Diagnosis
Which of the following is a hallmark symptom of schizophrenia?
A) Hallucinations
B) Panic attacks
C) Sudden weight loss
D) Persistent sadness
Explanation: Schizophrenia is commonly associated with positive symptoms like hallucinations (auditory or visual), delusions, and disorganized thinking.
A social worker is working with a client who has disclosed a history of drug use and possible illegal activities. The social worker suspects that the client might harm someone else. Under ethical guidelines, what should the social worker do?
A) Ignore the client’s history and continue therapy.
B) Maintain confidentiality and do not disclose any information.
C) Break confidentiality and inform the authorities about the potential harm.
D) Tell the client to stop committing illegal activities.
C) Break confidentiality and inform the authorities about the potential harm.
Explanation: If a social worker believes a client poses a risk to others, they are legally and ethically required to break confidentiality to prevent harm, following the “duty to warn” principle.
A social worker is meeting with a client who is experiencing a mental health crisis. The client is visibly distressed and expresses thoughts of suicide but does not have a specific plan or means. What should the social worker do first?
A) Reassure the client that the feelings will pass and schedule a follow-up appointment.
B) Provide the client with emergency phone numbers and ask them to call if needed.
C) Perform a risk assessment to determine the level of risk and intervene accordingly.
D) Advise the client to take medication to manage their distress.
C) Perform a risk assessment to determine the level of risk and intervene accordingly.
Explanation:
The first step in handling a mental health crisis is conducting a thorough risk assessment to determine the severity of the situation. The social worker should assess the client’s level of distress and potential for harm, then intervene as necessary, including involving emergency services or creating a safety plan.
A 35-year-old woman presents with intense sadness, low energy, and loss of interest in activities she once enjoyed. She has been experiencing these symptoms most of the day, nearly every day, for the past two weeks. What is the most likely diagnosis?
A) Generalized anxiety disorder
B) Major depressive disorder
C) Bipolar I disorder
D) Schizoaffective disorder
B) Major depressive disorder
Explanation: The key symptoms—sadness, low energy, and anhedonia (loss of interest)—align with major depressive disorder, especially given the duration of the symptoms.
A social worker is meeting with a client who is experiencing severe depression and has expressed thoughts of self-harm but denies having a specific plan or intent to carry out the thoughts. What is the most appropriate step the social worker should take?
A) Reassure the client that the thoughts will pass and schedule a follow-up session.
B) Immediately take the client to the hospital for an emergency psychiatric evaluation.
C) Discuss the client’s coping strategies and create a safety plan, including emergency contacts.
D) Continue to monitor the client over time and wait for further signs of distress.
C) Discuss the client’s coping strategies and create a safety plan, including emergency contacts.
Explanation:
While the client is expressing distressing thoughts, the social worker should focus on building a safety plan with the client. This may include identifying coping strategies, providing a support system, and offering referrals or emergency contacts if the client’s situation worsens. If the client shows an immediate risk of harm to themselves, further action, such as hospitalization, may be necessary, but it is important to first address the current state of the client’s safety.
A 28-year-old woman is brought to therapy by her partner because she has become increasingly irritable and withdrawn over the past few months. She reports frequent feelings of hopelessness, lack of energy, and difficulty concentrating at work. She has been sleeping excessively and eating more than usual. These symptoms have been present for the last six months and are significantly affecting her work and relationships. What is the most likely DSM-5 diagnosis?
A) Generalized Anxiety Disorder
B) Major Depressive Disorder
C) Persistent Depressive Disorder (Dysthymia)
D) Bipolar II Disorder
C) Persistent Depressive Disorder (Dysthymia)
Explanation: Persistent Depressive Disorder (PDD) involves a depressed mood lasting at least two years (one year in children and adolescents) and involves similar symptoms to Major Depressive Disorder, though they are generally less severe. The duration of symptoms (six months in this case) and the chronic nature of the problem point to PDD.
Which of the following is the best description of a social worker’s responsibility when dealing with client confidentiality?
A) Social workers must maintain confidentiality under all circumstances.
B) Social workers can possibly disclose information if the client gives consent.
C) Social workers can disclose information when it is beneficial for the client’s treatment.
D) Social workers must breach confidentiality if the client poses a danger to themselves or others.
D) Social workers must breach confidentiality if the client poses a danger to themselves or others.
Explanation: Confidentiality may be breached when there is an imminent risk of harm to the client or others, as part of ethical and legal duties.
A social worker is working with a client from a cultural background that values collective decision-making. The client seems hesitant to discuss personal issues and prefers to involve family members in the process. What should the social worker do?
A) Respect the client’s cultural values and encourage family involvement in the decision-making process.
B) Advise the client that therapy should be a personal experience and discourage family involvement.
C) Insist that the client attend therapy alone in order to maintain the confidentiality of the sessions.
D) Reassure the client that family involvement will not be necessary for treatment success.
A) Respect the client’s cultural values and encourage family involvement in the decision-making process.
Explanation:
Cultural competence involves respecting and adapting to the client’s cultural norms and preferences. The social worker should respect the client’s desire for family involvement and work collaboratively to support the client’s needs within their cultural context.
A social worker is seeing a 14-year-old client who is experiencing significant distress due to family problems. The client asks the social worker not to inform their parents about the sessions. The social worker believes that involving the parents will help address the issues more effectively. What is the social worker’s responsibility in this situation?
A) Keep the sessions confidential and not involve the parents.
B) Inform the client that their parents must be involved regardless of the client’s wishes.
C) Respect the client’s wishes, as they are a minor, and keep the sessions confidential.
D) Discuss the importance of involving the parents, assess the risks, and explore the client’s willingness to involve them.
D) Discuss the importance of involving the parents, assess the risks, and explore the client’s willingness to involve them.
Explanation: The social worker should discuss the importance of parental involvement, assess risks, and work with the client to explore how to involve the parents in the treatment process, balancing confidentiality with the need for collaboration in addressing issues.
A social worker is meeting with a client from a different cultural background who expresses dissatisfaction with the social worker’s approach. The client says that the social worker's direct, solution-focused style feels dismissive of their cultural values, which emphasize a more relational and narrative approach. What should the social worker do?
A) Insist on using a solution-focused approach, as it is more effective for the client’s issue.
B) Acknowledge the client’s concerns and adjust their approach to be more culturally sensitive and aligned with the client’s preferences.
C) Inform the client that their cultural preferences are not relevant to the therapy process.
D) Refer the client to a therapist from the same cultural background for better alignment.
B) Acknowledge the client’s concerns and adjust their approach to be more culturally sensitive and aligned with the client’s preferences.
Explanation:
Cultural competence is a key element of effective social work practice. It is essential for the social worker to acknowledge the client’s concerns and be flexible in adapting the therapeutic approach to respect and incorporate the client’s cultural values and preferences.
A 25-year-old man presents with excessive worry about work, health, and social situations. He finds himself unable to control these worries, which occur nearly every day for the past six months. He reports feeling restless, easily fatigued, and having difficulty concentrating. What is the most likely DSM-5 diagnosis?
A) Panic Disorder
B) Generalized Anxiety Disorder
C) Social Anxiety Disorder
D) Adjustment Disorder
B) Generalized Anxiety Disorder
Explanation: Generalized Anxiety Disorder (GAD) is characterized by excessive worry occurring more days than not for at least six months, about a variety of topics. The individual also experiences physical symptoms such as restlessness, fatigue, and difficulty concentrating.
A social worker in a private practice is seeing a 16-year-old client who discloses that they are considering suicide but do not want their parents to know. What is the social worker's ethical responsibility?
A) Maintain confidentiality and respect the client’s wishes.
B) Notify the parents immediately, as the client is a minor.
C) Assess the client's risk and inform the parents if necessary to ensure their safety.
D) Encourage the client to keep the information to themselves and do not inform anyone.
Answer: C) Assess the client's risk and inform the parents if necessary to ensure their safety.
Explanation: In cases of suicidal ideation, social workers have a duty to intervene to protect the client's safety. As the client is a minor, the social worker must evaluate the seriousness of the situation and may need to breach confidentiality to inform the parents if there is imminent risk of harm.
A social worker is preparing to terminate services with a client who has achieved their treatment goals. The client expresses sadness about the termination and says they feel they still need support. What is the social worker’s most appropriate response?
A) Encourage the client to find another therapist and move forward with their life.
B) Explore the client’s feelings about termination and address any remaining concerns.
C) Recommend that the client attend therapy indefinitely for continued support.
D) Reassure the client that they are ready to face life without therapy and that they should not seek further help.
B) Explore the client’s feelings about termination and address any remaining concerns.
Explanation:
Termination is an important part of the therapeutic process. The social worker should explore the client’s feelings about ending therapy and address any unresolved issues. It is important to ensure that the client feels prepared and supported in the transition, even if they need referrals for continued care.
A client is experiencing severe emotional distress after a recent breakup. The social worker is working on building a treatment plan to address the client’s symptoms. The client asks the social worker for advice about whether to contact their ex-partner. What is the social worker’s most ethical response?
A) Advise the client to call the ex-partner immediately to seek closure.
B) Give the client the phone number of their ex-partner and suggest they talk things through.
C) Discuss the pros and cons of contacting the ex-partner, helping the client explore their feelings and motivations.
D) Avoid discussing the topic of the ex-partner altogether.
C) Discuss the pros and cons of contacting the ex-partner, helping the client explore their feelings and motivations.
Explanation: The social worker should guide the client in exploring their feelings, motivations, and possible outcomes of contacting the ex-partner, rather than giving direct advice.
A social worker is working with a 15-year-old client who discloses that they are being physically abused by a parent. The client asks the social worker not to report the abuse, as they are afraid of being removed from their home. What should the social worker do?
A) Honor the client’s request and maintain confidentiality.
B) Encourage the client to talk to their parent about the abuse.
C) Report the abuse to the appropriate authorities, as required by law.
D) Suggest the client avoid confronting the parent and continue working with them in therapy.
Answer: C) Report the abuse to the appropriate authorities, as required by law.
Social workers are mandated reporters and are legally required to report any suspected abuse or neglect to protect the well-being of the child. The social worker must prioritize the safety of the client over confidentiality.
A 34-year-old woman presents with symptoms of intense fear and avoidance of certain situations, including public speaking and meeting new people. She experiences physical symptoms such as a racing heart and sweating when she anticipates social interactions. She has been experiencing these symptoms for over a year. Which DSM-5 diagnosis is most appropriate?
A) Social Anxiety Disorder
B) Specific Phobia
C) Panic Disorder
D) Agoraphobia
A) Social Anxiety Disorder
Explanation: Social Anxiety Disorder (also called Social Phobia) involves significant fear or anxiety about social situations, where the individual worries they will be negatively evaluated. Physical symptoms like a racing heart and sweating are common in these situations. The fear and avoidance of social interactions, lasting for more than six months, align with this diagnosis.
A social worker is conducting a therapy session with an adult client. The client asks the social worker to reveal details of their session to the client’s spouse. What should the social worker do?
A) Disclose the information to the spouse, as the client requested.
B) Disclose the information to the spouse only if it directly benefits the client’s treatment.
C) Discuss with the client the implications of sharing information and seek written consent before disclosing any information.
D) Refuse to share any information with the spouse, as confidentiality must always be maintained.
Answer: C) Discuss with the client the implications of sharing information and seek written consent before disclosing any information.
Explanation: Confidentiality is a key ethical obligation, but it can be breached with the client’s written consent. The social worker should discuss the potential benefits and risks of sharing information with the spouse, ensuring the client understands their rights.
A social worker is asked to provide a client’s records to another professional, but the client has not signed a release of information. What should the social worker do?
A) Provide the records, as the request comes from a professional.
B) Refuse to provide the records, as there is no release of information signed by the client.
C) Provide the records only if the other professional requests them in writing.
D) Seek the client’s consent and have them sign a release of information before sharing the records.
D) Seek the client’s consent and have them sign a release of information before sharing the records.
Explanation:
The social worker must maintain client confidentiality unless there is written consent from the client to release the information. A release of information form is necessary before sharing records with another professional, unless there are specific legal or ethical exceptions.
A social worker is working with a client who has been living in an abusive relationship for several years. The client is ready to leave, but they are unsure of how to go about it. The social worker should:
A) Provide a list of shelters and contact numbers without asking the client what they want.
B) Empower the client to make their own decisions by discussing options and providing support based on the client’s expressed wishes.
C) Tell the client what they should do and direct them to a shelter immediately.
D) Advise the client to return to the relationship until they can fully plan their departure.
B) Empower the client to make their own decisions by discussing options and providing support based on the client’s expressed wishes.
Explanation:
A client-centered approach involves respecting the client’s autonomy and empowering them to make informed decisions. The social worker’s role is to provide support, resources, and guidance while ensuring that the client has the opportunity to explore options and make the decision that is best for them.
A social worker is working with a client who is facing homelessness. The client expresses a desire to find stable housing but feels overwhelmed by the process. The social worker should:
A) Provide the client with a list of shelters and housing options and tell them to contact the resources themselves.
B) Empower the client by helping them identify their strengths and develop a plan for securing housing.
C) Offer to contact housing agencies on behalf of the client to solve the issue more quickly.
D) Advise the client to wait until they can save enough money for permanent housing.
B) Empower the client by helping them identify their strengths and develop a plan for securing housing.
Explanation:
A client-centered approach focuses on empowering the client to take an active role in their own life decisions. The social worker should collaborate with the client to identify strengths, resources, and action steps while offering guidance and support.
A 30-year-old man experiences flashbacks, nightmares, and intrusive thoughts related to a traumatic event that occurred several months ago. He avoids reminders of the trauma and experiences emotional numbness. His symptoms have lasted for more than a month. What is the most likely DSM-5 diagnosis?
A) Acute Stress Disorder
B) Post-Traumatic Stress Disorder (PTSD)
C) Adjustment Disorder
D) Panic Disorder
B) Post-Traumatic Stress Disorder (PTSD)
Explanation: PTSD is diagnosed when an individual has symptoms like intrusive thoughts, flashbacks, nightmares, and emotional numbness lasting more than one month after a traumatic event. Acute Stress Disorder involves similar symptoms but occurs for less than a month, making PTSD the more appropriate diagnosis in this case.
A social worker is treating a client who has a history of severe depression and suicidal ideation. The client is currently in a stable emotional state but expresses reluctance to continue treatment. What should the social worker do?
A) Respect the client’s decision to terminate treatment, as they are not currently in crisis.
B) Encourage the client to continue treatment to prevent a future crisis, despite the client’s reluctance.
C) Attempt to persuade the client to stay in treatment by discussing the risks of discontinuing care.
D) Document the client’s refusal to continue treatment and provide them with emergency contact information if needed.
D) Document the client’s refusal to continue treatment and provide them with emergency contact information if needed.
Explanation: It is important for the social worker to document the client’s decision and provide necessary resources in case the client experiences a crisis later. Encouraging treatment is ethical, but the client’s autonomy should be respected. The social worker must also ensure the client has the support needed in case of a future crisis.
A social worker is providing therapy to a client and learns that the client is the spouse of a close friend. The social worker feels comfortable working with the client but is aware that this relationship may cause potential conflicts of interest. What is the most appropriate action for the social worker to take?
A) Continue to work with the client without addressing the relationship, as the social worker feels comfortable.
B) Discuss the potential for a conflict of interest with the client and explore whether the client would prefer to work with another therapist.
C) Terminate the relationship immediately and refer the client to another therapist, even if the client is comfortable with the social worker.
D) Proceed with the therapeutic relationship without disclosing the conflict of interest to the client.
B) Discuss the potential for a conflict of interest with the client and explore whether the client would prefer to work with another therapist.
Explanation:
A dual relationship (e.g., treating a spouse of a close friend) can create a conflict of interest. The social worker should discuss the situation openly with the client, explaining the potential ethical concerns, and allow the client to decide if they are comfortable continuing therapy with that social worker.
A social worker is meeting with a parent and their 10-year-old child, who is displaying signs of emotional distress. During the session, the child reveals that they have been physically abused at home. The parent is unaware of the child’s disclosure and asks the social worker not to report the information. What should the social worker do?
A) Keep the information confidential and do not report the abuse.
B) Respect the parent’s wishes and avoid reporting the abuse.
C) Break confidentiality and report the abuse to the appropriate authorities, as mandated by law.
D) Tell the child they must discuss the situation with their parent before any action is taken.
C) Break confidentiality and report the abuse to the appropriate authorities, as mandated by law.
Explanation:
Social workers are mandated reporters of child abuse and neglect. In this scenario, the child’s safety is the top priority, and the social worker is legally required to report suspected abuse, even if the parent does not give consent. The social worker should explain their role as a mandated reporter to both the child and the parent, ensuring that the child’s well-being is protected.
A social worker has been seeing a client for therapy for several months. The client invites the social worker to their wedding. The social worker should:
A) Accept the invitation, as it is a sign of the client’s trust and appreciation.
B) Politely decline the invitation to avoid potential conflicts of interest.
C) Attend the wedding to continue building rapport with the client.
D) Encourage the client to invite other friends or family members instead.
B) Politely decline the invitation to avoid potential conflicts of interest.
Explanation:
Maintaining professional boundaries is critical in social work. Attending a client’s wedding could blur the lines of the therapeutic relationship and create a conflict of interest. The social worker should politely decline the invitation to preserve the professional relationship.