Assessment
A client reports feeling increasingly depressed after losing their job. What should the social worker do FIRST?
A. Develop a treatment plan
B. Assess the client’s current functioning and safety
C. Refer the client for medication
D. Begin cognitive behavioral therapy
What is:
Assess the client’s current functioning and safety
A social worker realizes they have developed strong personal feelings toward a client. What should the social worker do FIRST?
A. Terminate immediately
B. Discuss the feelings with the client
C. Seek supervision/consultation
D. Ignore the feelings
What is:
Seek supervision/consultation
A client experiencing anxiety frequently thinks, “Something terrible is going to happen.” Which intervention is MOST consistent with CBT?
A. Dream interpretation
B. Identifying and challenging cognitive distortions
C. Exploring unconscious conflicts
D. Free association
What is:
Identifying and challenging cognitive distortions
A client says, “Everyone would be better off without me.” What should the social worker do FIRST?
A. Reassure the client that things will improve
B. Ask directly about suicidal thoughts, intent, plan, and means
C. Schedule another appointment
D. Contact the client’s family immediately
What is:
Ask directly about suicidal thoughts, intent, plan, and means
A client repeatedly misses appointments because of transportation problems. What should the social worker do FIRST?
A. Discharge the client
B. Explore barriers and possible solutions with the client
C. Charge additional fees
D. Tell the client they are not committed to treatment
What is:
Explore barriers and possible solutions with the client
A client reports hearing voices telling them that they are worthless. What is the social worker’s priority?
A. Explore childhood experiences
B. Assess for suicidal/homicidal ideation and immediate safety
C. Challenge the client’s belief
D. Recommend group therapy
What is:
Assess for suicidal/homicidal ideation and immediate safety
A client asks the social worker to become friends on social media. What is the BEST response?
A. Accept the request but avoid messaging
B. Accept if the client’s treatment is ending
C. Decline and explain professional boundaries
D. Create a separate professional account and accept
What is:
Decline and explain professional boundaries
A client has difficulty identifying emotions and frequently becomes overwhelmed during conflict. Which intervention would be MOST appropriate initially?
A. Teach emotional-regulation and coping skills
B. Explore early childhood attachment exclusively
C. Encourage the client to avoid conflict
D. Immediately begin exposure therapy
What is:
Teach emotional-regulation and coping skills
A client reports suicidal thoughts and has a specific plan, access to the means, and intent to act soon. What is the social worker’s priority?
A. Create a long-term treatment plan
B. Explore childhood trauma
C. Take immediate steps to ensure safety
D. Schedule weekly therapy
What is:
Take immediate steps to ensure safety
A social worker disagrees with a client’s cultural beliefs about mental health. What is the BEST approach?
A. Explain why the client’s beliefs are incorrect
B. Avoid discussing culture
C. Explore the client’s beliefs with cultural humility
D. Encourage the client to adopt the social worker’s perspective
What is:
Explore the client’s beliefs with cultural humility
A client presents with depression, difficulty sleeping, and loss of appetite. What should the social worker assess FIRST?
What is:
Safety, including suicidal ideation.
A social worker realizes they have a personal bias that could affect treatment. What should they do FIRST?
What is:
Seek supervision/consultation and examine how the bias may affect clinical practice.
A client frequently says, “I’m a failure because I made one mistake.” What CBT intervention would be MOST appropriate?
What is:
Identify and challenge the cognitive distortion.
This is the first thing a social worker should do when a client says, “Everyone would be better off without me.”
A. Reassure the client that things will improve
B. Ask directly about suicidal thoughts, intent, plan, and means
C. Schedule another appointment
D. Contact the client's family immediately
What is:
Ask directly about suicidal thoughts, intent, plan, and means
A client repeatedly misses appointments because they cannot afford transportation. What should the social worker do FIRST?
What is:
Explore the barrier with the client and identify possible resources or alternatives.
A client reports hearing voices. What additional information is MOST important to assess?
What is:
The nature of the hallucinations, including frequency, content, command hallucinations, and potential risk to self or others.
A former client sends the social worker a friend request on social media. What is the BEST response?
What is:
Decline the request and maintain appropriate professional boundaries.
A client becomes emotionally overwhelmed during sessions and has difficulty calming themselves. What should the social worker prioritize?
What is:
Teaching and practicing emotional-regulation and grounding skills.
This is the social worker’s immediate priority when a client reports suicidal thoughts, has a specific plan, access to the means, and intent to act soon.
A. Create a long-term treatment plan
B. Explore childhood trauma
C. Take immediate steps to ensure safety
D. Schedule weekly therapy
What is:
Take immediate steps to ensure safety
A social worker notices that a client’s symptoms have worsened despite treatment. What should the social worker do FIRST?
What is:
Reassess the client’s needs, functioning, risk, and response to the current treatment plan.
A client presents with anxiety, substance use, and difficulty functioning at work. What should the social worker do FIRST?
What is:
Conduct a comprehensive assessment to determine the presenting problems, contributing factors, level of functioning, and safety concerns.
A social worker receives a subpoena for a client’s records. What should the social worker do FIRST?
What is:
Consult applicable laws, regulations, agency policy, and legal/clinical supervision before releasing information.
A client has repeatedly used avoidance to manage anxiety. The client is stable and willing to work on the problem. What intervention may be MOST appropriate?
What is:
Gradual exposure combined with coping skills and cognitive restructuring.
This factor would generally indicate a higher level of suicide risk during a safety assessment.
A. Strong family support and future goals
B. Mild stress related to work
C. A detailed suicide plan with access to means and expressed intent
D. Occasional feelings of sadness without suicidal thoughts
What is:
A detailed suicide plan with access to means and expressed intent
A social worker believes the current treatment approach is not producing meaningful progress. What is the BEST next step?
What is:
Review the treatment goals and interventions with the client, reassess the client’s needs, and modify the treatment plan as clinically appropriate.