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Quiz Session - Attempts With Random Questions

ASWB LCSW Exam Questions

Page 9 of 50

161.

In an initial interview with a new client, your main focus and important goal is which of the following?

  • To establish rapport with the client while building a sense of comfort with the therapeutic environment.

  • To explain policies and procedures and confirm that the client clearly understands them.

  • To obtain as much information as possible regarding the presenting problem and relevant client history.

  • To define overall goals for the therapeutic process.

Correct answer: To establish rapport with the client while building a sense of comfort with the therapeutic environment.

The primary priority in the initial worker-client interview with a new client is to set the foundation on which to develop a working relationship. Trust and a strong relationship between worker and client will affect the clients' progress down the line.

162.

Vance is working with his client, Joy, in a substance abuse treatment center. While forming a treatment plan for Joy, Vance has heard Joy describe her circumstances and obtained some data from other providers and her medical history.

What should Vance do NEXT?

  • Perform an assessment

  • Plan with Joy

  • Question Joy

  • Establish rapport

Correct answer: Perform an assessment

The standard SOAP treatment planning process has obtaining data as its first two steps: Subjective (hearing Joy out) and Objective (getting collateral data). The next thing to do is bring the first two stages together to perform an assessment and, only then, can Vance make a plan with Joy.

Establishing rapport is not exactly a part of treatment planning per se, but still important.

163.

Liam is a 23-year-old young man being raised by his parents in a middle-class neighborhood. When his grandparents became too old to care for themselves, the two of them moved in with Liam and his parents. When he was growing up, anytime someone in the family faced a problem, the entire family gathered together to brainstorm about it and figure out how it could be solved. When Liam got his first part time job, he gave a portion of the money he made to his parents to help the household, rather than keeping it for himself to spend out with his friends. 

Liam's family can BEST be described as:

  • Collectivist

  • Independent

  • Enmeshed

  • Individualistic

Correct answer: Collectivist

A collectivist society is one in which members act in the best interest of the group rather than the individual. In this question, Liam's family always puts the family before the person, as evidenced by caring for Liam's grandparents, tackling problems as a group, and Liam contributing personal income to the household.

An individualistic family or society acts in the best interest of the individual rather than the group. If, in this question, Liam had kept his personal income for himself, tried to solve problems on his own, and his grandparents were sent to an assisted living facility rather than living with the family, this would have been an individualistic family or society. An enmeshed family is one that lacks boundaries, is dysfunctional, and is unnaturally close, and the question does not suggest that Liam's family members are these things. Here, independent is used as synonymous with individualistic, not collectivist.

164.

You are meeting with the Gunderson family for the first time. During the initial assessment, the parents inform you that they are concerned about their youngest child, Susie, a 13-year-old girl who has recently become extremely defiant and disobedient. She regularly leaves the home without asking and rarely completes her homework, resulting in falling grades in school. During the session, Susie rolls her eyes, but says nothing. Mr. and Mrs. Gunderson explain that their other children, Tim, a 15-year-old boy who was recently diagnosed with a debilitating disease, and Kate, an 18-year-old girl, who moved away to attend her freshman year of college, are very well adjusted. The two parents do not understand "what went wrong" with Susie. 

What might be part of the reason why Susie is having trouble?

  • She is experiencing the stress of Tim having a chronic medical condition, as well as coping with the departure of Kate

  • She was born with a mental disorder that has not yet been diagnosed

  • Mr. and Mrs. Gunderson are too focused on her problems when they should be focused on the other children

  • Susie has recently begun experimenting with drugs, and this is affecting other areas of her life

Correct answer: She is experiencing the stress of Tim having a chronic medical condition, as well as coping with the departure of Kate

Sometimes it is difficult for families to see that changing dynamics within the family system can create an imbalance, which causes emotional distress. In this question, Tim's recent medical problems in combination with Kate's departure from the home have likely significantly impacted on Susie, the 13-year-old. You should spend time assessing the changes that have recently occurred related to Susie's role and expectations within the family.

There is no information offered in the question that would indicate that she has a mental disorder or that Susie has started engaging in drug usage. If anything, Mr. and Mrs. Gunderson may not be giving her enough attention due to the other changes in the family, and she is acting out in order to receive attention, even though it is negative.

165.

The following accurately describes how the minority stress model impacts LGBTQIA+ individuals:

  • It identifies a variety of ways in which members of society tend to treat LGBTQIA+ individuals as inferior to heterosexual persons.

  • It helps outline treatment plans that can also be used in individual treatment of LGBTQIA+ individuals.

  • It explains why/how LGBTQIA+ individuals are at a higher rate of suicide and mental illness than heterosexual persons.

  • It provides the evidence that sexual identity is socially defined instead of biologically defined.

Correct answer: It identifies a variety of ways in which members of society tend to treat LGBT individuals as inferior to heterosexual persons.

The minority stress model describes the high levels of stress experienced by members of stigmatized minority groups such as LGBTQIA+ individuals. It helps identify the various ways in which members of society tend to treat LGBTQIA+ individuals as inferior to heterosexual persons. These stressors include the pressure to hide one's sexual identity from others for fear of discrimination, internalized homophobia, and rejection sensitivity.

The minority stress model does not outline individual treatment plans for LGBTQIA+ persons or assert that sexual identity is socially defined. While LGBTQIA+ individuals do have higher rates of suicide and, in some cases, higher rates of mental illness than heterosexual persons, the minority stress model does not necessarily connect this reality with the fact that LGBTQIA+ individuals experience more stress than non-LGBTQIA+ individuals.

166.

Chandler's supervisor, Rachel, wants to review some of his documentation for clinical review purposes. Chandler is concerned that his patients might not want their records used. What is Chandler's BEST course of action?

  • Obtain informed consent before providing the documentation

  • Hand over the records since there is an exception to informed consent for clinical reviews

  • Do not provide the records, to protect the client's self-determination

  • Provide the records without identifying information

Correct answer: Obtain informed consent before providing the documentation

As a principle, informed consent should always be an important consideration, even in a situation where privacy law does not explicitly state that it is necessary. 

The rest of the choices are not the best course of action in the situation.

167.

You are particularly interested in your clients' social, familial, and professional relationships. You are MOST likely working from which perspective?

  • Systems theory

  • Psychoanalytical

  • Behavioral

  • Social learning theory

Correct answer: Systems theory

Many social workers operate from the systems theory perspective, as the systems theory perspective stresses the importance of clients' networks of relationships and interactions between them.

A social worker who operates from a psychoanalytical perspective believes that an individual's current state of dysfunction is a result of early childhood experiences. This can only be explored through conversations between the social worker/therapist and the client. A behavioral perspective is one based on the belief that one's behavior can be altered by offering positive/negative reinforcement. Social learning theory is the belief that individuals' behaviors are a result of direct observation of others.

168.

Your client, Megan, arrives at her session visibly upset and informs you that her husband sexually assaults her, and sometimes does it in front of their three children. Which of the following factors should you give the HIGHEST priority to?

  • The safety of Megan and her children

  • Respecting Megan's choices

  • Providing Megan with choices and resources

  • Placing blame on Megan for allowing the situation

Correct answer: The safety of Megan and her children

When a social worker is treating clients who are domestically abused, their main priority is the safety of the client. In this question/example, while you should respect Megan's choices and provide her with additional choices and resources, her safety and the children's should be your top priority. 

In no scenario, should a social worker place blame on the client for being sexually assaulted.

169.

You are meeting with a 33-year-old woman with an anxiety disorder for the first time. The following should be your PRIMARY goal for the initial session:

  • Allow your client to tell her story in her own words

  • Assess the need for medication management

  • Develop a treatment plan for your client

  • Gather information for a biopsychosocial assessment

Correct answer: Allow your client to tell her story in her own words

During the initial session with your client, your main goal should be to allow her to express herself in her own words. This not only gives you a picture of how your client perceives the problem, but also helps her to feel accepted and valued when given the chance to talk about her life without being judged.

Your primary goal is not to decide if the client needs medication, and you will want to gather information for the biopsychosocial assessment and formulate a treatment plan within the next several sessions, but neither of these should be your primary goal for the first, initial session.

170.

The following statement is the LEAST applicable regarding the diagnosis/characteristics of social anxiety disorder:

  • The onset and symptoms of the disorder are consistently linked to a traumatic experience involving public embarrassment or ridicule from others, usually in early childhood. The disorder leads to pervasive avoidance of social situations.

  • The disorder is marked by strong fear of public embarrassment and negative judgment of others, and the way in which it is manifested may vary widely between individuals with the disorder, ranging from very specific situations/activities to those that are much more generalized/broader in scope.

  • People with social anxiety disorder often develop anxiety/fear about engaging in fairly common/routine activities while in the presence of/observed by others. They usually acknowledge that the fear is unfounded or out of proportion to the situation, but cannot readily control their reactions when actually in the fear-evoking circumstances.

Correct answer: The onset and symptoms of the disorder are consistently linked to a traumatic experience involving public embarrassment or ridicule from others, usually in early childhood. The disorder leads to pervasive avoidance of social situations.

Social anxiety disorder, also known as social phobia, is marked by a strong fear of being embarrassed/negatively judged by others. The fear can be so severe that it interferes with everyday activities. Many diagnosed with social phobia fear engaging in common/necessary activities while in others' presence (for example: public restroom use, eating/drinking in front of others, etc.). For some, the problem only arises in certain situations, while in others, symptoms manifest in almost any social setting. The range of scenarios that evoke fear in those with the disorder are too extensive to be defined in terms of a specific phobia. Because of this, continued use of the term “social phobia” to describe the disorder may lead clinicians to misdiagnose those whose avoidance of social situations is relatively mild. 

While there may be some environmental factors at play in terms of the etiology of the disorder, there is no consistent link to a traumatic experience in sufferers' past/childhood.

171.

An exaggerated sense of self-importance is often found in clients who are diagnosed with which of the following personality disorders?

  • Narcissistic personality disorder

  • Borderline personality disorder

  • Paranoid personality disorder

  • Histrionic personality disorder

Correct answer: Narcissistic personality disorder

Narcissistic personality disorder is characterized by attention-seeking behavior, oversensitivity to failure, and an exaggerated sense of self-importance.

A paranoid personality disorder is characterized by pervasive distrust and suspiciousness of others. Borderline personality disorder is characterized by instability in interpersonal relationships, a fluctuating idea of self-image, and maladaptive behavior. Histrionic personality disorder is characterized by attention-seeking behavior, but it can also be indicated by "over the top" or melodramatic behavior. 

172.

You ask yourself, "Does this test measure the concept that it is intended to measure?" What type of validity is this?

  • Construct validity

  • Face validity

  • Criterion validity

  • Content validity

Correct answer: Construct validity

In quantitative research, you have to consider the reliability and validity of your methods and measurements. Validity tells you how accurately a method measures something. If a method actually measures what it claims to measure and the results closely correspond to real-world values, then it can be considered valid. There are four main types of validity: Construct, Content, Criterion, and Face.

Construct validity evaluates whether a measurement tool really represents the thing we are interested in measuring, which is expressed in the information in question.

Content validity assesses whether a test is representative of all aspects of the construct, face validity considers how suitable the content of a test seems to be on the surface, and criterion validity evaluates how closely the results of your test correspond to the results of a different test.

173.

Lenny, an adult male client, experiences erotic pleasure by “flashing” others. Which of the following diagnostic categories BEST describes Lenny?

  • Exhibitionism

  • Sexual masochism

  • Sexual sadism

Correct answer: Exhibitionism

According to the DSM-5, exhibitionism is when an individual experiences a sexual arousal by exposing genitals to those who do not wish to see them.

The other options do not fit the information offered in the question. Sexual masochism is when an individual experiences erotic pleasure by being subjected to pain or suffering, such as being beaten or bound, and sexual sadism is when an individual experiences erotic pleasure by inflicting pain on others.

174.

The MOST valid criticism of the concept of a family life cycle and its application as a general concept in social work practice is:

  • The theory and ideas that support this concept are derived from mainstream/traditional Western culture, which may not account for diversity in a number of cases.

  • The concept can be useful to apply in individual cases/families, but it is not able to be generalized to average families.

  • There are so many factors that may disrupt the normal and expected family life cycle that the concept has little relevance or practical application.

  • The concept does not address the progression of stages that occur in families where children are absent.

Correct answer: The theory and ideas that support this concept are derived from mainstream/traditional Western culture, which may not account for diversity in a number of cases.

The main criticism of the family life cycle concept relevant to social work practice is that the concept is primarily informed by and centers around traditional Western family composition and processes. However, one of the advantages of the idea is that it provides a method of accounting for disruptions that may prove significant to the family or its members.

As stated above, the family life cycle has significant relevance to most family situations. While the assumptions of this concept are primarily based on families with children, it can still be applied to couples as they move through a developmental process as a unit.

175.

You meet regularly with Keith, a teenage boy, and his father for family therapy, and you notice that every time Keith loses a hockey game or gets a bad grade on a test, he reassures his father. 

This is known as:

  • Diminishing generational boundaries

  • Double bind communication

  • Role reversal

  • Child abuse

Correct answer: Diminishing generational boundaries

Children often express empathy with a parent without it being pathological. As children develop, they become more emotionally mature and begin to be more sensitive. This is part of normal development and should be encouraged. In this question, Keith is offering his father reassurance to comfort him after Keith loses a game or gets a bad grade, instead of Keith's father reassuring his son. 

Double bind communication is the expression of two conflicting emotions or messages at the same time, which causes confusion in the recipient. There is no information in this question that leads us to believe double bind communication is taking place, or that child abuse is occurring. While some may think this is an example of role reversal, it is important to remember that Keith is simply expressing a healthy, developmentally appropriate reaction toward his father. 

176.

You have a client who was recently diagnosed with schizophrenia, but is now on a stable medication regimen and seems to be doing well overall. The client expresses some anxiety about the future. However, he states that he is more afraid that he may have another psychotic break at some point and would like to see you.

Your BEST suggestion to this client is:

  • To continue meeting with you for supportive therapy

  • To terminate therapy, as the client has reached his goals and further therapy would be pointless

  • To attend a day-treatment program so he can make progress

  • To engage in psychoanalytic therapy to determine reasons for his mental illness

Correct answer: To continue meeting with you for supportive therapy

For people with schizophrenia, supportive therapy has been shown to be very effective. From the information offered in the question, the client's symptoms are well-controlled on the medication, making it very likely that individual therapy will be greatly beneficial to him.

Because the client will continue to struggle with a serious mental illness, you should respect the client's wish to remain in therapy rather than terminate services. The client clearly states that he wishes to continue seeing you, and there is no indication that he should attend a day-treatment program instead. There is also no clear indication that psychoanalytic therapy instead of supportive therapy would help this client.

177.

Which of the following specifiers is used to describe the bipolar diagnosis of an individual who has at least three manic or hypomanic symptoms, while also meeting full criteria for a major depressive episode?

  • Depressive episode, with mixed features

  • Unspecified

  • Manic or hypomanic episode, with mixed features

Correct answer: Depressive episode, with mixed features

According to the DSM-5, individuals who have at least three manic or hypomanic symptoms and also meet the criteria for a major depressive disorder may have a depressive episode, with mixed features.

The other options are incorrect. "Unspecified" is used in the DSM-5 at times when an individual meets some criteria of a specific disorder within a larger group, such as anxiety disorders, but does not meet all criteria for any specific disorder. Manic or hypomanic episode, with mixed features is a specifier used when an individual meets at least three symptoms of depression while also meeting full criteria for a manic or hypomanic episode.

178.

Of the following areas of agency or government requirements or policies, which would be MOST likely to affect your activities with regard to clients?

  • Regulations/procedures that constrain the frequency or intensity of services provided

  • Legal regulations that limit social workers' caseload sizes such that they diminish to a certain level over a specified time period

  • Imposition of a new system whereby all client treatment plans must be reviewed and approved in advance by a designated centralized regulatory authority

Correct answer: Regulations/procedures that constrain the frequency or intensity of services provided

While policies and/or regulations that affect practice or agency infrastructure may impose additional burdens on social workers, those that potentially directly impact the quality or quantity of services that can be made available to clients would be of greatest concern in client-related activities. Social workers may be subjected to contending with clinically contraindicated reductions/restrictions in services to clients. When "best practices" recommendations are negatively affected by policies/procedures and client welfare is jeopardized, this places an additional ethical burden on the social worker, which may warrant advocacy either for individual cases or for systemic change.

The other options are incorrect, as they all may impose inconveniences on the social worker, but do not necessarily affect the social worker's direct activities with clients.

179.

Of the following drugs, which is MOST commonly prescribed for schizophrenia?

  • Mellaril (thioridazine)

  • Neurontin (gabapentin)

  • Tegretol (carbamazepine)

  • Paxil (paroxetine)

Correct answer: Mellaril (Thioridazine)

Mellaril is a drug in the class labeled "typical antipsychotics" and is most often used to treat positive symptoms of schizophrenia.

Neurontin is used to treat seizure disorders. Tegretol is used to treat seizure disorders and/or bipolar disorders. Paxil is used to treat depression, anxiety, and obsessive-compulsive disorder.

180.

Which of the following would be the BEST approach to conducting psychotherapy with clients?

  • Tailoring interventions to a client's unique needs

  • Using a one-size-fits-all approach

  • Always using the one psychotherapy method that you're familiar with

  • Learning various psychotherapy approaches so you can be eclectic in your practice

Correct answer: Tailoring interventions to a client's unique needs

Psychotherapy can help clients cope with stress and alter dysfunctional behaviors and thinking patterns. There are multiple approaches to psychotherapy, but the best option is to tailor your interventions so they meet a client's unique needs.

You should not use a one-size-fits-all approach to psychotherapy. Clients are diverse and come to therapy with a range of different needs and experiences. What works for one client may not work for another.

It's important to be familiar with the psychotherapy methods you use, but you should not limit yourself to just one method. The specific method you use may not work for all clients.

Finally, it can be helpful to be eclectic in your approaches, so you can meet the needs of a diverse range of clients. However, the best option here is still to tailor interventions to a client's unique needs. The client's needs are primary.

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