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All of the following may be considered indicators of resistance EXCEPT:
a. A client engaging in small talk about irrelevant topics during a session.
b. Client who limits the amount of information communicated to a social worker during treatment.
c. A client who is silent during appointments.
d. A client who was originally referred by another person.
d.
All of the options, except the last response choice, are actions taken by a client during treatment. Indicators of resistance can also include engaging in intellectual talk by using technical terms/abstract concepts, asking questions of a social worker that are not related to issues/problems, being preoccupied with past events instead of current issues, false promising, and/or flattering a social worker in an attempt to "soften" him/her so as not to be pushed.
A client who was referred by another person many not necessarily be apprehensive about change but instead may not have known where to go to seek help. Behaviors that occur after a client has seen a social worker are better indicators of resistance.
According to the Tarasoff decision, social workers must:
a. Notify both the authorities and intended victims of imminent danger.
b. Seek inpatient hospitalization if dangerousness exists.
c. Notify only the intended victims of imminent danger.
d. Identify risk factors that are linked to dangerousness of others.
A.
Since the Tarasoff case in 1974, duty to warn has come an important concept in social work. Being able to protect potential victims from harm and protecting clients from self-harm are ethical obligations.
A social worker is seeing a family for therapy. During a session, the 17-year-old daughter states that her father molested her when she was 6 years old. She says that it happened twice and has not occurred since that time. The father confirms the daughter's account and says that he is remorseful about his actions. He assures the social worker and his family that it will never happen again. In this situation, the social worker should:
a. Not contact the child protection agency given the length of time that has occurred since the incidents
b. Not contact the child protection agency because these were isolated incidents and the father realizes the inappropriateness of his actions.
c. Contact the child protection agency after telling the family of the need to do so because the social worker is a mandated reporter
d. Contact the child protection agency, but do not tell the family in order to preserve the therapeutic relationship
C.
Social workers are mandated reporters. In this instance, the social worker should not be making an assessment about these being isolated incidents or the likelihood that they would happen again. The code of ethics states that clients should be informed whenever possible of such reports. Not telling the family would not be warranted as they are likely to find out that the social worker contacted the child protection agency and will feel betrayed without being told that such a report was being made. The social worker should have reviewed the limits of confidentiality with this family upon intake.
Imaginary friends MOST often emerge in which stage of cognitive development?
a. Formal operations
b. Preoperational
c. Sensorimotor
d. Concrete operations
B.
Piaget defined four stages of cognitive development. They are sensorimotor, preoperational, concrete operations, and formal operations. The preoperational stage begins at about age 2 and ends at about age 7. It is characterized by magical thinking. Imaginary friends often emerge in this stage, when reality is not firm, and can last into elementary school.
Which of the following is NOT true about cultural, racial, and ethnic identities?
a. They are passed from one generation to the next
b. They are influenced by popular media, literature, and current events
c. They are linked to feeling of belonging
d. They are stable over the life course
D.
Cultural, racial, and ethnic identities are important, particularly for those who are members of minority groups. They may instill feelings of belonging to a particular group or groups and identification with that group.
A client stopped coming to sessions abruptly after 6 weeks. He calls the social worker and asks for a copy of his record about a month later. There is nothing in the record that is harmful to the client, but the social worker refuses to give it to him. In this situation, the social worker's actions are:
a. Ethical because he did not terminate with the social worker prior to not coming anymore.
b. Ethical because the request must come in writing with the reason that a copy of the record is needed.
c. Unethical because the social worker has a duty to give the client a copy of his record in this situation.
d. Unethical because the social worker has a duty to give the client a copy of his or her record under all circumstances.
C.
Social workers should provide clients with reasonable access to their records. Social workers who are concerned that clients' access to their records could cause serious misunderstanding or harm to a client should provide assistance interpreting the records and consultation with the client regarding the records. Social workers should limit access to their records, or portions of their records, only in exceptional circumstances when there is compelling evidence that such access would cause serious harm to a client.
In this case vignette, there was not a risk of harm due to the release, so the social worker should have provided access; however, information can be withheld in some circumstances, as described, as long as the request and the reason for denial is documented in the client's file.
Which of the following is NOT associated with low ego strength?
a. Viewing challenges as something to avoid
b. Feeling overwhelmed by reality
c. Finding new ways to deal with struggles
d. Using wishful thinking or fantasies
C.
Those with high ego strength approach problems with a sense that they can overcome problems and even grow as a result. They try to find new ways to cope with struggles and handle challenges without losing their sense of self.
Those with low ego strength view challenges as something to avoid. Reality seems overwhelming and they many try to avid it through wishful thinking, fantasies, and/or substance use.
Which of the following is the FIRST goal of assisting clients who have suffered a life crisis?
a. Helping them to develop coping skills to deal with similar crises in the future
b. Identifying the cause of the crisis in order to prevent it from reoccurring in the future
c. Assisting them to establish a sense of equilibrium and return to prior levels of functioning
d. Linking them with others who have experienced a similar crisis to build a network of support.
C.
The FIRST goal is to immediately relive the stress experienced, return clients to previous levels of functioning, and assist them with regaining equilibrium.
Which of the following contains thoughts, feelings, desires, and memories of which a client has no awareness, even though they influence his or her daily life?
a. Preconscious
b. Conscious
c. Superego
d. Unconscious
D.
The unconscious contains thoughts, feelings, desires, and memories of which clients have no awareness, but that influence every aspect of their day to day lives.
Which of the following BEST describes the benefit of peer supervision in social work practice?
a. It is less expensive than individual supervision
b. It can occur as needed, anytime and anywhere
c. It is a reciprocal learning relationship aimed at skill acquisition
d. It does not require "experts" in the field
C.
The primary benefit of peer supervision is the reciprocal learning through the sharing of experiences.
Peer supervision is based on the use of feedback to assist with self-directed learning and evaluation.
A client is extremely upset because her 14-year-old son is not helping around the house, independently doing his homework, or arriving to school on time. The son states that his mother watches over him too closely and does not give him needed privacy. This problem is best understood as:
a. A communication problem
b. Role discomplementarity
c. Progressive discipline
d. Developmental processes
B.
Role discomplementarity occurs when role expectations are not being met and activities associated with these expectations are not carried out in an expected manner. In this case vignette, the client's belief about what her son should be doing is not consistent with his behavior. In addition, the son is dissatisfied with the fulfillment of the role expectations that he has for his mother. This case vignette solely involves role issues and not communication, discipline or developmental problems.
Which of the following is NOT true about personality disorders?
a. They are characterized by distorted patters of thinking.
b. They involve over or underregulated impulse control
c. They cause interpersonal difficulties
d. They are usually diagnosed in childhood
D.
Personality disorders are not usually diagnosed in children because of the requirement that they represent enduring problems across time. Children's personalities are changing and developing as they grow. Personality disorders are most accurately diagnosed in those older than 21.
Which of the following is an objective outcome that might be associated with a foster care program?
a. Proportion of children served who are reunified with their biological families
b. Satisfaction of foster parents with the program
c. Perceived safety of children
d. Number of children served in the program
A.
Program evaluation usually relies on both subjective and objective data. The "facts" or objective outcomes include days incarcerated, number of subsequent hospitalizations, and so forth. Subjective information, such as how the "facts" are perceived by clients through descriptions of their feelings, experiences, and perceptions, is equally important.
After an assessment is completed, what follows according to the problem-solving process?
a. Intervention
b. Evaluation
c. Planning
D. Engagement
C.
The problem-solving process consists of engaging, assessing, planning, intervening, evaluating, and terminating. This, planning is done after an assessment is complete.
Which of the following is NOT a "deficiency need" according to Maslow?
a. Self-actualization
b. Safety
c. Esteem
d. Physiological
A.
Maslow's hierarchy of needs can be divided into basis (or deficiency) needs (psychological, safety, social, and esteem) and growth needs (self-actualization). Deficiency needs arise due to deprivation, according to Maslow.
A client has just been fired from his job, and he is focusing solely on the stress associated with the financial challenges that he is facing. Using a systems approach, the social worker can expect his unemployment to:
a. Result in a negative impact on his financial well being
b. Affect other areas of his life such as his physical and mental health
c. Cause him to be worried about finding another job
d. Build resilience that can be used to deal with other life crises
B.
This case vignette requires the social worker to view the unemployment "using a systems approach". Although the job loss is causing financial concerns, it would also have an impact on other aspects of the client's life, such as physical and mental health. Systems theory indicates that a change to one part of a client's life will impact on others.
Which of the following is NOT one of the therapeutic advantages of injectable antipsychotic medications?
a. They reduce medication noncompliance because they are needed less frequently than oral medications
b. They are less likely to be used for suicide or result in overdose because the dosing is controlled
c. They are associated with decreased hospitalizations due to fewer symptom relapses
d. They are less expensive than oral medications
D.
The cost of the medications is not a therapeutic consideration.
A client has made substantial progress in treatment and has achieved all established goals. When the social worker speaks to the client about discharge, the client states that he does not want to stop seeing the social worker because he is worried about his future needs. As there are no additional treatment goals, the social worker agrees to see the client pro bono for the next 6 months or until the client feels comfortable. The social worker's actions are:
a. Ethical since there is no fee for the sessions
b. Not ethical since there are no new treatment goals
c. Ethical since the client does not feel ready to end treatment
d. Not ethical because termination decisions are the responsibility of the social worker
B.
The code of ethics states that it is unethical to treat clients when services are no longer needed. Continuing to see the client with no treatment goals is not in the client's best interest.
A client shows a social worker a large tattoo on his arm dedicated to his mother who recently died. He begins to cry and states that it always makes him very emotional when he sees it because it reminds him of her bravery in fighting her illness. The tattoo is a form of:
a. Symbolization
b. Substitution
c. Sublimation
d. Splitting
A.
Symbolization occurs when emotional feelings are associated with an object or, in this instance, the client's tattoo.
Which of the following is the MOST important factor in choosing an appropriate intervention or treatment strategy?
a. It is currently being used by a social worker to assist clients with similar problems
b. It results from the biopsychosocial-spiritual-cultural assessment of a client
c. It is approved as medically necessary by third party payers
d. It is not constrained by agency practices and/or time limits for treatment
B.
Social work interventions or treatments MUST be selected based upon the biopsychosocial assessments of clients, which include the strengths they possess, as well the identification of feasible and desired outcomes within larger service contexts.
A client has dilated pupils, appears jittery, and complains that "he just needs to get some sleep". the client MOST likely using which of the following substances?
a. Cocaine
b. Heroin
c. Marijuana
d. Painkillers
A.
Cocaine use is indicated by dilated pupils, hyperactivity, euphoria, anxiety, and/or excessive talking.
Heroin use is indicated by contracted pupils, sleeping at unusual times, sweating, vomiting, twitching, and/or loss of appetite.
Marijuana use is indicated by glassy, red eyes; inappropriate laughter; and/or loss of interest/motivation.
Painkiller addiction is indicated by sleepiness, inattention, constipation, and/or loss of appetite.
When making level of care determinations, which criterion is primarily used in behavioral health settings?
a. Capitation
b. Medical necessity
c. Managed risk
d. Diagnostic groupings
B.
Medical necessity is a criterion to determine whether treatments and services are justified as reasonable, necessary, and/or appropriate, based on evidence-based clinical standards of care.
All of the following are associated with Borderline Personality Disorder EXCEPT:
a. Poor impulse control
b. Control of aggressive drives
c. Dichotomous thinking
d. Emotional dysregulation
B.
Clients with Borderline Personality Disorder tend to view the world in black-and-white, all-or-nothing, dichotomous thinking. These polarized thoughts lead to intense emotional reactions that are unable to be regulated. Clients with Borderline Personality Disorder often engage in self-destructive behavior and act impulsively.
Which of the following is a level of awareness as defined by Freud?
a. Id
b. Preconscious
c. Preconventional
d. Individualistic
B.
Freud believed that behavior and personality derive from the constant and unique interaction of conflicting psychological forces that operate at three different levels of awareness: the preconscious, the conscious, and the unconscious.
Which of the following is NOT true about co-occurring disorders and conditions?
a. Co-occurring usually refers to the presence of a mental health and substance use disorder
b. The co-occurrence of mental health and substance use disorders that do not meet the diagnostic threshold should not be treated in the same manner as those that do
c. Both disorders may be mild or severe and/or one may be more severe than the other
d. Co-occurring disorders may vary across clients and in the same client over time
B.
Co-occurring disorders typically refer to clients having coexisting mental health and substance use disorders. Other terms include dually diagnosed.