired." She receives very few services for her sons due to her high level of income and their ineligibility for public assistance. The mother's friends have invited her on a three-day vacation, but she is reluctant to leave the boys in anyone else's care. 

What is the BEST approach for you to take?

  • Recognize the mother's need for a brief vacation and help her find temporary and suitable arrangements for the children

  • Suggest that you care for the children yourself

  • Find a foster care placement for the children, since the mother is clearly unable to care for the boys right now

  • Try to figure out another way to handle the mother's level of exhaustion

Correct answer: Recognize the mother's need for a brief vacation and help her find temporary and suitable arrangements for the children

Though the mother is the biological parent of the boys, she is clearly in need of respite so she can reenergize and be the best parent she can be to her special-needs children. You can best serve this family by helping the mother find appropriate care for her children, so she is able to take a short break for herself.

The other options are incorrect because if you were to care for the children yourself, this would likely be an ethical boundary violation. A foster care placement is not necessary, as the mother is able to meet the boys' needs, but simply would benefit from a brief break. You could help the mother find another way to handle her level of exhaustion, but because there is a clear opportunity for the mother to take a break, it would be best for you to try and help the mother find temporary child care.

25.

Task-centered approaches can be applied in what therapeutic models or contexts?

  • They can be used across modalities and settings, and utilized in situations where there are discrete, definable activities to be accomplished to facilitate progress toward the primary goals of a case.

  • Task-centered techniques are most appropriately applied in the context of behavior modification modalities, and have little utility in promoting insight-oriented work.

  • In brief therapy settings, focus on tasks is the primary approach that is used to expedite solutions to presenting problems throughout the therapeutic process.

Correct answer: They can be used across modalities and settings, and utilized in situations where there are discrete, definable activities to be accomplished to facilitate progress toward the primary goals of a case.

While the relative degree to which a task-centered approach is applied, in part, is guided by the setting, the concept can apply across modalities/orientations/phases of treatment when any readily definable and often time-limited activity is necessary to goal attainment.

Though they may be time limited, task-focused techniques may promote insight in clients and can be used throughout the treatment process. While a task centered approach may be used in many brief therapy settings, there are many other types of therapy that are used as well and cannot always be relied upon to expedite a solution to the presenting problems.

26.

At which level of society is the focus on the WHOLE community?

  • Macro

  • Micro

  • Mezzo

  • Mini

Correct answer: Macro

Macro levels of society focus on whole communities, while micro levels of society focus on one individual at a time. 

Mezzo levels of society focus on groups and families, and there is no such thing as a mini level of society.

27.

During a session with Spencer, a male client who has a sexual addiction, you are informed that he has fondled his seven-year-old nephew while he was caring for him. You inform Spencer that he will need to report this incident to the appropriate authorities, and Spencer agrees to do so after the session. 

After the session, what should you do NEXT?

  • Contact the appropriate authorities to report Spencer's self-reported disclosure

  • Notify the victim’s parents

  • Follow up with Spencer during his next session to verify he reported the incident

Correct answer: Contact the appropriate authorities to report Spencer's self-reported disclosure

When abuse takes place, it is your legal, ethical, and professional responsibility to report the event to the appropriate authorities.

You should not contact the victim’s parents, as this violates social worker client confidentiality, and following up with the client during his next session does not address the assault that took place.

28.

As a clinical social worker, your work with clients focuses on helping them uncover unconscious thoughts and unresolved childhood problems that are contributing to current distress. Upon what theoretical perspective is your clinical work based?

  • Psychodynamic 

  • Systems

  • Humanistic

  • Social constructionist 

Correct answer: Psychodynamic 

Psychodynamic theories assert that unconscious mental activity drives human behavior. These theories also assert that early childhood experiences can play a role in distress. This theory aligns with the description in the question.

Systems theory states that the world consists of systems made up of interrelated parts, each of which affects all other parts and the system as a whole.

Humanistic theories view people as having the ability to change, as they are naturally driven toward personal growth.

Finally, social constructionist theory focuses on how clients create reality though interactions with others.

29.

Psychological defense mechanisms can be categorized on a continuum from "primitive," or "infantile," to more "mature." Which of the following BEST represents the correct order of such a continuum, from most primal to most mature?

  • Denial, displacement, and sublimation

  • Compensation, rationalization, and regression

  • Acting out, assertiveness, and intellectualization

  • Sublimation, repression, and assertiveness

Correct answer: Denial, displacement, and sublimation

Psychological Defense Mechanisms are unconscious, involuntary techniques that reduce anxiety, and defense mechanisms can be ordered from most primitive to least primitive.

The most primitive defense mechanisms are: denial, regression, acting out, dissociation, compartmentalization, projection, and reaction-formation. In the middle, are repression, displacement, intellectualization, rationalization, and undoing. Finally, defense mechanisms that are considered to be the most mature are sublimation, compensation, and assertiveness.

The remaining answer options are incorrect because they do not show the correct order from most primal to most mature.

30.

You ask the parents of two children what their parenting style is. The father self-reports to you that the two parents have established rules for their children in which they have explained why they have established said rules. The mother continues by stating that if one of their children does not follow a rule, parent(s) and child discuss the importance behind the rule and why it shouldn’t be broken. 

The following parenting style is being used:

  • Authoritative

  • Permissive

  • Authoritarian

Correct answer: Authoritative

Authoritative parents communicate, establish rules for their children, and nurture/forgive their children when the rules are broken.

The other options are incorrect as they do not fit the parenting style being described in the question. Authoritarian parents establish strict rules with no reasoning behind said rules and their children are punished if they break the rules. Permissive parents are indulgent, have few demands, and hardly ever discipline their children.

31.

Jamie previously threw a tantrum before he had to brush his teeth, and when his dad stopped giving him attention, he threw fewer and fewer ones until he stopped altogether eventually. Now, he brushes his teeth without any problems.

What type of behavior modification is present?

  • Extinction

  • Negative reinforcement

  • Positive reinforcement

Correct answer: Extinction

Extinction is the weakening of a conditioned response by discontinuing reinforcement after the response occurs. In this question, Jamie's dad is trying to take away what was previously provided as reinforcement (a tantrum) while the desired behavior (tooth brushing) continues. The learned tantrums have become extinct.

The other options are incorrect because they do not best match the information that was offered in the question. Positive reinforcement is the strengthening of a desired behavior by reinforcing a desired object or approval, and negative reinforcement is the strengthening of a desired behavior through the use of avoidance conditioning. 

32.

The diagnostic criterion for intellectual disability does NOT include:

  • Language and communication problems

  • Onset of deficits during the developmental period

  • Deficits in adaptive functioning

  • Deficits in intellectual functioning

Correct answer: Language and communication problems

Intellectual disability, which is also known as intellectual developmental disorder, is a disorder that has its onset during the developmental period and is one that includes both intellectual and adaptive functioning deficits. The intellectual functions include planning, reasoning, problem solving, and academic learning. Adaptive functions include abilities that meet standards for personal independence and social responsibility. 

While language and communication problems are sometimes present in individuals with intellectual disabilities, these are not criteria for a diagnosis.

33.

While holding a group therapy session, a controversial topic arises that sparks an extremely angry argument involving most of your group's members. What is the MOST immediate action you should take?

  • Firmly and persistently insist that the conflict be suspended, and refocus on a structured process to facilitate discussion of the process and group dynamics that have occurred with minimal (or no) reference to the topic-specific material that provoked the conflict

  • Do whatever is necessary to verbally intervene to stop all argument-related group interactions, dismiss all members who engaged in the conflict, continue the group with any remaining members, and plan an agenda for the next scheduled group session, in which ground rules are reviewed/clarified

  • Observe the interaction and allow it to continue, noting the positions and roles that each member takes, and plan to use this information as material for discussion in future sessions

Correct answer: Firmly and persistently insist that the conflict be suspended, and refocus on a structured process to facilitate discussion of the process and group dynamics that have occurred with minimal (or no) reference to the topic-specific material that provoked the conflict

Although there are a variety of perspectives on group work, your role as the therapist, and group process, in general, it is not productive to allow members to engage in prolonged, unstructured conflicts that may be expected to erode group cohesiveness.

It is very rarely appropriate for a therapist to exhibit an attitude or behavior that is partial to one sector of the group membership, to passively allow unproductive interactions to continue, or to prematurely terminate the interaction without opportunities to process what has occurred.

34.

Which axis of the DSM-5 is used to diagnose general medical conditions?

  • There are no axes in the DSM-5

  • Axis IV

  • Axis I

Correct answer: There are no axes in the DSM-5

DSM-IV-TR uses a multiaxial format. However, the DSM-5 uses a dimensional approach to diagnosis. Any medical conditions are listed underneath psychiatric diagnoses.

35.

Madeline is a college student and is meeting with you for the first time. She complains of general apathy toward her studies and social life, extreme fatigue, a loss of appetite, and feelings of worthlessness.

When formulating a diagnosis, you would MOST need to know:

  • How long Madeline has been experiencing symptoms

  • What social support Madeline has

  • If there is a history of depression or suicide in Madeline's family

  • What medications or medical problems Madeline has

Correct answer: How long Madeline has been experiencing symptoms

The duration of Madeline's symptoms is important for several reasons, because depressive disorders are outlined in the DSM-5 with a duration criterion for each type. Therefore, it is essential that you find out this information in order to make an accurate diagnosis.

The remaining answer options are incorrect. Once you find out how long Madeline has been experiencing symptoms, you can gather information about her support system, family psychiatric history, and any medications or medical problems Madeline might have. Again, this information should come only after you find out the duration of her symptoms. 

36.

Which theorist is related to the psychosocial development model?

  • Erikson

  • Bowen

  • McGregor

Correct answer: Erikson

Erik Erikson is known for his creation of the psychosocial development model, which classifies specific developmental stages in terms of how the individual relates to others.

The other options are not correct. Murray Bowen was a pioneer of family therapy and developed extended family systems therapy, and Douglas McGregor is credited for Theory Y, a theory of human motivation.

37.

You ask Abram, a client, “If you witnessed money falling out of a man’s pocket, would you keep the money or return it to the man?” What are you assessing?

  • Conscience

  • Dependency

  • Reality testing

Correct answer: Conscience

Conscience is an individual’s sense of right and wrong. In this question, you are asking Abram about his sense of what is right or wrong, which is part of a general assessment of his personality and functioning.

The other options are incorrect because dependency is when an individual has a reliance on other people or things for their existence or support, and reality testing is a client’s ability to judge the external world objectively and to distinguish between it and what is in their own mind.

38.

The following pattern of behavior in a child would LEAST indicate a potential problem in attachment/bonding with significant others:

  • The child clearly differentiates their parents from others present in the environment, demonstrates preference for parents over others, and may wander/explore the surroundings in the presence of one or both parents

  • The child displays little or no change in affect or behavior when parents leave or return, may turn away from parents to return to a focus on other activities/people, and may show few signs of differentiating parents from others in their surroundings

  • After a period of separation from parents, the child exhibits ambivalence, anger, and/or reluctance to disengage from the focus of present activity to reunite with parents upon their return. The child does not respond as well as others to strangers' efforts to calm/soothe.

Correct answer: The child clearly differentiates their parents from others present in the environment, demonstrates preference for parents over others, and may wander/explore the surroundings in the presence of one or both parents

Children with the healthiest form of attachment behavior (secure attachment) differentiate parents from others, show clear preference for parents, and exhibit a willingness to explore the environment as long as parents are present.

Avoidant attachment often stems from inadequate parent reaction to distress, discouragement of crying, and overemphasis on independence. Children with an avoidant attachment often appear disinterested when their parents leave or return. Disorganized attachment often arises from fright related, withdrawing, negative, intrusive, or confused parental behavior. Children with a disorganized attachment may exhibit ambivalence about the parent's presence, sometimes running up to them and immediately pulling away.

39.

You are referring a young client, Abigail, age 10, to therapy due to concerns by her parents about Abigail's eating habits, as well as a history of making excuses for teachers and her friends to avoid the cafeteria at school. She also declines to get together with her friends and family when the activities involve eating. Abigail's parents are worried that all of this has led to her losing 7 pounds recently. 

Because of this, you might consider a diagnosis of:

  • Avoidant/Restrictive Food Intake Disorder

  • Anorexia Nervosa

  • Bulimia Nervosa

  • Binge-Eating Disorder

Correct answer: Avoidant/Restrictive Food Intake Disorder

Avoidant/Restrictive Food Intake Disorder (ARFID) was previously known as "Feeding Disorder of Infancy or Early Childhood." It is characterized by picky eating and a lack of interest in eating, as a whole. Many with ARFID have significant weight loss or are underweight. In this question, it is stated that Abigail has lost weight recently and she declines social engagements, therefore harming her relationships. 

Anorexia Nervosa, while similar, is defined when a disturbance in the way one's body weight and/or shape is experienced. In this question, there are no indicators that Abigail thinks she is overweight or that she is afraid of gaining weight. These are two common characteristics of individuals with Anorexia Nervosa. Individuals with Binge-Eating Disorder consume an unusually large amount of food and feel that they are unable to stop eating. In this question, there are no indicators that Abigail has these concerns. Finally, Bulimia Nervosa is characterized by purging after periods of eating.

40.

The diagnostic criterion for a neurocognitive disorder MUST include:

  • Delirium

  • Childhood onset

  • A genetic component

  • Developmental changes in cognition

Correct answer: Delirium

Neurocognitive disorders begin with delirium and then are followed by syndromes of major or mild neurocognitive disorder. Diagnostic criteria for delirium include a disturbance in attention and awareness that is developed over a short period of time, and an additional disturbance in cognition.

Neurocognitive disorders typically do not develop during childhood. While it is common for neurocognitive disorders to have a genetic component, this is not a requirement for this diagnosis. And as is stated above, one criterion is that there is a noticeable disturbance in cognition, but this does not necessarily have to relate to developmental changes within an individual.

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