Defense Mechanisms 1
This defense mechanism involves refusing to accept reality or facts.
What is Denial?
A social worker discovers that a client has been seeing another therapist concurrently without informing either provider. What is the most appropriate initial action?
A. Immediately terminate therapy due to the client’s dishonesty
B. Contact the other therapist to coordinate care without informing the client
C. Discuss the situation with the client, expressing concerns about potential treatment interference
D. Continue treatment without addressing the concurrent therapy
C. Discuss the situation with the client, expressing concerns about potential treatment interference
A 24-yr old woman complains of depressed mood. She tells the social worker that she has felt this way the past 2-3 yrs. She has little energy for social or work activities, has difficulty making decisions and concentrating, and has poor appetite. There are no delusions or hallucinations. Her most likely DSM-5-TR diagnosis is.
A. Persistence Depressive Disorder (PDD)
(b) Bipolar disorder, depressed
(c) Cyclothymic disorder
D. Major depressive disorder, Recurrent.
A. Persistent Depressive Disorder
This defense mechanism involves justifying behaviors with logical reasons, avoiding the true reasons.
What is Rationalization?
This defense mechanism involves not remembering a traumatic event from childhood.
What is Repression?
This defense mechanism involves redirecting emotions from a threatening target to a safer one.
What is Displacement?
A social worker is developing a treatment plan with a client diagnosed with Generalized Anxiety Disorder. Which of the following goals is most appropriately written?
A. Client will feel less anxious
B. Client will learn to manage anxiety better
C. Client will reduce anxiety symptoms by learning and practicing two relaxation techniques, demonstrating use during sessions by week 4
D. Client will work on decreasing anxious thoughts
C. Client will reduce anxiety symptoms by learning and practicing two relaxation techniques, demonstrating use during sessions by week 4
Which of the following is NOT a diagnostic criterion in the DSM-5 for Gambling Disorder?
A. Lying to conceal gambling
B. Loss of relationship, job, or opportunity due to gambling
C. Legal problems associated with gambling
D. Preoccupation with gambling
B. Loss of relationship, job, or opportunity due to gambling
This defense mechanism involves acting in a way opposite to one's unacceptable desires.
What is Reaction Formation?
This defense mechanism example involves a person with aggressive tendencies taking up boxing to channel their energy.
What is Sublimation?
This defense mechanism involves a person blocking out distressing thoughts from consciousness.
What is Repression?
In an initial session with a social worker, a client mentions having been hospitalized several times for depression. When the social worker attempts to explore the hospitalizations, the client becomes tense and guarded, saying "it's old history". The client refuses to give permission for the records to be released. The social worker should FIRST:
(A) explore why this topic appears to be upsetting the client
(B) acknowledge the client's right to decide about release of records
(C) reassure the client that the focus will be on present issues
(D) assess the client's current level of depression
B. Acknowledge the client's right to decide about release of records.
A patient complains of sleeplessness, loss of appetite, feeling hopeless, general apathy. To help diagnose, a social worker would most need to know:
(a) medications the client is taking
(b) family history of depression
(c) how long the symptoms have persisted
(d) if the patient lives alone
(c) how long the symptoms have persisted
This defense mechanism involves reverting to behaviors typical of an earlier developmental stage when under stress.
What is Regression?
This defense mechanism example involves a student failing an exam but insisting the test was unfair.
What is Rationalization?
This defense mechanism involves channeling unacceptable impulses into socially acceptable activities.
What is Sublimation?
A social worker is treating a 35-year-old client with Post-Traumatic Stress Disorder related to a sexual assault. The client experiences intrusive memories, nightmares, and significant distress when encountering reminders of the trauma. Which intervention has the strongest empirical support for addressing these symptoms?
A. Supportive counseling
B. Prolonged Exposure Therapy
C. Client centered therapy
D. Psychodynamic Therapy
B. Prolonged Exposure Therapy
A clinician is working with a seven-year-old who has been sexually abused by his father. The father is now in prison. The child's mother reports that the child often hits her and screams, I hate you!" Which ego defense mechanism is the child MOST likely using?
A. Repression
B. Displacement
C. Projection
D. Sublimation
B. Displacement
This defense mechanism involves unconsciously adopting the characteristics and behaviors of another person.
What is Identification?
This defense mechanism example involves an adult throwing a temper tantrum when they don't get their way.
What is Regression?
This defense mechanism involves attributing one's own unacceptable feelings to another person.
What is Projection?
A social worker is developing a treatment plan for a client with Generalized Anxiety Disorder who also meets criteria for Alcohol Use Disorder. Research on co-occurring disorders would most strongly support which treatment approach?
A. Focus exclusively on alcohol abstinence before addressing anxiety
B. Treat the anxiety disorder first, then address the alcohol use
C. Implement integrated treatment addressing both disorders concurrently
D. Refer to separate specialists for each disorder
C. Implement integrated treatment addressing both disorders concurrently
A 45-year-old client reports persistent symptoms of fatigue, muscle tension, irritability, and difficulty concentrating for the past seven months. They describe constant worrying about multiple life circumstances that they recognize as excessive but cannot control. Sleep is disrupted due to racing thoughts. There is no history of panic attacks, trauma, or obsessions/compulsions. Which diagnosis best fits this presentation?
A. Persistent Depressive Disorder
B. Generalized Anxiety Disorder
C. Somatic Symptom Disorder
D. Adjustment Disorder
B. Generalized Anxiety Disorder
This defense mechanism involves using excessive reasoning or logic to avoid experiencing disturbing emotions.
What is Intellectualization?
This defense mechanism example involves feeling guilty about desires and behaving in the opposite way.
What is Reaction Formation?