ASWB BSW Exam Questions

Page 4 of 50

61.

A social worker is treating a client who is struggling to maintain sobriety and, at times, will relapse and have drinking binges. During these times, the client expresses feelings of severe depression, sometimes says he wants to die, and stays in bed for days or weeks afterward.

Which of the following statements is TRUE?

  • The client cannot be diagnosed with depression because his symptoms are directly related to his drinking problem

  • The client should be diagnosed with both substance disorder and depression

  • The client does not technically have a substance use problem because he does not continuously drink

  • The client would probably still have depression even if he stopped drinking

Correct answer: The client cannot be diagnosed with depression because his symptoms are directly related to his drinking problem

Co-occurring disorders, formerly referred to as dual diagnoses, occur when a client carries both a mental health diagnosis and substance-use disorder, physical disability, or intellectual disability. The term exists to highlight the compounding impact that carrying multiple diagnoses can have on clients. Research has indicated that clients with co-occurring disorders often have lengthier treatment durations, achieve treatment goals more slowly, experience a higher number of crises, and benefit from integrated treatment approaches. It is critical to understand, when diagnosing co-occurring disorders, that symptoms must be present separately in order to be diagnosed appropriately. In this situation, the client's depressive symptoms are a direct result of his drinking binges, so the social worker cannot diagnose him with both substance disorder and depression.

In order to have a "substance use problem," an individual does not have to drink continuously. There is not enough information in this question to know if the client would continue to experience depression even if he stopped drinking.

62.

A client presents to a meeting with a social worker reporting high levels of guilt and shame after being unfaithful to his wife of ten years. He reports that he owned up to his mistake and took responsibility. The social worker notes that this is an indicator of positive ego strength. Which of the following statements is NOT considered an additional indicator of positive ego strength? 

  • "I have so much empathy for my wife, and I'm just trying to lessen her pain."

  • "I feel self-pity, but I won't let it paralyze me."

  • "When I start to feel overwhelmed, I journal so that I can manage the feelings."

  • "Right now, being around our friends drains me physically and emotionally, so I'm limiting my time with them."

Correct answer: "I have so much empathy for my wife, and I'm just trying to lessen her pain."

The ability to empathize with others without trying to lessen or eliminate their pain is a sign of positive ego strength, but attempting to lessen or eliminate another's pain is not. 

Not allowing self-pity to paralyze or prevent one from moving forward is an additional indicator of positive ego strength. Other indicators include not becoming overwhelmed by moods, avoiding situations and people that drain mental and physical energy, being able to acknowledge feelings, using pain to build strength, understanding that feelings are temporary and will fade, working against addictive behaviors or impulses, and not blaming others for mistakes.

63.

A social worker is a case manager at a substance use treatment facility. They are meeting with a client who currently has a goal of developing coping skills to use during times of distress. Which stage of substance use treatment is this client engaged in currently? 

  • Rehabilitation 

  • Maintenance

  • Stabilization

  • Relapse 

Correct answer: Rehabilitation 

There are three stages of substance use treatment: stabilization, rehabilitation, and maintenance. Coping skills are developed during the rehabilitation phase. During this phase, clients also work to establish a healthy lifestyle, increase support systems, and grieve the loss of substance use. 

The stabilization stage of treatment involves working to establish abstinence or reduce substance use, accepting that there is a problem, and making a commitment to change. The maintenance phase focuses on maintaining accomplishments in treatment and preventing relapse. Relapse is part of the ongoing substance use treatment process but is not generally included as its own phase because it can occur during any phase.

64.

All of the following are protective factors for suicide, EXCEPT:

  • Extroverted personality

  • Restricted access to lethal methods

  • Learned coping skills

  • Cultural and religious beliefs that discourage suicide

Correct answer: Extroverted personality

Though there is no definite way to prevent suicide, many factors can reduce the possibility of the individual choosing to end their life. These are called protective factors. Protective factors mitigate the risk of suicide in individuals and include such things as restricted access to lethal instruments, coping skills, and cultural and religious beliefs that discourage suicide.

Both introverted and extroverted personalities choose suicide, and many people with successful careers and relationships choose to end their lives.

65.

A social worker is experiencing a high level of resistance to change in a client they are working with. The social worker identifies that the client is in the precontemplation stage of change. Which of the following strategies for managing resistance would be LEAST appropriate for the social worker to use? 

  • Emphasizing the client's free will 

  • Acknowledging the resistance 

  • Recognizing the client's fears and concerns

  • Keeping interactions less formal 

Correct answer: Emphasizing the client's free will 

The primary factor in precontemplation is that the client is either unaware or unwilling to pursue change to solve the identified problem. As a result, the best strategies for managing resistance in the precontemplation stage include continuing to develop rapport, openly acknowledging the resistance, keeping interactions less formal, continuing to engage the client, and recognizing the client's fears and concerns. 

Emphasizing a client's free will is a strategy for managing resistance when they are in the contemplation stage and have identified that there is an issue. Additional strategies for this stage are pro/con lists, discussing the ways in which a client's life will improve with change, and making sure the client is receiving information appropriately. 

66.

Which step of the assessment process involves identifying and prioritizing the client's needs and challenges?

  • Data collection

  • Intervention planning

  • Establishing rapport

  • Case termination 

Correct answer: Data collection

Data collection is the step in the assessment process in which social workers gather information about the client's circumstances, needs, and challenges. They then use this information to identify and prioritize the client's needs, leading to effective intervention planning. Social workers must remember to treat clients as the experts on their own lives, and clients' strengths must be maximized during treatment. 

Intervention planning occurs after data has been collected and after needs and challenges have been identified. Intervention planning involves identifying specific strategies or therapy modalities that will be used to treat the identified challenges or meet identified needs. Establishing rapport occurs from the onset of treatment and should be continued during assessment, intervention planning, and all phases of treatment. Rapport is trust and a therapeutic alliance between the social worker and the client. Case termination involves concluding the therapeutic relationship once interventions have been implemented and the client and social worker no longer need to engage. 

67.

Faye is seeing her client, Melvin. Melvin does not like the idea that he has been diagnosed with schizophrenia and insists that his symptoms of hallucination and delusion are attributable to a lung tumor. Melvin does have a tumor on his lung, but doctors have concluded (and explained to him) that it is impossible that his symptoms are related to his lung tumor. He has also had brain scans that show no evidence of tumor to ensure that is not the cause.

Which of the following BEST describes Melvin's behavior?

  • False imputation

  • Malingering

  • Conversion

  • Denial

Correct answer: False imputation

Malingering is intentional false reporting or exaggeration of physical or mental health issues for secondary gain, specifically external gain. Malingering is broken into three categories: 

  • False imputation: Attaching real symptoms to an unrelated source
  • Partial malingering: Exaggerating symptoms that are real
  • Pure malingering: Fabricating false symptoms completely 

While Melvin's reaction could be described as malingering, it is more specifically described as false imputation, as it aligns with the attachment of real symptoms (his hallucinations) to an unrelated source (his lung tumor). 

68.

A social worker is coordinating a family therapy session and wants to record the session to use for educational purposes in the future. Which of the following is TRUE regarding confidentiality? 

  • Separate informed consent must be obtained specific to recording sessions 

  • Consent must be obtained only if the recording will be shared with a third party

  • Consent to record is included in the standard informed consent procedure 

  • Informed consent does not need to be obtained unless personally identifiable health information is shared

Correct answer: Separate informed consent must be obtained specific to recording sessions 

The NASW Code of Ethics addresses audio and video recording directly, stating, "Social workers should obtain clients’ informed consent before making audio or video recordings of clients or permitting observation of service provision by a third party." In this instance, the social worker must obtain informed consent prior to making the recording and prior to sharing the recording with any third parties. 

Consent to record can be included in initial informed consent procedures but does need to be differentiated and discussed explicitly with the client. 

69.

A social worker is completing an intake with a mother and daughter who report ongoing conflict. The daughter (who is 14) reports that she feels overwhelmed as a result of being expected to take care of her younger siblings and her mother. The mother reports that she has worked hard all her life and is entitled to a little "fun time" to go out with her friends. Using systems theory, which of the following terms is MOST applicable to this family system?

  • Role reversal

  • Role conflict

  • Role ambiguity

  • Role complementarity

Correct answer: Role reversal 

Role theory, within systems theory, asserts that roles influence psychological outcomes. When two or more individuals switch roles, it is referred to as a role reversal. As the teen has been thrust into a parenting role while the mother has assumed a childlike role, this is the most appropriate descriptor.

Role conflict occurs when there are incompatible expectations of an individual's role. Role ambiguity occurs when there is not adequate clarity surrounding a person's role. Role complementarity occurs when an individual's role is carried out in the expected manner.

70.

You are a social worker who sees children for individual and family therapy. Charlie is a four-year-old boy living with his biological parents, who bring him to your office because he has recently been having frequent temper tantrums at home. Within the past two weeks, he has become afraid of the dark as well.

What should you do FIRST?

  • Validate the parents' concerns and inform them that this is typical behavior for a four-year-old

  • Administer behavioral rating scales to determine how severe Charlie's problems are

  • Refer the child to a psychiatrist in the community

  • Meet with Charlie for individual sessions

Correct answer: Validate the parents' concerns and inform them that this is typical behavior for a four-year-old

According to child development theorists, young children can have many fears and vivid imaginations, so having a fear of the dark is typical. Many four-year-olds also are beginning to assert their independence and test limits, and often, temper tantrums and power struggles occur during this age. The social worker should educate the parents about what to expect of Charlie and validate their concerns. The social worker may consider providing some brief education to the parents about handling Charlie's temper tantrums, but no extensive therapy is needed at this time.

Based on the information in the question, it is not yet necessary to administer behavioral rating scales, refer to a psychiatrist, or see Charlie for individual sessions. It is highly likely that Charlie will outgrow the tantrums and fears naturally without any additional intervention.

71.

According to Erikson's psychosocial stage of development Autonomy Versus Shame and Doubt, why might a child fail to develop self-confidence?

  • The child's choices are overly controlled

  • The child lacks a sense of consistency about the world

  • The child is given too many choices in a short time

  • The child develops mistrust in their caregivers

Correct answer: The child's choices are overly controlled

The testing of the environment by making autonomous choices is the key to the successful negotiation of Erickson's developmental stage of Autonomy Versus Shame and Doubt. Beginning between the ages of one and three years, children begin to assert their independence of their caregivers by making basic choices. They may walk away from their caregivers, they may experiment with the environment on their own, and they may begin to make choices about their own clothes.

These demonstrations of independence, successfully completed, are successful experiments in navigating the exterior world. According to Erikson, if children are encouraged to make these choices, they begin to learn that independence is not threatening. If the act of making choices is supported, children go on to develop confidence.

On the other hand, if the child's choices are overly controlled or criticized, the child will not develop the sense that their choices can be correct. The child will not develop self-confidence and assertiveness and begin to feel guilty and dependent on others.

72.

A social worker is meeting with a client who is struggling with depression and anxiety. The client appears to be female, though when completing the initial paperwork the client marks the "male" checkbox. When the social worker reviews the paperwork with the client, the client confirms that the correct checkbox is marked. What should the social worker do?

  • Refer to the client as male throughout the treatment

  • Include a goal related to gender confusion on the client's treatment plan

  • Engage the client in a discussion about why the client wants to be male

  • Refer the client to another provider with experience in treating individuals with gender identity issues

Correct answer: Refer to the client as male throughout the treatment

Gender identity is the knowledge of oneself as being male or female and usually conforms to anatomic sex in both heterosexual and homosexual individuals. However, individuals who identify as transgender feel themselves to be of a gender different from their biological sex; their gender identity does not match their anatomic or chromosomal sex. The social worker should be aware that it is important to let individuals define their own sexual orientation and gender identity.

The client did not come to the social worker asking for help related to gender confusion, so the social worker should not identify this as a goal on the treatment plan. The client came to the social worker for help with depression and anxiety, not gender identity problems. Unless the client initiates the topic of his sexuality, the social worker should focus on the client's symptoms of depression and anxiety.

73.

A family therapist is meeting with a new family. The parents report that their two children get into physical altercations frequently and the mother fears that they don't like each other. She reports that she and her husband instituted a rule that if the two children fight, they must hug and then hold hands and complete all tasks together for the rest of the day. She says she is frustrated because it doesn't seem to make them like each other any more than they did before. This is an example of which of the following family therapy concepts? 

  • First-order change

  • Second-order change

  • Relabeling

  • Paradoxical instruction 

Correct answer: First-order change 

First-order changes are superficial behavioral changes that do not meaningfully alter the underlying issue or structure of the problem. While the children are outwardly expressing love by hugging, the underlying emotions and relational dynamics have not changed and thus there has not been a meaningful shift. 

Second-order changes fundamentally change the dynamics of interactions (and patterns of behavior) such that the foundation of the relationship shifts in a meaningful way. If a rule was put in place that the children had to make the silliest face they could, the behavior pattern would be disrupted by breaking the rule of hostility that was present. Relabeling involves removing the "problem" label from a family member and attaching one that is more positive. It aims to shift others' perspective of that family member in hopes of eliciting alternate responses to the member. Paradoxical instruction is when a social worker asks a client to behave in a manner consistent with the symptomatic behavior in an effort to demonstrate that a client has control over that behavior. 

74.

Social workers understand that people should be engaged as partners in the helping process. This is an example of what core value listed in the NASW Code of Ethics?

  • Importance of human relationships

  • Dignity and worth of the person

  • Social justice

  • Integrity

Correct answer: Importance of human relationships

One of the six core values of social work is to recognize the importance of human relationships. This indicates that social workers understand that relationships between and among people are an important vehicle for change, and engage people as partners in the helping process. 

Dignity and worth of the person references the fact that social workers treat each person in a caring and respectful fashion. Social justice references the ways in which social workers pursue social change on behalf of vulnerable and oppressed individuals and groups. Integrity is the idea that social workers behave in a trustworthy manner.

75.

Which of the following is FALSE about a crisis?

  • A state of crisis is not specifically time-limited

  • A crisis can be short or long in duration

  • The main goal for clients is to get their needs met throughout the crisis

  • Brief intervention can help before a crisis if it is anticipated

Correct answer: A state of crisis is not specifically time-limited

States of crises are time-limited and divided into three stages: Precrisis, Crisis, and Post-crisis. Crises can be short or long in duration.

The state of crisis exists when events outstrip one's resources to deal with them. Intervention before a crisis can be helpful in alleviating some of it if the crisis is anticipated. The focus of intervention as the crisis unfolds should be to help clients meet their needs.

76.

Which of the following is NOT an indicator that a client is resistant to change? 

  • Oversharing information during sessions

  • Making false promises

  • Flattering the social worker

  • Focusing on past events 

Correct answer: Oversharing information during sessions

It is not uncommon for clients presenting to social workers to be resistant to change or to not be ready to engage in treatment. It is the social worker's responsibility to assess this and determine how to approach a client experiencing resistance. Common indicators of resistance or a lack of readiness for change/treatment include:

  • Limiting information shared with the social worker
  • Engaging/talking only minimally during sessions
  • Focusing on small talk or irrelevant topics
  • Using overly technical terms or over-intellectualizing during conversation with the social worker
  • Focusing on past events and avoiding discussion of current problems
  • Censoring thoughts/feelings prior to sharing them with the social worker
  • Making promises that are not kept (or not intended to be kept)
  • Attempting to soften the social worker by flattering them
  • Canceling appointments
  • Not paying fees at all / on time

Oversharing information is not associated with resistance to change but could be linked to nervousness, fear, or anxiety, and inquiry should be made in an appropriate fashion.

77.

You are a social worker conducting a biopsychosocial assessment for a client who recently experienced a traumatic event. Which of the following are you LEAST likely to consider during the assessment process? 

  • The client's husband's perspective of their functioning before and after the traumatic incident 

  • The client's medical history, focused on physical injuries and illnesses 

  • The client's current psychological well-being, including symptoms of PTSD

  • The client's available social supports, including family, friends, and community supports 

Correct answer: The client's husband's perspective of their functioning before and after the traumatic incident 

The purpose of a biopsychosocial assessment is to thoroughly assess all systems, strengths, and challenges that may impact a client's life and/or presenting problem. It is essential that information about biological, psychological, and social functioning be included. Social workers must view the client as the expert, and thus it would be most appropriate to gather the information directly from a client about their history, current symptoms, and available supports prior to including any information from other parties. Of note, if you have consent, it is helpful to gather information from collateral sources, but the client should be consulted first whenever possible. 

Gathering information about medical history assists in identifying any physical injuries or limitations resulting from the traumatic experience and determining whether medical intervention is necessary. Assessing the client's psychological well-being allows the client to share current symptoms or preexisting mental health conditions that may need psychological intervention. Assessing the client's available support systems helps identify potential resources and sources of strength and resiliency. These three components are essential in completing a comprehensive biopsychosocial assessment.

78.

Hugh is keeping a journal of his disturbing emotional states, the exact behaviors he was involved in at the time of the disturbing emotional states, and the thoughts that occurred as a result of the emotions. Which of the following therapeutic approaches BEST describes what Hugh is doing?

  • Cognitive restructuring

  • Psychoeducation

  • Empowerment

  • Problem-solving

Correct answer: Cognitive restructuring

Cognitive restructuring involves directly challenging undesirable emotional states in an effort to change them. Part of this technique is keeping an emotion log, which helps the client self-monitor.

The other answer choices are incorrect. Psychoeducation is essentially therapeutic knowledge transfer from therapist to client. Empowerment seeks to build the resources of the patient in all spheres. Problem-solving techniques tend to be rather brief and focus on a problematic situation rather than emotional states.

79.

A social worker using data collected and published by the US Census is MOST likely engaging in:

  • Macro practice

  • Mezzo practice

  • Micro practice

  • Direct practice 

Correct answer: Macro practice

Social workers are stereotypically thought to work at departments of social services when, in reality, they are trained and equipped to work in a vast array of agencies at a variety of levels. Social workers can practice on a systemic level, or engage in macro practice, by seeking to correct issues on the broader societal level rather than directly with the client. As the Census gathers data at a societal level, a social worker using this data is most likely reviewing broader issues and not issues impacting clients on an individual level. 

The mezzo level most often refers to mid-level populations such as communities or groups of people. Census data may reveal information about groups of people or smaller communities but is more likely to reveal macro-level data. Direct practice (on the micro-scale) is the term used to refer to work that is done with individual clients, families, or groups. This is the level of practice least likely to be influenced by census data.

80.

Which of the following BEST aligns with the primary purpose of assessment in social work? 

  • To gather information and understand client needs

  • To develop a comprehensive treatment plan 

  • To ensure insurance companies have adequate documentation to pay for a client's treatment 

  • To protect a social worker in the event of a malpractice lawsuit

Correct answer: To gather information and understand client needs

Assessment in social work is a process of gathering comprehensive information about clients' strengths, challenges, and needs. It helps social workers understand clients' situations and design appropriate interventions so that the social worker can provide informed and client-centered support.

One of the goals of the assessment is to help a social worker develop a comprehensive treatment plan, but the primary purpose is to ensure social workers have the information necessary to provide informed and client-centered support. Insurance companies do require a certain level of documentation to provide payment for services. However, this is not the primary reason assessments are completed (especially if insurance is not involved). Having appropriate assessments on file protects the social worker in the event of a lawsuit, but the social worker's needs are not the primary motivators for completing assessments. The client should always be centered.